Papillary rupture
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This document discusses cardiopulmonary disease and provides information on: 1. The causes of shortness of breath including pulmonary and cardiac issues as well as systemic illnesses. 2. The indications and uses of chest x-rays which can help diagnose lung, heart, skeletal and soft tissue problems. 3. The components of respiratory examination including inspection, palpation, percussion, and auscultation and what each technique evaluates. 4. Common breath sounds like vesicular, whistling, and crepitus and their characteristics.
Papillary rupture
- 1. Case 4.2 Fatima AlAwadh Fatima AlMohammed Saleh
- 2. Objectives List the causes of shortness of breath. State chest x-ray indications (uses). Describe breathing pattern assessment. Define vesicular & whistling breathing sounds. Define Crepitus & mention its causes. Enumerate the indications of Visible jugular veins, nitroglycerin, and continuous murmur of the apex. Discriminate the differential diagnosis. Explain the papillary muscle rupture. Define and relate cardiac asthma and COPD with our case.
- 3. Introduction Cardiopulmonary disease is disease which involves both the heart and lungs. It may be known as heart-lung disease. It can take a number of forms. Left untreated, cardiopulmonary disease can be deadly.
- 4. Shortness of Breath Defined as uncomfortable breathing. Etiology of SOB : Pulmonary • pneumonia, tuberculosis or chronic Asthma, chronic obstructive lung disease (COPD), emphysema, pulmonary embolism, pneumothorax. Cardiac • Heart Failure. Systemic Illness Problems • Anemia, and Increased metabolic states.
- 5. Indications of Chest X-Ray • Pathology of the skeletal system as well Diagnostic as for some soft tissue diseases. • To asses progression of a condition or effectiveness of treatment. • To check the position of implanted pacemaker wires and other internal Progressive devices • To check status of lungs and chest cavity after surgery.
- 6. Diagnostic Chest X-ray Cardiovascular Rib Fracture Lung Problems problems • Lung cancer. • Cardiomegaly. • COPD. • Congenital heart • Pleuritis. diseases. • Heart failure. • Pneumonia. • Pericardial effusion. • Pneumothorax. • Valvular heart • Pulmonary diseases. edema • Calcification of the heart structures.
- 7. Respiratory Examination RESPIRATORY ASSESSMENT CONSISTS OF FOUR COMPONENTS 1. Inspection 2. Palpation 3. Percussion 4. Auscultation
- 8. Inspection Inspection involves using your eyes and ears to assess a variety of things regarding the patient. With the patient sitting, examine the patient's anterior and posterior chest for the following General Appearance; Color, Ability to speak, & Respiratory effort. Skin Color; especially Around mouth/lips & Nail beds. Chest Wall Abnormalities; as Scoliosis & kyphosis. Noisy Breathing. Pursed Lip Breathing. Coughing. Respiratory Rate & Pattern.
- 9. Palpation An assessment technique in which the examiner uses the surface of the fingers and hands to feel for abnormalities. Assessment data that canbe obtained through palpation includes: identifying chest movement symmetry. chest skeletal abnormalities. Tenderness. skin temperature changes. Swelling & masses.
- 10. Percussion Types of percussion notes: Flat (over bone) Dull (muscle & soft tissue) Resonant (normal lung) Hyper-resonant (Emphysema) Tympanic (free air)
- 11. Auscultation During auscultation Patient should be upright taking deep breaths through the mouth. Eliminate outside noise if Possible.
- 12. Auscultation
- 13. Vesicular breathing sound Vesicular sounds are soft, or rustling sounds normally heard throughout most of the lung fields. Vesicular sounds are normally heard throughout inspiration, continue without pause through expiration. Medium pitch & loudness. Inspiration louder.
- 14. Whistling Abnormal, high pitched breath sounds. Heard in the airways. Caused by air being forced through narrowed passageways by secretions or another mechanical or functional obstruction.
- 15. Crepitus Is crackling chest sound heard in pneumonia and other lung diseases. Caused by fluid in the small airways. The popping sounds produced are created when air is forced through narrowed respiratory passages by fluid.
- 16. Crepitus Etiology Crackles are often associated with inflammation or infection of the small bronchi, bronchioles, and alveoli. Crackles may indicate pulmonary edema or fluid in the alveoli due to heart failure or adult respiratory distress syndrome (ARDS).
- 17. Differential Diagnosis Left sided Mitral valve heart regurgitation failure Papillary Pulmonary muscle Edema dysfunction
- 18. Papillary muscle Papillary muscles are small finger like structures that arise from the wall of the ventricles and are attached to the leaflets of atrioventricular valves.
- 19. Papillary muscle rupture As a result blood The entire The mitral valve will flow muscle may will no longer backwards into function become the lung, and they effectively detached from because of this will fill with fluid the ventricular causing acute sudden wall. pulmonary incompetence. edema.
- 20. Chronic Obstructive Pulmonary Disease COPD is a partially reversible airflow limitation caused by an inflammatory response to inhaled toxins, after cigarette smoke. Symptoms are productive cough and dyspnea that develop over years. Common signs include decreased breath sounds, prolonged expiratory phase, and wheezing. Diagnosis is based on history, physical examination, chest x-ray, and pulmonary function tests.
- 21. Cardiac Asthma A medical symptom, of wheezing, coughing or shortness of breath. It is known as cardiac asthma because the symptoms may mimic asthma. As a result of heart failure, fluid can build up in the lungs (pulmonary edema) and in and around airways.
- 22. Nitroglycerin The prevention or relief of angina pectoris. A thick, pale yellow liquid. Treating pulmonary Used as a vasodilator in hypertension, medicine. The drug should not be Helping to treat congestive heart failure following used continuously, acute myocardial infarction because tolerance develops within 24 to 48 And treating hypertensive emergencies during hrs. cardiovascular surgery. It is prescribed for :