CH 7: Principles of Pathology Flashcards
The volume of air that is moved in and out of the chest in a normal breath cycle is called:
tidal volume
In normal exhalation, the diaphragm and intercostal muscles relax to contract the chest, which creates a positive pressure. This is what type of process?
Passive
You respond to a patient who is choking on a foreign object. This would indicate that the problem is most likely in the ________ airway.
upper
What is the correct order of air flow from the nose to the alveoli in the lungs?
Nose, nasopharynx, hypopharynx, larynx, trachea, bronchi, alveoli
The disruption of lung tissue by mechanical forces or medical problems can upset diffusion, which is defined as:
the process of gas exchange between the alveoli and the capillaries.
Which of the following statements provides reasons for the disruption of respiratory control?
Stroke, infection, brain trauma, toxins and drugs, and neurologic disorders can interrupt this control.
What substances, when dissolved, separate into charged particles?
Electrolytes
When a person has an exaggerated response to a body invader, the person is said to have:
Hypersensitivity
-An exaggerated immune response is referred to as hypersensitivity, which is also known as an allergic reaction.
Production of energy occurs in what part of the cell?
Mitochondria
Graves’ disease is an example of a condition caused by:
too many hormones
Question content area top
Part 1
A 19-year-old male is reported to have taken too many narcotic pain pills that were prescribed for his recent knee surgery. He is extremely sleepy with very shallow breathing. His color is pale and his SpO Subscript 2 reading is 84 percent. His body is probably attempting to compensate for his poor level of ventilatory effort by stimulating the respiratory system to increase rate and tidal volume. Normally, respiratory drive is triggered by changing levels of:
carbon dioxide
The sympathetic nervous response causes which of the following to occur?
Breathing becomes faster and deeper, blood vessels constrict, heart beats stronger and faster, skin sweats, pupils dilate, and skin becomes pale.
________ blood returns to the right side of the heart.
Deoxygenated
A 12-year-old female patient is having an asthma attack after participating in some strenuous activity during recess at school. She’s taken several doses of her own bronchodilator with little relief. Your partner immediately administers oxygen. Providing supplemental oxygen will increase the amount of oxygen molecules carried by the ________ in her blood, helping oxygenate critical organs like the brain.
hemoglobin
You are caring for a 25-year-old male patient who has been shot once in the head. The patient is in extremis (near the point of death) with a noticeable breathing pattern that alternates between no breathing and fast breathing. Your understanding of pathophysiology leads you to believe the breathing pattern may be due to damage to the section of his brain responsible for respiratory control, also known as the:
medulla oblongata.
Plasma oncotic pressure is created by the movement of which of the following?
large proteins
The basic nutrient of the cell and the building block for energy is:
glucose
The metabolism that creates large amounts of carbon dioxide and lactic acid but generates little energy is called:
aerobic.
-anaerobic metabolism is the result of glucose being metabolized without enough oxygen; it produces much more waste such as lactic acid and far less energy.
A 59-year-old male has suffered a severe laceration from a circular saw while cutting wood in his garage. Upon your arrival, you find the patient sitting on the floor in a pool of blood. He is extremely pale. Based on your knowledge of pathophysiology, you would expect his body to try to compensate for the blood loss in all of the following ways, except:
Constricted pupils
-The sympathetic nervous response would cause the pupils to dilate not constrict.
the potential space between the lung and chest wall is called the:
pleural space.
-Although the lungs are in direct contact with the inner walls of the chest, there is a slight space between the lung tissue and chest wall called the pleural space.
Digestive disorders can seriously impact nutrient transfer and:
hydration levels
A decreased number of red blood cells is a condition called:
anemia
When the body’s water moves from the bloodstream into the interstitial space, this can often be seen as:
edema
-When water migrates out of the bloodstream and cells and into the interstitial space, it can be seen in the form of edema.
Carbon dioxide is transported back to the lungs via:
Plasma
-Some carbon dioxide is dissolved in the blood plasma and transported back to the lungs.
Not all inspired air reaches the alveoli; 150 mL is stopped in the airway leading to the alveoli. This is called:
dead air space
-Air that occupies the space between the mouth and alveoli, but that does not actually reach the area of gas exchange is call dead air space.
