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Pathophysiology Exam 2 > Disorders of Respiratory Function > Flashcards

Disorders of Respiratory Function Flashcards

1
Q

Lung Functions

A 
Gas exchange: Moves O2 into blood/Removes CO2 from blood
Blood reservoir
Regulate vasoconstricting substances
Inactivates Bradykinin
Angiotensin II
Heparin-producing cells
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2
Q

Upper Airways

A 
Move air into lungs
Warm, filter and humidify air
Trap inhaled particles
Cilia move the trapped material toward the oropharynx for expectorating or swallowing
The blood supply closest to the
	surface warms air and adds 
	humidity to improve gas 
	movement and gas exchange
The cough and sneeze 
	reflexes clear the airways
Glottis covers larynx during 
	swallowing
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3
Q

Membranes and Cavities

A

Serous Fluid holds everything together between lungs and chest wall. 10 mL’s
Infusion is when too much Serous Fluid is produced

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4
Q

Inspiration

A 
diaphragm contracts
 and chest cavity expands 
producing a decrease in 
intrathoracic pressure (-2) causing 
air to move into the lungs.
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5
Q

Expiration

A

diaphragm and chest cavity relax producing an increase in intrathoracic pressure which cause air to move out of the lungs.

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6
Q

Respiration

A

Controlled through the medulla in the central nervous system
Depends on a balance between the sympathetic and parasympathetic systems
Depends on a functioning muscular system

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7
Q

Accessory muscles of inhalation

A

External intercostals
Scalene
Sternocleidomastoid

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8
Q

Accessory muscles of exhalation

A

Internal intercostals

Abdominal muscles

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9
Q

Compliance

A 
How easily lungs can be inflated
Depends on:
Elastin and collagen fibers
Water content
Surface tension- reduced by surfactant
Compliance of thoracic cage
Poor compliance: a lot of force from the lungs.
If elastin is replaced by collagen, poor compliance occurs (pulmonary fibrosis)
Water/fluid decreases compliance
Fractured Rib: decreases compliance
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10
Q

A Man’s Lungs Were Damaged
During a Fire …
He developed severe respiratory distress
The doctor said smoke inhalation had caused an inflammation of his alveoli
The damage had also destroyed some of his surfactant
What had happened to his lung compliance?
Why was he given positive-pressure ventilation?

A

DECREASED COMPLIANCE

Positive pressure ventilation: to build pressure in the lungs

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11
Q

Gas Exchange

A

Oxygen moves from alveolar air into blood

Carbon dioxide moves from blood into alveolar air

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12
Q

Ventilation-Perfusion Mismatching

A

Blood goes to parts of the lung that do not have oxygen to give it (Shunt)
Blood does not go to parts of the lung that have oxygen (alveolar dead space)
Obstructed airway, mucous plug, food, stuck in alveolus
Pulmonary Embolism: Ventilation without perfusion
Lack of surfactant can cause a shunt

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13
Q

Oxygen-Hemoglobin Dissociation Curve

A

Shift to right: fever, acidosis

Shift to left: hypothermia, alkalosis

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14
Q

Carbon Dioxide

A

When you exhale you remove CO2 from your blood and also decrease the amount of carbonic acid, raising your blood pH

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15
Q

Apenuestic (respiratory centers)

A

begins inspiration

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16
Q

Pneumotaxic (respiratory centers)

A

stretch receptors increased lung volume

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17
Q

Central chemoreceptors

A

Function in breathing

Located in the resp center of medulla & in the CSF (cerebral spinal fluid)
Measure PCO2 and pH in cerebrospinal fluid
Increase respiration when PCO2 increases or pH decreases

If patient has chronic lung disease, central chemoreceptors aren’t really there.

