Final Flashcards
What is asthma?
- an obstructive pulmonary disease characterized by airway inflammation, bronchospasm and excessive mucus production in response to various stimuli
- a key feature of asthma is that the airway obstruction is reversible
What are the pathological changes of asthma?
- airway edema
- smooth muscle constriction of bronchial airways (bronchospasm)
- excessive production of thick white bronchial secretions
- mucus plugging
- hyperinflation of alveoli (air trapping)
What is extrinsic asthma?
predisposition, IgE antibody production, allergens such as dust mites, pollen, grass, house dust, cockroaches and food preservatives
What is the immunologic response to asthma?
- Exposure to antigen (antibody formation)
- Re-exposure (mast cell degranulation and release of chemical mediators)
- Chemical Response: inflammation, bronchospasm, mucus hypersecretion
Early response begins ____ and lasts about an hour. Late response begins ____ after exposure and lasts for a while.
in minutes; hours
What is intrinsic asthma?
occurs after age 40, not linked to a specific antigen, common stimuli include infections, exercise, cold air, industrial and occupation exposure (isocyanate, trimellitic anhydride), drug and food preservatives, GERD, nocturnal asthma, stress, and premenstrual asthma
What are the physical findings of asthma?
- Increased: Resp Rate, Heart Rate and Blood Pressure
- Accessory muscle use during inspiration and expiration
- Pursed Lip Breathing
- Increased Airway Resistence
- Retractions
- Cyanosis
- Cough, Sputum production, Hemoptysis (thick, white, tenacious sputum with eosinophils and other white blood cells)
- Pulsus Paradoxus
- Decreased blood pressure during inspiration and -increased during expiration
What are the chest assessment findings of asthma?
Prolonged expiratory phase Decreased tactile fremitus Hyperresonant percussion Diminished Heart Sounds Wheezing and Rhonchi
What are the radiologic findings of asthma?
Dark Lung fields (translucence)
depressed or flattened diaphragm
What are the PFT results of asthma?
VC- Decreased FRC- Increased FVC- Decreased FEV1- Decreased PEFR- Decreased
What is COPD?
- is a preventable and treatable disease state characterized by airflow limitation that is not fully reversible.
- the airflow limitation is usually progressive and is associated with an abnormal inflammatory response of the lungs to noxious particles or gases, primarily caused by cigarette smoking.
What tests confirm COPD?
Three main spirometry tests are FEV1, FVC, FEV1/FVC, when FEV1 and ratio are decreased
What are the stages of COPD?
Stage 1: FEV1 >= 80%
Stage 2: FEV1 50- <30% or 50% predicted, with chronic ventilatory failure
What is emphysema?
- Is defined pathologically as the presence of permanent enlargement of the airspaces distal to the terminal bronchioles, accompanied by destruction of their walls and without obvious fibrosis
- Emphysema is based on the pathology, or the “anatomic alterations of the lung,” associated with the disorder.
What are the anatomic alterations of emphysema?
˜Permanent enlargement and deterioration of the air spaces distal to the terminal bronchioles
˜Destruction of pulmonary capillaries
˜Weakening of the distal airways, primarily the respiratory bronchioles
˜Air trapping and hyperinflation of alveoli (air-trapping)
What is chronic bronchitis?
I-s defined clinically as chronic productive cough for 3 months in each of 2 successive years in a patient in whom other causes of productive chronic cough have been excluded Caused by: smoking, pollutants, more common among males
˜Chronic bronchitis is based on the major “clinical manifestations” associated with the disease.
What are the anatomical alterations of chronic bronchitis?
˜Chronic inflammation and swelling of the peripheral airways
˜Excessive mucus production and accumulation
˜Partial or total mucus plugging of the airways
˜Smooth muscle constriction of bronchial airways (bronchospasm)
˜Air trapping and hyperinflation of alveoli-occasionally in the late stages
What are the PFT findings of chronic bronchitis?
VT, FRC, TLC, RV/TLC- N or inc
RV- inc
IRV, ERV, IC- N or dec
VC- dec
What is bronchiectasis?
Comes in three forms, Varicose, Cylindrical and saccular
What are the anatomic alterations of bronchiectasis?
Chronic dilation and distortion of bronchial airways
Excessive production of foul smelling sputum
Bronchospasm
Hyperinflation of alveoli
Atelectasis, consolidation and parenchymal fibrosis
Hemorrhage secondary to bronchial arterial erosion
What are the findings of the physical exam of bronchiectasis?
Increased respiratory rate, heart rate and blood pressure
Use of accessory muscles during inspiration and expiration
Cyanosis, Pursed Lip Breathing, Digital Clubbing, Peripheral Edema and Venous Distention, Cough, Sputum Production and Hemoptysis
What are the chest assessment findings of bronchiectasis?
Decreased tactile and vocal fremitus
Hyperresonant percussion
Diminished breath sounds
Wheezing and Rhonchi
What are the PFT findings for bronchiectasis?
- VT, TLC, RV/TLC- N or inc
- RV, FRC- inc
- IRV, ERV, IC- N or dec
- VC- dec
What are the radiologic findings for bronchiectasis?
Depressed or Flattened Diaphragm, Long/Narrow heart or Enlarged heart, areas of consolidation and atelectasis
What are the anatomic alterations of pneumonia?
˜Inflammation of the alveoli
˜Alveolar consolidation
˜Atelectasis
What are the clinical signs of pneumonia?
Increased respiratory rate, heart rate, cardiac output, and blood pressure
Chest pain, cyanosis, cough, sputum production, hemoptysis
What are the chest assessment findings for pneumonia?
Increased tactile and vocal fremitus Dull percussion Bronchial breath sounds Crackles and Rhonchi Pleural friction rub and whispering pectoriloquy
What are the PFT findings of pneumonia?
- VT, IRV- N or dec
- RV, IC, ERV, FRC, VC, TLC- dec
- RV/TLC- N
What are the radiologic findings of pneumonia?
Increased density, air bronchograms, pleural effusions
