ch27: alterations of pulmonary function Flashcards
what are the purposes of the pulmonary system?
- oxygenate blood
- release CO2
- maintain pH
eupnea
normal breathing, rhythmic, and effortless
dyspnea
breathing discomfort, difficulty breathing, labored breathing, shortness of breath
what are severe signs of dyspnea?
flaring of nostrils, use of accessory muscles for respiration
apnea
temporary cessation of breathing
tachypnea
rapid shallow breathing
orthopnea
dyspnea that occurs during heart failure when a person lies flat
paroxysmal nocturnal dyspnea (PND)
awakening at night gasping for air, needed to sit or stand to relieve the dyspnea
hyperpnea (kussmaul respiration)
increased ventilatory rate, large tidal volumes, no expiratory pause
- caused by strenuous exercise or metabolic acidosis
labored breathing (what breathing sound can you hear?)
increased work of breathing, especially if the airways are obstructed (can hear stridor)
restricted breathing
usually WITHIN lung tissue; associated with disorders
cheyne stokes respiration
alternating periods of deep and shallow breathing
- result from any condition that reduces blood flow to the brainstem OR heart failure
hypoventilation
inadequate alveolar ventilation in relation to metabolic demands
- CO2 removal < CO2 production
hyperventilation
ventilation exceeding metabolic demands
- CO2 removal > CO2 proudction
hypercapnia
hypoventilation of alveoli –> excessive CO2 in blood stream
hypocapnia
not enough CO2 in bloodstream
respiratory acidosis
accumulation of CO2 in the bloodstream (<7.35)
respiratory alkalosis
not enough of CO2 in the bloodstream (>7.35)
cough
protective reflex that helps clear the airways by an explosive expiration
- productive
- non productive
hemoptysis
coughing up blood; usually indicates inflammation or infection of bronchi
cyanosis
bluish discoloration of the skin and mucous membranes (increased amounts of desaturated hemoglobin)
digital clubbing
selective bulbous enlargement of the end of a digit
- commonly associated with disease that disrupt the normal pulmonary circulation
why does mouth to mouth resuscitation work?
body releases around 10% of O2 inhaled
hypoxemia
lack of O2 in the blood
- can result from hyperventilation and/or diffusion abnormalities
v/q ratio
ratio of ventilation to perfusion
low v/q
impaired ventilation leads to hypoxemia
shunting (very low v/q)
blocked ventilation and collapsed alveolus lead to hypoxemia
high v/q
impaired perfusion and alveolar dead space lead to hypoxemia
acute respiratory failure
inadequate gas exchange
- PaO2 < 50mmHg, PaCO2 > 50mmHg
pulmonary edema
excess fluid in the lung
aspiration
could be own secretion or anything that impairs the ability of the body to bring in air
atelectasis
collapsed lung
what are two types of atelectasis
- compression atelectasis
2. absorption atelectasis
compression atelectasis
force from outside injury causes lung to collapse
absorption atelectasis
air is drawn out of lungs too quickly, collapses from inside force
bronchiectasis
common in patients with emphysema; (CAN’T EXHALE PROPERLY); persistent abnormal dilation of the bronchi
bronchiolitis
diffuse, inflammatory obstruction of the small airways
bronchiolitis obliterans organizing pneumonia (BOOP):
complication of bronchiolitis where alveoli and bronchioles become filled with plugs of connective tissue
pneumothorax
air between pleura
what are two types of pneumothorax?
- open pneumothorax
2. tension pneumothorax
open pneumothorax
“communicating” → air in between pleura can get in and out (air pressure in pleura matches outside pressure)
tension pneumothorax
air cannot get in and out (air between pleura much greater)
pleural effusion
water in the pleural cavity
what are three types of effusion?
- transudative
- exudative
- empyema
transudative effusion
watery
exudative effusion
full of proteins; turbid
empyema
pus between pleural layers
pleurisy (pleuritis)
inflammation of the pleura
pulmonary edema
left heart failure → back up of blood to the pulmonary system
pulmonary fibrosis
scar tissue infiltration of the lungs bc of
- smoking
- infectious disease
- lung cancer
chest wall restriction
when something is impeding inhalation
flail chest
inhale → air from one lung → other lung → exhale → goes back to the other lung = asynchronous inflation and deflation
what are the 4 types of inhalation disorders?
- toxic gas exposure
- oxygen toxicity
- pneumoconiosis
- allergic alveolitis
toxic gas exposure
exposure to toxic gas (carbon monoxide) can damage lung tissue
oxygen toxicity
toxic free radicals → body can’t detoxify fast enough
pneumoconiosis
inflammation of lung tissue; inorganic material is causing the damage - ASBESTOS; scarring and pulmonary fibrosis → can lead to lung cancer
allergic alveolitis
inflammation of the lung tissue; organic material is directly affecting immune system
acute respiratory distress syndrome (ARDS)
alveolar capillary membrane injury → shunting, pulmonary edema, hypoxemia
massive, acute inflammation of lungs
covid-19
ace2 receptor (supposed to break down angiotensin ii → accumulation → large scale inflammation and scar tissue
what is worse with obstructive pulmonary diseases?
expiration
what are 4 types of obstructive pulmonary diseases?
- asthma
- chronic bronchitis
- emphysema
- chronic obstructive pulmonary disease (COPD)
pneumonia
acute infection of lower respiratory tract Many causes (bacterial, fungal, viral)
tuberculosis
caused by Mycobacterium tuberculosis; can grow inside of macrophage (really like O2)
acute bronchitis
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
pulmonary embolism
usually a thromboembolism (could have originated somewhere else)
may lead to infarction of lung tissue
what is virchow’s triad
- venous stasis
- vessel injury
- hypercoagulability
pulmonary hypertension
high BP in pulmonary arteries
primary hypertension
idiopathic
secondary hypertension
defined cause
cor pulmonale
problem in the right ventricle → can get HYPERTROPHIED or DISTENDED, can become both
