Chap 22, 23, 24, 25, 26, 27, and 28 Flashcards
1
Q
Anatomic Alternations of the lungs of Flail Chest
A
- Double fracture of at least three or more adjacent ribs
- Causes chest wall to become unstable
- Affected ribs cave in during inspiration
- In a restrictive disorder
2
Q
Major pathologic or structural changes of the lungs in Flail chest
A
- Double fracture of numerous adjacent ribs
- Ribs instability
- Lung Volume Restriction
- Atelectasis
- Lung Collapse (pneumothorax)
- Lung Contusion
- Secondary pneumonia
3
Q
Etiology and Epidemiolgy of Flail Chest
A
- Blunt or crushing chest wall injuries
- Paradoxic movements of the chest wall
- Chest wall pain (usually intense with inspiration)
- Diminished BILATERAL breath sounds (due to small Vt’s)
- CXR
- Often accompanied with pneumothorax due to rib puncturing the pleural cavity and lung
4
Q
General management of Flail chest
A
Mild cases: -Pain med -Lung expansion therapy a. Incentive spirometry b. IPPB -O2 therapy- maybe refractive to O2 therapy do to atelectasis and capillary shunting Severe cases: -Intubation -Volume control ventilator with PEEP -General need to be on vent. for 5-10 days for ribs to heal -Pain control
5
Q
CXR flail chest
A
- Increased opacity
- rib fractures
- Increased density (whiter) because of atelectasis
6
Q
Blunt or crushing chest wall injuries causing Flail chest
A
- MVA
- Falls
- Blast injuries
- Industrial accidents
7
Q
Anatomic alternations of the lungs in Pneumothorax
A
- Exists when gas (free air) accumulates in the pleural space
- Visceral and parietal pleura separates
- Tendency for lung to recoil or collapse
- Tendency for chest wall to expand
- lung collapses with ensuing Atelectasis
- Greater veins maybe compressed causing diminished venous return to the heart and impaired cardiac output
- Is a RESTRICTIVE DISORDER
8
Q
Major Pathologic and structural changes in Pneumothorax
A
- Gas enters pleural space
- Gas accumulation normally is in the apex and works down
- Closed pneumothorax
- Open pneumothorax
- Tension pneumothorax
- Hemothorax
- Traumatic Pneumothorax
- Spontaneous pneumothorax
- Iantrogenic pneumothorax
9
Q
Closed pneumothorax
A
Gas is NOT in direct contact with atmosphere
10
Q
Open pneumothorax
A
Direct contact with atmospheric gas
11
Q
Tension pneumothorax
A
- Contact with atmosphere during inspiration, but NOT expiration
- Most potentially dangerous
- Quickly impairs cardiac funtion by squeezing the heart and major vessels
12
Q
Hemothorax
A
- Blood accumulation in the pleural space
- Normally settles in the bases
13
Q
Traumatic pneumothorax
A
- Penetrating wounds to the chest wall
- Sucking chest wound (open)
- One-way valve type (closed) normal leads to tension pneumothorax
14
Q
Spontaneous pneumothorax
A
- Sudden, without obvious cause
- Tall, thin people between the age 15-35
a. Due to high negative pleural pressure
b. Normal occurs in the apex
c. can occur for pneumonia , COPD, TB
15
Q
Iatrogenic pneumothorax
A
- Occurs during invasive procedures such as thoracentesis
- High peak airway pressures with ventilators
- High tidal volumes
16
Q
Clinical Manifestations of Pneumothorax
A
- Absent breath sounds over affected lung
- CXR changes
- Increased translucency with pneumothorax
- Increased density with hemothorax
- Mediastinal shift to AFFECTED side in pneumothorax
- Mediastinal shift AWAY from affected side in Tension Pneumothorax
- Depressed diaphragm if pneumothorax affects entire lung
- Atelectasis
17
Q
Mediastinal shift to affected side in
A
pneumothorax
18
Q
Mediastinal shift away from affected side in
A
tension pneumothorax
19
Q
General Management of pneumothorax
A
- 20% or less= Bed rest or limited activity, Reabsorption occurs within 30 days
- Larger than 20%
- One way valve (allows air to escape during inhalation)
- Chest tube
- Waterseal suction (pneuomVac)
- Use 28 to 36 Fr. Thoracostomy tube
- Usually 3rd intercostal space for pneumothorax
- 4-5th intercostals spaces for hemothorax
- O2 therapy
- Lung expansion therapy
- Pleurodesis
20
Q
Waterseal suction (pneumoVac)
A
a. -5 to -12 cmH2O pressure (suction
b. Once lung is expanded, bubbling ceases in PneumoVac
c. Leave to just H2O seal for 24 to 48 hours then use 28 to 36 Fr thoracostomy tube
21
Q
Intercostal spaces for hemothorax
A
4-5th
22
Q
Intercostals space for pneumothorax
A
usually 3rd
23
Q
O2 therapy in pneumothorax
A
Treat hypoxia
Maybe refractive to O2 because of shunting
24
Q
Lung expansion therapy in pneumothorax
A
- Incentive spirometry
- IPPB CONTAINDICTED
- maybe on volume control ventilator with mild PEEP
- Deep breathing and ambulation
25
Pleurodesis
- Thoracentesis injection of drug/chemical into pleural space
- Causes inflammation
- Results in adhesion of visceral and parietal pleura
- Painful post procedure!!
