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SYMPTOMS
Cardiopulmonary Symptoms
| Term | Definition |
|---|---|
| SYMPTOM | Evidence of disease or physical disturbance that indicates the presence of bodily disorder. |
| SYMPTOMS DETERMINE | -Seriousness of problem -Potential cause of problem -Effectiveness of treatment |
| CHARACTERISTICS OF SYMPTOMS | -Objective -Measureable -Assessed values EX. HR, BP, and Respiratory Rate |
| SIGNS | Subjective experiences reported to the physician from the patient. Ex. Fatigue |
| SIGNS DETERMINE | -Outcome of current bodily state -Past existence of disease or condition -Recognition and Identification of Disease |
| CHARACTERISTICS OF SIGNS | -Subjective -Patient Description -Measured by patient perception Ex. Pain, shortness of breath, cough |
| CARDIOPULMONARY DISEASE | A medical condition in which the heart and lungs don't function properly. |
| PRIMARY SYMPTOMS OF CARDIOPULMONARY DISORDERS | -Cough -Sputum production -Hemoptysis -Shortness of breath (Dyspnea) -Chest pain |
| COUGH | -Protective reflex -Stimulation of receptors, -Pharnyx, larynx, trachea, large bronchi, lung and visceral pleura |
| COUGH | -Caused by inflammatory, mechanical, chemical, or thermal stimulation of cough receptors |
| COUGH | Key to determine etiology is careful history, physical exam, and CXR |
| POSSIBLE CAUSES OF COUGH RECEPTOR STIMULATION INFLAMMATORY | -infection -lung abscess -drug reaction -allergy -edema -hyperemia -collagen vascular disease -radiotherapy -pneumoconiosis -tuberculosis |
| POSSIBLE CAUSES OF COUGH RECEPTOR STIMULATION MECHANICAL | -inhaled dusts -suction -catheter -food |
| POSSIBLE CAUSES OF COUGH RECEPTOR STIMULATION OBSTRUCTIVE | -Foreign bodies -aspirations of nasal secretions -tumor or granulomas within or around the lung -aortic aneurysm |
| POSSIBLE CAUSES OF COUGH RECEPTOR STIMULATION AIRWAY WALL TENSION | -pulmonary edema -atelectasis -fibrosis -chronic interstitial pneumonitis |
| POSSIBLE CAUSES OF COUGH RECEPTOR STIMULATION CHEMICAL | -inhaled irritant gases -fumes -smoke |
| POSSIBLE CAUSES OF COUGH RECEPTOR STIMULATION TEMPERATURE | -inhaled hot or cold air |
| POSSIBLE CAUSES OF COUGH RECEPTOR STIMULATION EAR | -tactile pressure in the ear canal (Arnold Nerve Response) -Otitis media |
| COUGH AFFERENT PATHWAY | -vagus, phrenic, glossopharyngeal, trigeminal nerves |
| COUGH EFFERENT PATHWAY | -smooth muscles of larynx and tracheobronchial tree via phrenic, spinal nerves |
| COUGH PHASES | -inspiratory -compression -expiratory |
| REDUCED EFFECTIVENESS OF COUGH | -weakness of inspiratory or expiratory muscles -inability of the glottis to open or close correctly |
| REDUCED EFFECTIVENESS OF COUGH | -obstruction, collapsibility, or alteration in shape or contours of the airways -decrease in lung recoil (ex. Emphysema) |
| REDUCED EFFECTIVENESS OF COUGH | -abnormal quantity or quality of mucus production (Ex. thick sputum) |
| ACUTE | -sudden onset -severe, short cause -self-limiting -viral infection |
| CHRONIC | -persistent -last >3 weeks |
| CAUSES OF CHRONIC COUGH | -postnasal drip -allergic rhinitis -asthma -GERD -COPD exacerbation -chronic bronchitis -bronchiectasis -left heart failure |
| PAROXYSMAL | -periodic -prolonged, forceful episodes |
| ASSOCIATED SYMPTOMS OF COUGH | -wheezing -stridor -chest pain -dyspnea |
| COMPLICATIONS OF COUGH | -torn chest muscle -Rib fractures -Disruption of surgical wounds |
| COMPLICATIONS OF COUGH | -pneumothorax of pneumomediastinum -syncope -arrhythmia |
| COMPLICATIONS OF COUGH | -esophageal rupture -urinary incontinence |
| SPUTUM | Secretions from tracheobronchial tree, pharynx, mouth, sinuses, nose |
| PHLEGM | Secretions from lungs and tracheobronchial tree |
| SPUTUM PRODUCTION COMPONENTS | -mucus, cellular debris, microorganisms, blood, pus, foreign particles |
| NORMAL SPUTUM | -upward displacement via wavelike motion of cilia until swallowed |
| ABNORMAL SPUTUM PRODUCTION | -excessive production by inflamed glands caused by; infection, cigarette smoking, allergies -Describe color, quantity, consistency, time of day, presence of blood |
| HEMOPTYSIS | -Expectoration of sputum containing blood -from streaking to frank bleeding |
| HEMOPTYSIS CAUSES | -Bronchopulmonary -Systemic disorders -Cardiovascular -Turberculosis -Hematologic -fungal infections |
| DESCRIPTION OF HEMOPTYSIS | -Amount -massive hemoptysis: 400 ml/3h or 600 ml/24h |
| DESCRIPTION OF HEMOPTYSIS | -odor -color -acuteness |
| HEMATEMESIS | Vomitted blood |
| DETERMINE SOURCE | -oropharynx -swallowed from respiratory tract -esophagus or stomach -alcoholism or cirrhosis of liver |