The process by which glucose and other nutrients are converted into energy is called:
metabolism
-The conversion of glucose into energy is an essential process of metabolism.
The net result of respiratory challenges is low oxygen, also called ________, within the body.
hypoxia
-The condition of low oxygen in the body is called hypoxia
The most vulnerable part of the cell is the:
membrane
-The cell membrane is the most vulnerable element of the cell. Many disease processes alter its permeability, or its ability to effectively transfer fluids, electrolytes, and other substances in and out of the cell.
The pressure that is created within the blood vessels when the heart beats is called:
hydrostatic pressure.
-When the heart beats, it creates hydrostatic pressure which pushes fluid back out of the blood vessels toward the cells.
What is a patent airway?
A term used by EMS practitioners to indicate that the patient has a secured and opened airway necessary for life
The balance between oncotic pressure and hydrostatic pressure is critical to regulating:
blood pressure and cell hydration.
-The balance between the pulling-in force of plasma oncotic pressure and the pushing-out force of hydrostatic pressure is critical to regulating both blood pressure and cell hydration.
Stroke volume depends on a series of factors: one is the force the myocardial muscle exerts to move the blood. This is known as:
contractility
-Contractility is the force of contraction; that is, how hard the heart squeezes. The more forceful the muscle squeezes, the greater the stroke volume.
Water that is found in the space between cells and blood vessels is called:
Interstitial water
-Interstitial water, found between the cells and vessels in the body, makes up about 25% of the total water volume.
If a hole is created in the chest wall, air could escape or be drawn in, or if bleeding develops within the chest, air and blood can accumulate in the pleural space. This would force the lung to:
collapse
- If bleeding develops within the chest, blood can accumulate in the pleural space and force the lung to collapse away from the chest wall. This can also occur if a hole in either the lung or the chest wall (or both) allows air to accumulate between the lung and the chest wall.
In the normal drive to breathe, chemoreceptors are stimulated by:
high carbon dioxide
-Normally, respiration or the need to breathe is triggered in the brain by chemoreceptors detecting increasing carbon dioxide levels.
What element does the cell need in order to not dehydrate and die?
Water
-Water moves into a cell from the environment around it. Without enough water, the cell will dehydrate and die.
The movement of ions across the cell membrane is needed to accomplish repolarization. What cell structure is used to prepare for depolarization?
Sodium potassium pump
- Ions are moved across cell membranes by the sodium potassium pump mechanism.
Your patient is an 86-year-old male with congestive heart failure. He called for help tonight because he cannot breathe and feels like he is “drowning in his own lungs.” The patient has had several heart attacks in the past and he tells you his “heart is shot.” What is not a likely reason the patient’s cardiac output is diminished?
Chemoreceptors are signaling that he has high levels of carbon dioxide in his bloodstream.
A patient breathing in room air should be receiving ________ percent oxygen.
21
-Typically, inhaled air contains about 79% nitrogen and 21% oxygen.
Which of the following is an indicator that a patient’s nervous system has been impaired?
Changes in pupil dilation
Hearing disturbances
General weakness
You and your EMT partner respond to a local shipping warehouse for a worker who was hit by a falling crate. Upon arrival, you find the man lying on the concrete floor of the facility, alert and oriented but unable to move or even feel his legs below the waist. Based on the mechanism of injury and the symptoms, which of the patient’s body systems would you suspect has been impaired?
nervous system
-Mechanical damage to the spine and other nervous pathways results in disruption of nervous system communication. That means when a nervous pathway is damaged, movement, sensation, and even automatic functions like breathing and blo
In Type 1 diabetes, which gland does not secret enough of the hormone insulin?
Pancreas
Daniel has been performing landscaping on a hot, humid summer day when he suddenly becomes dizzy and feels like he might faint. This disruption of fluid balance is most likely caused by:
Dehydration
-Dehydration is an abnormal decrease in the total amount of water in the body. This may be caused by a decreased fluid intake or a significant loss of fluid from the body by one or more of a variety of means.
Janie is having difficulty breathing. Her current tidal volume is 350 mL, and she is breathing at 28 times per minute. What would be her minute volume?
