Respiratory

• Sinuses


  • Lined with mucous membrane and filled with air
  • Mucous drains into the nasal cavity
  • Act as sound chambers for the voice, and reduce the weight of the skull
• Sinusitis


  An inflammation of the sinuses
• Sinusitis


  • Obstruction
  • Increased risk with allergies
• Decongestants


  Pseudoephedrine, Phenylephrine
• Intranasal corticosteroids


  Fluticasone (Flonase)
• Nose drops

  Blow nose before giving, Head back, Hold opposite nostril then inhale, Don't touch dropper or tip to nose
• Nasal Polyps


  Swollen masses of mucosa that grow, Associated with allergies, Grape like clusters, Can exist with asthma and aspirin allergy called "triad" disease
• Deviated Septum


  Septum: Cartilage wall separating nostrils, Very common: most adults have a slight deviation, Severe: nasal obstructions and decreased sinus drainage leading to repeated infections
• Sinus Surgery


  Can be used to treat chronic sinusitis, deviated septum, and nasal polyps, FESS: Functional Endoscopic Sinus Surgery, Surgery can: Remove obstruction, Strip membrane, Enlarge openings
• Allergic Rhinitis


  AKA "hay fever", Allergen, antibody, mast cell interactions resulting in release of histamine, Vasodilation, leaking fluids, swelling, Runny nose, red eyes, sneezing, clear drainage
• Acute Viral Coryza


  Aka, the common cold, Inflammation of the upper airway
• Pharyngitis


  Viral (90%), Bacterial (5-10%) caused by strep
• Obstructive Sleep Apnea (OSA)


  Airway obstruction caused by muscle tone relaxation or the tongue and soft palate partially or completely blocking the airway, Apnea ensues, causing CO2 buildup, Once enough CO2 has built up, the patient's ventilation drive causes them to wake up and breath; this is accompanied by snoring and gasping
• Laryngitis


  Inflammation of the larynx
• Laryngeal Carcinoma


  About 12,500 cases annually, with 4,000 deaths, Predominantly men over 55, More common in black men; black men have higher death rates than white men, 60% of cases start in the glottis (vocal cords), 35% are supraglottic, 5% are subglottic or have spread so the original site is unknown
• Radical Neck Dissection


  Can be done with a laryngectomy, especially if the cancer is in the lymph nodes, Excision of: Sternocleidomastoid muscle, Jugular vein, submaxillary salivary gland, Surrounding soft tissue, The spinal accessory nerve is cut, causing the shoulder to droop on the affected side, Modified radical neck will excise some but not all of these structures
• Artificial Airways


  Endotracheal tubes (if on a ventilator), Temporary tracheostomy, Permanent tracheostomy, Laryngectomy tube
• Laryngectomy Tube


  Permanent neck breather, Temporary (surgeon decides how long it will stay int), After stoma and tract are established, can be removed, Will need to suction stoma and keep it clean, Must learn new ways to speak
• Tracheostomy Tube


  Permanent neck breather, Permanent device, Will need to suction and perform trach care, Must learn new ways to speak