Unit 3 - Dyspnea and Abnormal Breathing Flashcards Preview

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Flashcards in Unit 3 - Dyspnea and Abnormal Breathing Deck (71)
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1
Q

What zone makes up the majority of the lung volume?

A

the respiratory zone

2
Q

What structures are in the respiratory zone?

A

respiratory bronchioles, alveolar ducts, and alveolar sacs

3
Q

What structures are in the conducting zone?

A

trachea, bronchi, bronchioles, and terminal bronchioles

4
Q

What are the anatomical disease divisions of the respiratory system?

A

nasal and sinuses, upper airway, lower airway, parenchymal, and pleural space

5
Q

What structures make up the upper airway?

A

pharynx, larynx, trachea, bronchi, and bronchioles

6
Q

What structures make up the lower airway?

A

respiratory bronchioles and alveoli

7
Q

It is best to auscultate the lungs in a _____ ____.

A

quiet room

8
Q

How should a patient be positioned for auscultation?

A

standing, with the mouth closed

9
Q

How do bronchial sounds sound?

A

harsh, hollow, and blowing

10
Q

Where are bronchial sounds loudest?

A

over the trachea

11
Q

Are bronchial sounds inspiratory or expiratory?

A

both

12
Q

How do vesicular sounds sound?

A

rustling

13
Q

Where are vesicular sounds made?

A

airflow through lobar bronchi - peripheral

14
Q

Are vesicular sounds inspiratory or expiratory?

A

primarily inspiratory

15
Q

What are the types of abnormal breath sounds?

A

crackles, wheezes, stertor, and stridor

16
Q

What do crackles sound like?

A

discontinous popping sounds

17
Q

What is the cause of crackles?

A

snapping open of small airways that have collapsed or accumulated fluid/debris

18
Q

When is the timing of crackles?

A

during inspiration

19
Q

How are crackles characterized?

A

moist vs. dry, and fine vs. course

20
Q

What are the differentials for crackles?

A

pulmonary edema, pneumonia, or fibrosis (dry, stiff airways)

21
Q

What do wheezes sound like?

A

continous, whistling musical sounds

22
Q

What is the cause of wheezes?

A

airflow through constricted or narrowed airways

23
Q

When is the timing of wheezes?

A

during expiration

24
Q

What are the differentials for wheezes?

A

lower airway inflammatory disease or an anaphylactic reaction

25
Q

What do stertor sounds sound like?

A

snoring, snorting, and snuffling noise that can be heard without a stethoscope

26
Q

What is the cause of stertor?

A

upper airway obstruction of airflow due to excess tissue or secretions

27
Q

When is the timing of stertor?

A

variable

28
Q

Stertor suggests that diseases is located where?

A

in the nasal cavity and/or the nasopharynx

29
Q

What are the differentials for stertor?

A

Brachycephalic syndrome, nasal congestion/infiltration, nasopharyngeal polyps, nasal/nasopharyngeal neoplasia, inflammatory/infectious rhinitis, and nasal/nasopharyngeal foreign body

30
Q

What do stridor sounds sound like?

A

intense, high-pitched wheeze - shouldn’t need a stethoscope

31
Q

What is the cause of stridor sounds?

A

extrathoracic upper airway collapse and/or narrowing

32
Q

When is the timing of stridor sounds?

A

virtually always inspiratory

33
Q

When stridor is present with voice change, what should you suspect?

A

laryngeal involvement

34
Q

What are the differentials for stridor?

A

laryngeal paralysis, laryngeal collapse, tracheal collapse, and laryngeal/tracheal obstruction

35
Q

What can cause intraluminal laryngeal/tracheal obstruction?

A

foreign body or mass

36
Q

What can cause extraluminal laryngeal/tracheal obstruction?

A

mass or soft tissue swelling

37
Q

What is dyspnea?

A

difficult or labored breathing due to hypoxemia or hypercapnia

38
Q

What is hypoxia?

A

a state in which the oxygen in the blood, lung, and/or tissues is abnormally low

39
Q

What is hypoxemia?

A

oxygenation of the blood that is too low to meet tissue demands - PaO2 <80mmHg

40
Q

What is hypercapnia?

A

a state in which the amount of CO2 in the blood is increased above normal

41
Q

Where does dyspnea typically localize?

A

upper airway, lower airway, parenchymal, and pleural space

42
Q

Characterize obstructive dyspnea.

A

Due to obstruction of airway, normal to increased respiratory rate, increased depth of breathing

43
Q

Characterize obstructive inspiratory dyspnea.

A

Slow, deep inhalation - +/-stridor, the obstruction moves in front of the airway due to pressure

44
Q

What is obstructive inspiratory dyspnea due to?

A

a dynamic extra-throacic obstruction (tracheal or laryngeal)

45
Q

Characterize obstructive expiratory dyspnea.

A

slow prolonged expiration - the airways condense during expiration

46
Q

What is obstructive expiratory dyspnea due to?

A

due to intra-throacic airway disease (large airway obstruction or small airway disease)

47
Q

Characterize restrictive dyspnea.

A

Increased respiratory rate, variable depth depending on the disease state

48
Q

What is restrictive dyspnea due to?

A

It is due to a disease process that restricts lung inflation

49
Q

What is tachypnea?

A

increased respiratory rate at rest

50
Q

What is the normal respiratory rate of dogs?

A

18-34 rpm

51
Q

What is the normal respiratory rate of cats?

A

16-40 rpm

52
Q

What is the normal FiO2?

A

approximately 21% - the percent of air composed of oxygen

53
Q

What is the normal PaO2?

A

97-100 mmHg - partial pressure of oxygen dissolved in arterial blood

54
Q

What is the normal SaO2?

A

98-100% - saturation of Hb binding sites with O2

55
Q

What is pulse oximetry(SpO2) equivalent to?

A

SaO2

56
Q

What does a pulse ox measure?

A

It emits red and infared lights and measured unabsorbed light (oxygenated blood absorbs the light, deoxygenated blood absorbs red light)

57
Q

If SpO2 is 97.5%, PaO2 is what?

A

100 mmHg

58
Q

If SpO2 is 93%, PaO2 is what?

A

80 mmHg

59
Q

If SpO2 is 90%, PaO2 is what?

A

60 mmHg

60
Q

What is the PaO2 if a patient is hypoxemic?

A

less than 80 mmHg

61
Q

Why does O2 supplementation help?

A

It incrases FiO2 which increases PAO2, which increases PaO2, which thus increases tissue oxygenation

62
Q

What percentage FiO2 does an oxygen cage reach?

A

40-60%

63
Q

What are the pros to an oxygen cage? Cons?

A

Pros: non-invasive, non-stressful
Cons: takes time, expensive, isolation

64
Q

What percentage of FiO2 does nasal oxygen achieve?

A

40-50%

65
Q

What are the pros to nasal oxygen? Cons?

A

Pros: Good for large dogs, easy to care for the patient
Cons: Uncomfortable, nasal bleeding, inadvertent removal

66
Q

What FiO2 level does face mask oxygen reach?

A

approximately 50%

67
Q

What are the pros to face mask oxygen? Cons?

A

Pros: convenient
Cons: need a tight seal, can be stressful

68
Q

What FiO2 level does hood oxygen reach?

A

40-60%

69
Q

What are the pros of using hood oxygen? Cons?

A

Pros: easy and economical
Cons: Gets hot/humid, variable FiO2, and may need sedation

70
Q

What FiO2 does flow-by oxygen reach?

A

30-40%

71
Q

What are the pros to flow-by oxygen? Cons?

A

Pros: easy, convenient
Cons: high flow rates, not long-term solution

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