Chapter 3 Respiratory System Flashcards
1
Q
What is Adult Respiratory Stress Syndrome?
A
The sudden respiratory system failure because of the inability of the alveolar capillary to exchange air and gases
2
Q
What age does ARDS develop?
A
Anyone over the age of 1 year
3
Q
What is ARDS caused by?
A
acute alveolar injuries such as toxic inhalation, septic shock, and near drowning
4
Q
What happens when ARDS first happens?
A
It starts with swelling of tissue in the lungs and building upon fluid in the alveoli which leads to low blood oxygen levels
5
Q
Who are more susceptible to getting ARDS?
A
Those who smoke, those with COPD, or those over the age of 65 years
6
Q
What is Asthma?
A
A chronic disease that affects the lining of the bronchioles.
7
Q
What happens to the bronchioles with asthma?
A
They become inflamed and swollen
8
Q
What is the cause of asthma?
A
The cause is unknown but factors that are thought to trigger an attack are respiratory tract infection, anxiety, exercise, and changes in the weather or allergies
9
Q
What are symptoms of an acute asthma episode?
A
Wheezing, coughing, and a feeling of chest tightening
10
Q
With chronic asthma, what happens to a persons breathing?
A
There is forced breathing over a long period of time that may result in fatigue
11
Q
What is there a secretion of with asthma?
A
There is secretion and edema of the bronchial mucosa and bronchiolar muscle spasm which narrows the lumen of the bronchi, trapping air in the alveoli and causing labored breathing
12
Q
What may happen to the bronchial muscle with asthma?
A
It may become hypertrophied and there is hyperplasia of the mucous glands in the bronchi
13
Q
How does the diaphragm appear on a radiograph with asthma?
A
the diaphragm appears low
14
Q
What are complications associated with severe asthma attacks?
A
Obstruction due to a mucous plug and pneumothorax or oneumomediastinum
15
Q
What is atelectasis?
A
The collapse of a lung or a portion of it
16
Q
What is atelectasis caused by?
A
A pathologic condition and therefore it is not a disease in itself
17
Q
What is bronchiectasis?
A
The irreversible chronic dilation of smaller bronchi or bronchioles of the lung
18
Q
What are the different types of bronchiectasis?
A
Congenital or acquired
19
Q
What plays an important role in congenital bronchiectasis?
A
Cystic fibrosis
20
Q
What causes acquired bronchiectasis?
A
Repeated pulmonary infection and bronchial obstruction which causes a weakening of the wall of the bronchus, allowing the bronchi to become dilated
21
Q
What is bronchiectasis common in?
A
Lung abscess cases
22
Q
What are the typical symptoms of bronchiectasis?
A
A chronic productive cough, often associated with recurrent episodes of acute pneumonia
23
Q
What helps diagnose bronchiectasis?
A
A bronchoscopy
24
Q
What is Chronic obstructive pulmonary disease?
A
A disease in which the lungs have difficulty expelling carbon dioxide
25
The term COPD is really a process that is characterized by what?
The presence of either chronic bronchitis or emphysema
26
What is Croup?
Primarily a viral infection, particularly of the parainfluenza viruses
27
Who does croup most often affect?
Very young children, generally aged about 6 months to 3 years
28
What are symptoms of Croup?
Labored breathing and a harsh, rough cough
29
What images are taken to demonstrate croup?
AP soft-tissue and lateral neck radiographs which show spasms and constriction of the airway by demonstrating characteristic smooth, tapered narrowing of the subglottic airway
30
What is plural effusion?
Fluid in the pleural cavity
31
What are possible causes of pleural effusion?
Congestive heart failure, infection, neoplasm, and trauma
32
What is the most common cause of bilateral or right-sided pleural effusion?
CHF
33
If only one side is affected by a pleural effusion, what side is it usually?
The right side
34
What will help determine the cause of a pleural effusion?
The type of fluid (transudates vs. exudates)
35
What are exudates associated with?
Infection, tumor, and embolism
36
What are transudates associated with?
CHF and renal failure or cirrhosis
37
What modality plays an important role in the diagnosis of pleural effusion?
Chest radiographs
38
Where does fluid first accumulate with pleural effusion?
In the posterior costophrenic angle that is viewed on the erect lateral view of the chest
39
How much fluid is required for detection on a lateral image with pleural effusion?
More than 175 mL
40
On a PA view with pleural effusion, where can fluid be seen?
At the lateral costophrenic angles (less than 75 mL of fluid is required for detection)
41
What do opacities do with pleural effusion?
They blunt or round off the normally sharp costophrenic angles by displaying an upper concavity knows as the meniscus sign
42
How is a small amount of effusion best shown?
