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Pathophys > Alterations of Lung Function > Flashcards

Alterations of Lung Function Flashcards

1
Q

dyspnea

A

subjective sensation of uncomfortable breathing

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2
Q

orthopnea

A

dyspnea when lying down

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3
Q

paroxysmal nocturnal dyspnea

A

awaking at night and gasping for air

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4
Q

hemoptysis

A

coughing up blood/bloody secretions

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5
Q

eupnea

A

normal breathing patterns

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6
Q

abnormal breathing patterns happen because

A

adjustments are made by the body to minimize the work of the respiratory muscles

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7
Q

Kussmaul Respirations (hyperpnea)

A

slightly increase ventilatory rate, very large tidal volume, no expiratory pause

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8
Q

compliance

A

dV/dP or the change in lung volume per unit pressure

the ability of the lung to expand

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9
Q

elasticity

A

the ability of the lung to recoil back to normal
the pressure against the stretch of the lung
dp/dV

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10
Q

what factors affect lung compliance

A
  1. the elasticity of the lungs
  2. surface tension of the alveoli
  3. the elasticity of the chest wall
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11
Q

Restrictive Lung Diseases

A

diseases where the chest wall and lungs are stiff, decreasing the compliance of the lungs

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12
Q

S/S of Pulmonary Disease

A

cyanosis, clubbing, pleural or chest wall pain

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13
Q

hypercapnia

A

increase CO2 concentration in arterial blood

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14
Q

what leads to hypercapnia

A

hypoventilation

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15
Q

hyperventilation

A

alveolar ventilation rate that exceeds metabolic demands

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16
Q

conditions caused by pulmonary disease/injury

A

hypercapnia, hypoxemia, acute respiratory failure

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17
Q

hypoxia

A

tissue failure due to lo O2

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18
Q

hypoxemia

A

lo arterial O2 due to respiratory failure - PaO2 <60 mmHg

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19
Q

restrictive lung disease makes it difficult

A

to get the air in

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20
Q

elements of restrictive lung disease

A

stiff lungs = interstitial lung disease
stiff chest wall = scoliosis, ankylosing spondylitis, obesity
respiratory muscle weakness = neuro/muscular disease

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21
Q

obstructive lung disease makes it difficult

A

get air out

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22
Q

elements of obstructive lung disease

A

mechanical obstruction of airway = tumor, mucus, foreign
body
increased airway resistance = airway thickening from
inflammation (most common)
increased tendency for airway closure = component of
asthma & emphysema

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23
Q

in RLD the difficulty to getting air in is due to

A

stiff lungs, and the alveolar walls become thick and inflexible

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24
Q

restriction of lungs lead to decreased

A

Total Lung Capacity (TLC)

Forced Expiratory Volume 1 sec (FEV1) and Forced Vol Capacity (FVC) are both reduced

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25
Q

the FEV1/FVC ratio in RLD is

A

either NORMAL or INCREASED

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26
Q

diffusion deficit

A

seen in RLD due to fibrosis = thick alveolar membrane

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27
Q

hallmark of pulmonary fibrotic disease

A

DLCO is decreased

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28
Q

DLCO is

A

a measurement to assess the ability of the lungs to transfer gas from inspired air to the bloodstream

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29
Q

S/S of RLD

A

SOB, accessory muscle use, crackles

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30
Q

aspiration

A

passage of fluid and solid particles into lungs

obstruction = inflammation and collapse of airways distal to obstruction

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31
Q

Risk factors for aspiration

A

altered LOC, sedation, NM disorders, esophageal disorders, NGT tubes

32
Q

S/S of aspiration

A

sudden onset of choking, and intractable cough

33
Q

Tx of aspiration

A

prevention = avoid excess sedation
supplemental oxygen
restrict fluids to decrease blood vol and pulmonary edema

34
Q

3 types of atalectasis

A

compression atelectasis
absorption atelectasis = inhalation of conc. O2, hyperventilated alveoli, obstructed alveoli
surfactant impairment

35
Q

S/S of atelectasis

A

dyspnea, cough, fever and leukocytosis

36
Q

bronchiectasis

A

persistant abnormal dilation of the bronchi due to systemic inflammatory conditions e.g. rheumatic disease, AIDs

37
Q

causes of bronchiestasis

A

recurrent infection and inflammation leading to destruction of elastic and muscular components resulting bronchial lumen obstruction, fibrosis and permanent dilation

38
Q

bronchiestasis vs bronchiolitis

A 
Bronchiestasis = chronic productive cough months/years, hemoptysis, pleuritic chest pain, decrease in FVC, eventual cor pulmonale
Bronchiolitis = most common in children, adults who have inhaled toxic gas, rapid RR, low grade fever, dry non productive cough
39
Q

Bronchiolitis Obliterans Organizing Pneumonia (BOOP)

A

bronchioles and alveoli become filled with plugs of connective tissue
complication of LUNG TRANSPLANT or bronchiolitis

40
Q

Pulmonary Fibrosis

A

occurs after ARDS, TB, autoimmune disorders, or inhalation of toxic substances
lungs become stiff and difficult to ventilate