26
In flail chest, which of the following occurs?
1. Tidal volume increases
2. Atelectasis often occurs
3. Intrapulmonary shunting occurs
4. Pneumothorax is rare
2. Atelectasis often occurs
3. Intrapulmonary shunting occurs
(tidal volume decreases)
27
When a patient has a severe fail chest which of the following occurs
cardiac output decreased
| central venous pressure increases
28
A flail chest consists of a double fracture of at least
three adjacent ribs
29
Which of the following resp care techniques is/ are commonly used in the tx of severe flail chest
Intubation with continuous mandatory ventilation
| Postitive end-expiratory pressure/continuous positive airway pressure (PEEP/CPAP)
30
When mechanical ventilation is used to stabilize a flail chest, how much time generally is needed for adequate bone healing to occur
5-10 days
31
When gas moves between the pleural space and the atmosphere during a ventilatory cycle, the patient is said to have a(n)
Closed pneumothorax
32
When gas enters the pleural space during inspiration but is unable to leave during expiration, the patient is said to have a(n)
Valvular pneumothorax
| Tension pneumothorax
33
Which of the following may cause a pneumothorax?
1. pneumonia
2. tuberculosis
3. COPD
4. Blebs
34
When a patient has a pneumothorax because of a sucking chest wound, which of the following occurs?
2. The mediastinum often moved to the unaffected side
3. Intrapleural pressure on the affected side often rises above the atmospheric pressure during expiration
4. The mediastinum often moves to the affected side during expiration
35
The increased ventilatory rate commonly manifested in patients with pneumothorax may result from which of the following?
1. Stimulation of the J receptors
2. Increased lung compliance
3. Increased stimulation of the Hering-Breuer reflex
4. Stimulation of the irritant reflex
1. Stimulation of the J receptor
| 4. Stimulation of the irritant reflex
36
The physician usually elects to evacuate the intrathoracic gas when the pneumothorax is greater than:
20%
37
During treatment of a pneumothorax with a chest tube and suction, the negative (suction) pressure usually need not exceed:
-12cmH2O
38
A patient with a severe tension pneumothorax demonstrates which of the following on the affected side?
1. Diminished breath sounds
2. Hyperresonant percussion note
3. Dull percussion not
4. Whispered perctoriloqy
1. Diminished breath sounds
| 2. Hyperresonant percussion note
39
When a patient has a large tension pneumothorax, which of the following occurs?
PA increases
40
Which of the following is or are associated with exudative effusion
- Inflammation
| - Disease of the pleural surfaces
41
Which of the following is probably the most common cause of a transudative pleural effusion
CHF
42
A hemothorax is said to be present when the hematocrit of the pleural fluid is at least
50%
43
What percentage of patients with pulmonary emboli develop pleural effusion
30-50%
44
Which of the following is or are associated with pleural effusion?
- Decreased FRC
| - Decreased VC
45
Pleural effusion and empyema will produce what kind of lung disorder?
Restrictive lung disorder
46
Major pathologic or structural changes associated with pleural effusion are:
- Lung compression
- Atelectasis
- Compression of the great veins and decreased cardiac venous return
47
Transudate effusion:
- Fluid from pulmonary capillaries moves into the pleural space
- Fluid is thin and watery, containing few blood cells and protein
- Pleural surfaces are not involved
48
Exudate effusion
- Pleural surfaces are diseased
- Fluid has high protein count and cellular debris
- Usually caused by inflammation, infection, or malignancy
49
What kind of curvature of the spine is manifested in kyphosis
Posterior
50
Kyphoscoliosis affects approximately what percentage of the U.S. population
2%
51
```
Which of the following is/are associated with kyphoscoliosis?