With the patient lying with the affected side DOWN in a lateral decub
43
What is bronchogenic carcinoma?
A broad term used to describe any carcinoma of the bronchus
44
What is the highest risk factor for all types of bronchogenic carcinoma?
Smoking
45
What are other factors for bronchogenic carcinoma?
radiation and uranium miners, and asbestos exposure
46
What are symptoms of bronchogenic carcinoma?
Persistent cough, bloody sputum, dyspnea, and weight loss
47
What do chest images show with bronchogenic carcinoma?
a rounded opacity without calcification in the lobes of the lung
48
What is TB caused by?
Mycobacterium TB or M. bovis
49
How is TB spread?
Through inhalation or infected material from someone who already has the disease
50
What are general symptoms of TB?
Fever, loss of weight, and weakness
51
What depend on the type of TB the patient has?
Coughing and sputum
52
What patients are more likely to contract TB?
Homeles, alcoholic, immigrants from medico, philippines, indochina, or Haiti; the elderly, AIDS patients and prisoners
53
Where might TB also be found?
In the GI tract by spreading through the blood stream to the kidneys, ureters, bladder, and seminal vesicles and epididymis in the male
54
What is a pneumothorax?
When free air gets into the pleural space through any route
55
What are causes of pneumothorax?
Penetrating chest wounds, surgery, biopsy, and pathologic conditions of the bronchi that cause a spontaneous rupture of an emphysematous bleb
56
What is displaced away from the chest wall with a pneumothorax?
The lung
57
What does an upright chest image show with a pneumothorax?
A lung that is not expanded with air
58
What happens to air in the erect position with a pneumothorax?
It rises to the apex; therefore a small pneumothorax unless lobulated, is first seen at the apex on the upright image with maximum expiration
59
What should always be identified with a pneumothorax?
the lung edge
60
How should chest images for pneumothorax be taken?
With the patient in the upright position
61
If the patient is unable to handle the upright position when imaging a pneumothorax, what alternate position should they be placed in?
lateral decub with the affected side UP
62
What other images should be obtained with a pneumothorax?
A PA image with the lungs in full expiration to identify small pneumothoraxes
63
What is pneumonia?
inflammation of the lungs
64
What are the lungs filled with, with pneumonia?
fluid, causing opacity on the image
65
What happens to technical factors with pneumonia?
They should increase slightly
66
What are complications of pneumonia?
Emphysema, fistula between the bronchus and pleural space, bronchiectasis, and pulmonary fibrosis
67
What is pneumoconiosis?
The ling-continued irritation of certain dusts encountered in industrial occupations which may cause chronic interstitial pneumonia
68
What is the dangerous element in dust with a pneumoconiosis?
Silica
69
What does the dust do with pneumoconiosis?
It overwhelms the normal clearance mechanism of the respiratory tract
70
What is silicosis pneumoconiosis?
The most widespread and oldest of all occupational disease and is caused by inhalation of crystalline forms of silica
71
Who does silicosis pneumoconiosis affect?
Miners, sandblasters and foundry workers
72
What carries very small crystalline particles of silica into the alveoli with silicosis pneumoconiosis?
Phagocytes
73
What does the dust act as with silicosis pneumoconiosis?
An irritant, which stimulates the formation of large ambits of connective tissue
74
What is asbestosis pneumoconiosis?
a disease caused by the inhalation of asbestos dust
75
How is asbestosis pneumoconiosis acquired?
Either during the handling and crushing of abestos rock or if the person was involved the manufacture and installation of asbestos when it was being used as insulation
76
What is abestosis associated with?
Pulmonary fibrosis, bronchogenic carcinoma, and malignancy of the pleura
77
What is the determining factor between radiographs of asbestosis and silicosis?
The involvement of the pleura
78
What is the appearance of berylliosis pneumoconiosis?
ground glass pattern
79
What is berylliosis caused by?
inhalation of beryllium salt fumes or the absorption of the salt through the skin
80
What is Coal Workers pneumoconiosis dependent on?
The type of coal that is inhaled
81
What is another name for coal workers pneumoconiosis?
Anthracosis
82
What is cystic fibrosis?
A recessive genetic (inherited) disease of the exocrine glands involving the lungs, pancreas and sweat glands
83
What is excreted into the lungs with cystic fibrosis disease?
heavy secretions of abnormally thick mucus and cause progressive clogging of the bronchi and bronchioles, leading to frequent and progressive pulmonary infections
84
What is the main manifestation of cystic fibrosis disease?
chronic cough, pulmonary disease with repeated bouts of pneumonia and pancreatic insufficiency
85
What may a patient suffer from with cystic fibrosis?
hypertension, bronchiectasis, and for pulmonale
86
What must be present for bronchitis to qualify as chronic?
there must be a cough that produces sputum for at least 3 months during 2 consecutive years
87
What symptoms are associated with chronic bronchitis?
