Chapter 10 Flashcards
is respiratory disease incidence rate increasing or decreasing
increasing secondary to pollution
what is the leading cause of cancer related deaths
lung cancer
upper respiratory tract
nasal cavity
pharynx
larynx
lower respiratory tract
trachea
primary bronchi
lungs
ventilation
movement of air through inhalation and exhalation
what drives ventilation
differences in pressure gradients
types of alveoli
type I and II
macrophages
type I cells
cell walls
type II cells
produce surfactant
macrophages
stay put
muscocilary escalator
keeps airway clear
what must be required for gas exchange
air moves freely
open alveoli
sufficient pulmonary membrane
thin interstitium
pneumothorax
loss of intrapleural pressure
lungs collapse
what 2 vascular systems serve the lungs
pulmonary (alveoli only)
bronchial (trachea and brochi)
true or false: are the lungs in direct contact with the environment
true
what are the lungs exposed to within the environment
micro-organisms
immune defenses of the lungs
cilia
MALT
IgA
macrophages
what tests lung disorders
spirometry
restrictive lung diseases
characterized by low lung volumes
hard to take breath
ratio is normal
obstructive lung diseases
prevents outflow of air
hard to breathe out
low ratio
USA leading cause of death
chronic lower respiratory disease
world leading cause of death
COPD
signs and symptoms of lung disorder
dyspnea
apnea
orthopnea
tachypnea
cough (sputum, hemoptysis)
cyanosis
why does orthopnea occur
more blood in lungs results in left sided heart failure because blood backs up into pulmonary circuit
hemoptysis
coughing up blood
atelectasis
collapse of lung
pneumothorax
brochiectasis
dilation of bronchus
permanent and abnormal
consolidation
filling of air spaces by anything other than air
fluid, mucus, bacteria
atelectasis
lack of stretch
inability to expand
collapse of lungs
types of atelectasis
obstruction
compression
contraction
obstruction atelectasis
obstruction of conducting airways by foreign bodies, mucus plugs
mucus is so thick
reversible
compression atelectasis
compression of lung by liquid, solid, or gas within pleural space
can result in sudden death
reversible
contraction atelectasis
fibrosis of lung preventing expansion
tuberculosis
lung tissue is replaced by scar tissue
irreversible
bronchiectasis
UNCOMMON
permanent dilation of bronchi SECONDARY to underlying disorder (recurrent bacterial infection)
what is bronchiectasis associated with
cystic fibrosis
bronchial obstruction
chronic infection
immunodeficiency
symptoms of brochiectasis
severe cough
foul smelling bloody expectorant
dyspnea
active cases are febrile
complications of bronchiectasis
pneumonia
sepsis
lung abcess
respiratory distress syndrome of newborn
progressive distress soon after birth, inadequate surfactant in lungs
what form of lung disease is respiratory distress syndrome of newborn
atelectasis, due to difficulty breathing
at risk groups of respiratory distress syndrome of newborn
premie babies
maternal diabetes
treatment for respiratory distress syndrome of newborn
administer surfactant and oxygen
cystic fibrosis
genetic autosomal recessive disease of mutation in chloride channel
is cystic fibrosis autosomal recessive or dominant
recessive
how old do people live with cystic fibrosis
30yrs
what is cystic fibrosis…pathologically
passageways are clogged with thick mucus
bronchiectasis
hemoptysis
atelectasis
cystic fibrosis bronchiectasis
dilation of airways due to weakening of walls
what is cystic fibrosis bronchiectasis associated with
repeated chronic infections
decreases ability for mucus to move
distended bronchioles retain more mucus secretions
creates environment for bacterial growth
cystic fibrosis treatment
medical manuevers to improve mucus clearance
immunizations
bronchodilators
antibiotics
are men or women more effected by cystic fibrosis
both are equally effected
agents of upper respiratory tract infections
virus (more common, less complications)
bacteria (more complications)
common URIs
rhinitis
sinusitis
pharyngitis
laryngitis
infectious rhinitis
virus
inflammation of nose