9,800 mL
-The minute volume is calculated by multiplying the tidal volume by respiratory rate; 350 mL × 28 = 9,800 mL.
Shock occurs as a result of which of the following?
Inadequate perfusion
-Inadequate perfusion is referred to as hypoperfusion, which is considered to be a synonym for shock.
Nausea, vomiting, and diarrhea are common ________ disorders.
digestive
Injuries to the brain and spinal cord, sepsis, and systemic allergic reactions can cause what similar cardiovascular problem?
loss of tone
-Loss of tone, or vasodilation, can be caused by brain and spinal cord injuries, severe allergies, or sepsis.
The seat of respiratory control is found in the:
medulla oblongata.
-A section of the brain called the medulla oblongata is the seat of respiratory control. From time to time, disorders that affect this portion of the brain can interfere with respiratory function.
What is the type of metabolism that occurs when energy is created with a balance of adequate oxygen and nutrients?
aerobic
-Metabolism that occurs in the presence of sufficient oxygen and nutrients is called aerobic metabolism.
The cellular structure that is responsible for synthesizing proteins is the:
endoplasmic reticulum.
-The endoplasmic reticulum plays a key role in the synthesizing of proteins in the cell.
An infection of the protective covering for the brain and spinal cord is called:
meningitis.
What is the best description of the chest’s mechanical functions?
The chest is a closed space with only one opening; the trachea, to inspire air; the diaphragm contracts down and the intercostal muscles expand the ribs, causing a negative pressure that fills the lungs with air.
What do chemoreceptors found in the body and vascular system measure?
Low oxygen and high carbon dioxide
-Chemical sensors in the brain and blood vessels that identify low levels of oxygen and high levels of carbon dioxide are called chemoreceptors.
Certain blood vessels that contain specialized sensors that detect the level of internal pressure and transmit messages to the nervous system, which then triggers the smooth muscle in the vessel walls to make any needed size adjustments. These sensors are called:
stretch receptors
-Certain blood vessels contain specialized sensors called stretch receptors that detect the level of internal pressure and transmit messages to the nervous system, which then triggers the smooth muscle in the vessel walls to make any needed size adjustments.
An infection of the brain is called:
encephalitis.
Your patient is a 22-year-old female who accidentally ate some shellfish and is now having a severe reaction. She tells you that the last time she ate shellfish, “They had to put a breathing tube in my throat and I almost died.” Her face is starting to swell up and you can hear audible wheezing when she breathes. The chemical that produces edema and narrowing of the airways during hypersensitivity reactions like this is called:
histamine
-Severe allergic reactions can occur when chemicals like histamine are released, which can produce edema and narrowing of the airways.
The respiratory system moves air in and out; however, to ________ cells, the air that is inhaled must meet up with the circulatory system.
perfuse
-The respiratory system moves air in and out, but to perfuse cells the air that is breathed in must meet up with blood.
You are on the scene at a local park where a 51-year-old male is reported to be confused and having difficulty walking. Your partner notes that the patient is wearing a bracelet indicating he is diabetic. Upon questioning, the patient is able to report that he has not eaten in 8 hours. Your knowledge of pathophysiology suggests that the patient may be suffering from a diabetic emergency. Glucose is a building block for what form of energy in the cell?
ATP
-Adenosine triphosphate (ATP) is the energy created in the mitochondria of the cell when glucose and other nutrients are converted.
When carbon dioxide is not exchanged, the net result is high carbon dioxide, a condition called ________, within the body.
hypercapnia
Our blood transports oxygen from the lungs to the cells and returns with what byproduct of metabolism?
carbon dioxide
- One of the primary waste products of metabolism is carbon dioxide, which is transported back to the lungs in the blood stream and released through exhalation.
What best defines adenosine triphosphate (ATP)?
It is the form of energy produced in the endoplasmic reticulum and is the cell’s engine responsible for all cell function.
-ATP, which is produced in the mitochondria, is essentially the cell’s internally created fuel and is responsible for powering all the other cellular functions.
What is FiO2
The concentration of oxygen in our inhaled air, which is referred to as the fraction of inspired oxygen
-The concentration of oxygen in the air we breathe in is referred to as the fraction of inspired oxygen, or FiO2.
The human body is made up of ________ percent water.
60
