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Patho Exam 4 > CH 15: Altered Ventilation > Flashcards

CH 15: Altered Ventilation Flashcards

1
Q

process of moving air into and out of the trachea, bronchi, and lungs

A

Ventilation

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2
Q

process of moving and exchanging the oxygen acquired during ventilation with carbon dioxide waste across the alveolar–capillary membranes.

A

Diffusion

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3
Q

process of supplying oxygenated blood to the lungs and organ systems via the blood
vessels.

A

Perfusion

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4
Q

process in which cells throughout the body use oxygen aerobically to make energy.

A

Respiration

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5
Q

defense mechanisms of the pulmonary systems

A

protective structures
mucosal lining of airway
irritant receptors
immune protections

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6
Q

protective structures ex and uses

A

such as hairs and turbinates (shell-shaped structures) in the nose and cilia in the upper and lower airwayswhich trap and remove foreign particles from the air

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7
Q

mucosal lining use

A

warms and humidifies air

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8
Q

irritant receptors uses

A

recognize injurious agents and respond by triggering a sneeze or cough reflex to remove foreign particles

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9
Q

immune protections ex and uses

A

immune coating in the respiratory tract mucosa and
macrophages in the alveoli
which ingest and remove bacteria and other foreign materials via phagocytosis

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10
Q

pulmonary circulation is responsible for:

A

delivering oxygen and other nutrients to the lung tissues
filtering clots, air, or other foreign materials from circulation

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11
Q

facilitate the exchange or O2 and carbon dioxide

A

capillaries near the alveoli

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12
Q

ventilation is regulated by

A

 Respiratory control centers in the brain
 Lung receptors
 Chemoreceptors

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13
Q

respiratory control centers comprise:

A

neurons in the pons and medulla, which send neural
impulses to the diaphragm
intercostal muscles, sternocleidomastoid muscles
other accessory muscles, causing them to contract or relax.

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14
Q

ANS innervates the lungs by:

A

acts on the smooth muscles of the conducting airways to promote airway constriction (parasympathetic division) or dilation (sympathetic division).

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15
Q

neural impulses are direct by:

A

lung receptors that map the current state of breathing and lung function

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16
Q

role of epithelium sensing receptors

A

cough reflex

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17
Q

role of smooth muscle sensing receptors

A

make you exhale to prevent excessive lung inflation

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18
Q

roles of capillary receptors

A

detect increase in capillary pressure and reduce pressure

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19
Q

role of chemoreceptors

A

detect gas exchange needs based on the partial pressures of oxygen (PaO2) and carbon dioxide (PaCO2), along with the pH levels in the blood and cerebrospinal fluid (CSF).
– then alter rate of breathing

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20
Q

if blood levels become too acidic ____

A

respiratory drive increases to blow off the CO2

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21
Q

most sensitive to oxygen levels in the arterial blood

A

peripheral chemoreceptors

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22
Q

how do you measure ventilation

A

pulmonary function tests

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23
Q

what is a pulmonary function test

A

noninvasive tests that show how well the lungs are working. The tests measure lung volume, capacity, rates of flow, and gas exchange.
This information can help your healthcare provider diagnose and decide the treatment of certain lung disorders.

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24
Q

results of PFT are dependent on

A

Age, sex, race, ethnicity, height

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25
Q

the amount of air that is exhaled after passive inspiration –
adults approximately 500 mL

A

Total Lung Capacity

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26
Q

the maximal amount of air that can be moved in and out of the lungs with forced inhalation and exhalation.

A

Vital Capacity

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27
Q

the maximal amount of air that can be expired from the lungs in 1 second.

A

FEV1

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28
Q

A problem of blocking airflow in and out of the lungs, thereby restricting oxygen intake and carbon dioxide removal from the body.

A

impaired ventilation

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28
Q

A problem of blocking airflow in and out of the lungs, thereby restricting oxygen intake and carbon dioxide removal from the body.