1. Diminished breath sounds
2. Dull percussion note
3. Decreased tactile fremitus
4. Bronchial breath sounds
A. 1
B. 2
C. 1, 3
D. 2, 4
```
D. 2, 4
Patients with kyphoscoliosis will exhibit a dull percussion note and bronchial breath sounds because of atelectasis. They will also have increased tactile fremitus.
52
What do ABG look like in advanced kyphoscoliosis?
normal pH, +HCO, +PaCO2
53
Which of the following is another name for hypersensitivity pneumonitis
pg 373
54
Which of the following is commonly located near a central bronchus or hilus and projects into the large bronchi?
Squamous cell carcinoma
55
Which of the following arises from the mucous glands of the tracheobronchial tree?
Adenocarcinoma
56
Which of the following carcinomas has the strongrst correlation with cig smoking
Small cell carcinoma(oat cell)
57
Which of the following has the fastest growth (doubling) rate
Small cell carcinoma
58
Which of the following is or are associated with bronchogenic carcinoma?
1. Alveolar consolidation
2. Pleural effusion
3. Alveolar hyperinflation
4. Atelectasis
Alveolar Consolidation
Pleural Effusion
Atelectasis
59
Which of the following is another name for hypersensitivity pneumonitis?
Extrinsic Allergic Alveolitis
60
Which of the following is or are considered pulmonary vasculitides?
1. Rheumatoid arthritis
2. Wegeners granulomatosis
3. Lymphomatoid granulomatosis
4. Churg-Strauss Syndrom
Wegener's Granulomatosis
Lymphomatoid Granulomatosis
Churg-Strauss Syndrome
61
What disorder is associated with desquamative interstitial pneumonia and usual interstitial pneumonia
Idiopathic Pulmonary Fibrosis
62
Which of the following is/are systemic connective tissue diseases?
Rheumatoid arthritis
| Sjorgen's syndrome
63
Which of the following pulmonary function study findings is or are associated with chronic interstitial lung disease?
1. Increased FRC
2. Decreased FEVT
3. Increased RV
4. Decreased FVC
Decreased FEVT
| Decreased FVC
64
Which of the following hemodynamic indices is or are associated with advanced or severe interstitial lung disease?
1. Increased CVP
2. Decreased PCWP
3. Increased PA
4. Decreased RAP
Increased CVP
| Increased Mean Pulmonary Arterial Pressure (PA)
65
Which of the following chest assessment findings is associated with interstitial lung disease?
a. Diminished BS
b. Hyperresonant percussion note
c. Decreased tactile fermitus
d. Bronchial breath sounds
Bronchial breath sounds
66
which of the following oxygenation indices is or are associated with the pneumoconioses?
1. Decreased C(a-v)O2
2. Increased O2ER
3. Decreased SvO2
4. Increased SvO2
Increased O2ER
| Decreased SvO2
67
The fibrotic changes that develop in coal worker's pneumoconiosis usually result from which of the following?
Silica
68
Which of the following are associated with interstitial lung disease?
1. Pleural friction rub
2. Dull percussion note
3. Cor pulmonale
4. Elevated Mean Pulmonary Arterial Pressure
Pleural friction rub
Dull percussion note
Cor pulmonale
Elevated Mean Pulmonary Arterial Pressure
69
Cancer is a general term that refers to
abnormal new tissue growth characterized by the progressive, uncontrolled multiplication of cells.
The abnormal growth of new cells is called a neoplasm or tumor.
A tumor may be localized or invasive, benign or malignant.
70
Which tumors do not endanger life unless they interfere with the normal functions of other organs or affect a vital organ?
Benign
71
Which tumors are composed of embryonic, primitive, or poorly differentiated cells. They grow in a disorganized manner and so rapidly that nutrition of the cells becomes a problem?
Malignant
72
Necrosis, ulceration and cavity formation are commonly associated with which tumors?
Malignant
73
True/False.
Malignant tumors also invade surrounding tissues and may be metastatic.
They most commonly originate in the mucosa of the tracheobronchial tree.
