Chapter 11 Flashcards
what tubes involve the conduction of air into and out of the lungs in the respiratory system?
- trachea
- bronchi: largest conducting tube
- bronchioles
- respiratory bronchioles
- alveoli (O2/CO2 exchange, cells producing surfactant)
mucociliary escalator
- specialized epithelial lining of bronchial tree
- mucus traps inhaled particles
- cilia conveys mucus upward toward mouth, where it is swallowed
requirements for efficient gas exchange
- large capillary surface area in contact with alveolar membrane
- unimpeded diffusion across alveolar membrane
- normal pulmonary blood flow
- normal pulmonary alveoli
normal plasma pH tightly controlled between..
7.35-7.45
acid-base balance is maintained in the..
lungs and kidneys
lots of CO2 leads to..
increased H+
less CO2 leads to..
decreased H+
respiratory acidosis
caused by hypoventilation (holding breath), too much H+
respiratory alkalosis
occurs with hyperventilation, too little H+
pleura
CT on lungs
visceral pleura
CT right on lungs
parietal pleura
CT lines thoracic cavity
pleural cavity
space between lungs and chest wall
intrapleural pressure
pressure within pleural cavity (needs to be lower than intrapulmonary)
- no air
- holds lungs open
dyspnea (sign/symptom of respiratory disorder)
short of breath at rest
apnea (sign/symptom of respiratory disorder)
not breathing
tachypnea (sign/symptom of respiratory disorder)
fast breathing
cough (sign/symptom of respiratory disorder)
- sputnum (productive, mucus)
- hemoptysis (coughing up blood)
cyanosis (sign/symptom of respiratory disorder)
tissues turn blue
tests of respiratory function
- percussion
- auscultation
- spirometry (measures breathing)
- radiography (x-ray/CT scan)
lung volumes and capacities (spirometry)
- FVC: forced vital capacity (deep breath, blow out as fast as possible)
- FEV1: forced expiratory volume in one second
tests of respiratory structure
bronchoscopy (tube down throat to look at bronchioles)
atelectasis
without inflation, collapse of the lung
bronchiectasis
abnormal, don’t go back to normal, dilation of a bronchus
consolidation
filling of air spaces by anything other than air (water or mucus)
pneumothorax
- presence of air in pleural cavity
- leads to collapsed lung
restrictive lung disorder
- difficulty taking breath in
- FEV1/FVC ratios messed up
respiratory distress syndrome
progressive respiratory distress soon after birth
pathogenesis of respiratory distress syndrome
inadequate surfactant in lungs
- alveoli don’t expand normally during inspiration
- collapse during expiration
at risk groups for respiratory distress syndrome
- premature infants
- infants delivered by cesarean section
- infants born to diabetic mothers
treatment of respiratory distress syndrome
after delivery, give oxygen and surfactant to baby
cystic fibrosis
mutation in chloride channel, various passageways become plugged with thick mucus
bronchiectasis
abnormal dilation of bronchioles (more room for thick mucus)
hemoptysis
coughing up blood
atelectasis
mucus plug
what is the life expectancy for someone with cystic fibrosis?
~35 year life expectancy
cystic fibrosis: bronchiectasis
pathologic dilation of airways due to weakening of walls, typically associated with repeated chronic infections
how are the lungs affected during bronchiectasis?
- decrease ability to move mucus
- distended bronchioles retain more mucus secretions
- creates an environment for bacteriial growth
treatment of bronchiectasis
- medical maneuvers to improve mucus clearance
- immunizations
- bronchodilators
- antibiotics
pneumonia
inflammation of the lungs (alveoli), leading cause of death in elderly and children
what are possible causes of pneumonia?
