ch27: alterations of pulmonary function

Question 1

what are the purposes of the pulmonary system?

Answer 1

1. oxygenate blood
2. release CO2
3. maintain pH

Question 2

eupnea

Answer 2

normal breathing, rhythmic, and effortless

Question 3

dyspnea

Answer 3

breathing discomfort, difficulty breathing, labored breathing, shortness of breath

Question 4

what are severe signs of dyspnea?

Answer 4

flaring of nostrils, use of accessory muscles for respiration

Question 5

apnea

Answer 5

temporary cessation of breathing

Question 6

tachypnea

Answer 6

rapid shallow breathing

Question 7

orthopnea

Answer 7

dyspnea that occurs during heart failure when a person lies flat

Question 8

paroxysmal nocturnal dyspnea (PND)

Answer 8

awakening at night gasping for air, needed to sit or stand to relieve the dyspnea

Question 9

hyperpnea (kussmaul respiration)

Answer 9

increased ventilatory rate, large tidal volumes, no expiratory pause
- caused by strenuous exercise or metabolic acidosis

Question 10

labored breathing (what breathing sound can you hear?)

Answer 10

increased work of breathing, especially if the airways are obstructed (can hear stridor)

Question 11

restricted breathing

Answer 11

usually WITHIN lung tissue; associated with disorders

Question 12

cheyne stokes respiration

Answer 12

alternating periods of deep and shallow breathing

- result from any condition that reduces blood flow to the brainstem OR heart failure

Question 13

hypoventilation

Answer 13

inadequate alveolar ventilation in relation to metabolic demands
- CO2 removal < CO2 production

Question 14

hyperventilation

Answer 14

ventilation exceeding metabolic demands

- CO2 removal > CO2 proudction

Question 15

hypercapnia

Answer 15

hypoventilation of alveoli –> excessive CO2 in blood stream

Question 16

hypocapnia

Answer 16

not enough CO2 in bloodstream

Question 17

respiratory acidosis

Answer 17

accumulation of CO2 in the bloodstream (<7.35)

Question 18

respiratory alkalosis

Answer 18

not enough of CO2 in the bloodstream (>7.35)

Question 19

cough

Answer 19

protective reflex that helps clear the airways by an explosive expiration

• productive
• non productive

Question 20

hemoptysis

Answer 20

coughing up blood; usually indicates inflammation or infection of bronchi

Question 21

cyanosis

Answer 21

bluish discoloration of the skin and mucous membranes (increased amounts of desaturated hemoglobin)

Question 22

digital clubbing

Answer 22

selective bulbous enlargement of the end of a digit

- commonly associated with disease that disrupt the normal pulmonary circulation

Question 23

why does mouth to mouth resuscitation work?

Answer 23

body releases around 10% of O2 inhaled

Question 24

hypoxemia

Answer 24

lack of O2 in the blood

- can result from hyperventilation and/or diffusion abnormalities

Question 25

v/q ratio

Answer 25

ratio of ventilation to perfusion

Question 26

low v/q

Answer 26

impaired ventilation leads to hypoxemia

Question 27

shunting (very low v/q)

Answer 27

blocked ventilation and collapsed alveolus lead to hypoxemia

Question 28

high v/q

Answer 28

impaired perfusion and alveolar dead space lead to hypoxemia

Question 29

acute respiratory failure

Answer 29

inadequate gas exchange | - PaO2 < 50mmHg, PaCO2 > 50mmHg

Question 30

pulmonary edema

Answer 30

excess fluid in the lung

Question 31

aspiration

Answer 31

could be own secretion or anything that impairs the ability of the body to bring in air

Question 32

atelectasis

Answer 32

collapsed lung

Question 33

what are two types of atelectasis

Answer 33

1. compression atelectasis | 2. absorption atelectasis

Question 34

compression atelectasis

Answer 34

force from outside injury causes lung to collapse

Question 35

absorption atelectasis

Answer 35

air is drawn out of lungs too quickly, collapses from inside force

Question 36

bronchiectasis

Answer 36

common in patients with emphysema; (CAN’T EXHALE PROPERLY); persistent abnormal dilation of the bronchi

Question 37

bronchiolitis

Answer 37

diffuse, inflammatory obstruction of the small airways

Question 38

bronchiolitis obliterans organizing pneumonia (BOOP):

Answer 38

complication of bronchiolitis where alveoli and bronchioles become filled with plugs of connective tissue

Question 39

pneumothorax

Answer 39

air between pleura

Question 40

what are two types of pneumothorax?