TRUE
74
A tumor that originates in the bronchial mucosa is called?
Bronchogenic Carcinoma.
75
What are the Anatomical Alterations of the Lungs associated with Cancer of the Lung?
```
The major pathologic or structural changes associated with bronchogenic carcinoma are:
Inflammation, swelling, and destruction of the bronchial
airways and alveoli.
Excessive mucus production.
Tracheobronchial mucosa accumulation and plugging.
Airway obstruction:
Blood
Mucus accumulation
Tumor projecting into a bronchus
Atelectasis
Alveolar consolidation
Cavity formation
Pleural effusion
```
76
What are the Environment/Occupational risk factors associated with Cancer of the Lung?
```
Uranium mining
Radiation/nuclear fallout
Polycyclic aromatic hydrocarbons and arsenicals
Asbestos fibers
Diesel exhaust
Nickel
Silica
Air pollution
Coal and iron mining
```
77
What are the 2 types of cancer?
```
-Non-Small Cell Lung Carcinoma (NSCLC)
Squamous Cell Carcinoma
Adenocarinomas
Large-Cell Carcinomas (Undifferentiated)
-Small-Cell Lung Carcinoma (SCLC)
Small Cell (or Oat Cell) Carcinoma
Combined Small Cell
Mixture of Small Cell and Non-Small Cell Carcinoma
```
78
What are the 2 types of cancer?
```
-Non-Small Cell Lung Carcinoma (NSCLC)
Squamous Cell Carcinoma
Adenocarinomas
Large-Cell Carcinomas (Undifferentiated)
-Small-Cell Lung Carcinoma (SCLC)
Small Cell (or Oat Cell) Carcinoma
Combined Small Cell
Mixture of Small Cell and Non-Small Cell Carcinoma
```
79
Pleural Effusion Anatomic alternations of the lung
- Fluid accumulates in the pleural space
- Fluid is called; Pleural effusion
- Fluid separates visceral and parietal pleura and compresses lung
- Atelectasis, compression of the greater veins, and diminished cardiac venous return may develop
80
Etiology and epidemiology of pleural effusion
- Chest pain- can occur early when there is inflammation of the pleural surface
- Chest pressure- occurs in greater then 500-1500ml of effusion fluids
- Cough develops due to atelectasis
81
Transudative effusion Etiology and Epidemiology
- Fluid from pulmonary capillaries(CHF)
- Thin watery/ clear
- Few RBC's
- Little protein
- no bacteria
82
Exudative effusion etiology and epidemiolgy
- Caused by inflammation, infection, or malignancy
- high in protein
- high in cellular debris
- may be high in bacteria
83
Common causes of Transudate Effusion
```
CHF
-Right or left sided failure
-Increased hydrostatic pressure
-Fluids from pulmonary capillaries
HEPATIC HYDROTHORAX
-Hepatic cirrhosis
-free fluid in abdomen
-General result in right sided pleural effusion
NEPHRITIC SYNDROME
-Generally bilateral
-result from decrease oncotic pressure
PULMONARY EMBOLI
-Obstructive of pulmonary vasculature causes R. sided heart failure
-pulmonary infarct causes increased permeability on visceral pleura
```
84
Common causes of Exudate Effusion
MALIGNANT PLEURAL EFFUSION
-highly associated with breast and gynecologic malignancies (women)
MESOTHELIOMAS
-Asbestosis exposure
BACTERIA PNEUMONIAS
-Empyema develops if not reated with antibiotic therapy
TB
FUNGUS DISEASE
CHYLOTHORAX (milky white)
-Normal malignant tumor occlusion of the thoracic duct in lymphatic system
HEMOTHORAX (blood)
85
Best way to diagnose Pleural effusion
```
CXR
Findings-
Blunting of the costophrenic angle
Fluid level on the affected side
Depressed diaphragm
possible mediastinal shift to unaffected side
Atelectasis
Meniscus sign
```
86
Best way to treat pleural effusion
first treat the underlying cause!
