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Pathology: Respiratory System
Terms in this set (94)
Listening to sounds within the body
Physical examination technique that uses short tapping on the surface of the skin . Percussion over an air-filled structure, such as the lung, produces a resonant, hollow note. When the lungs or pleural space are filled with fluid, as in pneumonia, resonance is replaced by dullness.
pleural rub/ friction rub
Scratchy sound produced by pleural surfaces rubbing against each other. occurs when the pleura are roughened and thickened by inflammation, infection, scarring, or neoplastic cells. It is heard on auscultation and can be felt by placing the fingers on the chest wall.
Fine crackling sounds heard on auscultation (during inhalation) when there is fluid in the alveoli. These popping or clicking sounds can be heard in patients with pneumonia, bronchiectasis, or acute bronchitis.
Loud rumbling sounds heard on auscultation of bronchi obstructed by sputum. These coarse rumbling sounds resemble snoring and are usually caused by secretions in larger bronchial tubes.
Material expelled from the bronchi, lungs, or upper respiratory tract by spitting.
contain pus, often is green or brown. It results from infection and may be seen with asthma.
Suggests tuberculosis or malignancy
specimen is maintained in a nutrient medium to promote growth of a pathogen.
Culture and sensitivity (C&S)
studies that identify the sputum pathogen and determine which antibiotic will be effective in destroying or reducing its growth.
Strained, high-pitched sound heard on inspiration caused by obstruction in the pharynx or larynx. Common cause include throat abscess, airway injury, croup, allergic reaction, or epiglottitis and laryngitis.
Continuous high-pitched whistling sounds produced during breathing. Wheezes are heard when air is forced through narrowed or obstructed airways. Patients with asthma commonly experience wheezes as bronchi narrow and tighten.
Acute viral infection of infants and children with obstruction of the larynx, accompanied by barking cough and stridor. The most common causative agents are influenza viruses or respiratory syncytial virus,RSV.
Acute infection of the throat and upper respiratory tract caused by the diphtheria bacterium (corynebacterium). Inflammation occurs, and a leathery, opaque membrane forms in the pharynx and trachea. Immunity to diphtheria is given between 6th and 8th weeks of life (DPT injections)
Injections usually given as combination vaccines with pertussis and tetanus toxins. It induces the the immunity to diphtheria by the administration of weakened toxins beginning between the sixth and eighth weeks of life.
Nosebleed. It commonly results from irritation of nasal mucous membranes, trauma, vitamin K deficiency, clotting abnormalities, blood-thinning medications such as aspirin and warfarin, or hypotension
A whooping cough and a highly contagious bacterial infection of the pharynx, larynx, and trachea caused by Bordetella pertussis. It is also characterized by paroxysmal which are violent, sudden spasms of coughing that ends in a loud "whooping" inspiration.
a sudden attack or increase of symptoms of a disease such as pain, coughing, shaking, etc., that often occurs again and again
Chronic bronchial inflammatory disorder with airway obstruction due to bronchial edema, constriction and increased mucus production. Caused by allergy or infection. Symptoms are dyspnea, wheezing, and cough. Triggers include exercise, strong odors, cold air, stress, allergens, and medications.
Treatment for asthma
Bronchodilator such as an albuterol inhaler are fast-acting agents for acute symptoms. Inhaled Glucocorticoids, oral steroids, and leukotriene blockers such as Singulair are long-acting agents for long term control.
Chronic dilation of a bronchus secondary to infection. This condition is caused by chronic infection with loss of elasticity of the bronchi. Secretions puddle and do not drain normally. Signs and Symptoms include cough, fever, and expectoration of foul-smelling, purulent sputum.
Treatment for bronchiectasis
Treatment is palliative, noncurative, and includes antibiotics, mucolytics, bronchodilators, respiratory therapy, and surgical resection if other therapies are not effective.
Inflammation of bronchi persisting over a long time; type of chronic obstructive pulmonary disease (COPD). Caused by Infection and cigarette smoking. Symptoms include excessive secretion of often infected mucus, a productive cough, and obstruction or respiratory passages.
Chronic obstructive pulmonary disease (COPD)
Chronic condition of persistent obstruction of air flow through bronchial tubes and lungs. Caused by smoking, air pollution, infection, and asthma. Chronic bronchitis = "blue bloaters", cyanotic, stocky build. Emphysema = "pink puffers", SOB with near-normal blood oxygen levels, no skin change.
cystic fibrosis (CF)
Inherited disorder of exocrine glands resulting in thick mucinous secretions in the respiratory tract leading to chronic airway obstruction, infection, bronchiectasis, and sometimes respiratory failure. also involves the pancreas for insufficient secretion of digestive enzymes and salty tasting skin
Treatment for Cystic fibrosis
Diagnosed by newborn screening blood test, sweat test, and genetic testing. There is no known cure, but therapy includes antibiotics, aerosolized medications, chest physiotherapy, and replacement of pancreatic enzymes. Lung transplantation can restore lung function and prolong life.