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18
Q

Peripheral chemoreceptors

A

Located in the carotid and aortic bodies
Measure PO2 in arterial blood
Increase respiration when PO2 <60 mm Hg

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19
Q

Signs and Symptoms

of Pulmonary Disease

A 
Dyspnea (difficulty breathing) and cough (productive/nonproductive)
Altered breathing patterns
Hyperventilation (low CO2)
Hypoventilation (high CO2)
Hemoptysis
Abnormal sputum (cough spit)
Cyanosis (turning blue, lips, nailbeds)
Chest pain
Clubbing
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20
Q

Dyspnea

A

Sign and Symptom of Pulmonary Disease
shortness of breath
Uncomfortable breathing

Severe dyspnea
Flaring of the nostrils
Use of accessory muscles of respiration
Retraction of the intercostal spaces

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21
Q

Orthopnea

A

Dyspnea when lying down

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22
Q

Paroxysmal nocturnal dyspnea

A

GABY.
Awaking at night and gasping for air; must sit up or stand up
Pushes adipose tissue onto diaphragm, depends on sleep position

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23
Q

Cough

A

Protective reflex that helps clear the airways by an explosive expiration
Acute: 2-3 weeks
Chronic 3+ weeks

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24
Q

Hemoptysis

A

Coughing up blood or bloody secretions

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25
Eupnea
Normal breathing
26
Kussmaul respirations (hyperpnea)
Slightly increased ventilatory rate, very large tidal volume, and no expiratory pause (eliminate CO2)
27
Cheyne-Stokes respirations
Alternating periods of deep and shallow breathing; apnea lasting 15 to 60 seconds, followed by ventilations that increase in volume until a peak is reached, after which ventilation decreases again to apnea
28
Hypoventilation
Alveolar ventilation is inadequate in relationship to the metabolic demands. Leads to respiratory acidosis from hypercapnia. Is caused by airway obstruction, chest wall restriction, or altered neurologic control of breathing.
29
Hyperventilation
Alveolar ventilation exceeds the metabolic demands. Leads to respiratory alkalosis from hypocapnia. Is caused by anxiety, head injury, or severe hypoxemia.
30
Cyanosis
Bluish discoloration of the skin and mucous membranes | Develops when have five grams of desaturated hemoglobin, regardless of concentration
31
Peripheral cyanosis
Most often caused by poor circulation | Best observed in the nail beds
32
Central cyanosis
Caused by decreased arterial oxygenation (low partial pressure of oxygen [Pao2]) Best observed in buccal mucous membranes and lips
33
Clubbing
Chronic respiratory problem, lower O2 levels Found in people with COPD Round fingers
34
Pleural pain
Is the most common pain caused by pulmonary diseases. Is usually sharp or stabbing in character. Infection and inflammation of the parietal pleura (pleuritis or pleurisy) can cause pain when the pleura stretch during inspiration and are accompanied by a pleural friction rub.
35
Chest wall pain
May be from the airways. | May be from muscle or rib pain.
36
Hypercapnia
caused by hypoventilation Increased carbon dioxide (CO2) in the arterial blood Occurs from decreased drive to breathe or an inadequate ability to respond to ventilatory stimulation
37
Hypoxemia
caused by hyperventilation, O2 is abnormally low. Hypoxemia versus hypoxia: hypoxia is low O2 in blood. Ventilation-perfusion abnormalities: Most common cause of Hypoxemia. Shunting Alveolar dead space: Area where alveoli are ventilated but not perfused
38
ATELECTASIS
Incomplete expansion of a lung or portion of a lung (alveolar collapse) most commonly occurs postoperatively because of sedation (Under sedation, a patient’s respiratory rate decreases and shallow breathing occurs.)
39
A Mucus plug is not a high risk in post-op patients
False, they are at high risk
40
How do you treat atelectasis?
