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PTAE 113 CLINICAL PATHOLOGY > Chapter 4 > Flashcards

Chapter 4 Flashcards

1
Q

Upper respiratory tract

A

nose, nasal passages, pharynx, larynx

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2
Q

parts of the larynx

A

vocal cords, hyoid bone, cartilages, epiglottis

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3
Q

lower respiratory tract

A

trachea, bronchi, branches of bronchioles, terminal alveoli in the lung

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4
Q

inhalation

A

diaphragm contracts and pushes down on organs

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5
Q

anatomy of lungs

A

lobes; pleura; surfactant, bronchopulmonary segments

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6
Q

lobes of the lungs

A

2 left; 3 right

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7
Q

Pleura

A

visceral pleura-inner lining and attached to the lung

parietal pleura-lines the thorax and is actually an extension of the visceral pleura

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8
Q

surfactant

A

fluid to allow the two layers of pleura to glide over each other as the lungs expand during breathing

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9
Q

bronchopulmonary segments

A

left lung consists of 9

right lung consists of 10

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10
Q

eupnea

A

normal breathing 12-20 bpm

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11
Q

apnea

A

not breathing (sleep apnea)

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12
Q

tachypnea

A

greater than 24 bpm

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13
Q

brandypnea

A

less that 10 bpm

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14
Q

sleep apnea

A

stop breathing for a time; not enough O2; do a sleep study; affects memory, growth (growth hormone helps growth and tissue repair), weight gain; immune system problems

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15
Q

hypopnea

A

disease that reduces ventilation; seen at night; wear O2 at night

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16
Q

cheyne-stokes breathing

A

breathing pattern done right before death; very distinct; gasp and then shallow (last 5 breaths)

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17
Q

ataxic breathing

A

disruption of cerebellum; irregular depth breaths

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18
Q

apneustic breathing

A

brain damage; prolonged inhalation phase and inadequate exhalation (like a gasping)

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19
Q

ventilation control

A

voluntary and involuntary

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20
Q

voluntary ventilation control

A

valsalva maneuver

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21
Q

involuntary ventilation control

A

control centers located in primitive area of brain (medulla and pons); chemoreceptors (in carotid and medulla; vascular system to detect CO2; running and SOB till levels even out; yawn, laughing, vomiting

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22
Q

reflexes that affect ventilation control

A

hering-breuer; cough; stretch

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23
Q

Hering-Breuer

A

in smooth mm of trachea; stretch reflex so lungs don’t over inflate; causes a reflex to make mm contract; delays the start of the next inhalation

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24
Q

cough for ventilation control

A

anything that isn’t supposed to be there (in trachea, lungs, etc)
Problem with spinal cord injury at C6…they don’t have a good cough reflex

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25
Q

stretch for ventilation control

A

muscle spindles respond to elongation of the mm where they are located. Muscle spindles are located both in the diaphragm and the intercostal mm. When they are stretched it initiates further contraction

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26
Q

Inhalation process

A

alveoli pressure is lower than atmospheric pressure; external intercostals help with inhale
problems- COPD and emphysema- cause all inhalation mm to contract and will have problems because all of the mm are trying to help

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27
Q

exhalation process

A

internal intercostals and diaphragm relax and air leaves; very passive; abs help with forced exhalation

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28
Q

tidal volume (VT) OR (TV)

A

air inhaled/exhaled, each breath, in normal, quiet breathing

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29
Q

inspiratory reserve volume (IRV)

A

extra air that can be inhaled over tidal volume

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30
Q

expiratory reserve volume (ERV)

A

extra air that can be exhaled over tidal volume

problem- if it’s too low causes CO2 to stay in body-ketoacidosis

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31
Q

residual volume (RV)

A

air that stays in lungs after forced expiration

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32
Q

inspiratory capacity

A

tidal volume plus inspiratory reserve volume

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33
Q

functional residual capacity

A

expiratory reserve volume plus residual volume minus air left in lungs after normal exhalation

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34
Q

Vital capacity VC or forced vital capacity FVC

A

inspiratory reserve volume plus tidal volume plus expiratory reserve volume minus max amount of air exhaled after a max inhalation

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35
Q

forced expiratory volume in 1 second

A

volume of air that is forcibly expired after maximal inspiration in one second; usually 80% of VC

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36
Q

total lung capacity TLC

A

all lung volumes added together

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37
Q

minute ventilation V

A

tidal volume X rate of ventilation (500*15=7500)

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38
Q

restrictive vs. obstructive

A

restrictive-can’t breathe in (asthma); everything will be restricted
obstructive-can’t breathe out; can practice to increase expiratory volume

