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Pathophysiology Exam 3 Chapter 23,23, 31 > Chapter 31 Disorders Of Ventilation And Gas Exchange > Flashcards

Chapter 31 Disorders Of Ventilation And Gas Exchange Flashcards

1
Q

Gases of respiration

A

. Primary function of respiratory system

  • Remove CO2
  • Addition of O2

. Insufficient exchange of gases

  • Hpoxemia
  • Hypercarpnia
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2
Q

Hypoxemia

A 
. Hypoxemia results from
- An inadequate o2 in the air
- Disease of the respiratory system
- Dysfunction of the neurological system
- Alterations in circulatory function
. Mechanisms 
- hypoventilation 
- impaired diffusion of gases
- Inadequate circulation of blood through the pulmonary capillaries 
- Mismatching of ventilation and perfusion
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3
Q

Manifestations of hypoxemia

A

. Mild hypoxemia

  • Metabolic acidosis
  • increase in heart rate
  • Peripheral vasoconstriction
  • Diaphoresis
  • increase in blood pressure
  • Slight impairment of mental performance
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4
Q

Manifestations of hypoxemia

A

. Chronic hypoxemia
- Manifestations of chronic hypoxia may be insidious in onset and attributed to other causes.
. Compensation masks condition
- Increased ventilation
-Pulmonary vasoconstriction
- Increased production of red blood cells
- Cyanosis

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5
Q

Hypercapnia

A 
. Increased arterial PCO2
. Caused by hyperventilation or mismatching of ventilation and perfusion 
. Effects 
- Acid - base balance
- kidney function
- nervous system function
- cardiovascular function
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6
Q

Disorders of the pleura

A

. Pleural effusion: abnormal collection of fluid in the pleural cavity
- Transudate or exudate, purulent, chyle, or sanguineous
. Hemorathorax
. Pleuritis
. Chylothorax
. Atelectasis
. Empyema

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7
Q

Types of pneumothorax

A

. Spontaneous pneumothorax
- Occurs when an air- filled blister on the lung surface ruptured
. Traumatic Pneumothorax
- Caused by penetrating or nonpenetrating injuries
. Tension Pneumothorax
- Occurs when the intrapleural pressure exceeds atmospheric pressure

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8
Q

Causes of Disorders of Lung Inflation

A

. Conditions that produce lung compression or lung collapse

  • Compression of the lung by an accumulation of fluid in the intrapleural space
  • Complete collapse of an entire lung as in pneumothorax
  • Collapse of a segment of the lung ad in atelectasis
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9
Q

Characteristics and symptoms of pleural pain

A

. Abrupt in onset
. Unilateral; localized to lower and lateral part of the chest
. May be referred to the shoulder
. Usually made worse by chest movements
- Tidal volume are kept small
- Breathing becomes more rapid
- Reflex splinting of the chest may occur

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10
Q

Pleural Effusion

A

. Definition
- An abnormal collection of fluid in the pleural cavity

. Types of fluid

  • transudate
  • Exudate
  • Purulent drainage
  • Chyle
  • Blood
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11
Q

Diagnosis and treatment of pleural effusion

A 
. Diagnosis 
- chest radiographs, chest ultrasound 
- computed tomography (CT)
. Treatment 
- Thorencentesis
- Injection of a sclerosis agent into the pleural cavity
- open surgical drainage
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12
Q

Atelectasis

A

. Definition
- the incomplete expansion of a lung or portion of a lung
. Causes
- Airway obstruction
- lung compression such as that occurs in pneumothorax or pleural effusion
- increased recoil of the lung due to loss of pulmonary surfactant

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13
Q

Types of Atelectasis

A

. Primary
- present at birth

. Secondary
- develops in the neonatal period or later in life

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14
Q

Physiology of Airway Disease

A 
. Upper respiratory tract 
- trachea and major bronchi
. Lower Respiratory tract
- Bronchi and alveoli 
. Creation of negative pressure
. Effects of CO2/ pH
. Role of inflammatory mediators 
. Increase airway responsiveness by
- producing bronchospasm
- increasing mucus secretion
- producing injury to the mucosal lining of the airways
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15
Q

Functions of Bronchial Smooth Muscle

A

. The tone of the bronchial smooth muscles surrounding the airways determines airway radius
. The presence or absence of airways secretions influences airway patency
. Bronchial smooth muscle is innervated by the autonomic nervous system
- Parasympathetic: Vagal control
. Bronchoconstrictor
- Sympathetic: B2- adrenergic receptors
. Bronchodilator

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16
Q

Factors Involved in the pathophysiology of Asthma

A 
. Genetic 
- Atopy
. Early versus late phase
. Environmental 
- Viruses
- Allergens
- Occupational exposure
17
Q

Classification of Asthma Severity

A

. Mild intermittent
. Mild persistent
. Moderate Persistent
. Severe Persistent

18
Q

Chronic obstructive Airway Disease

A

. Inflammation and fibrosis of the bronchial wall
. Hypertrophy of the submucosal glands
. Hypersecretion of mucus
. Loss of elastic lung fibers
- Impairs the exploratory flow rate, increase air trapping, and predispose to airway collapse
. Alveolar tissue
- Decrease the surface area for the gas exchange