To treat atelectasis, the patient needs to cough and deep breathe to open all the alveoli—an incentive spirometer is used. Supplemental oxygen; may require mechanical ventilation with positive end-expiratory pressure (PEEP). Restrict fluids to decrease blood volume and minimize pulmonary edema. Administer steroids during the first 72 hours after aspiration. May need broad-spectrum antibiotics.
41
Clinical Manifestations of Atelectasis
``` Dyspnea Cough Fever Leukocytosis Absent breath sounds ```
42
What lobe is most frequently impacted when food/saliva go down in a patient with atelectasis?
Right Lower Lobe
43
Who is most at risk for atelectasis?
``` Bed ridden patients with a lot of sputum Stroke patients (weak swallowing muscles) Cerebral palsy (decreased consciousness, muscle weakness) ```
44
Pneumonia
is an inflammation of parenchymal structures of the lungs (alveoli/bronchioles)
45
Typical Pneumonia
Typical: bacteria that multiply in the alveoli Lobar: affect part or entire lobe of the lung (in the middle lobe) Bronchopneumonia: patchy distribution over more than one lobe
46
Atypical Pneumonia
Viral & Mycoplasma infections of alveolar septum or interstitium Less severe symptoms
47
Pneumonia: Predisposing factors
Loss of cough reflex Damage to the ciliated endothelium Impaired immune function The critically or chronically ill
48
Pneumonia: S/S
``` Fever Malaise: Discomfort Cough Productive or non-productive Sputum characteristics Pleuritic pain (sharp) Elderly (losing appetite, mental process) ```
49
Dx of Pneumonia
Sputum Culture, H&P, CXR
50
Tuberculosis
Infection caused by Mycobacterium tuberculosis, an acid-fast bacillus Leading cause of death from a curable infectious disease throughout the world Airborne droplet transmission Tubercle formation: Granulomatous lesion Caseous necrosis: Cheeselike material
51
Clinical Manifestations of Tuberculosis
Latent tuberculosis infection: Asymptomatic Fatigue, weight loss, lethargy, anorexia (loss of appetite), a low-grade fever that usually occurs in the afternoon, and night sweats; purulent cough
52
Diagnosis of Tuberculosis
Positive tuberculin skin test (TST) a purified protein derivative (PPD): Does not differentiate past, latent, or active disease Sputum culture, immunoassays Chest radiographs
53
Tuberculosis Treatment
Isoniazid, rifampin, pyrazinamide, and ethambutol Drug-resistant bacilli: Combination of at least four drugs to which the microorganism is susceptible, administering for 18 months. Check every 6 months
54
Secondary TB
Re-infection from inhaled droplet nuclei/Reactivation of a previously healed primary lesion Bacteria damage tissues in the airways, creating cavities Immunocompromised MOST at risk Signs of chronic pneumonia: gradual destruction of lung tissue S&S: cough (dry→productive purulent or blood-tinged), low-grade fever, night sweats, weight loss, anorexia, fatigue.
55
Pleural Effusion
Collection of fluid in the pleural cavity. (too much fluid) | Caused by CHF (increased capillary pressure), protein malnutrition, kidney failure, etc.
56
Hemothorax
collection of blood in the pleural cavity. | Causes: Blunt trauma
57
Pneumothorax
Air in the pleural cavity. | Causes: Spontaneous, ruptured blebs, emphysema, trauma, tension.
58
Different types of Pleural Effusion
Hydrothorax: serous fluid Empyema: pus (maybe pneumonia) Chylothorax: lymph Hemothorax: blood
59
Spontaneous Pneumothorax
An air-filled blister on the lung ruptures
60
Open Pneumothorax
air enters pleural cavity through the wound on inhalation but cannot leave on exhalation, FATAL
61
Tension Pneumothorax
air enters pleural cavity through the wound on inhalation and leaves on exhalation, medical emergency
62
Who is MOST at risk for pneumothorax?
Weight lifters, smokers, etc. are at risk for the bleb to form/pop
63
Pneumothorax—S&S
``` Chest pain (ipsilateral) Tachypnea: rapid/shallow respirations Dyspnea Tachycardia Hyperresonant chest percussion (a lot of air) Decreased or absent BS on affected side Hypoxemia ```

Pathophysiology Exam 2 (4 decks)

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