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39
Q

diffusion

A

O2 transported into RBC from the alveoli of the lungs

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40
Q

perfusion

A

relates to blood in the pulmonary vessels that supply the lung tissue; amount of O2 that actually makes it across

41
Q

ventilation-perfusion ratio or quotient

A

if perfusion is reduced in an area of the lung, there will also be a reduced ability for O2 to diffuse from the lungs into the BV’s for transport of O2 to tissues. The ratio in a healthy adult is 80%

42
Q

oxyhemoglobin dissociation curve

A

correlation between the hemoglobin and the release of O2 from the hemoglobin

43
Q

muscles of ventilation

A

diaphragm (main mm); accessory mm, abdominals (forced exhalation); external and internal intercostals

44
Q

accessory mm of ventilation

A

sternocleidomastoids, scalenes, serratus anterior, pectoralis major/minor, trapezius, erector spinae

45
Q

excursion

A

how much chest wall moves; landmark is the xiphoid process and in a “young adult between 20-30 yrs” the rib excursion should be 8.5 cm

46
Q

intercostal indrawing

A

spaces between the ribs occurs in individuals with marked resistance to airflow during inhalation. The skin and intercostal mm tissue between the ribs is drawn inward during inhalation as the result of an increases negative pressure in the thoracic cavity; can be seen more often in children than adults

47
Q

breath sounds

A

ausculation-listen in different locations
tracheal vs. lung tissue - the exhalation tracheal breath sound is a little higher pitched and last slightly longer than the inhalation in the trachea.

48
Q

spirometry

A

a device that encourages patients to inhale deeply after a pulmonary infection or thoracic surgery to prevent further complications

49
Q

PEF - peak expiratory flow

A

measured with a peak flow meter; PEF is reached at about 100 milliseconds into exhalation and then starts to reduce as the air continues to be expelled from the lungs

50
Q

arterial blood gases

A

hypoxemia-reduction in O2 levels in the blood

hypercapnia- increase CO2 levels in the blood

51
Q

respiratory acidosis

A

results from a rise in the CO2 and is present in patients with chronic bronchitis during episodes of exacerbations.

52
Q

respiratory alkalosis

A

occurs with a reduction in the CO2 level and is present in persons with pneumonia

53
Q

lung function tests

A 
chest radiograph
computed tomography CT
magnetic resonance imaging MRI
pulmonary arteriography or angiography
bronchoscopy
54
Q

exercise capacity and tolerance

A

MET-metabolic equivalence test; based on how much you need at rest
RPE-rate of perceived exertion; how hard patient thinks they’re working

55
Q

cough

A

stimulated through stimulus to remove foreign matter. May be productive or nonproductive. For pathology the sputum is collected and sent to lab for identification for diagnosis

56
Q

types of sputum

A

saliva-normally present
frothy-pulmonary edema
mucoid-pulmonary condition w/no infection (asthma, chronic bronchitis)
mucopurulent-cystic fibrosis, pneumonia, bronchiecstasis
purulent-pulmonary infections (pseudomonosa)
hemoptysis-infections such as tb or bronchiectasis
black sputum-inhalation of smoke from cigarettes, etc

57
Q

dyspnea

A

breathlessness, shortness of breath (SOB), may be an indication of either pulmonary or cardiac problems.

58
Q

paroxysmal nocturnal dyspnea

A

result CHF at night. Can measure by how many pillows the patient sleeps with. Laying more flat increases the venous return to the heart and increases stress and exacerbates CHF

59
Q

Cyanosis

A

blue tinge of skin from low O2 below 80%. May be due to central or peripheral sources

60
Q

chest pain

A

many causes-cardiac, pulmonary, costochondral or pleuritic

61
Q

chest shape and reduced thoracic mobility

A

pectus carinatum (pigeon chest), pectus cavus, barrel chest-all result in change in thoracic excursion and loss of volume

62
Q

pulmonary edema

A

edema build up in the lungs int he interstitial spaces and alveoli as a result of left ventricular failure

63
Q

atelectasis

A

lungs collapse (all or part)

64
Q

bronchiolitis

A

inflammation of the bronchi resulting in increased secretions and inflammatory exudate in the lungs resulting in cough

65
Q

pneumothorax and pleural effusion

A

life threatening condition when the lung collapses as a result of air or fluid entering between the pleural layers. Can be a result of trauma or spontaneous in response to lung conditions such as asthma, cystic fibrosis, tuberculosis, COPD or whooping cough

66
Q

lung abscess

A

lung cavity filled with pus and encapsulated by fibrous tissue. may be caused by cancer, infection, pneumonia. May be result of secondary infection from a traumatic injury. Can develop with aspiration of food when the item festers in the lungs. Treatment is based on the cause of the abscess