Collapsed lung and incomplete expansion of alveoli. The bronchioles and alveoli resemble a collapsed balloon. common cause include bronchial obstructions or tumor, poor breathing ability after surgery, or chest wounds leading to air, fluid, or blood accumulation in the pleural cavity.
Hyperinflation of air sacs with destruction of alveolar walls. Loss of elasticity and the breakdown of alveolar walls result in expiratory flow limitation. Caused by cigarette smoking. As a result, the destruction of lung parenchyma including blood vessels lead to having cor pulmonale.
Failure of the right side of the heart to pump a sufficient amount of blood to the lungs because of underlying lung disease
Malignant tumor arising from the lungs and bronchi. This group of cancers, often associated with cigarette smoking, is the most frequent fatal malignancy. Lung cancers are divided into two general categories: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC)
Non-small cell lung cancer (NSCLC)
There are three main types: adenocarcinoma derived from mucus-secreting cells, squamous cell carcinoma derived from the lining cells of the upper airway, and large cell lung cancer. When diagnosed, physicians assess the stage of the tumor to prepare a protocol for treatment
Treatment for NSCLC
For localized tumors, surgery may be curative. Assessing mediastinal lymph node is critical. If nodes are negative, surgery is an option. If nodes are positive, multimodality treatment like chemotherapy and irradiation, with or without surgery, is an option.
small cell lung cancer (SCLC)
derives from small, round "oat" cells found in pulmonary epithelium. It grows rapidly early and quickly spreads outside the lung. Treatment with radiation therapy and chemotherapy may lead to remissions.
Abnormal condition caused by dust in the lungs, with chronic inflammation, infection, and bronchitis. Various forms are named according to the type of dust particle inhaled: anthracosis = to black lung disease, asbestosis in shipbuilding and constructions; and silicosis = to grinders disease.
coal dust accumulates in the lungs; also associates with black lung disease
Asbestos particles accumulate in the lungs
Disease due to silica or glass dust in the lungs; occurs in mining occupations.
acute inflammation and infection of alveoli, which fill with pus or products of the inflammatory reaction. Etiologic agents are pneumococci, staphylococci, and other bacteria, fungi, or viruses. From infections, an exudate glues the alveoli sacs together making air exchange less effective.
Fluid, cells, and other substances-like pus that filter from cells or capillaries that ooze into lesions or areas of inflammation.
a fluid-filled area within the lungs as seen on a chest x-ray or CT scan.
involves an entire lobe of a lung. The patients signs and symptoms include fever, chills, cough,dark sputum, rapid shallow breathing, and hypoxia. If diagnosis is made early, antibiotic therapy is successful.
a limited form of infection that produces patchy consolidation-like abscesses in the lung parenchyma. Treatment includes appropriate antibiotics and, if necessary, oxygen and mechanical ventilation in severe cases.
results from a contagious respiratory infection, caused by a variety of viruses and bacteria, especially Mycoplasma bacteria. It usually is treated at home with oral antibiotics.
Hospital-acquired pneumonia or nosocomial pneumonia
Acquired during hospitalization. For example, patients may contract pneumonia while on mechanical ventilation or as a hospital-acquired infection.
caused by material, such as food or vomitus, lodging in bronchi or lungs. It is a danger in the elderly, Alzheimer disease patients, stroke victims, and people with esophageal reflux and feeding tubes.
Large collection of pus, bacterial infection, in the lungs
fluid in the air sacs and bronchioles. This condition most often is caused by the inability of the heart to pump blood ( congestive heart failure). Acute pulmonary edema requires immediate medical attention, including diuretics, oxygen in high concentration, and high Fowlers position
pulmonary embolism (PE)
Clot or other material lodges in vessels of the lung. The clot (embolus), travels from distant veins, usually in the legs. Occlusion can cause pulmonary infarction. signs = chest pain on inspiration, blood in sputum, fever, & respiratory insufficiency. The primary diagnostic tool is CT angiography.
area of necrosis, death of lung tissue.
Formation of scar tissue in the connective tissue of the lungs. This condition may be the result of chronic inflammation or irritation caused by tuberculosis, pneumonia, or pneumoconiosis.
Chronic inflammatory disease in which small nodules develop in lungs, lymph nodes, and other organs. The cause is unknown and asymptomatic, but may affect the brain, heart, liver, and other organs causing impaired pulmonary functions. Corticosteroid drugs are used to prevent progression of illness.
Infectious disease caused by Mycobacterium tuberculosis, bacilli bacteria; lungs usually are involved, but many organ in the body may be affected. Advanced signs = cough, weight loss, night sweats, hemoptysis, and pleuritic pain. Early TB is asymptomatic and detected by chest x-ray studies.
