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Pathophysiology > Chap 22, 23, 24, 25, 26, 27, and 28 > Flashcards

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
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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
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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
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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
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5
Q

CXR flail chest

A
  • Increased opacity
  • rib fractures
  • Increased density (whiter) because of atelectasis
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6
Q

Blunt or crushing chest wall injuries causing Flail chest

A
  • MVA
  • Falls
  • Blast injuries
  • Industrial accidents
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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
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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
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9
Q

Closed pneumothorax

A

Gas is NOT in direct contact with atmosphere

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10
Q

Open pneumothorax

A

Direct contact with atmospheric gas

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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
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12
Q

Hemothorax

A
  • Blood accumulation in the pleural space

- Normally settles in the bases

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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
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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
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15
Q

Iatrogenic pneumothorax

A
  • Occurs during invasive procedures such as thoracentesis
  • High peak airway pressures with ventilators
  • High tidal volumes
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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
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17
Q

Mediastinal shift to affected side in

A

pneumothorax

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18
Q

Mediastinal shift away from affected side in

A

tension pneumothorax

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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
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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

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21
Q

Intercostal spaces for hemothorax

A

4-5th

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22
Q

Intercostals space for pneumothorax

A

usually 3rd

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23
Q

O2 therapy in pneumothorax

A

Treat hypoxia

Maybe refractive to O2 because of shunting

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24
Q

Lung expansion therapy in pneumothorax

A
  • Incentive spirometry
  • IPPB CONTAINDICTED
  • maybe on volume control ventilator with mild PEEP
  • Deep breathing and ambulation
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25
Q

Pleurodesis

A
  • Thoracentesis injection of drug/chemical into pleural space
  • Causes inflammation
  • Results in adhesion of visceral and parietal pleura
  • Painful post procedure!!
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26
Q

In flail chest, which of the following occurs?

  1. Tidal volume increases
  2. Atelectasis often occurs
  3. Intrapulmonary shunting occurs
  4. Pneumothorax is rare
A
  1. Atelectasis often occurs
  2. Intrapulmonary shunting occurs

(tidal volume decreases)

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27
Q

When a patient has a severe fail chest which of the following occurs

A

cardiac output decreased

central venous pressure increases

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28
Q

A flail chest consists of a double fracture of at least

A

three adjacent ribs

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29
Q

Which of the following resp care techniques is/ are commonly used in the tx of severe flail chest

A

Intubation with continuous mandatory ventilation

Postitive end-expiratory pressure/continuous positive airway pressure (PEEP/CPAP)

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30
Q

When mechanical ventilation is used to stabilize a flail chest, how much time generally is needed for adequate bone healing to occur

A

5-10 days

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31
Q

When gas moves between the pleural space and the atmosphere during a ventilatory cycle, the patient is said to have a(n)

A

Closed pneumothorax

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32
Q

When gas enters the pleural space during inspiration but is unable to leave during expiration, the patient is said to have a(n)

A

Valvular pneumothorax

Tension pneumothorax

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33
Q

Which of the following may cause a pneumothorax?

A
  1. pneumonia
  2. tuberculosis
  3. COPD
  4. Blebs
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34
Q

When a patient has a pneumothorax because of a sucking chest wound, which of the following occurs?

A
  1. The mediastinum often moved to the unaffected side
  2. Intrapleural pressure on the affected side often rises above the atmospheric pressure during expiration
  3. The mediastinum often moves to the affected side during expiration
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35
Q

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
A
  1. Stimulation of the J receptor

4. Stimulation of the irritant reflex

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36
Q

The physician usually elects to evacuate the intrathoracic gas when the pneumothorax is greater than:

A

20%

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37
Q

During treatment of a pneumothorax with a chest tube and suction, the negative (suction) pressure usually need not exceed:

A

-12cmH2O

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38
Q

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
A
  1. Diminished breath sounds

2. Hyperresonant percussion note

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39
Q

When a patient has a large tension pneumothorax, which of the following occurs?

A

PA increases

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40
Q

Which of the following is or are associated with exudative effusion

A
  • Inflammation

- Disease of the pleural surfaces

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41
Q

Which of the following is probably the most common cause of a transudative pleural effusion

A

CHF

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42
Q

A hemothorax is said to be present when the hematocrit of the pleural fluid is at least

A

50%

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43
Q

What percentage of patients with pulmonary emboli develop pleural effusion

A

30-50%

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44
Q

Which of the following is or are associated with pleural effusion?