67
Q

type a

A

“pink puffer” - person with emphysema

68
Q

type b

A

“blue bloater” - person with chronic bronchitis

69
Q

asthma

A

an acute, reversible, inflammatory, obstructive pulmonary condition affecting both adults and children. Stimuli can be extrinsic (allergens) or intrinsic (exercise)

70
Q

pneumonia

A

pulmonary disease involving inflammation of the alveoli and small bronchi

71
Q

bronchopneumonia

A

if both lungs are involved and is usually the result of interstitial pneumonia of a viral cause

72
Q

pyothorax

A

the whole pleural cavity is filled with pus (if pleural effusion is purulent)

73
Q

cystic fibrosis

A

chronic, hereditary lung disorder; autosomal recessive train on chromosome 7; results in reduced pancreatic enzymes that cause malfunction of the mucous membranes and mucous producing glands of the pancreas and lungs with resultant severe lung abnormalities; high levels of NaCl in sweat for diagnosis;

74
Q

PEP therapy

A

positive expiratory pressure therapy; airway clearance technique; the machine resists exhalation of air from the lungs and helps to keep airways open

75
Q

tuberculosis

A

bacterial lung disease with similar effects to those of pneumonia; more common among individuals with HIV, homeless and overcrowded prisons; airborne infection;

76
Q

lung cancer; benign and malignant tumors

A

smokers at higher risk; many tumors develop in the larger bronchi and spread to occlude the airways and cause atelectasis distal to the blockage; could be secondary sites due to metastasis from brain or breast

77
Q

pulmonary infarction

A

areas of lung tissue are deprived of O2; tissue may recover or become necrotic

78
Q

pneumoconioses

A

group of lung diseases caused by inhaling small particles from the air (asbestosis, coal-workers lung, etc)

79
Q

sarcoidosis

A

inflammatory condition with granuloma formation in various organs of the body including the lymphatic system and the lungs; granulation occurs in the lymph nodes throughout the body, but particularly in those within the thorax and lungs

80
Q

adult respiratory distress syndrome

A

rapid lung failure; causes include pneumonia, other infections such as sepsis, cardiac failure, inhalation of toxic fumes or smoke and near-drowning;

81
Q

bronchopulmonary dysplasia in pediatric respiratory distress syndrome

A

immature infant with respiratory distress syndrome who is placed on O2 and a ventilator may develop BPD

82
Q

pneumonectomy

A

removal of an entire lung. Radical and aggressive procedure. For therapy we are going to focus on airway clearance and management of fluids (huffing over coughing), incentive spirometry and breathing exercises and thoracic excursion

83
Q

lobectomy

A

removal of one lobe of the lung usually as a response to cancer or damage to lungs

84
Q

hemothorax and pneumothorax

A

air or blood int he pleural cavity; usually caused by trauma

85
Q

postpulmonary surgery complications

A

tracheotomy-may require a plug, loss of voice

lung transplant-a last resort procedure; will require mechanical ventilation for first 1-3 ;days

86
Q

classes of medications used to treat respiratory diseases

A

antibiotics; antimicrobials; anti-inflammatory agents; bronchodilators; humidification

87
Q

antibiotics

A

for bacterial infection and specific to the type of microbial, which is why a diagnosis is required

88
Q

antimicrobials

A

a general medication for bacteria or fungus that is nonspecific

89
Q

anti-inflammatory agents

A

include corticosteroids or NSAID’s

90
Q

bronchodilators

A

used for obstructive air diseases

91
Q

humidification

A

add hydration to thick fluids in the lung to allow the fluid to pass out of lungs easier

92
Q

nebulizer

A

o2 passed over a humidification and often includes adding of medications to deliver to the lung tissue

93
Q

intervention for patients with respiratory pathologies

A

postural drainage; coughing and huffing techniques; breathing exercises; ventilators; CMV

94
Q

breathing exercises

A

used to facilitate thoracic excursion for restrictive pathologies; manually resisted thoracic breathing to encourage deep inhalation

95
Q

CMV - controlled mechanical ventilation

A

used when patients are paralyzed and unable to participate in breathing

96
Q

AC units

A

assist control unit completely controls breathing with the machine programmed at specific settings.

97
Q

intermittent mandatory ventilation

A

IMV; patients have no control; the machine delivers preset amounts of O2 at intervals to supplement the breathing, while allowing patients to exhale

98
Q

PSV pressure support ventilation

A

provides patients with more control over the breathing, while ensuring a minimum level of inspiration.

PTAE 113 CLINICAL PATHOLOGY (15 decks)

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