Exam 4 part 1 Flashcards
hypoxic drive
chronic elevations of CO2 levels (like those with COPD/emphysema) causes chemoreceptors to be insensitive to CO2 levels, so the primary drive to breathe is from low O2
paroxysmal nocturnal dyspnea
sudden acute type of dyspnea that occurs in patients with left sided congestive heart failure which results from pulmonary edema. waking up gasping for air and coughing up frothy blood tinged sputum
general s/s lung disorders
fatigue
lethargy
muscle weakness
acid-base imbalance
body compensation for lung disorders
- tachycardia
- chronic hypoxia (respiratory or cardiovascular disease –> increased erythropoietin –> can cause secondary polycythemia
ventilation perfusion matching
You match ventilation (airflow to the alveoli) with blood flow to the alveoli. If you have a decrease in blood flowing to alveoli, you get bronchoconstriction in that alveoli and it won’t be ventilated. The opposite is also true - this maximizes gas exchange. disruptions can cause too imbalanced levels of o2 and co2
alveolar dead space
alveoli that should be involved gas exchange, but bc of a disease, are not
- The volume of inhaled air delivered to the alveoli that receives no blood flow
what makes alveolar dead space worse?
- Pulmonary Embolism
- Hyperinflation of the alveoli as with ventilators and Positive End Expiratory Pressure (PEEP) or COPD –> incomplete expiration
anatomical dead space
those regions of the respiratory tract that is not involved in gas exchange bc of anatomy
- upper airways, Trachea, primary, secondary tertiary bronchi (conducting zone)
Physiologic Dead Space
Anatomic Dead Space + Alveolar Dead Space
anatomical dead space and physiologic dead space relationship
In healthy individual anatomical dead space = physiological dead space; should be closer zero
age of patient that suffers from rhinoviruses
Occur in early fall and late spring in persons between ages 5 and 40
age of patient that suffers from Parainfluenza viruses
children younger than 3
age of patient that suffers from Respiratory syncytial virus
Occur in winter and spring in children younger than 3
age of patient that suffers from Coronaviruses and adenoviruses
Occur in winter and spring (any age?)
pneumococcal pneumonia progression
Infection of alveoli and bronchioles, and then inflammation. Alveoli fill with serous exudate, and then fibrin/purulent/cellular exudate: red tinged sputum. this causes consolidation (fluid and bacteria in alveoli). then WBCs denature the hemoglobin and destroy fibrous proteins and liquefy exudate - it is reabsorbed into circulation. (resolution)
primary infection TB (not immunocompromised)
initial exposure to TB, bacteria is isolated in ghon foci (bacteria is inactive and not contagious, but pos TB test) latent TB
primary TB (immunocompromised)
upon initial exposure, bacteria multiplies in the lungs, causing progressive primary TB (active infection, positive test, bacteria in sputum)
secondary tb infection
reinfection from inhaled droplet nuclei, reactivation of a previously primary lesion. bacteria / immune system damages tissues in the lungs, causing cavities.
s/s of TB
- Signs of chronic pneumonia: gradual destruction of lung tissue
- Low grade fever, night sweats, anorexia and weight loss, sputum becomes purulent and often contains blood
- Pathogen in sputum
Miliary TB
comes from progressive primary TB - bacteria erodes blood vessels and spreads through the body (looks like grains of millet on x ray)
latent TB
infected with TB bacteria, but it is isolated and unable to spread to others or cause any symptoms
intrinsic asthma
nonatopic - trigger respiratory infection, cold, exercise, drugs –> immune system no involved
extrinsic asthma
atopic - triggers type 1 hypersensitivity reaction (IgE mediated asthma)
- early acute phase response (10-20 mins)
- late phase response (4-8 hours)
s/s asthma
- cough, marked dyspnea, tight feeling in chest and agitation
- wheezing
- thick mucus coughed up
- rapid breathing with use of accessory muscles
- tachycardia
asthma treatment
- avoid trigger factors
- inhalers - bronchodilators (beta 2 adrenergic agonist like albuteral)
- glucocorticoid to reduce inflammation
- leukotriene agonist: reduce inflammation
- cromolyn sodium - preventative med that decreases sensitivity to causative factor
