Exam 4 part 2 Flashcards
wheezing
indicated obstruction in intrathoracic airways (lower airways) prolonged expiration
- acute bronchiolitis
- asthma
stridor
obstruction of the extrathoracic (upper) air ways
- high pitched inspiration
- croup
- epiglottitis
ghon focus
granulomatous lesion containing macrophages, t cells, and inactive/alive TB bacteria - seen in primary TB
ghon complex
nodules in the lung tissue and lymph nodes
- caseous necrosis inside nodules
- calcium may deposit in fatty area of necrosis
- visible on xrays
- includes ghon focus + lymph nodes
typical pneumonia
bacteria in the alveoli
- lobar (affects entire lobe of lung) or bronchopneumonia (patchy distribution over more than one lobe)
- inflammation and purulent exudate, productive cough
- pneumococal pneumonia: most common type (pyogenic with 80 subtypes)
atypical pneumonia
walking pneumonia
- viral/mycoplasma infections of alveoler septum or interstitium
- unproductive cough: dry/hacking
- lack of consolidation
- decreases lung defenses - predisposed to bacterial infection
- fever, headache, muscle aches
- antigen is not in the lungs, but the ECM around alveoli
4 types of pleural effusion and the treatment
hydrothorax, chylothorax, empyema, hemothorax. treated depending on cause, but usually start with draining/sampling (thoracentesis)
Hydrothorax
accumulation of serous fluid
- Seen in heart failure, renal failure, liver failure
- yellow
Empyema
infection in plural cavity -> pus (debris from dead cells, protein, leukocytes)
Chylothorax
lymph -> milky white
- Results from trauma, inflammation, indicates ruptured lymphatic vessel
Hemothorax
blood in the plural cavity
Chest injury, chest surgery
- Requires drainage
dangers of pleural effusion
To much fluid in plural cavity - separation of plural membranes - collapsed lung - atelectasis (unable to inflate)
difference between pulmonary edema and effusion
effusion: fluid accumulation in the pleural cavity
edema: fluid accumulation in the lung tissue/alveoli
pneumothorax
air enters pleural cavity and takes up space, restricting lung expansion
- partial or complete collapse of the lung - atelectasis
spontaneous / closed pneumothorax
rupture of air filled bleb/blister on lung surface
- bleb is then sealed off
- no effect on unaffected lung
- pt with lung disease
open pneumothorax
- air moves in and out of opening in chest wall
- mediastinal flutter impairs venous return
- decreases amount of air that enters unaffected lung during inspiration
tension pneumothorax
- air moves in during inspiration, but not out at expiration
- air build up compresses unaffected lung and pushes mediastinum to unaffected side
- compresses vena cave and reduces venous return and CO
- life threatening
pneumothorax s/s
- Increased respiration rate
- Ipsilateral lung pain (pain on side of collapsed lung)
- Asymmetry of the chest during inspiration
- Decreased breathing sounds on affected side
treatment pneumothorax
- small spontaneous - air is reabsorbed on its own
- other: needle aspiration or closed drain system - one way valve. remove air with chest tube and cause the pleura to come back together and close up wound
3 types of COPD
- emphysema
- chronic bronchitis
- bronchiectasis
emphysema pathophysiology
- diseases characterized by increase compliance to air flow bc of chronic or recurring expiratory obstruction
- Breakdown of alveoli wall –> decreases surface area
- Lost of pulmonary capillaries –> decreased gas exchange
- Lost of elastic fibers –> easy to get air in but not out (increased compliance)
emphysema etiology
- Smoking or genetic
- Smoking: Neutrophils in the alveoli secrete elastase.
Increased neutrophil numbers due to inhaled irritants –> increase release of elastase –> damage alveoli by breaking down the elastic tissue - Elastase also decreases antitrypsin activity
Genetic: antitrypsin deficiency
Exposure to other air pollutants - easy to get air in, difficult to get it out
emphysema s/s
- Dyspnea
- Hyperventilation with prolonged expiratory phase
- Anorexia
- Clubbed fingers with secondary polycythemia
- breathing with pursed lips
chronic bronchitis pathophysiology
- Obstruction of small airways
- Changes in bronchi - constant irritation from smoking or exposure to industrial pollution.
- Effects are irreversible and progressive
chronic bronchitis characteristics
- inflammation of the bronchi from cigarette smoke
- Inflammation and obstruction
- repeated infection
- chronic coughing
- Increased number of mucous cells - hypersecretion of mucous
chronic bronchitis s/s
Constant productive cough
Shortness of breath
Mucous secretion are thick and purulent
Cough: more sever in morning
Airway obstruction - hypoxia