leads to secondary bacterial infections
allergic rhinitis
type I hypersensitivity
sinusitis
impaired drainage of sinus fluid
pharyngitis/tonsilitis
sore throat
virus
laryngitis
lose voice
acute respiratory distress syndrome (ARDS)
inflammation of pulmonary capillaries or alveoli
caused by diffuse damage
increases pulmonary edema
impairs gas exchange..hypoxia
is ARDS primary or secondary
secondary to…
sepsis
pulmonary infections
gastric aspiration
near drowning
heroin overdose
what is the end result of ARDS
organ failure
pathogenesis of ARDS
increase in inflammation
activates alveolar macrophages and neutrophil migration
increases edema (interstitial and alveolar)
outcomes of ARDS
most patients present w/predisposing condition and then develop ARDS
develops in hospital
long term complications of ARDS
scarring that replaces lung tissue
contraction atelectasis
IRREVERSIBLE
mortality rate of ARDS
high, 60%
pneumonia
inflammation of alveoli
what age is pneumonia the leading cause of death in
elderly and children
what causes pneumonia
virus (dry cough)
bacteria
fungi
mycoplasma
how to diagnose pneumonia
chest xray or auscultation (crackles in lung sounds)
predisposing factors of pneumonia
any condition w/poor lung ventilation and retention of bronchial secretions
post-op pneumonia
accumulation of mucus secretions in bronchi
aspiration pneumonia
foreign body, food, vomit
clinical features of pneumonia
fever (103-104º)
cough
purulent sputum
pain w/respiration
dyspnea
examples of obstructive diseases
emphysema
bronchitis
bronchiectasis
asthma
examples of restrictive diseases
neuromuscular (ALS)
kyphosis
obesity
fibrosis
amyloidosis
types of COPD
emphysema
bronchitis
does COPD have decreasing or increasing prevalence
increasing due to increase in pollution
what percent of COPD cases are smokers
90%
is COPD reversible or irreversible
irreversible and progressive
main cause of COPD
smoking
are men or women more affected with COPD
men
is COPD age associated
yes
COPD symptoms
lots of mucus
coughing in morning
dyspnea
chest tightness
barrel chest
complications of COPD
respiratory failure
arrhythmia
right sided heart failure..cor pulmonale
pneumonia or other infections
death (acidosis)
cor pulmonale
alteration of right side of heart secondary to changes in lungs
enlargement of RVent
SECONDARY to pulmonary HTN
emphysema
destruction of elastic tissue
alveoli and pulmonary capillary bed
abnormal, permanent enlargement
air trapping
pathogenesis of emphysema
increase in inflammatory cells
leads to imbalance of anti-inflammation/pro-inflammation
neutrophils
alpha-1 antitrypsin
alpha-1 antitrypsin
neutralizes digestive enzymes (neutrophils)
made by liver
tobacco inhibits production
chronic bronchitis
inflammation of medium sized bronchioles
combined w/other obstructive diseases
symptoms of chronic bronchitis
persistent cough for ~3mo/yr in 2 consecutive years
long term complications of bronchitis
COPD
cor pulmonale
metaplasia of bronchiole epithelium=CANCER
what initiates bronchitis
inhalation of irritant, irritant leads to mucus production and glandular hypertrophy, pulmonary capillary bed is undamaged
asthma
inflammation of bronchioles
is asthma COPD
no, because it is reversible
what causes asthma
episodic bronchospasm
is asthma incidence rate decreasing or increasing
increasing
types of asthma
atopic (allergies)
non-atopic (strenuous exercise, drug reaction, air pollution)
occupational
atopic asthma
type I hypersensitivity
cascade of atopic asthma
mast cells release eosinophils causing acute response in 10-20 minutes
airway inflammation is late phase response after 4-8hrs
treatment for asthma
avoidance of trigger
bronchodilators (beta adrenergic agonists…ALBUTEROL)
NSAIDS (steroids, cortisol)
decrease release of leukotrienes from mast cells
sleep apnea
pause of breathing while sleeping
are men or women affected more by sleep apnea
men
risk factors
obesity…obstructive
signs/symptoms of sleep apnea
loud snoring
daytime fatigue
what can sleep apnea lead to if untreated
hypertension
accidents
heart failure
treatment of sleep apnea
CPAP that keeps airways open
valvular lung
