Trắc nghiệm, bài giảng pptx các môn chuyên ngành Y dược hay nhất có tại “tài liệu ngành Y dược hay nhất”; https://123doc.net/users/home/user_home.php?use_id=7046916. Slide môn anh văn chuyên ngành y ppt dành cho sinh viên chuyên ngành Y dược. Trong bộ sưu tập có trắc nghiệm kèm đáp án chi tiết các môn, giúp sinh viên tự ôn tập và học tập tốt bộ môn anh văn chuyên ngành y bậc cao đẳng đại học ngành Y dược và các ngành khác
FUNCTIONAL RESPIRATORY DISORDERS What is functional respiratory disorders? Functional respiratory disorders can be characterized as occurring in patients with persisting respiratory symptoms lacking an identifiable organic or physiologic basis, or symptoms in excess of what would be expected from just their physiologic cause Common functional respiratory disorders: • • • • Chest pain Shortness of breath (Dyspnea) Chronic cough Expectorate (khạc đàm) Chest pain • • • • Pulmonary embolism (thuyên tắc phổi) Pleurisy (viêm màng phổi) Collapsed lung (xẹp phổi) Pulmonary hypertension (tăng áp phổi) Chest pain • Pulmonary embolism. This cause of chest pain occurs when a blood clot becomes lodged in a lung (pulmonary) artery, blocking blood flow to lung tissue • Pleurisy. If the membrane that covers your lungs becomes inflamed, it can cause chest pain that's made worse when you inhale or cough Chest pain • Collapsed lung. The chest pain associated with a collapsed lung typically begins suddenly and can last for hours A collapsed lung occurs when air leaks into the space between the lung and the ribs • Pulmonary hypertension. High blood pressure in the arteries carrying blood to the lungs (pulmonary hypertension) also can produce chest pain Dyspnea • • • • • • • Croup (Diphtheria) Lung cancer Pleurisy Pulmonary edema Pulmonary fibrosis Pulmonary hypertension Tuberculosis Dyspnea • Croup (Diphtheria) refers to an infection of the upper airway, generally in children, which obstructs breathing and causes a characteristic barking cough • Lung cancer is a type of cancer that begins in the lungs. (so simple ^^) Dyspnea • Pleurisy is a condition in which the pleura becomes inflamed Also called pleuritis, pleurisy causes sharp chest pain (pleuritic pain) that worsens during breathing • Pulmonary edema is a condition caused by excess fluid in the lungs This fluid collects in the numerous air sacs in the lungs, making it difficult to breathe Tactile vocal fremitus To assess tactile vocal fremitus, use the ulnar side of the hand, by the hypothenar eminence with the palms facing upwards Place it at various levels over the back, each time asking the patient to say "ninety-nine" Note how the sound is transmitted to the hand Tactile vocal fremitus is increased over areas of consolidation and decreased or absent over areas of effusion or collapse Percussion For percussion of the chest, it is usual to use the middle finger of the dominant hand to this The clavicle is percussed directly, usually about a third of the way between the sternum and the acromium The rest of the chest is percussed by placing the nondominant hand on the chest and using the dominant middle finger to tap the other middle finger over the middle phalanx Percuss over all the lobes of the lung, front and back except that the middle lobe does not have surface anatomy on the back Percussion Percuss over the heart In hyperinflation of the chest, there is loss of cardiac dullness A hyper-resonant sound suggests hyperinflation or a pneumothorax A dull sound is easier to distinguish from normal It may suggest collapse or consolidation, or a pleural effusion Percussion Auscultation Heart auscultation (see link for separate article): mainly to detect heart abnormalities but severe lung disease may cause pulmonary hypertension and a loud P2 Place the stethoscope over each of the lobes of the lungs in turn, on the front and back of the chest Ask the patient to take deep breaths in and out with their mouth open Normal breath sounds are called vesicular They are described as quiet and gentle There is usually no gap between the inspirato ry and expiratory phase sounds Auscultation Pleural rub: a creaking sound caused by stiff pleural membranes such as with pleurisy Stridor: harsh inspiratory sound caused by partial obstruction of a large airway Auscultation Rhonchi Rales Bronchial breathing Vocal resonance Whispering pectoriloquy Rhonchi (wheezes): Musical sound heard on expiration In severe cases they may be both inspiratory and expiratory Imply narrowing of the airways The loudness of rhonchi gives no indication of the severity of the condition Rales (crackles) Probably represent opening of small airways and alveoli They may be normal at the lung bases if they clear on coughing or after taking a few deep breaths Basal rales are a classical feature of pulmonary congestion with left ventricular failure They may be more diffuse in pulmonary fibrosis Bronchial breathing The sounds of bronchial breathing are generated by turbulent air flow in large airways (similar sounds can be heard in healthy patients by listening over the trachea Sounds are harsh and poor in nature Unlike normal vesicular breath sounds, there is a gap between the inspiratory and expiratory phase sounds Bronchial breathing suggests consolidation or fibrosis, which permits the sound to be conducted more effectively to the chest wall Vocal resonance Place the stethoscope at various levels over the back and ask the patient to whisper "ninetynine" each time Note how well the sound is transmitted The sound is muffled over a normal lung, increased if there is consolidation, and decreased or absent if there is effusion or collapse Whispering pectoriloquy Is elicited as for vocal fremitus but ask the patient to whisper "one, two, three" Whispering pectoriloquy is the increased quality and loudness of whispers that are heard with a stethoscope over an area of lung consolidation ... What is functional respiratory disorders? Functional respiratory disorders can be characterized as occurring in patients with persisting respiratory symptoms lacking an... symptoms in excess of what would be expected from just their physiologic cause Common functional respiratory disorders: • • • • Chest pain Shortness of breath (Dyspnea) Chronic cough Expectorate... Pulmonary embolism. This cause of chest pain occurs when a blood clot becomes lodged in a lung (pulmonary) artery, blocking blood flow to lung tissue • Pleurisy. If the membrane that covers your lungs