The Case of the Coughing Housewife What risk factors and symptoms did Jessica present with prior to the physical examination that suggested a pulmonary disorder? The risk factors that Jessica presented with are a history that is positive for smoking, bronchitis and living in a large urban area with decreased air quality. The symptoms that suggest a pulmonary disorder include a productive cough with discolored sputum, elevated respiratory rate, use of the accessory respiratory muscles during quite breathing, exertional dyspnea, tachycardia and pedal edema. The discolored sputum is indicative of a respiratory infection. The changes in respiratory rate, use of respiratory muscles and exertional dyspnea indicate a pulmonary disorder since there is an increased amount of work required for normal breathing. Tachycardia may arise due to the lack of oxygenated blood available to the tissue stimulating an increase in heart rate. The pedal edema most probably results from decreased systemic blood flow. How did the physical examination, chest x-ray, and spirometry confirm this hypothesis? The physical examination indicated that …show more content…
The contraction of the inspiratory muscles increases the volume of the thoracic cavity causing the pressure within the alveoli to decrease and air to flow into the alveoli. During resting inspiration, the diaphragm, the external intercostals and the parasternal intercostals contract to stimulate inspiration. During forced inspiration the scalene and the sternocleidomastoid muscles contract to further expand the thoracic cavity. The pectoralis minor muscles also play a minor role in forced inspiration. During quiet breathing, relaxation of these muscles causes the volume of the thoracic cavity to decrease, resulting in expiration. During a forced expiration, the compression of the chest cavity is increased by contraction of the internal intercostal muscles and various abdominal
R.S. has chronic bronchitis. According to the UC San Francisco Medical Center “Chronic bronchitis is a common type of chronic obstructive pulmonary disease (COPD) in which the air passages in the lungs — the bronchi — are repeatedly inflamed, leading to scarring of the bronchi walls. As a result, excessive amounts of sticky mucus are produced and fill the bronchial tubes, which become thickened, impeding normal airflow through the lungs.” (Chronic Bronchitis 2015) There are many things that can be observed as clinical findings. R.S. will have a chronic cough that has lasted from 3 months to two years or more, and a lot of sputum. The sputum is due to
ations such as less oxygen circulating the body. Because the body is unable to receive enough oxygen, it compensates by making the heart work harder (tachycadia). Another factor that points to COPD in Mrs Walkers case is the presentation of oedema in both her legs which is indicative of Pulmonary hypertension, a common complication of having COPD (Robert Naeije,
On admission, a complete physical assessment was performed along with a blood and metabolic panel. The assessment revealed many positive and negative findings. J.P. was positive for dyspnea and a productive cough. She also was positive for dysuria and hematuria, but negative for flank pain. After close examination of her integumentary and musculoskeletal system, the examiner discovered a shiny firm shin on the right lower extremity with +2 edema complemented by severe pain. A set of baseline vitals were also performed revealing a blood pressure of 124/80, pulse of 87 beats per minute, oxygen saturation of 99%, temperature of 97.3 degrees Fahrenheit, and respiration of 12 breaths per minute. The blood and metabolic panel exposed several abnormal labs. A red blood cell count of 3.99, white blood cell count of 22.5, hemoglobin of 10.9, hematocrit of 33.7%, sodium level of 13, potassium level of 3.1, carbon dioxide level of 10, creatinine level of 3.24, glucose level of 200, and a BUN level of 33 were the abnormal labs.
The skeleton of the respiratory system is important for keeping the organs and structures safe. The skeleton is the spinal column, pelvic girdle, the rib cage, the clavicles, the scapulae, and the skull. The skeleton of the respiratory system and the soft tissues allow the muscles of the respiratory system to move gasses in and out of the lungs and respiratory passages. Bringing air and gas into the system is called inspiration while forcing out gas and air is expiration. One of the primary muscles of inspiration is the diaphragm. It is located right under the lungs and when it contracts, it flattens part of the thorax which flattens the abdomen and makes the lungs larger. That is why it is called diaphragmatic or abdominal movement. Changing the dimensions of the thoracic cavity with several other muscles by acting on the ribs is called costal movement. “Pump Handle Movement” shifts the thorax up and forward by movement of ribs one through six. The other is called “Bucket Handle Movement” which shifts up and laterally by movement of ribs seven through ten. Intercostal muscles allow the ribs to move in that way. Primary muscles are used for normal
Other symptoms are breathing frequent and superficial, the fever and then can often present a noise very particular in the chest area, which is heard through the stethoscope. The symptom picture is completed by shortness of breath, sobs, anemia and decreased body weight.
Diagnosis include a pulmonary function test, a test which helps measure the lungs ability to exchange oxygen and carbon dioxide. This type of test is performed with a special machine called spirometry (Mayo Clinic, 2011). A spirometry determines how well the lungs intake, hold, and utilize the air and can even detect the severity of lung disease and determine whether the disease has decreased airflow or a disruption of airflow has occurred. Another device used is a peak flow monitor (PFM). A device that measures the speed at which an individual can blow air out of lungs (Mayo Clinic, 2011). A doctor can diagnose a patient with symptoms that correspond to emphysema, such as a cough that doesn’t go away, coughing up a large sum of mucus, shor...
In clinical, one of my patients was diagnosed with pneumonia, history of asthma and COPD. She informed me that
Normal breathing is controlled by the lungs and the chest cavity. Airways are tubes with muscle that contracts and relaxes wrapped around them, and this accounts for the motion of the chest that is associated with breathing. The diaphragm, which is located underneath the rib cage, along with the intercostal muscles, or those in between the ribs, control the movement of the chest cavity(6). When these muscles contract, the chest expands, which lowers the pressure inside the lungs. Since air moves naturally from high to low pressure, the lungs are automatically inflated. In order to exhale, the diaphragm and the intercostal muscles relax, causing the chest cavity to become smaller. The decrease in volume causes the pressure in the lungs to go...
Parker, Steve. "Chronic Pulmonary Diseases." The Human Body Book. New ed. New York: DK Pub., 2007.
The breath is brought into the nose and exhaled through the mouth with slightly pursed lips which should help you to feel a deeper contraction of the abdominals. = == == ==
The patient has high temperature-sign of fever, a very fast pulse rate (tachycardia), and chest wheezing when listened to using a stethoscope (Harries, Maher, & Graham, 2004, p.
While quiet breathing, external intercostal muscles contract, which causes the ribcage to expand and move up. The diaphragm then contracts and moves down. The volume of the chest cavity increases, the lungs expand and the pressure inside the lungs decreases. Air then flows into the lungs in response to the pressure gradient. Inspiration (inhalation or breathing in) is accomplished by increasing the space, therefore decreasing the
The Young Housewife by William Carlos William is a short poem that portraits the sexism towards women. The poem gives the reader a lot of details how married women in society are viewed. It also shows the reader what women are expected to do once married. The Young Housewife poem has hidden views about women that are particularly sexist. Through the eyes of William Carlos William it portraits what society thinks of women. Their thoughts and/or his thoughts are not necessarily something a woman would want society to regard them as.
Breathing is made of two separate acts, inspiration (breathing in) and expiration (breathing out). The muscles in the chest act to expand and contract the chest cavity, causing the lungs to fill or empty. There is a pause between inspiration and expiration and that pause is shorter during fast
disease is coughing, rapid breathing, discharge from the nose and eyes, swelling near the neck