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Patho > Chapter 23 > Flashcards

Chapter 23 Flashcards

1
Q

3 stages of breathing

A
  1. Ventilation
  2. Diffusion
  3. perfusion
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2
Q

Ventilation, perfusion, deffusion

A

V- movement of air into lungs
P- movement of O2 and CO2 into and out of circulation
D- movement of blood through the pulmonary circualtion.

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3
Q

Decrease in amount of O2 in blood

A

Hypoxemia

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4
Q

Hypoxemia

A
  • effects are due to compensatory mechanisms of body
  • SNS ^ = ^HR, ^BP, vasoconstriction
  • ^ serum lactate from anaerobic respiration
  • ^ respiratory rate, cyanosis, mental status changes
  • ^ RBC production
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5
Q

Hypercapnia

A

PCO2 greater than 50 mm Hg

too much CO2 in circulation

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6
Q

causes of hypercapnia

A

hypoventilation
changes in metabolic rate
^ carbohydrate diet

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7
Q

treatment for hypercapnia

A
  • improvement of respiratory muscles (gas exchange)

- provide supplemental O2

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8
Q

Hypercapnia (PCO2 ____)

Hypoxemia (PO2 ____)

A

PCO2 > 50 mm Hg

PO2 < 60 mm Hg

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9
Q

Bronchia are surrounded by ___

Bronchioles are surrounded by ___

A
  • cartilage & smooth muscle

- smooth muscle only

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10
Q

Autonomic NS controls ___ in breathing
Parasympathetic ____
Sympathetic ___

A

smooth muscle

  • Constriction- through vagus nerve (epi and norepi)
  • Dilation- through B2 adrenergic receptor during sress and exercise
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11
Q

Inflammatory disease that causes obstruction to flow of air in/out of lungs

A

asthma

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12
Q

Asthma is caused by:

A

overreaction of the airways to irritants

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13
Q

In Asthma, the irritant exposure triggers immune response by: (1st thing)

A
  • Bronchoconstriction (^ inflammatory mediators do this)
  • ^ vascular permeability
  • ^ mucus production
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14
Q

In Asthma, the irritant exposure triggers immune response by: (2nd thing)

A
  • TH2 cell involvment-
  • binds to allergen and triggers B cells to secrete IgE
  • IgE binds to mast cells
  • Mast cells initiate inflammatory response (mucus & asthma attack)
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15
Q

Asthmatics have more ___ cells that increase their chance to pick up more potential allergens

A

Th2 cells

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16
Q

Their are 2 types of Asthma:

A
  1. Extrinsic (Atopic) Asthma- allergy

2. Intrinsic (Nonatopic) Asthma- Irritation

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17
Q

Extrinsic (Atopic) Asthma

A
  • Hypersensitivity to allergen

- initiated by allergic response

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18
Q

Steps in Atopic Asthma

A
  1. mast cells release inflammatory mediators
    • this causes an ACUTE response within (10-20 mins)
  2. Bronchospasm, ^ vessel permeability, ^ mucus production.
  3. WBC’s enter area, release more inflammatory med.
  4. Airway inflammation causes LATE-PHASE response (4-8 h later)
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19
Q

Intrinsic (Nonatopic) Asthma is caused by:

A
  1. Respiratory Infections- epithelial damage, IgE produc
  2. Exercise, Hyperventilation, cold air
  3. Inhaled Irritants- inflammation, vagus reflex
20
Q

Their are 2 types of Chronic Obstructive Pulmonary Disorder, what are they?

A
  1. Emphysema

2. Chronic Obstructive Bronchitis

21
Q

Emphysema is characterized by:

A
  • destruction of alveoli and capillary beds
  • Neutrophils in the alveoli secrete proteases (breaks down elastin)
  • can have genetic defect in a1-antitrypsin
22
Q

a1-antitrypsin deactivates ____ which deactivates ____

A

elastase (which is used to breakdown elastin)
which deactivates
elastin which destroys alveoli ability to expand and contract

23
Q

Emphysema main symptoms:

A
  1. barrel chested- air constantly getting trapped and can’t escape the lungs, so its distended
  2. Pink Puffer- ppl purse lips to create more resistance in air so their airways don’t collapse
24
Q

Emphysema creates ___ of airways that then ___ on exhale. This contributes to the inability of a person to breathe fully.