The PPD skin test is given to most hospital and medical employees because TB is highly contagious. A positive PPD test, in the absence of infection, requires treatment with isoniazid. Antituberculosis like isoniazid and rifampin is effective. Several drugs may be taken at same time.
Rare malignant tumor arising in the pleura. Mesotheliomas are derived from mesothelium, which forms the lining of the pleural surface. These tumors are caused by asbestos exposure.
Abnormal accumulation of fluid in the pleural space. Two types of pleural effusions are exudates which are fluid from tumors and infections and transudates which are fluid from congestive heart failure, pulmonary embolism, or cirrhosis.
Inflammation of the pleura. This condition causes pleurodynia and dyspnea and , in chronic cases, pleural effusion.
Collection of air in the pleural space. This occur in the course of a pulmonary disease, when a break in the lung surface releases air into the pleural space.
production of adhesions between the parietal and visceral pleura for treatment of persistent pneumothorax and severe pleural effusion. This is accomplished by using talc powder or drugs, such as antibiotics, that cause irritation and scarring of the pleura.
Radiographic image of the thoracic cavity (chest film)
Computed tomography (CT) scan of the chest
Computer-generated series of x-ray images show thoracic structures in cross section and other planes.
CT pulmonary angiography (CTPA) is the combination of CT scanning and angiography.
The combination of CT scanning and angiography. It is useful to examine the pulmonary circulation in the diagnosis of a pulmonary embolism.
Magnetic resonance imaging (MRI) of the chest
Magnetic waves create detailed images of the chest in frontal, lateral , and cross-sectional planes. This test is helpful in defining mediastinal tumors difficult to assess by CT scan.
positron emission tomography (PET) scan of the lung
Radioactive glucose is injected and images reveal metabolic activity in the lungs. This scanning technique can identify malignant tumors, which have higher metabolic activity. it is also used to assess small nodules seen on a CT scan.
ventilation-perfusion (V/Q) scan
Detection device records radioactivity in the lung after injection of a radioisotope or inhalation of small amount of radioactive gas. This test can identify areas of the lung not receiving air flow or blood flow. Q is the symbol for blood volume or rate of blood flow.
Fiberoptic endoscope examination of the bronchial tubes. A physician places the bronchoscope through the throat, larynx, and trachea into the bronchi for diagnosis, biopsy, or collection of secretions.
bronchoalveolar lavage (bronchial washing)
fluid is injected and withdrawn during a bronchoscope.
a brush is inserted through the bronchoscope and is used to scrape off tissue.
Endobronchial ultrasound (EBUS)
performed during bronchoscopy to diagnose and stage lung cancer. An EBUS-guided forceps biopsy allows for sampling of small, less than 3 centimeter, peripheral lesions endoscopically.
Placement of a tube through the mouth into the pharynx, larynx, and trachea to establish an airway. This procedure also allows the patient to be placed on a mechanical ventilator.
Visual examination of the voice box. A lighted, flexible endoscope is passed through the mouth or nose into the larynx.
Removal of lung tissue followed by microscopic examination. Specimens may be obtained by bronchoscopy, thoracotomy (open-lung biopsy) or by needle biopsy through the chest wall.
Endoscopic visual examination of the mediastinum. An incision is made above the breastbone (suprasternal) for inspection and biopsy of lymph nodes in the underlying space (mediastinum).
pulmonary function tests (PFTs)
Tests that measure the ventilation mechanics of the lungs: airway function, lung volume, and the capacity of the lungs to exchange oxygen and carbon dioxide efficiently.
measures the volume and rate of air passing into and out of the lung.
obstructive lung disease
airways are narrowed, which results in resistance to air flow during breathing.
Surgical puncture to remove fluid from the pleural space. This procedure is used to obtain pleural fluid for diagnosis or to therapeutically drain a pleural effusion. In a sitting position, the needle is inserted close to the base of the effusion and is kept away from the diaphragm.
Large surgical incision of the chest. The incision is large, cutting into bone, muscle, and cartilage. It is necessary for lung biopsies and resections.
Visual examination of the chest via small incisions and use of an endoscope. Thoracoscopy can diagnose and treat conditions of the lung, pleura, and mediastinum.
video-assisted thoracic surgery (VATS)
allows surgeon to view the chest from a video monitor. The throrascope is equipped with a camera that magnifies the image on the monitor.
Determines past or present tuberberculous infection based on a positive skin reaction. Examples are the Heaf test and the tine test, using purified protein derivative (PPD) applied with multiple punctures of the skin, and the Mantoux test, using PPD given by intradermal injection.
Surgical creation of an opening into the trachea through the neck. A tube is inserted to create an airway. The tracheostomy tube may be permanent as well as an emergency device. A tracheotomy is the incision necessary to create a tracheostomy.
A flexible, plastic chest tube is passed into the pleural space through an opening in the chest. This procedure is used to continuously remove air, fluid, or pus.
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