| -Improve cardiac function then when found infection treat with antibiotic therapy
87
General management of pleural effusion
- Treat underlying cause
- Thoracentesis
- Chest tube
- O2 therapy
- hyper expansion therapy
- Mechanical ventilation
- Pleurodesis
88
Thoracentesis
Drainage of the pleural effusion
89
Chest tube size
28 to 36 fr
| inserted between 4-5 intercostal space, midaxillary
90
Pleurodesis
(if you cant stop) Chemically adherence of the visceral and parietal pleura
91
Biggest complication of thoracentesis
hypotension
92
Kyphosis
Posterior curvature of spine, forward bend
93
Scoliosis
Curvature to one side, S or C shape, lateral deformation
94
Kyphoscoliosis causes deformation to
the thorax/ spine, Compression of the lung, Alveolar hypoventilation and atelectasis, impaired cough and secretion clearance, May cause mediastinal shift in same direction
95
Kyphoscoliosis is a what disorder
restrictive
96
Congential scoliosis
Formation of the spine or fused ribs during fetal development
97
Neuromuscular scoliosis
- Muscle weakness or paralysis
| - cerebral palsy, muscular dystrophy, spina bifida, poliomyelitis
98
Idiopathic scoliosis
- unkown cause
- infantile, during first 3 years of life
- juvenile, age 4 to adolescene
- Adolescent, after age 10
99
Diagnosis of kyphoscoliosis
- Medical history
- Physical exam
- xray
- Curve measurement; cobb angle
100
Curve measurement
cobb angle
101
General Management
```
Braces
-Boston
-Charleston
-Milwaukee
Surgery
-Spinal fusion: fuse spine discs
-Rodd instrumentation: rodd straighten spine
```
3-12 months and lots of PT
102
Interstitial lung disease (ILD) refers to
a broad group of inflammatory lung disorders
-More than 180 disease entities are characterized by acute, subacute, or chronic inflammatory infiltration of alveolar walls by cells, fluid, and CT
103
If ILD left untreated,
the inflammation process can progress into irreversible pulmonary fibrosis- thickening of alveoli, alveolar capillary space
104
ILD is a what disorder
restrictive, obstructive, or combined pulmonary disorder (most prevalent is restrictive)
105
ILD may involve the
bronchi, alveolar walls, and adjacent alveolar spaces
106
Acute stages of ILD
General inflammatory condition characterized by edema, and infiltration of WBC's on the alveolar walls and interstitial spaces
107
Chronic stage of ILD
- Further interstitial thickening, fibrosis, granulomas
| - May develop into honeycombed or cavity formation
108
Structural changes of ILD
- Destruction of the alveoli and adjacent pulmonary capillaries
- Fibrotic thickening of the resp bronchioles, alveolar dusts (farmer lungs), and alvioli
- Granulomas
- Honeycombing or cavitation formation
- Fibrocalcific pleural plaques (Asbestosis)
- Bronchospasm
- Excessive bronchial secretions
109
Intertitial lung disease of known causes or associations
-Occupational, Environmental, and Therapeutic Exposures
110
Occupational, Environmental, and Therapeutic Exposures
- Inorganic particulate dust exposure
- Coal dust
- Silicosis
- Beryllium
- Organic material exposure
- Medications and illicit drugs
- Radiation therapy
111
Systemic dieseases
Connective tissue diseases
- Scleroderma
- Rheumatoid arthritis
- Sjogrens syndrome
- Polymyotis dermatomyositis
- Systemic lupus erthermatosus
- Sarcoidosis
112
Etiology and epidemiology of ILD
1. Intertitial lung diseases of known causes or associations
2. Systemic diseases
3. Idiopathic Interstitial Pneumonias
4. Specific Pathology
5. Miscellaneous Diffuse interstitial lung diseases
113
Idiopathic interstitial pneumonias (ILDs)
- Idiopathic pulmonary fibrosis
- Cryptogenic organizing pneumonia
- Lymphocytic Interstitial pneumonia
114
Specific pathology of (ILDs)
- Lymphangioleiomyomatosis (LAM)
- Pulmonary langerhans cell histiocytosis
- Pulmonary alveolar proteinosis
- Pulmonary Vasculitides
115
Miscellaneous Diffuse Interstitial lung diseases
- Goodpastures syndrome
- Idiopathic pulmonary hemosiderosis
- chronic eosiophilic pneumonia
116
General management of ILD
Corticosteroids
O2 therapy
Mech vent
Plasmaphereis (good pastures syndrome)
117
Cancer
Refers to abnormal new tissue growth characterized by the progressive, uncontrolled multiplication of cells
118
Neoplasm or tumor
abnormal grow of the new cells
119
