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Anatomy and Physiology-DNP > Alterations of pulmonary function > Flashcards

Alterations of pulmonary function Flashcards

1
Q

Kussmaul respirations (hyperpnea)

A

-Slightly increased ventilatory rate, very large tidal volume, and no expiratory pause

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2
Q

Restricted breathing

A

disorders that stiffen the lungs or chest wall and decrease compliance

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3
Q

Cheyne-stokes respirations

A

alternating periods of deep and shallow breathing; apnea lasting 15-60 seconds

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4
Q

Hypoventilation

A

Leads to respiratory acidosis from hypercapnea

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5
Q

Hyperventilation

A

Leads to respiratory alkalosis from hypocapnia

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6
Q

Cyanosis

A
  • Peripheral-poor circulation. Best observed in nail beds

- Central-decreased arterial O2 (low PaO2). Best observed in buccal mucous membranes and lips

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7
Q

Pleural pain

A
  • most common from pulmonary diseases
  • Sharp or stabbing
  • Infection and inflammation of the parietal pleura can cause pain when pleura stretch during inspiration and accompanied by pleural friction rub
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8
Q

Hypercapnea

A
  • Increased Co2

- Decreased drive to breathe or an inadequate ability to respond to ventilatory stimulation

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9
Q

Hypoxemia

A

Hypoxemia vs. hypoxia

  • Ventilation-perfusion abnormalities: most common cause
  • Shunting
  • Alveolar dead space
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10
Q

Shunting

A
  • Abnormal communication between left and right sides of heart or from pulmonary and systemic vessels allowing blood from one circulatory system to another
  • Right to left shunt-allows deoxygenated systemic venous blood to bypass the lungs and return to the body.
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11
Q

Alveolar dead space

A

area where alveoli are ventilated but not perfused

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12
Q

Flail chest

A

Instability of a portion of the chest wall from rib or sternal fractures

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13
Q

Pneumothorax

A
  • Presence of air or gas in the pleural space
  • Primary (spontaneous) pneumo: Occurs unexpectedly
  • Secondary pneumo: caused by disease, trauma, injury, or condition
  • Iatrogenic pneumo: medical treatments, esp from needle aspirations
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14
Q

Tension pneumo

A

-acts as a one way valve-permitting air to enter but not escape.

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15
Q

S/S and Tx of pneumo

A
  • Sudden pleural pain, tachypnea, mild dyspnea, tension
  • Tension pneumo: severe hypoxemia, tracheal deviation away from affected lung and hotn
  • Tx: CT, if persistent air leak-surgery, thorascopic surgical techniques
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16
Q

Pleural effusions

A

-Presence of fluid in the pleural space
-Transudative effusion: watery and diffuses out of capillaries
-Exudative effusion: contains high concentrations of WBC’s and plasma proteins
Tx: thoracentesis, CT and surgery
-Dyspnea, chest pain

17
Q

Empyema

A
  • Infected pleural effusion
  • Pus in pleural space
  • Cyanosis, fever, tachy, cough and pleural pain
  • Tx: administration of antimicrobial meds, drainage
  • Severe cases-US guided pleural drainage, instillation of fibrinolytic agents or DNase injected in pleural space
18
Q

Aspiration

A
  • More common to happen in right lower lobe

- Supplemental O2-may require PEEP, steroids w/in first 72 hours, abx

19
Q

Atelectasis

A
  • Collapse of lung tissue
  • Dyspnea, cough, fever, and leukocytosis
  • Tx: prevention, deep breathing
20
Q

Bronchiectasis

A
  • Persistent abnormal dilation of the bronchi
  • Chronic productive cough
  • Tx: surgery, chest physiotherapy, supplemental O2, sputum culture abx, bronchodilators, antiinflammatory drugs
21
Q

Bronchiolitis

A
  • diffuse inflammation of small airways or bronchioles
  • Most common in children
  • Occurs in adults w/ chronic bronchitis, or those w/ viral infection or who’ve inhaled toxic gases
22
Q

Pulmonary fibrosis

A
  • Excessive amount of fibrous or connective tissue in the lung
  • Tx: corticosteroids, combined tx w/ cytotoxic drugs, antifibrotic drugs, interferon and anticoagulants, lung transplantation
23
Q

Pulmonary edema pathophysiology

A
  • Injury to capillary endothelium
  • Increased capillary permeability, and disruption of surfactant production by alveoli
  • Movement of fluid and plasma proteins from capillary to interstitial space (alveolar septum) and alveoli
24
Q

Pulmonary edema patho w/ valves

A
  • Valvular dysfunction, coronary artery disease, LV dysfunction
  • Increased left atrial pressure
  • Increased pulmonary capillary hydrostatic pressure
25
Q

Pulmonary edema patho w/ blockage

A
  • Blockage of lymphatic vessels
  • inability to remove excess fluid from interstitial space
  • Accumulation of fluid interstitial space
26
Q

Acute lung injury/acute respiratory distress syndrome w/in 72 hours

A

(exudative or inflammatory): Alveolocapillary membrane damage, increased capillary membrane, pulmonary edema, surfactant inactivated

27
Q

ALI/ARDS: W/in 4-21 days

A

-Proliferative: Resolution of the pulmonary edema and proliferation of type 2 pneumocytes, fibroblasts, and myofibroblasts, hyaline membranes, hypoxemia

28
Q

ALI/ARDS: w/in 14-21 days:

A

-Fibrotic: remodeling and fibrosis. Alveoli destruction, severe right to left shunting, acute respiratory failure

29
Q

Early asthmatic response

A
  • IgE causes mast cells to degranulate, releasing a large number of inflammatory mediators
  • Vasodilation, increased capillary permeability, mucosal edema, bronchial smooth muscle contraction, tenacious mucous secretion
  • IL-5 stimulates the activation of eosinophils-contributes to increased bronchial hyperresponsiveness, fibroblast proliferation epithelial injury and airway scarring
30
Q

Emphysema

A
  • Abnormal permanent enlargement of the gas-exchange airways accompanied by the destruction of the alveolar walls w/out obvious fibrosis
  • Loss of elastic recoil
31
Q

Pulmonary Embolism

A
  • Occlusion of a portion of the pulmonary vascular bed by a thrombus, embolus, tissue fragment lipids or air bubble
  • Commonly arise from DVT
  • Virchow triad: venouse stasis, hypercoagulability, and injuries to the endothelial cells that line the vessels
  • tx: Filter in the IVC, embolectomy, anticoagulation, O2 and fluids
32
Q

S/S PE

A

-Pleural chest pain, dyspnea, tachypnea, tachycardia, and unexplained anxiety

33
Q

Cor Pulmonale

A
  • Secondary to PAH
  • RV enlargement
  • Pulmonary htn creating chronic pressure overload in the right ventricle
34
Q

Non-small cell lung cancer

A
  • Nonproductive cough or hemoptysis (squamous cell carcinoma)
  • Large cell carcinoma-undifferientiated-surgical therapy, radiation and chemo aren’t helpful
  • Adenocarcinoma-tumor arising from glands
35
Q

Mesotheliomas

A
  • Associated w/ asbestos

- May take 20-40yrs before cancer appears

Anatomy and Physiology-DNP (18 decks)

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