Path quiz 5

What is congestive heart failure (CHF)?

A condition in which the heart cannot pump enough blood to meet the body's oxygen and nutrient demands.

What happens to blood flow in CHF?

The heart pumps ineffectively, causing reduced cardiac output and fluid backup (congestion).

What are the two main types of heart failure?

Systolic heart failure (HFrEF) and Diastolic heart failure (HFpEF).

What is systolic heart failure (HFrEF)?

The heart cannot contract forcefully enough to eject blood.

What is diastolic heart failure (HFpEF)?

The ventricles cannot relax or fill properly.

What is a normal left ventricular ejection fraction (LVEF)?

55-70%.

What LVEF suggests heart failure?

Less than 40%.

What LVEF is considered life-threatening?

Less than 35%.

What are common causes of CHF?

Coronary artery disease, hypertension, cardiomyopathy, valve disease, myocarditis, acute coronary syndrome.

What are major risk factors for CHF?

Age, smoking, hypertension, diabetes, obesity, high LDL, low HDL, family history, sleep apnea.

What are common symptoms of CHF?

Dyspnea, cough, fatigue, peripheral edema, decreased exercise tolerance.

What lung sound is commonly heard in CHF?

Crackles.

What heart sounds may be heard in CHF?

S3 and S4 gallop.

Why does pulmonary edema occur in left-sided heart failure?

Increased pressure in pulmonary capillaries forces fluid into the alveoli.

What causes peripheral edema in right-sided heart failure?

Systemic venous congestion.

What laboratory test helps diagnose myocardial injury in CHF?

Troponin.

What imaging study commonly shows cardiomegaly and pulmonary edema?

Chest X-ray.

What is the primary goal of CHF treatment?

Improve cardiac output, reduce congestion, and prevent cardiac remodeling.

What do diuretics do in CHF?

Remove excess fluid and decrease preload.

What do ACE inhibitors do in CHF?

Decrease blood pressure and prevent ventricular remodeling.

What do beta blockers do in CHF?

Decrease heart rate and improve cardiac filling.

What do vasodilators do in CHF?

Decrease preload and afterload.

What medications support cardiac output during cardiogenic shock?

Dobutamine, dopamine, and norepinephrine.

What lifestyle changes help CHF patients?

Low-sodium diet, exercise, weight loss, smoking cessation, alcohol avoidance.

What respiratory therapies are commonly used in CHF?

Oxygen, CPAP, and BiPAP.

What is the main RT goal in CHF?

Improve oxygenation and reduce work of breathing.

What is a pneumothorax?

Air in the pleural space causing partial or complete lung collapse.

What causes a traumatic pneumothorax?

Penetrating or blunt chest trauma.

Who commonly develops spontaneous pneumothorax?

Tall, thin males ages 15-35.

What underlying diseases can cause spontaneous pneumothorax?

COPD, pneumonia, tuberculosis, ruptured blebs or bullae.

What is an iatrogenic pneumothorax?

A pneumothorax caused by a medical procedure.

Name procedures that may cause an iatrogenic pneumothorax.

Thoracentesis, central line placement, tracheostomy, mechanical ventilation.

What is a closed pneumothorax?

Air enters the pleural space without communication with the atmosphere.

What is an open pneumothorax?

The pleural space communicates directly with the atmosphere.

What is a tension pneumothorax?

Air enters the pleural space but cannot escape, causing increasing pressure and lung collapse.

Why is a tension pneumothorax life-threatening?

It compresses the lungs, heart, and great vessels, reducing venous return and cardiac output.

What happens to the lung during a pneumothorax?

It collapses because negative intrapleural pressure is lost.

What is atelectasis?

Collapse of alveoli.

What are common symptoms of pneumothorax?

Sudden pleuritic chest pain, dyspnea, cough, tachypnea, tachycardia, cyanosis.

What percussion sound is heard with pneumothorax?

Hyperresonance.

What happens to breath sounds over a pneumothorax?

They are decreased or absent.

Which direction does the trachea shift during a tension pneumothorax?

Away from the affected side.

What chest X-ray findings suggest pneumothorax?

Collapsed lung, increased translucency, mediastinal shift, depressed diaphragm.

How is a small pneumothorax treated?

Observation, bed rest, oxygen.

How is a large pneumothorax treated?

Needle aspiration or chest tube.

What is the emergency treatment for a tension pneumothorax?

Immediate needle decompression followed by chest tube placement.

When is lung expansion therapy appropriate in pneumothorax?

Only after a chest tube is in place.

What is pleurodesis?

A procedure that causes the lung to adhere to the chest wall to prevent recurrent pneumothorax.

What is flail chest?

Double fractures of three or more adjacent ribs creating a free-floating chest wall segment.

What commonly causes flail chest?

Blunt chest trauma such as motor vehicle accidents, falls, crush injuries, and blast injuries.

What is paradoxical chest movement?

The flail segment moves inward during inspiration and outward during expiration.

Why does paradoxical movement occur?

The fractured ribs are no longer attached to the rest of the chest wall.

What lung injury commonly accompanies flail chest?

Pulmonary contusion.

What complications can occur with flail chest?

Atelectasis, pneumothorax, pneumonia, lung collapse.

What are common symptoms of flail chest?

Chest pain, tachypnea, cyanosis, paradoxical chest movement.

What breath sound change is common with flail chest?

Diminished breath sounds.

What pulmonary function pattern is seen with flail chest?

Restrictive.

What chest X-ray findings are seen with flail chest?

Multiple rib fractures, pulmonary contusion, atelectasis, increased lung opacity.

How are mild cases of flail chest treated?

Pain control, bronchial hygiene, lung expansion therapy.

How are severe cases of flail chest treated?

Mechanical ventilation with PEEP, chest stabilization, and sometimes paralytics.

Why is PEEP used in severe flail chest?

To improve oxygenation and keep alveoli open.

How long do severe flail chest patients typically require mechanical ventilation?

About 5-10 days while the ribs heal.

Which condition is characterized by pulmonary edema?

Congestive heart failure.

Which condition is characterized by sudden lung collapse due to air in the pleural space?

Pneumothorax.

Which condition is identified by paradoxical chest wall movement?

Flail chest.

Which pneumothorax is considered a medical emergency?

Tension pneumothorax.

Which side of the heart usually causes pulmonary edema when it fails?

Left side.

Which side of the heart usually causes peripheral edema when it fails?

Right side.