| SHORTNESS OF BREATH | -Most distressing symptom of respiratory disease -single most important factor limiting ability to function -cardinal symptom of cardiac disease |
| DYSPNEA | -Subjective experience of breathing discomfort -components -sensory input to cerebral cortex -perception of the sensation; breathless, short-winded, feeling of suffocation |
| DYSPNEA SCORING SYSTEMS | -Scale of 0(no SOB to 10(max SOB) -visual analog scales -modified Borg scales -ATS SOB scale -UCSD SOB Questionnaire |
| CLINICAL TYPES OF DYSPNEA: CARDIAC AND CIRCULATING | -Inadequate supply of oxygen to tissues -Primarily during exercise |
| CLINICAL TYPES OF DYSPNEA: PSYCHOGENIC | -panic disorder -not related to exertion |
| CLINICAL TYPES OF DYSPNEA: HYPERVENTILATION | -Rate, depth exceeds body's metabolic need -Results in hypocapnia and decreased cerebral blood flow |
| ACUTE AND RECURRENT: CHILDREN | -Asthma -Bronchiolitis -Croup -Epiglottitis |
| ACUTE AND RECURRENT: ADULTS | -pulmonary embolism -pulmonary edema -Asthma -hyperventilation -Pneumonia -panic disorder -Pneumothorax |
| CHRONIC DYSPNEA | -Most common causes: -COPD -CHF |
| PAROXYSMAL NOCTURNAL DYSPNEA (PND) | -Sudden dyspnea when sleeping in recumbent position -Associated with coughing -Sign of left heart failure |
| ORTHOPNEA | -Dyspna when lying down -Associated with left heart failure |
| TREPOPNEA | -Dyspnea when lying on one side -unilateral lung disease, pleural effusion |
| PLATYPNEA | -Dyspnea in upright position |
| ORTHODEOXIA | -Hypoxemia in upright position relieved by returning to a recumbent position |
| CHEST PAIN | -Causes -cardiac ischemia -inflammatory disorders of thorax, abdomen -musculoskeletal disorders, trauma, anxiety -referred pain from indigestion, dissecting aortic aneurysm |
| CARDINAL SYMPTOMS OF HEART DISEASE | -Angina -quickly assess if pain is an emergency condition |
| PULMONARY CAUSES OF CHEST PAIN | -Involvement of chest wall or parietal pleura -Pleuritic pain -Inspiratory, sharp, and abrupt in onset |
| PULMONARY CAUSES OF CHEST PAIN | -Worsens w/ inspiration, cough, sneeze, hiccup, or laughter -increase w/ pressure and movement |
| CHEST WALL PAIN | -Intercostal and pectoral muscles -well localized |
| DIZZINESS AND FAINTING (SYNCOPE) | -Temporary loss of consciousness -resulting from reduced cerebral blood flow and oxygen |
| DIZZINESS AND FAINTINR (SYNCOPE) CAUSES | -Thrombosis, embolism, atherosclerotic obstruction -Pulmonary: embolism, bouts of coughing,hypoxia, hypocapnia |
| VASOVAGAL | -Most common type of syncope -loss of peripheral venous tone |
| ORTHOSTATIC HYPOTENSION | -Sudden drop in blood pressure when a person stands up. -Dizziness,blurred vision, weakness, syncope -Elderly, vasodilator use, dehydration |
| CAROTID SINUS SYNCOPE | -Hypersensitive carotid sinus -slows pulse rate, decrease blood pressure, syncope |
| TUSSIVE SYNCOPE | -Syncope caused by strong coughing -seen most often in men with COPD, obesity, a positive smoking history, and frequently use of alcohol |
| DEPENDENT EDEMA | -Edema is soft tissue swelling from abnormal accumulation of fluid |
| BILATERAL PERIPHERAL EDEMA | -Most often occurs in ankles and lower legs -Most often caused by right or left heart failure -right heart failure often caused by cor pulmonale |
| EUTHERMIA | -97 TO 99.5 degrees Fahrenheit |
| FEVER (HYPERTHERMIA PYREXIA) | -sustained -remittent -intermittent -relapsing |
| CAUSES OF FEVER | -Hot Environment -Dehydration -Reaction to chemicals -Drugs -Hypothalamic damage -Infection -Malignancy |
| PULMONARY INFECTIONS | Lung abscess, empyema, tuberculosis, pneumonia -Remittent fever in mycoplasma, pneumonia, Legionnaires disease, acute viral infections |
| INFECTIONS WITH NO FEVER | -High-dose corticosteroids -Immunosuppressants -Immunocompromised (Leukemia, AIDS) |
| HEADACHE | A Manifestation of cerebral hypoxia and hypercapnia -Lung disease altitude |
| ALTERED MENTAL STATUS IN HYPERCAPNIA | -From affected alertness to coma |
| PERSONALITY CHANGES IN ADVANCED PULMONARY DISORDERS | -Forgetfulness, inability to concentrate, anxiety irritability |
| SNORING | -Serious concern when associated with apnea -evaluation for OSA |
| INCIDENCE AND CAUSES OF SNORING | -10% to 12% of children -10% to 30% of adults -Peak at age 50 to 59 (male), 60 to 64 (female) |
| INCIDENCE AND CAUSES OF SNORING | -Obesity is one the most common -Fatigue -Excessive daytime sleepiness (daytime somnolence) |
| GASTROESOPHAGEAL REFLUX (GERD) | -Heart burn and regurgitation -Extraesophageal manifestations -Laryngitis, asthma, chronic and nocturnal dry cough, chest pain, dental erosion -GER more than twice a week = GERD |
| Risk Factors | -Obesity -Cigarette smoking -Pregnancy |
Created by:
Shenika
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