19
Q

Causes of Chronic Obstructive Airway Disease

A

. Chronic Bronchitis
. Emphysema
. Bronchiectasis
. Cystic fibrosis

20
Q

Types of Chronic Obstructive Pulmonary Disease

A 
. Emphysema 
- Enlargement of air spaces and destruction of lung tissue
- Types : Centriacinar and panacinar
. Chronic Obstructive Bronchitis 
- obstruction of small airways
21
Q

Characteristics of Type A pulmonary Emphysema

A 
. Smoking history
. Age of onset: 40 years to 50 years 
. Often dramatic barrel chest
. Weight loss 
. Decreased breath sounds
. Normal blood gases until late in disease process
. Cor pulmonale only in advanced cases
. Slowly debilitating disease
22
Q

Characteristics of type B chronic Bronchitis # 1

A

. Smoking history
. Age of onset 30 to 40 years
. Barrel chest May be present
. Shortness of breath, a predominant early symptoms
. Rhonchi often present
. Sputum frequent, an early manifestations

23
Q

Characteristics of type B chronic bronchitis # 2

A

. Often dramatic cyanosis
. Hypercapnia and hypoxemia May be present
. Frequent cor pulmonale and polycythemia
. Numerous life- threatening episodes due to acute exacerbation

24
Q

Bronchiectasis

A

. Permanent dilation of the bronchial and bronchioles
. Secondary to persisting infection or obstruction
. Manifestations
- Atelectasis
- Obstruction of the smaller airways
- Diffuse bronchitis
- Recurrent bronchopulmomary infection
- Coughing: production of copious amounts of foul- smelling, purulent sputum, and hemoptysis
- Weight loss and anemia are common

25
Q

Cystic Fibrosis

A

. Definition
- An autosomal recessive disorder involving fluid secretion in the exocrine glands and the epithelial lining of the respiratory, gastrointestinal, and reproductive tracts
. Cause
- Mutations in a single gene on the long arm of chromosome 7 that encodes for the cystic fibrosis transmembrane regulator ( CFTR) , which functions as a chloride ( CI-) channel in epithelial cell

26
Q

Manifestations of Cystic Fibrosis

A 
. Pancreatic exocrine deficiency 
. Pancreatitis 
. Elevation of sodium chloride in the sweat 
. Excessive loss of sodium in the sweat 
. Nasal polyps
. Sinus infections 
. Cholethiasis
27
Q

Diffuse Interstitial Lung Diseasee

A

. Definition
- A diverse group of lung disorders that produce similar inflammatory and fibrotic changes in the interstitum or interalveolar septa of the lung

.Types

  • Sarcoidosis
  • The occupational lung diseases
  • Hypersensitivity pneumonitis
  • Lung disease caused by exposure to toxic drugs
28
Q

Occupational Lung Disease

A

. Pneumoconionoses
- The inhalation of inorganic dusts and particulate matter
. Hypersensitivity diseases
- The inhalation of organic dusts and related occupational antigens
. Byssinosis: Cotton workers; has characteristics of the pneumoconioses and hypersensitivity lung disease

29
Q

Pulmonary Embolism

A

. Development
- A blood - borne substance lodges in a branch of the pulmonary artery and obstructs the flow
. Types
- Thrombus : arising from DVT
- Fat: mobilized from the bone marrow after a fracture or from a traumatized fat depot
. Amniotic Fluid: enters the maternal circulation after rupture of the membranes at the time of delivery

30
Q

Pulmonary Hypertension

A

. Signs and symptoms of secondary pulmonary hypertension
- Dyspnea and fatigue
- peripheral edema
- ascites
- signs of right heart failure
. A disorder characterized by an elevation of pressure within the pulmonary circulation
. Pulmonary arterial hypertension

31
Q

Cor Pulmonale

A

. Right heart failure resulting from primary lung disease and long- standing primary or secondary pulmonary hypertension
. Involves hypertrophy and the eventual failure of the right ventricle
. Manifestations include the signs and symptoms of the primary lung disease and the signs of the right- sided heart failure

32
Q

Acute Respiratory Distress Syndrome

A

. A number of conditions may lead to ALI/ ARDS.
. They all produce similar pathological lung changes that include diffuse epithelial cell injury with increased permeability of the alveolar- capillary membrane

33
Q

Causes of ARDS

A 
. Aspiration of gastric contents
. Major trauma
. Sepsis secondary to pulmonary or non pulmonary infections 
. Acute pancreatitis 
. Hematologist disorders 
. Metabolic events 
. Reactions to drugs and toxins
34
Q

Causes of respiratory failure

A 
. Impaired ventilation 
- upper airways obstruction 
- Weakness of paralysis of respiratory muscles
- Chest wall injury 
. Impaired matching of ventilation and perfusion 
. Impaired diffusion 
- pulmonary edema
- Respiratory distress syndrome
35
Q

Treatment of respiratory failure

A

. Respiratory supportive care directed toward maintenance of adequate gas exchange
. Establishment of an airway
. Use of bronchodilator drugs
. Antibiotics for respiratory infections
. Ensure adequate oxygenation

Pathophysiology Exam 3 Chapter 23,23, 31 (3 decks)

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