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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
the FEV1/FVC ratio in RLD is
either NORMAL or INCREASED
26
diffusion deficit
seen in RLD due to fibrosis = thick alveolar membrane
27
hallmark of pulmonary fibrotic disease
DLCO is decreased
28
DLCO is
a measurement to assess the ability of the lungs to transfer gas from inspired air to the bloodstream
29
S/S of RLD
SOB, accessory muscle use, crackles
30
aspiration
passage of fluid and solid particles into lungs | obstruction = inflammation and collapse of airways distal to obstruction
31
Risk factors for aspiration
altered LOC, sedation, NM disorders, esophageal disorders, NGT tubes
32
S/S of aspiration
sudden onset of choking, and intractable cough
33
Tx of aspiration
prevention = avoid excess sedation supplemental oxygen restrict fluids to decrease blood vol and pulmonary edema
34
3 types of atalectasis
compression atelectasis absorption atelectasis = inhalation of conc. O2, hyperventilated alveoli, obstructed alveoli surfactant impairment
35
S/S of atelectasis
dyspnea, cough, fever and leukocytosis
36
bronchiectasis
persistant abnormal dilation of the bronchi due to systemic inflammatory conditions e.g. rheumatic disease, AIDs
37
causes of bronchiestasis
recurrent infection and inflammation leading to destruction of elastic and muscular components resulting bronchial lumen obstruction, fibrosis and permanent dilation
38
bronchiestasis vs bronchiolitis
``` 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
Bronchiolitis Obliterans Organizing Pneumonia (BOOP)
bronchioles and alveoli become filled with plugs of connective tissue complication of LUNG TRANSPLANT or bronchiolitis
40
Pulmonary Fibrosis
occurs after ARDS, TB, autoimmune disorders, or inhalation of toxic substances lungs become stiff and difficult to ventilate
41
Idiopathic Pulmonary Fibrosis
most common in M > 60 | survival time 2-5 yrs after Dx
42
oxygen toxicity (RLD)
prolonged exposure to hi conc of O2 | damage to alveolocapillary membranes, surfactant disruption, decrease in compliance
43
pneumoconiosis
silica, asbestos, coal deposition of microparticles = release of proinflamm. cytokines leading to chronic inflammation and scarring of AC membrane
44
hallmark of Obstructive Lung Disease
FEV1/FVC ration decreases floppy non elastic lungs do not exhale so FEV1 decrease expiratory wheezing loss of elastic recoil
45
asthma pathophys
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
danger sign for impending death
PaCO2 > 70mmHg, silent air movement
47
normal PaO2
60-100mmHg
48
Cardinal Symptoms of COPD
dyspnea, chronic cough, sputum production, wheezing
49
Risk Factors COPD
95% smoking, cannabis smoking, Air pollution, recurrent infection, alpha1 antiproteinase
50
COPD diseases
Chronic Asthma, Chronic Bronchitis, Emphysema
51
Blue Puffers
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
Pink Bloaters
Emphysema = skinny, barrel chest, accessory muscle use, decreased perfusion and ventilation lead to matched V/Q deficit, silent lung, pursed lip breathing
53
Respiratory Distress Syndrome and Hyaline Membrane Disease are caused by
surfactant deficiency due to developmental immaturity
54
paradoxical/ diaphragmatic breathing in young children
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
a newborn has blunted ventilatory response to hypoxia due to what process
reduced activity of the peripheral chemoreceptors in the carotid body, and nonadaptive responses in the respiratory center of the brainstem
56
signs of acute respiratory failure in neonates
tachycardia, mottling, increased respiratory effort and gasping, cyanosis and pallor
57
snoring noise in young children is telltale
nasopharyngeal obstruction
58
stridor
harsh, vibratory sound caused by turbulent flow through obstructed airway
59
inspiratory stridor
extrathoracic airway obstruction = voice quality zone
60
expiratory stridor
intrathoracic airway obstruction = cough/ trachea zone
61
acute epiglottitis is caused by
haemophilus influenzae Type B (Hib)
62
acute epiglottitis S/S
hi fever, irritability, inspiratory stridor, hot potato voice, tripod w/ drooling
63
tx for acute epiglottitis
emergency airway and rifampin
64
croup aka
acute laryngotracheobronchitis
65
s/s of acute laryngotracheobronchitis
- common in children from 6 mos - 5 yrs - sublottic edema from infection - inspiratory stridor, seal like bark cough
66
s/s peritonsillar abcess
- usually unilateral | - fever, sore throat, trismus, pooling salive, cervical adenopathy
67
tx for peritonsillar abcess
drain and antibiotics
68
most common potentially life threatening upper airway infxn in children
bacterial thracheitis
69
s/s bacterial thracheitis
- airway edema and copious purulent secretions leading to airway obstruction - may be sudden or preceded by URI - tachypnea, stridor, fever, cough
70
tx for bacterial tracheitis
broad spectrum Antibiotic, endotracheal intubation
71
cause for retropharyngeal abscess
nasopharngeal infxn, penetrating local injury,
72
obstructive sleep apnea in children s/s
snoring, restlessness, sweating during sleep, failure to thrive, untreated heart, lung and behavioral problems
73
obstructive sleep apnea is mostly associated with
adenotonsillar hypertrophy
74
bronchiolitis in children most commonly associated with
RSV
75
Acute Lung Injury precedes the development of
ARDS from either indirect or direct injury - life threatening
76
Cystic Fibrosis is
- an autosomal multisystem disease due to chloride transport
77
s/s of CF
- 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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