A

impaired ventilation

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29
Q

2 mechanisms of impaired ventilation

A

compression or narrowing of airways disruption of neural transmission needed to stimulate the mechanics of breathing

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30
Q

compression or narrowing of the airways

A

o can occur anywhere between the mouth and alveoli
o trouble with airway clearance
o occlusion can be partial or complete

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31
Q

ex of compression or narrowing of the airways

A

 inflammation
 edema
 exudate
 structural narrowing
 strangulation
 foreign body

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32
Q

ex of disruption of the neural transmissions needed to stimulate the mechanics of breathing.

A

 Oversedation or overdose of medication
 Damage to respiratory center of brain, cervical nerves, or thoracic nerves
 Examples severing cervical nerves requires mechanical ventilation

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33
Q

expected breathing patter characterized by a rate between 10-20 breaths per min in adultsreason for occurence:

A

eupnea

effective and responsive gas exchange

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34
Q

rapid, shallow breathing characterized bu a rate of breathing above 24 breaths per min in adults reason for occurrence:

A

tachypnea

body needs to release extra carbon dioxide

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35
Q

cessation of breathing for 10 sec or longer
reason for occurrence:

A

apnea

can result from brain injury, premature birth, or obstructive process during sleep

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36
Q

increase in the rate and depth of breathing leads to hyperventilation
reason for occurrence:

A

hyperpnea (Kussmal respirations)

excess carbon dioxide needs to be released

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37
Q

slow breathing with regular depth and rate
reason for occurrence:

A

bradypnea - hypoventilation

drug-induced depression
increased intracranial pressure
diabetic coma

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38
Q

a breathing pattern that alternate hyperpnea and apnea
reason for occurrence:

A

cheyne-stokes

increased intracranial pressure
bilateral damage to breathing areas
drug induced resp depression
heart failure
uremia

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39
Q

a breathing pattern of unpredictable irregularity
reason fro occurrence:

A

ataxic breathing

severe head trauma and damage to resp center
brain abscess
heat stroke
spinal meningitis
encephalitis

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40
Q

prolonged and incomplete expiration to overcome increased airway resistance and air trapping
reason for occurrence:

A

obstructive breathing

COPD
asthma
chronic bronchitis

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41
Q

Problem with the transfer of oxygen or carbon dioxide across the alveolar-capillary junction

A

impaired diffusion

42
Q

When the body is unable to keep up with the demands, this can lead to

A

 Hypoxemia
 Hypoxia
 Hypercapnia

43
Q

decreased oxygen in arterial blood

A

hypoxemia

44
Q

causes of hypoxemia

A

o Oxygen deprivation
o Hypoventilation
o Inadequate perfusion
o Inadequate uptake in oxygen in the blood
o Mild to severe

45
Q

When cells that depend on oxygen for cellular metabolism are deprived of oxygen

A

hypoxia

46
Q

consequences of hypoxia

A

 Particularly bad for brain, heart, lungs with high oxygen demands
 Cell function reduced
 When it causes anaerobic metabolism - Leads to metabolic acidosis
 Can lead to cell death

47
Q

increase CO2 in the blood

A

hypercapnia

48
Q

local manifestations of impaired ventilation and diffusion

A

-vasodilation, increased capillary permeability, exudate formation, and pain in the affected region of the airways, lungs, or chest cavity.
o Cough
o Excess mucus
o Hemoptysis
o Dyspnea
o Use of accessory muscles
o Chest pain
o Barrel chest

49
Q

noninvasive test that measures oxygen saturation

A

pulse oximetry

50
Q

direct visualization of bronchioles; can be used to take biopsy, take sputum samples, or remove foreign objects from airway

A

bronchoscopy

51
Q

used to detect structural problems, presence of consodilation, obstruction, or cavitation in the airways and lung tissue

A

radiograph, CT, MRI

52
Q

detects pulmonary embolism and lung disease, such as emphysema and COPD, by using a nuclear medicine camera and computer imaging

A

nuclear lung scan

53
Q

determines presence and type of microorganisms in the blood and/or sputum; the results dictate appropriate antibiotic treatment if indicated

A

culture and sensitivity

54
Q

determines presence of pleural effusion by inserting a needle from chest or back in lung pleural space
fluid is examined

