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Pathophysiology: Respiratory System > Expansion Disorders > Flashcards

Expansion Disorders Flashcards

1
Q

Atelectasis

A

Nonaeration or collapse of lung or part of a lung

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2
Q

What does atelectasis lead to?

A

A decreased gas exchange and hypoxia

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3
Q

ls atelectasis a primary or secondary condition?

A

Secondary, it can occur as a complication of many primary conditions.

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4
Q

What happens to the alveoli during atelectasis?

What does this do to the elastic fibers of the alveoli?

A

The alveoli become airless

The elastic fibers shrivel up

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5
Q

What happens to the lung, pathophysiologically during atelectasis?

A

Collapse and inflammation or atrophy occur

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6
Q

How does atelectasis affect blood flow through lungs?

A

It interferes with it.

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7
Q

In patients with atelectasis, ventilation and perfusion are both altered, what does this have an effect on?

A

It affects oxygen diffusion

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8
Q

What type of atelectasis is caused by total obstruction of the airway?
Describe what happens to the air and tissue distal to the obstruction.

A

Obstructive or resorption atelectasis
Air distal to the obstruction diffuses into the tissues and is not replaces.
The tissue begins to shrivel.

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9
Q

Compression atelectasis is caused by:

This prevents:

A

Mass or tumor exerts pressure on a part of the lung

It prevents air from entering a portion of the lung

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10
Q

What causes increased surface tension in alveoli?

What does increased surface tension prevent?

A
  • Surfactin prevents surface tension in alveoli

- This prevents lung expansion

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11
Q

Where does fibrotic tissue form during atelectasis?

What might this type of tissue cause?

A

Fibrotic tissue forms in the lungs or pleura

It may restrict expansion and lead to collapse

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12
Q

What event could lead to atelectasis?

A

After surgery, a patient could acquire postoperative atelectasis.

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13
Q

If the patient only has small areas of atelectasis, what symptoms can they expect?

A

None, the patient is asymptomatic.

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14
Q

If the patient only has large areas of atelectasis, what symptoms can they expect? (4)

A
  1. Dyspnea
  2. Increased heart rate
  3. Rales
  4. Chest pain
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15
Q

What sound would you expect to hear from the chest of a patient with large areas of atelectasis?

A

Rales

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16
Q

What is a Pleural Effusion?

A

Presence of excessive fluid in the pleural cavity

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17
Q

What does pleural effusion cause?

A

It causes increased pressure in the pleural membrane and the separation of the pleural membranes

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18
Q

What are exudative effusions in response to?

A

Inflammation

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19
Q

What type of effusions are caused by transudate effusions?

A

Watery effusions

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20
Q

What is the scientific name for watery effusions?

A

Hydrothorax

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21
Q

What are transudate effusions the result of?

A

Result of increased hydrostatic pressure or decreased osmotic pressure in blood vessels

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22
Q

Define hydrostatic pressure

A

The pressure of the water being pushed

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23
Q

A decrease in what protein decreases osmotic pressure?

A

Albumin

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24
Q

Describe the cough and respiratory sound and rate of a patient with a pleural effusion.

A

Dyspnea
Increased respiratory rate
Decreased breath sound
Pleural friction rub

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25
Q

Where would a patient with pleural effusion have pain?

A

In their chest.

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26
Q

What are the treatments for pleural effusion?

A
  1. Removing of underlying cause to treat respiratory impairment
  2. Analyze fluid to confirm cause
  3. Chest drainage, throacocentesis
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27
Q

What is throacocentesis?

What does it do?

A

It’s done to remove fluid and relieve pressure

It is done putting a needle inserted under armpit to allow fluid drainage.

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28
Q

What is pneumothorax?

A

Air in the pleural cavity

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29
Q

What is a closed pneumothorax?
Is there any opening?
Where does air enter from?

A

When air can enter the pleural cavity from internal airways, there are no openings in the chest wall.

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30
Q

What is a simple or spontaneous pneumothorax?
Is there a tear?
Where does air enter from?
What closes the leak?

A

A tear on the surface of the lung.
Air enters pleural cavity from a bronchus.
Eventually the lung collapses and closes off the leak

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31
Q

In what patient type is simple pneumothorax most common?

A

In young men with no history

32
Q

What idiopathic problem could cause simple pneumothorax?

A

Possible idiopathic bleb or defect

33
Q

What is a secondary pneumothorax associated with?

A

An underlying respiratory disease

34
Q

What is a secondary pneumothorax caused by?

A 
A rupture of an emphysematous bleb on the lung surface 
or 
Erosion by a tumor
or 
By a tubercular cavitation
35
Q

What is an open pneumorax?

A

Atmospheric air enters the pleural cavity through an opening in the chest wall.

36
Q

What is the term for the would associated with an open pneumothorax?

A

Sucking wound: a large opening in the chest wall.

37
Q

What is the most serious form of a pneumothorax?

A

Tension pneumothorax.

38
Q

What is a tension pneumothorax the result of?

A

It is the result of an opening through the chest wall and parietal pleura
or
from a tear in the lung tissue and visceral pleura

39
Q

When does the hole close during a tension pneumothorax, during inspiration or expiration

A

Air entry into pleural cavity on inspiration but hole closes on expiration

40
Q

During a tension pneumothorax, what does the entrapment of the air lead to?

