Exam 2: chapter 29 Flashcards
what are some generalized clinical presentations of respiratory dysfunction?
o Dyspnea
-Orthopnea
- Paroxysmal nocturnal dyspnea (PND) (at night gasping for air; change
positions to breathe)
o Cough
- Acute cough normally resolves within 2-3 weeks of onset
- Chronic cough is persistent
- Smoking is a contributing factor, but so is GERD, asthma, ace inhibitors (end in -pril)
o Abnormal sputum
- Hemoptysis (coughing up blood)
->Can indicate infection, inflammation, cancer, or PE
o Abnormal breathing patterns
- Kussmaul respirations (hyperpnea)
- Cheyne-Stokes respirations
o Hypoventilation results in hypercapnia
o Hyperventilation results in hypocapnia
o Clubbing
o Pain
o Cyanosis
- Peripheral vs central
what is a pneumothorax?
Pneumothorax (collapsed lung): air leaks into the space between the lung and the chest
wall
what is a closed pneumothorax?
Closed pneumothorax: Pleural cavity pressure is less than atm p
what is a open pneumothorax?
Open pneumothorax: Pleural cavity is equal to atm p
what is a tension pneumothorax
Tension pneumothorax (medical emergency): Pleural cavity pressure is more than atm p
An acute lung injury (ALI) is characterized by…
acute lung inflammation and diffuse alveolocapillary injury
ALIs can be caused by….
Caused by sepsis, multiple trauma, pneumonia, burns, etc
ALIs can result in….
pulmonary edema
What are the three phases of an acute lung injury
Three phases
- Exudative (72 hrs): produces a ton of fluid
- Proliferative (4-21 days)
- Fibrotic (14-21 days): scarring
ALI manifestations
- Dyspnea and hypoxemia
- Hyperventilation and respiratory alkalosis
- Decreased tissue perfusion, metabolic acidosis, and organ dysfunction
-Increased work of breathing, decreased tidal volume, and hypoventilation - Hypercapnia, respiratory acidosis
- Respiratory failure, decreased CO, hypoTN, death
COPD is characterized by….
persistent airflow limitation
COPD is usually
a. untreatable
b. progressive
c. not preventable
b. progressive
Which of the following is the most common chronic lung disease in the world?
a. pulmonary fibrosis
b. asbestosis
c. pneumonitis
d. COPD
d. COPD
list risk factors of COPD
-Tobacco smoke
-Occupational dust and chemicals
-Air pollution
-Any factor affecting lung growth during gestation/childhood
what is emphysema?
Abnormal permanent enlargement of the gas-exchange airways accompanied by destruction
of alveolar walls without obvious fibrosis
-Inherited deficit of alpha-one antitrypsin protein
(protein that protects the lungs)
what are some physiological changes seen in emphysema?
Loss of elastic recoil
Barrel chest
Why does barrel chests happen?
Air exchange becomes difficult in damaged alveoli, air becomes trapped
What is chronic bronchitis?
Hypersecretion of mucus and chronic productive cough that lasts for at least 3 months of the year and for at least 2 consecutive years
explain why people with chronic bronchitis experience hypersecretion of mucus and a chronic productive cough.
Inspired irritants increase mucus production and the size and number of mucus glands
Mucus is thicker than normal
What are some treatment options for chronic bronchitis
Bronchodilators, expectorants, and chest PT used to Tx
What is asthma?
Chronic inflammatory disorder of the airways
explain the pathophysiology of asthma
Inflammation results from hyperresponsiveness of the airways
Can lead to obstruction and status asthmaticus
what are some symptoms of asthma?
Symptoms including expiratory wheezing, dyspnea, tachypnea
What are some treatments for asthma
Peak flow meters, corticosteroids, beta-agonists, and anti-inflammatories
used to Tx
describe the difference between latent Tb and active TB
Persons with latent TB infection are not infectious and cannot spread TB infection to others. They are infected with M. tuberculosis but do not have TB disease. they don’t have symptoms
Persons with TB disease (active TB) are considered infectious and may spread TB bacteria to others. they have symptoms
the name of the bacteria that causes TB
Mycobacterium tuberculosis
TB is spread by….
airborne transmission
what are tubercle formations?
Tubercles are nodules that contain caseous necrosis, which forms in the lungs as a result of an infection with Mycobacterium tuberculosis in patients with tuberculosis.
what test helps indicate if a patient has mycobacterium tuberculosis?
a positive TB skin test (PPD)
a positive skin test does not mean they are currently active but indicates further assessment with a chest X-ray
what are some risk factors for pulmonary embolus?