a tumor maybe
- localized
- invasive
- Benign
- Malignant
120
Begnin Tumors
Do not endanger life unless they interfere with normal functions of other organs
- They grow slowly and push tissue aside, but dont invade it
- Usually capsulated
- Not invasive or metastatic
- Do not travel via the blood system or lymphatic system
121
Malignant tumors
Composed of embryonic, primitive, or poorly differentiated cells
- grow in disorganized manner and rapidly
- invade surrounding tissue and may be metastatic
- in the lung, they common form in the mucosa of the bronchopulmonary tree
122
Malignant tumor , in the lung, common form in the mucosa of the bronchopulmonary tree is called
bronchogenic carcinoma
123
Tumors may protrude into the
bronchopulmonary tree, excessive mucus production and airway obstruction
124
Tumors may invade
- pleural space
- Mediastinum
- Chest wall
- Ribs
- Diaphragm
125
Structure changes in lung cancer
- Inflammation, swelling , and destruction of the airways and alveoli
- Excessive mucus production
- mucus accumulation and plugging
- airway obstruction
- Atelectasis
- Alveolar consolidation
- pleural effusion
126
Among women, lung cancer is now
the leading cause of death compared to any other cancer form
127
most common cause of cancer
Cigarette smoking, heavy smoker are 64 times more likely to develop lung cancer
- second hand smoke increases the risk factor for lung cancer by 30%
128
Types of cancers
- Nonsmall cell carcinoma
| - Small cell carcinoma
129
Non-Smalll Cell carcinoma (NSCLC) - 3 types
- Squamous cell carcinoma
- Adenocarcinoma
- Large cell carcinoma
- -Is more common and accounts for 80% of lung cancer
- --Found early, is often surgically removed
130
Small cell carcinoma (SCLC) 1 type
Small cell or oat cell carcinoma
-Spreads aggressively and responds best to chemotherapy and radiation therapy
131
Squamous cell carcinomas
- Commonly located near a central bronchus or hilus
- Project into the large airways
- Easily seen via bronchoscope
- Slow growth rate and late metastatic tendency
- Surgical resection is preferred tx
- Persistent non productive cough or hemoptysis is common
132
Adenocarcinoma
- Arise from mucus glands of the tracheobronchial tree
- weakest association with smoking
- Commonly found in the peripheral regions of the lung parenchyma
- grow is moderate
- metastatic tendency is early
- Secondary cavity formation and pleural effusion are common
- if detected early, can be successful removed surgically
133
Large cell carcinoma
- Found centrally
- Often distort the trachea
- Rapid growth rate
- early and widespread metastasis
134
Small Cell Carcinoma
- Arise centrally near hilar region
- Grows rapidly and becomes larger
- Metastasizes early
- Poorest prognosis
- Strongest correlation to smoking
135
Screening and diagnosing lung cancer
-CXR then do
CT scan
Confirm positron emission tomography (PET) scan- specific for identifying cancers
Biopsy is only definitive dianosis
136
Small cell lung carvinomas
Limited
| Extensive
137
Limited- small cell lung carcinomas
Cancer is confined to only one lung and to its neighboring lymph nodes
138
Extensive- Small cell lung carcinomas
both lungs involved, lymph nodes, and other organs
139
Surgery for lung cancers
```
SURGERY
-Wedge section
-Segmentectomy
-Lobectomy
-Pneumonectomy
CHEMOTHERAPY
RADIATION THERAPY
PALLIATIVE CARE
```
140
Wedge section
partial removal of a lobe
141
Segmentectomy
removal of a lung segment
142
Lobectomy
removal of one lobe
143
Pneumonectomy
removal of entire lung
144
Bilobectomy
removal of two lung lobes
145
Chemotherapy
Primary treatment of SCLC
146
Radiation therapy
SCLC treatment
| LSCLC treatment if patient is NOT a surgical candidate
147
Palliative care
comfort measures treating symptoms of cancer and not the cancer itself= end stage
148
ARDS
inflammation process of the lung from an injury
| onset slow about 72hours
149
ARDS Anatomic alterations
- Pulmonary capillaries become engarged
- increased alveolar capillary permeability
- interstitial and intra alveolar edema and hemorrhage
- alveolar consolidation
- Intra alvolar hyaline membrane formation
- Pulmonary surfactant deficiency
- Atelectasis and increase surface tension
150
ARDS is a what disorder
Restrictive disorder and diffuse disorder