A
  • Decreased FRC

- Decreased VC

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45
Q

Pleural effusion and empyema will produce what kind of lung disorder?

A

Restrictive lung disorder

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46
Q

Major pathologic or structural changes associated with pleural effusion are:

A
  • Lung compression
  • Atelectasis
  • Compression of the great veins and decreased cardiac venous return
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47
Q

Transudate effusion:

A
  • 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
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48
Q

Exudate effusion

A
  • Pleural surfaces are diseased
  • Fluid has high protein count and cellular debris
  • Usually caused by inflammation, infection, or malignancy
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49
Q

What kind of curvature of the spine is manifested in kyphosis

A

Posterior

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50
Q

Kyphoscoliosis affects approximately what percentage of the U.S. population

A

2%

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51
Q 
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
A

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.

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52
Q

What do ABG look like in advanced kyphoscoliosis?

A

normal pH, +HCO, +PaCO2

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53
Q

Which of the following is another name for hypersensitivity pneumonitis

A

pg 373

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54
Q

Which of the following is commonly located near a central bronchus or hilus and projects into the large bronchi?

A

Squamous cell carcinoma

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55
Q

Which of the following arises from the mucous glands of the tracheobronchial tree?

A

Adenocarcinoma

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56
Q

Which of the following carcinomas has the strongrst correlation with cig smoking

A

Small cell carcinoma(oat cell)

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57
Q

Which of the following has the fastest growth (doubling) rate

A

Small cell carcinoma

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58
Q

Which of the following is or are associated with bronchogenic carcinoma?

  1. Alveolar consolidation
  2. Pleural effusion
  3. Alveolar hyperinflation
  4. Atelectasis
A

Alveolar Consolidation
Pleural Effusion
Atelectasis

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59
Q

Which of the following is another name for hypersensitivity pneumonitis?

A

Extrinsic Allergic Alveolitis

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60
Q

Which of the following is or are considered pulmonary vasculitides?

  1. Rheumatoid arthritis
  2. Wegeners granulomatosis
  3. Lymphomatoid granulomatosis
  4. Churg-Strauss Syndrom
A

Wegener’s Granulomatosis
Lymphomatoid Granulomatosis
Churg-Strauss Syndrome

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61
Q

What disorder is associated with desquamative interstitial pneumonia and usual interstitial pneumonia

A

Idiopathic Pulmonary Fibrosis

62
Q

Which of the following is/are systemic connective tissue diseases?

A

Rheumatoid arthritis

Sjorgen’s syndrome

63
Q

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
A

Decreased FEVT

Decreased FVC

64
Q

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
A

Increased CVP

Increased Mean Pulmonary Arterial Pressure (PA)

65
Q

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

A

Bronchial breath sounds

66
Q

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
A

Increased O2ER

Decreased SvO2

67
Q

The fibrotic changes that develop in coal worker’s pneumoconiosis usually result from which of the following?

68
Q

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
A

Pleural friction rub
Dull percussion note
Cor pulmonale
Elevated Mean Pulmonary Arterial Pressure

69
Q

Cancer is a general term that refers to

A

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
Q

Which tumors do not endanger life unless they interfere with the normal functions of other organs or affect a vital organ?

71
Q

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?

72
Q

Necrosis, ulceration and cavity formation are commonly associated with which tumors?

73
Q

True/False.
Malignant tumors also invade surrounding tissues and may be metastatic.
They most commonly originate in the mucosa of the tracheobronchial tree.

74
Q

A tumor that originates in the bronchial mucosa is called?

A

Bronchogenic Carcinoma.

75
Q

What are the Anatomical Alterations of the Lungs associated with Cancer of the Lung?

A 
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
Q

What are the Environment/Occupational risk factors associated with Cancer of the Lung?

A 
Uranium mining
Radiation/nuclear fallout
Polycyclic aromatic hydrocarbons and arsenicals
Asbestos fibers
Diesel exhaust
Nickel
Silica
Air pollution
Coal and iron mining
77
Q

What are the 2 types of cancer?

A 
-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
Q

What are the 2 types of cancer?