A

thoracentesis

55
Q

The principles that guide improving ventilation are based on:

A

 Removing obstructions (i.e., foreign body, tumor, edema)
 2Restoring the integrity of the chest wall, lungs, and other respiratory structures
 3Decreasing inflammation
 Decreasing, thinning, and moving mucus out of the airway
 Opening and maintaining integrity of the airways
 Supplementing oxygen
 Controlling infectious processes
 Using mechanical ventilation, as indicated

56
Q

reduces inflammatory response by acting on chemical mediators to decrease excess blood flow, swelling, heat, redness, and pain to affected area

A

anti-inflammatory meds

57
Q

when to use anti-inflammatory meds

A

inflammation that impinges on ventilatory function suc has with asthma

58
Q

moistens and liquifies secretion to aid in expectoration

A

humidification

59
Q

when to use humidification

A

with the presence of excessive, thick, and sticky mucous

60
Q

decreases nasal congestion through vascular vasoconstriction, which decreases blood flow, reduces exudate, and shrinks swollen mucous membranes

A

decongestants

61
Q

when to use decongestants

A

with the presence of excessive, thick, and sticky mucous

62
Q

suppressive cough by inhibiting cough receptors in the medulla

A

antitussives

63
Q

when to use antitussives

A

when cough is excessive and interferes with sleep

64
Q

opens airway by relaxing bronchial smooth muscles

A

bronchodilators

65
Q

when to use bronchodilators

A

conditions that cause bronchoconstriction: asthma, COPD

66
Q

using a pounding motion or vibration on the chest to physically loosen thick secretions

A

chest physiotherapy

67
Q

when to use chest physiotherapy

A

conditions that result in thick, tenacious secretions such as in CF

68
Q

antibiotics have a range of mechanisms focused on destroying or reducing impact of bacteria; antivirals may also be prescribed as appropriate

A

antimicrobials

69
Q

when to use antimicrobials

A

bacterial infection

70
Q

provides direct oxygen supplementation

A

oxygen therapy

71
Q

when to use oxygen therapy

A

hypoxia

72
Q

life support measure that provides the work of breathing

A

mechanical ventilation

73
Q

when to use mechanical ventilation

A

respiratory failure

74
Q

surgical treatment of altered ventilation and diffusion

A

surgical removal of abnormal tissues or structures within the chest

75
Q

 Inflammation of the lungs – bronchioles, intersitial lung tissue, alveoli
 Older and young people, immunosuppressed or hospitalized are at risk
 Top cause of death in the US

A

pneumonia

76
Q

Failure of the lungs to provide enough oxygen to the body and remove carbon dioxide

A

respiratory failure

77
Q

total lack of O2

A

anoxia

78
Q

clinical manifestations of pneumonia

A

 fever, chills, cough, sputum production, fatigue, loss of appetite, dyspnea, tachypnea, tachycardia, pleuritic pain, and adventitious breath sounds caused by fluid accumulation
 Crackles bs
 Confusion – sometimes first sign
 Different colors of sputum

79
Q

rust colored sputum

A

pneumococcal

80
Q

green colored sputum

A

haemophilus or pseudomonas

81
Q

treatment of pneumonia

A

 Goal is to restore ventilation and diffusion
 Antibiotic or 2 – macrolide
 IV fluids dehydration

82
Q

generic term that describes all chronic obstructive lung problems, including asthma, emphysema, and chronic bronchitis, separately or in combination.
one of leading causes of death

A

COPD

83
Q

irreversible enlargement of the air spaces beyond the terminal bronchioles,
 most notably in the alveoli, resulting in destruction of the alveolar walls and obstruction of
airflow.

A

emphysema

84
Q

most notable cause of emphysema

A

chronic smoking

85
Q

development of emphysema is often due to

A

genetically inherited deficiency of alpha-1 antitrypsin (AAT).

86
Q

sources of respiratory obstructions

A

 Development of inflammation of small airways
 loss of elastic recoil in the alveoli is the primary mechanism of airflow obstruction.
 Vascular changes in the lungs develop simultaneously along with the airway obstruction.
 inner lining of the arteries and arterioles that perfuse the lungs becomes thick and fibrotic.
 Air trapping

87
Q

lung consequences of chronic smoking

A

The elasticity of the lung is significantly reduced leading to the inability of the alveoli to recoil and release CO2 into the atmosphere.