41
Q

Idiopathic Pulmonary Fibrosis

A

most common in M > 60

survival time 2-5 yrs after Dx

42
Q

oxygen toxicity (RLD)

A

prolonged exposure to hi conc of O2

damage to alveolocapillary membranes, surfactant disruption, decrease in compliance

43
Q

pneumoconiosis

A

silica, asbestos, coal
deposition of microparticles = release of proinflamm. cytokines leading to chronic inflammation and scarring of AC membrane

44
Q

hallmark of Obstructive Lung Disease

A

FEV1/FVC ration decreases
floppy non elastic lungs do not exhale so FEV1 decrease
expiratory wheezing
loss of elastic recoil

45
Q

asthma pathophys

A

OLD
chronic inflammatory disorder of the bronchial mucosa
Early Response: vasodilation, mucosal edema, smooth muscle edema, mucous secretion
Late Response: 4-8 hrs after early
- airway scarring, increased hyperresponsiveness, impaired mucocilliary function, decreased Treg cells (T cells that modulate attack on self)

46
Q

danger sign for impending death

A

PaCO2 > 70mmHg, silent air movement

47
Q

normal PaO2

A

60-100mmHg

48
Q

Cardinal Symptoms of COPD

A

dyspnea, chronic cough, sputum production, wheezing

49
Q

Risk Factors COPD

A

95% smoking, cannabis smoking, Air pollution, recurrent infection, alpha1 antiproteinase

50
Q

COPD diseases

A

Chronic Asthma, Chronic Bronchitis, Emphysema

51
Q

Blue Puffers

A

Chronic Bronchitis = alveolar hypoxia leads to over production of RBCs and elevated hgb, hypoxemia and cyanosis, Cor Pulmonale, fat due to Rt Sided and possibly Lft Sided HF

52
Q

Pink Bloaters

A

Emphysema = skinny, barrel chest, accessory muscle use, decreased perfusion and ventilation lead to matched V/Q deficit, silent lung, pursed lip breathing

53
Q

Respiratory Distress Syndrome and Hyaline Membrane Disease are caused by

A

surfactant deficiency due to developmental immaturity

54
Q

paradoxical/ diaphragmatic breathing in young children

A

normal due to high compliance of chest wall = during inspiration air is drawn in by downward movement of diaphragm but resulting negative pressure pulls in soft chest wall

55
Q

a newborn has blunted ventilatory response to hypoxia due to what process

A

reduced activity of the peripheral chemoreceptors in the carotid body, and nonadaptive responses in the respiratory center of the brainstem

56
Q

signs of acute respiratory failure in neonates

A

tachycardia, mottling, increased respiratory effort and gasping, cyanosis and pallor

57
Q

snoring noise in young children is telltale

A

nasopharyngeal obstruction

58
Q

stridor

A

harsh, vibratory sound caused by turbulent flow through obstructed airway

59
Q

inspiratory stridor

A

extrathoracic airway obstruction = voice quality zone

60
Q

expiratory stridor

A

intrathoracic airway obstruction = cough/ trachea zone

61
Q

acute epiglottitis is caused by

A

haemophilus influenzae Type B (Hib)

62
Q

acute epiglottitis S/S

A

hi fever, irritability, inspiratory stridor, hot potato voice, tripod w/ drooling

63
Q

tx for acute epiglottitis

A

emergency airway and rifampin

64
Q

croup aka

A

acute laryngotracheobronchitis

65
Q

s/s of acute laryngotracheobronchitis

A
  • common in children from 6 mos - 5 yrs
  • sublottic edema from infection
  • inspiratory stridor, seal like bark cough
66
Q

s/s peritonsillar abcess

A
  • usually unilateral

- fever, sore throat, trismus, pooling salive, cervical adenopathy

67
Q

tx for peritonsillar abcess

A

drain and antibiotics

68
Q

most common potentially life threatening upper airway infxn in children

A

bacterial thracheitis

69
Q

s/s bacterial thracheitis

A
  • airway edema and copious purulent secretions leading to airway obstruction
  • may be sudden or preceded by URI
  • tachypnea, stridor, fever, cough
70
Q

tx for bacterial tracheitis

A

broad spectrum Antibiotic, endotracheal intubation

71
Q

cause for retropharyngeal abscess

A

nasopharngeal infxn, penetrating local injury,

72
Q

obstructive sleep apnea in children s/s

A

snoring, restlessness, sweating during sleep, failure to thrive, untreated heart, lung and behavioral problems

73
Q

obstructive sleep apnea is mostly associated with

A

adenotonsillar hypertrophy

74
Q

bronchiolitis in children most commonly associated with

A

RSV

75
Q

Acute Lung Injury precedes the development of

A

ARDS from either indirect or direct injury - life threatening

76
Q

Cystic Fibrosis is

A
  • an autosomal multisystem disease due to chloride transport
77
Q

s/s of CF

A
  • abnormal secretions cause obstructive problems in respiratory, digestive and reproductive tracts
  • mucus plugging, chronic inflammation and infection of small ariways

Pathophys (3 decks)

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