Exam #4 - Respiratory Flashcards
triggers for breathing regulating chemoreceptors
blood pH - increase in CO2, decrease in pH (acidosis)
in chronic hypercapnia -> hypoxia becomes stimulus to breathe - can’t overtreat with O2
PFTs tests - MVV
maximal voluntary ventilation - the max amount that can be breathed of air in a given time
Forced vital capacity
max amt rapidly/forcefully exhaled after full inspiration
FEV 1.0
volume of air exhaled in first second of FVC
percentage of FVC
FEV1.0/FVC%
V/Q = 0
V-ventilation Q-perfusion
Shunt - perfusion without ventilation
e.g. mucous
V/Q= high
ventilation without perfusion - e.g. pulmonary embolism
2 sequelae of chronic hypoxemia
increased pulmonary HTN - vasoconstriction compensatory - can lead to RSHF
Polycythemia - inc RBC count
atelectisis
incomplete expansion of the lungs or portion of the lung -> reduced gas exchange
eti: tumor, post surgery, narcotics, anesthesia, pain, immobility
aspiration
eti - trouble clearing lungs due to diminished gag or cough or decreased LOC
aspiration can turn into pneumonia - higher risk is lower right lobe
Rhinitis
inflammation of the mucous membranes of the nose, generally viral
acute pharyngitis
usually viral, can be bacterial such as Strep or Gr. A Strep. if bacterial - worry about rheumatic heart disease as a complication
acute sinusitis
inflammation of the sinuses, can be acute or chronic, caused by virus or bacteria. HA, facial pain, pressure over sinuses, fever
tonsillitis
sore throat, difficulty swallowing, viral or bacterial
influenza
viral - either A, B or C
droplet
starts as upper, travels to lower (risk of pneumonia)
vaccine
Acute Bronchitis
typically viral
starts as upper respiratory, but marked by persistent cough (10-20 days)
inflammation of bronchi w/o evidence of pneumonia or COPD
pneumonia
bacterial or viral
inflammation of the lung tissue in the alveolar space which fills with purulent drainage. Can start as upper respiratory infection or aspiration inflammation - inhaled droplets result in mucus and exudate and edema hindering gas exchange. Lobar or bronchopneumonia (patchy and across lobes)
Hospital acquired vs community acquired pneumonia
HA - 48 hours after admission or while in hospital. 20-50% mortality
CA - usually someone who is not immunocompromised
treatment is different - HA is more aggressive
atypical pneumonia
viral or mycoplasma involving alveolar septum and interstitium of lung. minimal CMs
no leukocytosis no purulent sputum, nonproductive cough
typical pneumonia
bacterial
cough, fever, leukocytosis
Asthma
chronic, obstructive
bronchial hyperresponsiveness - restriction and spasms
triggers - smoke, fust, frequent viral infections can predispose
IgE mediated
Chronic Bronchitis
type of COPD
cough for 3 months out of the year for 2 consecutive years
hypersecretions (obstruction to inspiration), hypoxia, cyanosis
can’t get air in
Emphysema
type of COPD
overdistention of alveoli with trapped air - obstruction to expiration - loss of elastic recoil of alveoli
can’t get air out
COPD
smoker, hx of asthma or hyperresponsiveness
by the time detected it is advanced, goal is to slow progression
barrel chest, tripod, inc WOB
prolonged expiration, expiratory wheezing, crackles, tripod positioning
OSA - Obstructive Sleep Apnea
most attributed to obesity- structural
intermittent cessation of airflow
sequalae - polycythemia, pulmonary hypertension, cor pulmonale (RSHF)
CF
autosomal recessive
impaired chloride transport from CFTR gene mutation - inc NA absorption and water from the airways to the blood - cause mucous to be more viscous and sticky - same process in pancreatic and biliary ducts - leads to chronic infections, poor digestion,
Pleural effusion
abnormal collection of fluid in pleural cavity (exudate, transudate, purulent, lymph, sanguieous)
eti: HF, pulmonary infection, neoplasm
Empyema
pleural effusion - infection of the pleural cavity results in exudate w/ glucose, proteins, leukocytes
caused by adjacent bacterial PNA, infection, trauma, ruptured lung abscess
hemothorax
type of pleural effusion
blood in pleural cavity caused by chest injury or after chest surgery
sx can be sudden and distressing
pneumothorax
“collapsed lung” - air in the pleural cavity
Spontaneous Pneumo
air present in the pleural space without preceding trauma
tall young men btwn 10-30, rare in over 40
traumatic pneumo
penetrating or non-penetrating (fractured ribs) - opening to outside atmosphere, inability to maintain negative pressure - air comes in and builds up in pleural space - compresses lung
tension pneumo
intrapleural pressure exceeds atmospheric pressure - life threatening - air can enter but not leave the pleural space - puts pressure on both lungs because air accumulates in pleural space
pulmonary edema
increased hydrostatic pressure in pulmonary capillaries causes fluid from blood to diffuse into interstitial tissues
pink frothy sputum
Pulmonary hypertension
elevated pulmonary artery pressure
idiopathic, r/t left sided HF, chronic lung disease