A 
-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
Q

Pleural Effusion Anatomic alternations of the lung

A
  • 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
Q

Etiology and epidemiology of pleural effusion

A
  • 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
Q

Transudative effusion Etiology and Epidemiology

A
  • Fluid from pulmonary capillaries(CHF)
  • Thin watery/ clear
  • Few RBC’s
  • Little protein
  • no bacteria
82
Q

Exudative effusion etiology and epidemiolgy

A
  • Caused by inflammation, infection, or malignancy
  • high in protein
  • high in cellular debris
  • may be high in bacteria
83
Q

Common causes of Transudate Effusion

A 
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
Q

Common causes of Exudate Effusion

A

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
Q

Best way to diagnose Pleural effusion

A 
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
Q

Best way to treat pleural effusion

A

first treat the underlying cause!

-Improve cardiac function then when found infection treat with antibiotic therapy

87
Q

General management of pleural effusion

A
  • Treat underlying cause
  • Thoracentesis
  • Chest tube
  • O2 therapy
  • hyper expansion therapy
  • Mechanical ventilation
  • Pleurodesis
88
Q

Thoracentesis

A

Drainage of the pleural effusion

89
Q

Chest tube size

A

28 to 36 fr

inserted between 4-5 intercostal space, midaxillary

90
Q

Pleurodesis

A

(if you cant stop) Chemically adherence of the visceral and parietal pleura

91
Q

Biggest complication of thoracentesis

A

hypotension

92
Q

Kyphosis

A

Posterior curvature of spine, forward bend

93
Q

Scoliosis

A

Curvature to one side, S or C shape, lateral deformation

94
Q

Kyphoscoliosis causes deformation to

A

the thorax/ spine, Compression of the lung, Alveolar hypoventilation and atelectasis, impaired cough and secretion clearance, May cause mediastinal shift in same direction

95
Q

Kyphoscoliosis is a what disorder

A

restrictive

96
Q

Congential scoliosis

A

Formation of the spine or fused ribs during fetal development

97
Q

Neuromuscular scoliosis

A
  • Muscle weakness or paralysis

- cerebral palsy, muscular dystrophy, spina bifida, poliomyelitis

98
Q

Idiopathic scoliosis

A
  • unkown cause
  • infantile, during first 3 years of life
  • juvenile, age 4 to adolescene
  • Adolescent, after age 10
99
Q

Diagnosis of kyphoscoliosis

A
  • Medical history
  • Physical exam
  • xray
  • Curve measurement; cobb angle
100
Q

Curve measurement

A

cobb angle

101
Q

General Management

A 
Braces
-Boston 
-Charleston
-Milwaukee
Surgery
-Spinal fusion: fuse spine discs
-Rodd instrumentation: rodd straighten spine

3-12 months and lots of PT

102
Q

Interstitial lung disease (ILD) refers to

A

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
Q

If ILD left untreated,

A

the inflammation process can progress into irreversible pulmonary fibrosis- thickening of alveoli, alveolar capillary space

104
Q

ILD is a what disorder

A

restrictive, obstructive, or combined pulmonary disorder (most prevalent is restrictive)

105
Q

ILD may involve the

A

bronchi, alveolar walls, and adjacent alveolar spaces

106
Q

Acute stages of ILD

A

General inflammatory condition characterized by edema, and infiltration of WBC’s on the alveolar walls and interstitial spaces

107
Q

Chronic stage of ILD

A
  • Further interstitial thickening, fibrosis, granulomas

- May develop into honeycombed or cavity formation

108
Q

Structural changes of ILD

A
  • 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
Q

Intertitial lung disease of known causes or associations

A

-Occupational, Environmental, and Therapeutic Exposures

110
Q

Occupational, Environmental, and Therapeutic Exposures

A
  • Inorganic particulate dust exposure
  • Coal dust
  • Silicosis
  • Beryllium
  • Organic material exposure
  • Medications and illicit drugs
  • Radiation therapy
111
Q

Systemic dieseases

A

Connective tissue diseases

  • Scleroderma
  • Rheumatoid arthritis
  • Sjogrens syndrome
  • Polymyotis dermatomyositis
  • Systemic lupus erthermatosus
  • Sarcoidosis
112
Q

Etiology and epidemiology of ILD

A
  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
Q

Idiopathic interstitial pneumonias (ILDs)

A
  • Idiopathic pulmonary fibrosis
  • Cryptogenic organizing pneumonia
  • Lymphocytic Interstitial pneumonia
114
Q