Shortness of breath and wheezing, similar to the breathing problems experienced by people with asthma
88
What is the chief cause of chronic bronchitis?
Cigarette smoking
89
What is emphysema?
It is characterized by increased air spaces and associated tissue destruction leading to hypoxia
90
What does emphysema cause?
Dyspnea, particularly when the patient is laying down
91
What happens to the lungs with emphysema?
The lungs become stiff and brittle. The alveoli lose their elasticity and remain filled with air during expiration
92
What is compromised with emphysema?
gas exchange
93
What happens to the technical factors with emphysema?
They should be decreased
94
What is another name for respiratory distress syndrome?
hyaline membrane disease
95
What occurs with hyaline membrane disease?
A lipoprotein surfactant coats the alveoli in the lung to reduce surface tension and prevents the collapse of the alveoli
96
What is there a deficiency of in premature infants hyaline membrane disease?
Surfactant, making inhalation difficult
97
What is the most common cause of Death in premature infants due to failure to maintain aeration of the alveoli?
RDS/hyaline membrane disease
98
Where does the pharynx extend from?
The skull to the esophagus
99
What passes through the pharynx?
Both food and air
100
Where is the larynx located?
between the pharynx and the trachea
101
Where is the trachea located?
anterior to the esophagus and extends from the larynx to the level of T5
102
Which bronchus is shorter, wider, and more vertical?
The right
103
What hilum is lower?
The right hilum because the heart displaces the left hilum upward
104
What are the functional units for gas exchange?
Alveoli
105
How many lobes and fissures does the right lung have?
three lobes and two fissures
106
What are the lobes and fissures of the right lung?
The right horizontal (minor) fissure separates the upper (superior) lobe from the middle lobe. The right oblique (major) fissure separates the middle lobe from the lower (inferior) lobe. The left oblique (major) fissure divides the upper (superior) lobe and lower (inferior) lobe
107
What is the lingula?
The lower part of the upper lobe of the left lung
108
How many segments does the right lung contain?
10 segments
109
How many segments does the left lung contain?
8 or 9 segments
110
What are each of the lobes of the lungs divided into?
Segments that are the structural units of the lungs
111
What are the lungs encased in?
A double-walled serous membrane sac called the pleura
112
What is the inner layer of the membrane sac called?
The visceral, or pulmonary pleura
113
What is the outer later of the membrane sac called?
The parietal pleura
114
What is the space between the two pleural walls called?
The pleural cavity
115
What is located within the mediastinum?
The heart, aortic arch, great blood vessels, trachea, esophagus, lymph tissue, thymus gland, and nerves such as the vagus and phrenic nerves, and main bronchi
116
What does the pharynx act as?
A passage for both air and food
117
what are the functions of the larynx?
sound production and the prevention of liquids and solids from entering the trachea
118
What is the function of both the trachea and bronchi?
to provide pathway for air to reach the lungs
119
What does the respiratory system do as a whole?
Takes oxygen into the body and rids it of carbon dioxide
120
What has to happen to carry out the main function of the respiratory system?
Air must be moved from the atmosphere to the terminal units of the lung, a process called ventilation, and gas must pass across tissue from air to blood and blood to air, a process called gas exchange or perfusion
121
What happens as the dome of the diaphragm contracts and pushes down?
The abdominal organs are compressed, allowing the lungs to increase in length. At the same time, the ribs are expanded outward, which increases the width of the lungs. The change in the shape of the lungs causes a decease in intrapulmonic pressure, causing air to rush into the lungs
122
What happens to pressure at the end of inspiration?
the pressure between the outside atmosphere and the lung is equal
123
What happens at expiration?
The diaphragm relaxes and the chest cavity returns to its normal size. Air pressure within the lungs is now greater than outside, so air must be expelled again to equalize the two pressures
124
What allows the expansion of the alveoli on inspiration
Surfactant that coats the alveoli
125
What is surfactant composed of?
multiple phospholipids and proteins
126
What plays a major role in the function of respiration?
The thorax
127
What brings about inspiration and expiration?
The changes in size of the thorax
128
What does the respiratory center in the brain control?
The rhythmic movements produced by respiration
129
What are the nerves from the brain that pass down the chest wall and diaphragm to control respiration?
Vagus nerve, phrenic nerve, and thoracic nerve