88
Q

loss of elasticity affects:

A

ability of the alveoli to contract and move air back out of the body.

89
Q

air trapping decreases

A

effective O2 intake and especially CO2 release.

90
Q

clinical manifestations of emphysema

A

 Chronic cough upon waking
 Dyspnea and wheezing with exertion
 Barrel chest
 Pursed lip breathing to increase pressure in the airways

91
Q

diagnostic tests for emphysema

A

 PFTs
 Increase respiration rate
 Cyanosis
 Peripheral edema
 Hyperinflation on chest xray

92
Q

treatment of emphysema

A

 Goal is to maintain lung function
 Smoking cessation
 Bronchodilators
 Steroids
 Mucolytics
 Supplemental oxygen

93
Q

presence of a persistent, productive cough with excessive mucus production that lasts for 3 months or longer for two or more consecutive years.

A

chronic bronchitis

94
Q

most common cause of chronic bronchitis

A

smoking or environmental

95
Q

Chronic bronchitis results from several changes in the bronchi and bronchioles of the lungs in response to chronic injury including:

A

Chronic inflammation and edema of the airways
Hyperplasia of the bronchial mucous glands and smooth muscles
Destruction of cilia
Squamous cell metaplasia
Bronchial wall thickening and development of fibrosis

96
Q

clinical manifestastions of chronic bronchitis

A

 Chronic cough
 Purulent sputum
 Dyspnea with exertion
 Prolonged expiratory phase
 Wheezing and crackles
 Hypoxemia, hypercapnia, cyanosis

97
Q

diagnostics for chronic bronchitis

A

 Productive cough for 3 months or more in 2 years
 Recurrent upper and lower respiratory infections
 Polycythemia – compesatory to chronic hypoxemia
 PFTs = reduce FEV and prolonged FET

98
Q

treatment for chronic bronchitis

A

 Goal is to improve or maintain lung function
 Stop smoking
 Bronchodilators, steroids, mucolytics, Oxygen

99
Q

chronic inflammatory disorder of the airways that results in intermittent or persistent airway obstruction because of bronchial hyperresponsiveness, inflammation, bronchoconstriction, and
excess mucus production.

A

asthma

100
Q

possible causes of asthma

A

-increased in individuals who are frequently exposed to
environmental allergens, such as cigarette smoke or dust mites.
 inflammatory and immune response is often stimulated through exposure to an allergen.
 There’s also exercise induced asthma – exercise triggers a bronchospasm
 Trigger exposure – IgE mediated hypersensitivity reaction

101
Q

clinical manifestations of asthma

A

 Hyperreactivity and inflammation
 Times of remission and exacerbation
 In times of exacerbation, hyperreactivity and inflammation in the airways causes wheezing, breathlessness, chest tightness, excessive sputum production, and coughing, particularly at night or in the early morning
 During an asthma episode, the individual may exhibit anxiety, tachypnea, and the use of accessory muscles. Hyperventilation initially leads to respiratory alkalosis; however, compensation is usually temporary, and acidosis develops because of ineffective expiration.
Even with partial airway obstruction, hypoxia quickly results.

102
Q

diagnostics for asthma

A

 Evidence of respiratory distress
 Pulsus paradoxus, an exaggerated decrease in systolic blood pressure during inspiration
 Wheezing breath sounds
 A prolonged expiratory phase
 Atopic dermatitis, eczema, or other allergic skin conditions that may indicate hypersensitivities
 Eosinophilia – WBC present during allergic response
 Use of spirometry PEFR peak expiratoryu flow rate – Peak flow meter
 Xray shows hyperinflation or infiltrates in the lungs

103
Q

During diffusion, two major processes are occurring simultaneously:

A

(1) Oxygen is trying to get to all cells
(2) carbon dioxide is trying to escape the body through the lungs.

Patho Exam 4 (2 decks)

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