Specific pathology of (ILDs)

A
  • Lymphangioleiomyomatosis (LAM)
  • Pulmonary langerhans cell histiocytosis
  • Pulmonary alveolar proteinosis
  • Pulmonary Vasculitides
115
Q

Miscellaneous Diffuse Interstitial lung diseases

A
  • Goodpastures syndrome
  • Idiopathic pulmonary hemosiderosis
  • chronic eosiophilic pneumonia
116
Q

General management of ILD

A

Corticosteroids
O2 therapy
Mech vent
Plasmaphereis (good pastures syndrome)

117
Q

Cancer

A

Refers to abnormal new tissue growth characterized by the progressive, uncontrolled multiplication of cells

118
Q

Neoplasm or tumor

A

abnormal grow of the new cells

119
Q

a tumor maybe

A
  • localized
  • invasive
  • Benign
  • Malignant
120
Q

Begnin Tumors

A

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
Q

Malignant tumors

A

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
Q

Malignant tumor , in the lung, common form in the mucosa of the bronchopulmonary tree is called

A

bronchogenic carcinoma

123
Q

Tumors may protrude into the

A

bronchopulmonary tree, excessive mucus production and airway obstruction

124
Q

Tumors may invade

A
  • pleural space
  • Mediastinum
  • Chest wall
  • Ribs
  • Diaphragm
125
Q

Structure changes in lung cancer

A
  • Inflammation, swelling , and destruction of the airways and alveoli
  • Excessive mucus production
  • mucus accumulation and plugging
  • airway obstruction
  • Atelectasis
  • Alveolar consolidation
  • pleural effusion
126
Q

Among women, lung cancer is now

A

the leading cause of death compared to any other cancer form

127
Q

most common cause of cancer

A

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
Q

Types of cancers

A
  • Nonsmall cell carcinoma

- Small cell carcinoma

129
Q

Non-Smalll Cell carcinoma (NSCLC) - 3 types

A
  • Squamous cell carcinoma
  • Adenocarcinoma
  • Large cell carcinoma
  • -Is more common and accounts for 80% of lung cancer
  • –Found early, is often surgically removed
130
Q

Small cell carcinoma (SCLC) 1 type

A

Small cell or oat cell carcinoma

-Spreads aggressively and responds best to chemotherapy and radiation therapy

131
Q

Squamous cell carcinomas

A
  • 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
Q

Adenocarcinoma

A
  • 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
Q

Large cell carcinoma

A
  • Found centrally
  • Often distort the trachea
  • Rapid growth rate
  • early and widespread metastasis
134
Q

Small Cell Carcinoma

A
  • Arise centrally near hilar region
  • Grows rapidly and becomes larger
  • Metastasizes early
  • Poorest prognosis
  • Strongest correlation to smoking
135
Q

Screening and diagnosing lung cancer

A

-CXR then do
CT scan
Confirm positron emission tomography (PET) scan- specific for identifying cancers
Biopsy is only definitive dianosis

136
Q

Small cell lung carvinomas

A

Limited

Extensive

137
Q

Limited- small cell lung carcinomas

A

Cancer is confined to only one lung and to its neighboring lymph nodes

138
Q

Extensive- Small cell lung carcinomas

A

both lungs involved, lymph nodes, and other organs

139
Q

Surgery for lung cancers

A 
SURGERY
-Wedge section
-Segmentectomy
-Lobectomy
-Pneumonectomy
CHEMOTHERAPY
RADIATION THERAPY
PALLIATIVE CARE
140
Q

Wedge section

A

partial removal of a lobe

141
Q

Segmentectomy

A

removal of a lung segment

142
Q

Lobectomy

A

removal of one lobe

143
Q

Pneumonectomy

A

removal of entire lung

144
Q

Bilobectomy

A

removal of two lung lobes

145
Q

Chemotherapy

A

Primary treatment of SCLC

146
Q

Radiation therapy

A

SCLC treatment

LSCLC treatment if patient is NOT a surgical candidate

147
Q

Palliative care

A

comfort measures treating symptoms of cancer and not the cancer itself= end stage

148
Q

ARDS

A

inflammation process of the lung from an injury

onset slow about 72hours

149
Q

ARDS Anatomic alterations

A
  • 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
Q

ARDS is a what disorder

A

Restrictive disorder and diffuse disorder

Pathophysiology (9 decks)

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