Occlusion of a portion of the pulmonary vascular bed by a thrombus, embolus, tissue fragment, lipids, or an air bubble
pulmonary emboli commonly arise from the ______in the ______
a. arteries: heart
b. surface veins; right arm
c. deep veins; lower legs
d. deep veins; upper legs
c. deep veins; lower legs
Define the Virchow triad.
implicates three contributing risk factors in the formation of thrombosis
What are the three contributing risk factors in the formation of a thrombosis
Venous stasis, hypercoagulability, and injuries to the endothelial cells that line the vessels
pathophysiology of cystic fibrosis
CF is caused by a mutation in the CF transmembrane conductance regulator (CFTR) gene. When mutations occur in one or both copies of the gene, ion transport is defective, and results in a buildup of thick mucus throughout the body, leading to respiratory insufficiency, along with many other systemic obstructions and abnormalities. an altered ion transport allows for bacterial colonization of the respiratory tractThese pathogens cause an overwhelming inflammatory response. Ultimately, chronic infection and this repetitive inflammatory response can lead to airway destruction
A patient has enlargement of the distal segments of the fingers. Which disease is associated with this condition?
A. Cystic fibrosis
B. Acute pneumonia
C. Sickle cell disease- doesn’t have anything to do
D. Acute myocardial infarction
A. Cystic fibrosis
A patient has a history of emphysema and has hyperinflated lungs. Which of the following would be TRUE regarding this patient?
A. Increased compliance
B. Decreased surfactant
C. Increased elastic recoil
D. Increased airway resistance
D. Increased airway resistance
- Two mechanisms: bronchoconstriction and mucous production
Which of the following is TRUE regarding the pathophysiology of asthma?
A. IgA is the major factor.
B. There is decreased vascular permeability.
C. Inflammation results in hyperresponsiveness.
D. Smooth muscle dilation occurs.
C. Inflammation results in hyperresponsiveness.
A patient has right ventricular enlargement secondary to pulmonary hypertension. Which of the following would be the most likely diagnosis?
A. Cor pulmonale
B. Acute bronchitis
C. Pulmonary embolism
D. Pulmonary thromboembolism
A. Cor pulmpnale
__________ is defined as pus within the pleural cavity.
A. Hemoptysis
B. Hypoxemia
C. Atelectasis
D. Empyema
D. Empyema
__________ refers to the bluish discoloration of the skin caused by desaturation of hemoglobin.
A. Hypoxia
B. Cyanosis
C. Hypoxemia
D. Anemia
B. cyanosis
Presence of fluid in the pleural space is known as a pleural __________.
A. effusion
B. edema
A. effusion
__________ is the passage of fluid and/or solid particles into the lung.
A. Aspiration
B. Pneumonia
C. Bronchiectasis
D. Atelectasis
A. Aspiration
__________ is an infection of the lower respiratory tract, resulting in inflammation of the alveoli, caused by bacteria, virus, fungi, protozoa, or parasites.
A. Emphysema
B. Pneumonia
C. Bronchitis
D. COPD
B. Pneumonia
Asthma can be described by all of the following characteristics EXCEPT:
A. asthma involves variable airflow obstruction
B. asthma is not reversible
C. asthma involves constriction of the airways
D. asthma involves bronchial hyperresponsiveness
B. asthma is not reversible
Chronic bronchitis is defined as:
A. acute infection or inflammation of the airways or bronchi that is usually self-limiting
B. permanent enlargement of gas-exchange airways accompanied by destruction of alveolar walls
C. persistent airflow limitation that is reversible with medications and other treatment
D. hypersecretion of mucus and chronic productive cough for at least 3 months of the year for at least 2 consecutive years.
D. hypersecretion of mucus and chronic productive cough for at least 3 months of the year for at least 2 consecutive years.
__________ is defined as the collapse of lung tissue/ alveoli.
A. Aspiration
B. Atelectasis
C. Pulmonary edema
D. Bronchiolitis
B. Atelectasis
__________ __________ occurs with alveolar hypo-perfusion and/or ventilation issues, resulting in an excess of carbon dioxide in the blood.
A. Respiratory alkalosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Metabolic acidosis
B. Respiratory acidosis
________ is a symptom, known as the subjective experience of breathing discomfort; while __________ is breathing discomfort that occurs specifically when an individual lies flat.
A. orthopnea; dyspnea
B. dyspnea; orthopnea
B. dyspnea; orthopnea
_________ is a protective reflex that can rid the airway of a foreign body. We would label this reflex as part of __________ immunity.
A. Cough; adaptive
B. Cough; innate
B. Cough; innate
The term _______ is the result of chronic hypoxemia and is described as the bulbous enlargement of distal extremities.
A. hypercapnia
B. cyanosis
C. ischemia
D. clubbing
D. clubbing
A __________ is the presence of air or gas in the pleural space caused by a rupture in the visceral pleura.
A. pneumonia
B. pneumothorax
C. pleural effusion
D. empyema
B. pneumothorax
Pulmonary edema is defined as excess ___________ in the lungs.
A. oxygen
B. arterial blood flow
C. fluid
D. carbon dioxide
c. fluid
In emphysema, the barrel chest/ hyper-expanded chest is caused by __________.
A. hypocapnia
B. hypoxemia
C. air trapping
D. high blood pressure
c. air trapping
Cor pulmonale occurs secondary to pulmonary artery hypertension and resultant __________ ventricular failure.
A. right
B. left
A. right
