EXAM I Pulmonary Flashcards
fetal lungs are not fully inflated with air until when?
2 weeks after birth
in fetal lungs, surfactant that lowers alveolar surface tension is not present until ___
late in fetal development and may not be present in premature babies
in cystic fibrosis, over-secretion of thick mucus clogs the ___
respiratory system
what is common in the aged respiratory system?
- elasticity of lungs decreases
- vital capacity decreases; max amount of air moved in 1 breath
- blood oxygen levels decrease
- stimulating effects of carbon dioxide decreases
- more risks of respiratory tract infection
describe how respiration rate differs between newborns and adults
rate often increases with age
the respiratory membrane forms the ___ barrier
air-blood
what is the mechanical process of pulmonary ventilation?
- depends on volume changes in the thoracic cavity
- volume changes lead to pressure changes, which lead to equalize pressure of flow of gases
- 2 phases
- inspiration and expiration
during the process of gas exchange, ___ enters the blood as ___ enters the alveoli
- oxygen
- carbon dioxide
which cells provide protection during gas exchange? what coats the gas-exposed alveolar surfaces?
- macrophages
- surfactant
describe the process of inspiration
- diaphragm and intercostal muscles contract
- the size of the thoracic cavity increases
- external air is pulled into the lungs due to an increase in intrapulmonary volume
normal breathing moves about ___ml of air with each breath. this describes the ___
- 500
- tidal volume
what are some factors that affect respiratory capacity?
- a person’s size
- sex
- age
- physical condition
- pulmonary diseases
- restrictive lun diseases
- chronic obstructive pulmonary disease (COPD)
___ is the amount of air that can be taken in forcibly over the tidal volume, and is usually between ___ and ___ ml
- inspiratory reserve volume (IRV)
- 2100-3200ml
___ is the amount of air that can be forcibly exhaled, and is approximately ___ml
- expiratory reserve volume (ERV)
- 1200ml
___ is air remaining in the lung after expiration, and is usually about ___ml
- residual volume
- 1200ml
___ is air that actually reaches the respiratory zone, and is usually about ___ml
- functional volume
- 350ml
respiratory capacities are measured with a ___
spirometer
during neural regulation of respiration, activity of respiratory muscles is transmitted to the brain by which two nerves?
phrenic and intercostal nerves
neural centers that control rate and depth of respiration are located in the ___
medulla oblongata
which part of the brain smooths our respiratory rate?
the pons
what is eupnea?
normal respiratory rate; 12-15 per minute
___ is increased respiratory rate, often due to extra oxygen need
hyperpnia
what are some possible causes of shortness of breath?
- asthma
- mucus plugs
- PE/pneumothorax
- COPD/pulmonary edema
- poor inspiratory effort: restricting or obstructing
what is PAINT?
- pulmonary alveolar interstitial neuromuscular thoracic - a form of chronic restrictive lung disease
- the restrictive lung disease patient has a problem with expansion, so the lung volume is small
the following are characteristics of what respiratory disorder?
restricted lung expansion, decreased lung volume, decreased total lung capacity, parenchyma altered/pleural linings altered, interstitial lung diseases
PAINT
chronic restrictive lung disease
what are some interstitial lung diseases that can result from PAINT?
pneumonitis, sarcoidosis, mesothelioma, connective tissue autoimmune diseases
chronic obstructive pulmonary disease is exemplified by ___ and ___
chronic bronchitis and emphysema
what respiratory disorder is a major cause of death and disability in the US?
COPD
what are some features of patients with COPD?
- history of smoking
- labored breathing (dyspnea)
- coughing and frequent pulmonary infections
- most victims retain carbon dioxide
- have hypoxic and respiratory acidosis
- those infected will ultimately develop respiratory failure
in ___, the alveoli enlarge as adjacent chambers break through the terminal bronchioles
emphysema (pink puffers)
with emphysema, the destruction of alveoli leads to loss of ___
capillary beds
emphysema results in an increased ___ to ___ mismatch
ventilation to perfusion
low cardiac output, muscle wasting, weight loss, large amount of energy needed to exhale, and over-inflation of the lungs causing a barrel chest are characteristics of ___
emphysema
what causes emphysema patients to have a “pink puffer” appearance?
hyperventilation/ less hypoxemia
___ is a result of inflammation of the mucosa of the lower respiratory passages; metaplasia of goblet cells
chronic bronchitis (blue bloaters)
in chronic bronchitis, mucus production increases and there is chronic inflammation around ___
bronchi
in chronic bronchitis, pooled mucus around bronchi impairs ___, which can cause ___
- ventilation and gas exchange
- polycythemia due to increased ventilation/perfusion mismatch and cardiac output increases
in chronic bronchitis, the risk of ___ increases, and ___ is common
lung infection, pneumonia
___ and ___ occur early in chronic bronchitis, causing increased CO2 hypercapnia and bloating
hypoxia and cyanosis
(cyanotic refers to the “blue” in blue bloaters)
___ is chronic inflammation of the bronchiole passages, and often responds to irritants with dyspnea, coughing, and wheezing on expiration
COPD: asthma
what are imporant questions to ask asthmatic patients?
- last attack
- precipitant (what causes attack)
- ever hospitalized/intubated
- carry inhaler - daily meds, childhood asthma
what are some causes of dyspnea and asthma that are a medical emergency/ respiratory distress?
COPD, CVD, aspiration, PE, pneumonia
what are some signs/symptoms of dyspnea and asthma that are a medical emergency/ respiratory distress?
- wheezing
- anxiety
- increased respiratory rate, efforts
- diaphoresis
- flushing of face or gray, mottled appearance
what is the treatment for dyspnea and asthma that are a medical emergency/ respiratory distress?
- establish, maintain airway/ anxiety relief/ meds/ nitrous oxide
- 100% oxygen except with COPD
- monitor
- identify cause/ treat if possible
- ER