A

Increased pressure in the pleura and atelectasis

41
Q

What does a flail chest result from?

A

Fractures of ribs, which allow ribs to move independently during respiration

42
Q

How to the broken portions of the ribs in a flail chest move during inspiration?

A

The Flailed or broken section moves inward rather than outward

43
Q

What does in the inward movement of ribs in a flail chest do to lungs during inspiration?

A

Prevents expansion of affected lung

44
Q

What can a large flail section do to adjacent lung tissue?

A

Compress adjacent lung tissue

45
Q

How can a large flail section compress adjacent lung tissue?

A

Pushing air out of that section – up the bronchus

46
Q

Where does the air in the damaged lung of a flailed chest go?

A

Air (stale) from damaged lung crosses into the other lung with newly inspired air

47
Q

What happens to the unstable flail section during expiration?

A

Unstable flail section pushed outward by increasing intrathoracic pressure

48
Q

What happens to the airflow of a large flail section during expiration?

A

Paradoxical movement of ribs alters airflow during expiration

49
Q

Where does air move in a flail chest during expiration ?

A

Air from unaffected lung moves across into affected lungs

50
Q

What does hypoxia result from when it is accompanied with a flail chest?

A

Hypoxia results from limited expansion and decreased inspiratory volume

51
Q

What type of infants is infant respiratory distress syndrome most common in?

A

Usually related to premature birth

52
Q

Which innate immune system collectin is missing in the alveoli of premature infants with Respiratory Distress Syndrome?

A

Surfactant

53
Q

Why do premature babies develop infant respiratory distress syndrome?

A

Patients have poorly developed alveoli with are difficult to inflat

54
Q

What results due to the poor alveolar inflation of patients with infant respiratory distress syndrome?

A

Diffuse atelectasis results

55
Q

What effect of blood flow does the poor alveolar inflation have in patients with infant respiratory distress syndrome?

A
  1. Decreased pulmonary blood flow
  2. Pulmonary vasoconstriction
  3. Severe Hypoxia
56
Q

When may the respiratory difficulties of patients with infant respiratory distress syndrome be evident?

A

At birth or shortly thereafter

57
Q

Describe the respirations, their sounds, and the actions of the chest and nostrils of a patient with infant respiratory distress syndrome.

A

Respirations are rapid, irregular and shallow with periods of apnea
Decreased breath sounds
Chest Retractions
Flaring of nares (nostrils)

58
Q

Describe the sputum of a patient with infant respiratory distress syndrome?
What do they do to get it out?

A

Frothy sputum and expiratory grunt

59
Q

What happens to the blood pressure of a patient with infant respiratory distress syndrome?

A

The BP falls

60
Q

Due to the hypoxia, what happens to a patient with infant respiratory distress syndrome? (2)

A

Cyanosis, decreased responsiveness

61
Q

Due to the drop in blood pressure, what happens to a patient with infant respiratory distress syndrome?

A

Peripheral edema

62
Q

What treatments are given to mothers who are in premature labor?

A

Glucocorticoids

63
Q

What treatments are given to a High risk neonate patient with infant respiratory distress syndrome?

A

Synthetic surfactant

64
Q

How does a patient with infant respiratory distress syndrome get help with ventilation?

A

CPAP

65
Q

What drug or molecule therapies are given to a patient with infant respiratory distress syndrome?

A

Nitrous Oxide Drugs

Oxygen Therapy

66
Q

What does Adult (Acute) Respiratory distress syndrome result from?

A

Injury to the alveolar wall and capillary membrane

67
Q

What does Adult (Acute) Respiratory distress syndrome cause the release of?
What four things do they do

A

Chemical Mediators which:

  1. Increase permeability of alveolar capillary membranes
  2. Increased fluid and protein in interstitial area and alveoli
  3. Damage to surfactant-producing cells
  4. Diffuse necrosis and fibrosis if patient survives
68
Q

What is Adult (Acute) Respiratory distress syndrome often associated with?

A

Often associated with multiple organ dysfunction or failure

69
Q

Describe the cough of a patient with Adult (Acute) Respiratory distress syndrome.

A

Dyspnea

70
Q

Describe the behavior of a patient with Adult (Acute) Respiratory distress syndrome.

A

Restless

71
Q

Describe the respiration of a patient with Adult (Acute) Respiratory distress syndrome.

A

Rapid, shallow respiration

72
Q

Describe the heart rate of a patient with Adult (Acute) Respiratory distress syndrome.

A

Increased heart rate

73
Q

Do patients with Adult (Acute) Respiratory distress syndrome have respiratory or metabolic acidosis?

A

Both

74
Q

What are the ways to treat patients with Adult (Acute) Respiratory distress syndrome?

A
  1. Treatment of underlying cause

2. Supportive respiratory therapy

75
Q

What could Acute Respiratory Failure result from?
Acute or chronic disorders?
Name one disorder.
What type of disorders, where are their origins?

A

Acute or chronic disorders
Emphysema
Acute respiratory disorders or neuromuscular diseases

76
Q

Treatment from patients with Acute Respiratory Failure are (2):

A
  1. Primary problem must be resolved

2. Supportive treatment to maintain respiratory function

Pathophysiology: Respiratory System (6 decks)

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