Atelectasis

Question 1

What is atelectasis

Answer 1

it is the collapse of the lung tissue. it may part or in all of the lung. the alveoli are deflated down to little or no volume. It is can be described as a collapsed of the lung tissue.

Question 2

What are the causes for atelectasis

Answer 2

it can occur as a post operative complication or a result of surfactant deficiency

Question 3

What are the different types of atelectasis

Answer 3

Resorption, compression and surfactant deficiency

Question 4

What is Resorption Atelectasis

Answer 4

occurs when an obstruction prevents air from reaching the distal airways. the air gradually becomes absorbed and the alveolar collapse. it depends on the level of airway obstruction. Common cause is the obstruction of a bronchioles by mucous and muco-purulent Plug. Usually a postoperative complication with 24 hrs. clinical finding are fever and shortness of breath, absent breath sounds and treated with incentive spirometry

Question 5

What is compression Atelectasis ?

Answer 5

Associated with accumulation of fluid, blood, or air with the pleural cavity. Pleural effusion cause by congestive failure (CHF). Pneumothorax is league of air into the pleural cavity

Question 6

What are the signs or symptoms of atelectasis

Answer 6

SOB(dyspnea), Chest Pain, Cough, Hemoptysis

Question 7

What are signs of a respiratory diseases

Answer 7

Palpation, Tachypnea and lung sounds

Question 8

Where is the exchange of the gases in the lungs

Answer 8

Alveoli

Question 9

What is the structure of the respiratory unit

Answer 9

there is the capillary endothelium, Basement membrane, pulmonary interstitial: (fine elastic fibers, small bundles of collagen, a few fibroblast like cells, smooth muscle cells, mast cells, rate mononuclear cells) and the alveolar Epithelium

Question 10

What does the alveolar epithelia made of

Answer 10

Type 1 and type 2 pneumocytes

Question 11

What is the function of type 1 pneumocytes

Answer 11

it functions in the actual gas exchange between the alveoli and blood . the cells are flattened, platelike and cover 95% of the alveolar surface

Question 12

What is the function of type 2 pneumocytes

Answer 12

it functions in the secretion of the pulmonary surfactant that decreases the surface tension within the alveoli along with the repair of alveolar epithelia after damage to the type 1 and they tend to have a round shape.

Question 13

What are the different lung alveolar structures and their lung disease

Answer 13

airway disease = ventilation defects
Interstitum diseases = diffusion defects
Pulmonary disease = vasculature

Question 14

What happen when there is a lose of surfactant in a newborn

Answer 14

it is hyaline membrane disease or IRDS where there is a general loss of lung expansion and its duel to the loss of surfactant in the lamellar bodies.

Question 15

What does IRDS lead to

Answer 15

Decrease of surfactant in the fetal lungs, maternal diabetes that leads to metal hyperglycemia, increase in insulin release, counter reacts with corticosteroids and decrease surfactnace synsthesis.

C- section : no stress on the baby, no release of cortisol.

Question 16

What is Acute lung injury

Answer 16

is an inflammation of the lungs that can be life-threatening and Progress to ARDS

Question 17

What are the causes of ARDS?

Answer 17

Left Heat Failure, Nephrotic syndrome and liver cirrhosis.

There is also: 
Infection 
drowning
drugs
high altitude

Question 18

What is the progression of ARDS

Answer 18

acute one of shortness of breath
decreased arterial oxygen pressure/ PaO2 (hypoxemia)
Development of bilateral pulmonary infiltrates on the chest radiograph
no clinical evidence of primary left sided heart failure
may process to ARDS

Question 19

What are the MCC of Acute lung Injury

Answer 19

Gram Negative sepsis
Acute Pancreatitis
Near drowning

Question 20

What is the mechanism for actor lung injury

Answer 20

Under the Influence of Pro-inflammatory Cytokines such as Interleukins IL-8, IL-1 and Tumor Necrosis Factor (TNF), Released by Macrophages, Neutrophils Initially Undergo Sequestration in the Pulmonary Microvasculature, followed by Margination and Egress into the Alveolar Space, Where they Undergo Activation.
• Activated Neutrophils Release Chemical Mediators which Contribute to Local Tissue Damage, Accumulation of Edema Fluid in the Air Spaces, Surfactant Inactivation, and Hyaline Membrane Formation.
Subsequently, the Release of Macrophage-derived Fibrogenic Cytokines such as Transforming Growth Factor-β (Tgf-β) And Platelet-derived Growth Factor (PGDF) Stimulate Fibroblast Growth and Collagen Deposition Associated with Healing.

Question 21

What is ARDS

Answer 21

It is a clinical syndrome causes by diffused alveolar capillary and epithelial Damage. Rapid onset of life threatening respiration insufficiency, cyanosis, and severe arterial hypoxemia. the hypoxemia (low concentration) is refractory to oxygen therapy and may progress to mulitsystem organ failure.

Question 22

What is the pathogenesis of ARDS

Answer 22

There is endothelia and epithelial injury where the vascular permeability increases and causes alveolar flood. the macrophages release cytokines and cause neutrophils to migrate.there is production of hyaline membrane and decrease in surfactant

Question 23

How does ARDS look on an x- ray

Answer 23

Bilateral, intestinal and infiltrates

Question 24

What is the clinical features of ARDS

Answer 24

SOB, productive cough, white oink expectoration and fatigue.