A

overextension of the airways that then collapses on exhale.

25
Q

Chronic bronchitis has 3 main characteristics:

A
  1. Chronic irritation of airways
    * ^ mucous cells, ^ mucus hypersecretion
  2. Productive cough- lasting at least 3 months
  3. Blue Bloaters
    • can’t ^ respiration enough to maintain O2 levels
    • cyanosis and polycthemia
26
Q

Chronic Bronchitis can be diagnosed from emphysema by it’s distinctive: (3)

A
  1. tripod position to use accessory muscles in breathing
  2. wheezing and crackling in lungs
  3. Productive cough
27
Q

Pulmonary Embolism signs and symptoms:

A
  1. severe, crushing chest pain

2. loss of consciousness

28
Q

How to diagnose pulmonary embolism:

A
  • Pulmonary Angiography- passing of catheter directly into pulmonary arteries
29
Q

Most common causes of COPD:

A
  1. Smoking
  2. Exposure to occupational dusts and chemicals
  3. Airway infections
  4. Asthma
  5. Airway hypersensitivity
30
Q

The term chronic obstructive pulmonary disease encompasses 2 types of obstructive airway disease:

A
  1. Emphysema

2. Chronic Obstructive Bronchitis

31
Q

Asthma

A

Enlargement of air spaces and destruction of lung tissue

32
Q

Chronic Obstructive Bronchitis

A

^ in mucus production, obstruction of small airways, chronic productive cough

33
Q

Emphysema is characterized by:

A

Loss of lung elasticity and abnormal enlargement of air spaces distal to the terminal bronchioles, with destruction of alveolar walls and capillary beds.

34
Q

2 causes of emphysema

A
  1. Smoke- kills lung tissue

2. Deficiency in a1-antitrypsin: antiprotease enzyme that protects the lung from injury

35
Q

Emphysema results from:

A

Breakdown of elastin and other alveolar wall components by an enzyme called proteases

36
Q

Mechanisms of COPD (4)

A
  1. Inflammation and fibrosis of the bronchial wall
  2. Hypertrophied mucous glands—- lead to excess mucus and obstructed airways
  3. Loss of alveolar tissue—- decreased surface area for gas exchange
  4. Loss of elastic lung fibers—- airway collapse, obstructed exhalation, air trapping
37
Q

Elastase

A

Breaks down fibers and elastin in lungs

38
Q

Antiprotease (alphatripsin)

A

Protects the lungs from protease ingestion but smoking and other irritants signal neutrophils to secrete more proteases, overpowering the antiprotease enzymes

39
Q

Asthmatics are called “pink puffers” because:

A

Lack of cyanosis
Use of accessory muscles “pursed-lips” breathing

-loss of lung elasticity and hyperinflation of the lungs causes airways to collapse during expiration because of pressure in the surrounding lung tissues exceeding airway pressure.

40
Q

Emphysema pt’s often have “barrell chest”, why?

A

-air becomes trapped in alveoli and lungs, producing an increase in the anteroposterior dimensions of the chest.

41
Q

Those with chronic bronchitis are called “blue bloaters”, why?

A

In reference to their cyanosis and fluid retention associated with R-sided heart failure.

42
Q

COPD symptoms for both emphysema and chronic bronchitis

A
  • respiratory impairment on exhale
  • increased work of breathing but decreased effectiveness
  • exertional dyspnea
  • labored breathing even at rest
  • crackles and exploratory wheezing lung sounds
  • accessory muscle use (tripod stance)
43
Q

Pursed lips breathing does what for those with COPD

A

Enhances air flow bc it increases the resistance to the outflow of air and helps to prevent airway collapse by increasing airway pressure

44
Q

Pulmonary emboli originate from where?

A

Most arise from deep vein thrombosis int he large veins in the lower leg.

45
Q

A congenital defect in a1-antitrypsin in a patient who is also a long-term smoker is likely to lead to which of the following conditions:

A

emphysema

Patho (18 decks)

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