Answer 40

1. open pneumothorax | 2. tension pneumothorax

Question 41

open pneumothorax

Answer 41

“communicating” → air in between pleura can get in and out (air pressure in pleura matches outside pressure)

Question 42

tension pneumothorax

Answer 42

air cannot get in and out (air between pleura much greater)

Question 43

pleural effusion

Answer 43

water in the pleural cavity

Question 44

what are three types of effusion?

Answer 44

1. transudative 2. exudative 3. empyema

Question 45

transudative effusion

Answer 45

watery

Question 46

exudative effusion

Answer 46

full of proteins; turbid

Question 47

empyema

Answer 47

pus between pleural layers

Question 48

pleurisy (pleuritis)

Answer 48

inflammation of the pleura

Question 49

pulmonary edema

Answer 49

left heart failure → back up of blood to the pulmonary system

Question 50

pulmonary fibrosis

Answer 50

scar tissue infiltration of the lungs bc of - smoking - infectious disease - lung cancer

Question 51

chest wall restriction

Answer 51

when something is impeding inhalation

Question 52

flail chest

Answer 52

inhale → air from one lung → other lung → exhale → goes back to the other lung = asynchronous inflation and deflation

Question 53

what are the 4 types of inhalation disorders?

Answer 53

1. toxic gas exposure 2. oxygen toxicity 3. pneumoconiosis 4. allergic alveolitis

Question 54

toxic gas exposure

Answer 54

exposure to toxic gas (carbon monoxide) can damage lung tissue

Question 55

oxygen toxicity

Answer 55

toxic free radicals → body can’t detoxify fast enough

Question 56

pneumoconiosis

Answer 56

inflammation of lung tissue; inorganic material is causing the damage - ASBESTOS; scarring and pulmonary fibrosis → can lead to lung cancer

Question 57

allergic alveolitis

Answer 57

inflammation of the lung tissue; organic material is directly affecting immune system

Question 58

acute respiratory distress syndrome (ARDS)

Answer 58

alveolar capillary membrane injury → shunting, pulmonary edema, hypoxemia massive, acute inflammation of lungs

Question 59

covid-19

Answer 59

ace2 receptor (supposed to break down angiotensin ii → accumulation → large scale inflammation and scar tissue

Question 60

what is worse with obstructive pulmonary diseases?

Answer 60

expiration

Question 61

what are 4 types of obstructive pulmonary diseases?

Answer 61

1. asthma 2. chronic bronchitis 3. emphysema 4. chronic obstructive pulmonary disease (COPD)

Question 62

pneumonia

Answer 62

``` acute infection of lower respiratory tract Many causes (bacterial, fungal, viral) ```

Question 63

tuberculosis

Answer 63

caused by Mycobacterium tuberculosis; can grow inside of macrophage (really like O2)

Question 64

acute bronchitis

Answer 64

rapid onset, usually VIRAL, inflammation of the bronchioles - Usually resolves self fairly easily but can lead to more serious - Bark, cough, high pitched, non productive cough

Question 65

pulmonary embolism

Answer 65

usually a thromboembolism (could have originated somewhere else) may lead to infarction of lung tissue

Question 66

what is virchow's triad

Answer 66

1. venous stasis 2. vessel injury 3. hypercoagulability

Question 67

pulmonary hypertension

Answer 67

high BP in pulmonary arteries

Question 68

primary hypertension

Answer 68

idiopathic

Question 69

secondary hypertension

Answer 69

defined cause

Question 70

cor pulmonale

Answer 70

problem in the right ventricle → can get HYPERTROPHIED or DISTENDED, can become both