- virus
- bacteria
- fungi
- mycoplasma
mycoplasma
bacteria that lives inside cell, harder for immune system to see and fight off
detection of pneumonia
auscultation and chest x-ray
predisposing factors of pneumonia
any condition associated with poor lung ventilation and retention of bronchial secretions
post-op pneumonia
accumulation of mucous secretions in bronchi
aspiration pneumonia
foreign body, food, vomit
clinical features of pneumonia
- fever
- cough
- purulent sputnum
- pain on respiration
- shortness of breath
obstructive lung disease
occur with partial impediment of flow from air spaces back out into environment
obstructive lung disease leads to..
- retention of carbon dioxide
- decreased oxygenation of RBC
symptoms for obstructive lung diseases
- wheezing
- cough
- dyspnea
- tachypnea
types of obstructive lung disease
- asthma
- chronic obstructive airway disorders (COPD)
how high is COPD on the leading cause of death list?
3
COPD
group of disorders characterized by reduced airflow and impaired gas exchange, inflammatory conditions of lungs
is COPD progressive?
yes
is COPD reversibile?
no
signs and symptoms of COPD
- large amount of mucus
- coughing
- shortness of breath
- chest tightness
- barrel chest
diagnosis of COPD
spirometry (decreased FEV 1 and vital capacity)
treatment of COPD
- smoking cessation
- steroids and bronchodilators
- supplemental oxygen
- antibiotics to treat infection
COPD: chronic bronchitis
inflammation of medium sized walls in bronchioles
symptoms of chronic bronchitis
- persistent cough for at least 3 months/year in two consecutive years
- excessive mucous
- frequent respiratory infections
COPD: emphysema
- destruction of elastic walls of alveoli
- abnormal, permanent enlargement of the alveoli
complications of COPD
- respiratory failure (acidosis, arrhythmia due to hypoxia)
- right sided heart failure
- more infections such as pneumonia
- acute respiratory failure
- arrhythmia
- lung cancer
is asthma reversible?
yes
clinical symptoms of attacks
- dyspnea (short of breath)
- chest tightness
- wheezing
why are most asthma attacks caused?
- allergic reaction (exposure)
- mast cells release inflammatory mediators
what kind of allergens are asthma attacks precipitated by ?
- dust
- pollen
- animal dander
treatment of asthma
- avoid the allergen
- drugs that dilate bronchial walls (epinephrine/beta agonist inhalers)
- reduce inflammation (cortiosteroid inhalers)
- drugs that block release of mediators from mast cells
acute respiratorry distress syndrome (ARDS)
- medical emergency (damaging respiratory system, cannot get air)
- diffuse alveolar damage (alveolar epithelium and vascular endothelium)
causes of acute respiratory distress sydrome
- fire
- almost drowning
- lung surgery
result of acute respiratory distress syndrome
- hypoxia (low oxygen in blood)
- results in organ failure
treatment of acute respiratory distress syndrome
- treatment of underlying condition if possible
- supportive care
- oxygen therapy
pulmonary embolism (PE)
- potentially fatal
- results when thrombi are pumped into the pulmonary arteries
- presentation is variable (can cause sudden death)
pulmonary hypertension
- increases pulmonary edema
- leads to right side heart failure
- average survival rates ~ 10 years following diagnosis
small cell (SCLC) lung cancer
- 15% of cancers
- typically smokers
- detected after metastasized
non-small cell (NSCLC) lung cancer
more localized
etiology of lung cancer
- smoking (80-90%) of lung cancers
- radon gas
- asbestos
- pollution
- genetics
why is lung cancer so deadly?
60% will die within the first year, little screening tests
symptoms of lung cancer
- unexplained cough
- weight loss
- coughing up blood
- loss of appetite
why does organ failure occur in the lungs?
gas exchange across the alveolar-capillary membrane is compromised to the point where:
- oxygen saturation is insufficient to support life
- carbon dioxide is elevated to the point it causes acidosis of the extracellular environment
what disease result in lung failure?
- atelectasis
- ARDS
- pulmonary edema
- decreased respiratory activity resulting from trauma or opiate toxicity
- drowning
