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Final Exam- Pulmonary Flashcards

1
Q

What are the 2 forms of O2 in serum

A

dissolved O2
hemoglobin bound O2

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2
Q

What are some factors that impact oxygenation

A

poor inspiration
alveolar damage
surfactant production
anemia
diseased tissue

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3
Q

What is the function of surfactant

A

prevents alveolar collapse
keep fluid and pathogens away

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4
Q

Term for inhalation of air into lungs and exhalation of air out of lungs

A

ventilation

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5
Q

What causes air to move in and out of lungs

A

change in intrathoracic pressure
based on contracting of diaphragm and intercostal muscles

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6
Q

What happens to diaphragm on inspiration

A

moves down (contracts)

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7
Q

What happens to diaphragm on expiration

A

moves up (relaxes)

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8
Q

what occurs during hyperventilation

A

ventilation exceeds the metabolic demand
hypocapnia (blow out excessive CO2=respiratory alkalosis)

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9
Q

What occurs during hypoventilation

A

inadequate ventilation related to metabolic demand
hypercapnia= slower breathing/high CO2

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10
Q

What is the effect of severe hypercapnia

A

vasodilation
increased intracranial pressure= decreased cerebral diffusion
mental status changes

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11
Q

What is the effect of severe hypocapnia

A

vasoconstriction
decreased cerebral perfusion= mental status changes

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12
Q

What are the main muscles used for normal inspiration

A

diaphragm
external intercostal muscles

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13
Q

What accessory muscles are used if a person is struggling to breathe

A

I: sternocleidomastoid; scalene
E: abdominal; internal intercostal

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14
Q

2 major causes of obstructed ventilation

A

compressed; narrowing of airway
disrupted neural transmission to stimulate air movement

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15
Q

Measure of ease of expansion of lungs

A

lung compliance

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16
Q

What impacts ease of lung expansion

A

lung elasticity
elastic recoil of chest wall

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17
Q

What can changes in lung compliance/ airway resistance affect

A

oxygenation and ventilation

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18
Q

any impediment to airflow on inspiration or expiration

A

airway resistance

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19
Q

What impacts airway resistance

A

change in airway diameter
airway obstruction

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20
Q

blood flow to lung tissue

A

perfusion

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21
Q

What impacts perfusion

A

cardiac function
shock
narrowed blood vessels
blood vessel obstruction

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22
Q

Term when blood leaves heart without doing gas exchange

A

shunting

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23
Q

Anatomical vs intrapulmonary shunt

A

ventricular septal defects
vs
blood enter pulmonary space w/o doing gas exchange

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24
Q

Term for area of lung where there’s no perfusion

A

dead space

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25
What leads to dead space
blood supply obstruction shunting
26
What are the 2 types of respiratory failure
hypercapnic hypoxemic
27
CO2 and pH in Hypercapnic respiratory failure
high CO2 low pH (not compensated)
28
Mechanisms of hypercapnic respiratory failure
respiratory disorder that affects ventilates CNS disorder (brainstem injury) chest well disorder (muscle damage) neuromuscular disorder (myasthenia gravis)
29
What is seen with hypoxemic respiratory failure
shunting diffusion limitation alveolar hypoventilation VQ mismatch
30
Condition where part of the chest wall is unstable from a trauma/CPR
flail chest
31
Manifestations of Flail chest
SOB (hypoxia/hypercapnia) inward movement on inspiration outward movement on expiration
32
Term for collapsed lung
pneumothorax
33
Primary vs Secondary pneumothorax
from a bleb rupture (in healthy ppl) vs chest trauma, CPR, mechanical ventilation, iatrogenic
34
What is the mechanism of an open pneumothorax
air fils in pleura on inspiration and leaves on expiration drops negative pressure lung collapses
35
What is the mechanism of a tension pneumothorax
air goes in pleural space after an injury but doesn't leave shifts the heart/trachea
36
Manifestations of pneumothorax
tachypnea chest pain (sharp when breathing) decreased breath sounds on affected side
37
Term for excess fluid in pleural space
pleural effusion
38
What diagnostic test is used for pleural effusion
diagnostic thoracentisis- to determine infection
39
Term for watery fluid in pleural effusion
transudative
40
Term for WBCs and plasma protein fluid in pleural effusion
exudative
41
Term for passage of fluid, food, or gastric fluids into lungs
aspiration
42
Term form collapse of alveoli
atelectasis
43
When does atelectasis occur
after surgery immobile patients patients with pneumonia
44
Term for persistent dilation of bronchi
bronchiectasis
45
What are causes or bronchiectasis
excess mucus, aspiration, CF
46
How does bronchiectasis occur
accumulation of mucus wides the airway impacts gas exchange
47
Term for inflammatory obstruction of bronchioles
bronchiolitis
48
Causes of bronchiolitis
respiratory infection (RSV) inhaled toxic gas repeated infections
49
Manifestations of bronchiolitis
hyper inflated chest respiratory distress
50
What is the mechanism of pulmonary fibrosis
chronic inflammation leads to changes in lung tissue less compliance in lungs leading to ventilation issues
51
Manifestation of pulmonary fibrosis
coarse crackles
52
Term for excess water in lungs
pulmonary edema
53
What is a predisposing factor to pulmonary edema
left sided heart failure due to increased capillary hydrostatic pressure
54
Manifestations of pulmonary edema
crackles pink frothy sputum
55
Condition where there is damage to lungs from pneumonia, smoke inhalation, trauma that triggers an inflammatory response
acute lung injury
56
What are the criteria to get diagnosed with acute lung injury
bilateral infiltrate on chest radiography low O2 not from heart failure
57
What determines an ARDS diagnose
acute lung inflammation + diffuse alveolocapillary injury
58
What are the 3 phases of acute lung inflammation/ARDS
exudative phase (72 hrs) proliferative phase (4-21 days) fibrotic phase (14-21 days)
59
Manifestations of acute lung inflammation/ARDS
leukocytosis rales, rhonchi, wheezing white out on X-ray
60
Chronic airway disorder from constricted airways that affect ventilation
asthma
61
Manifestations of an asthma attack
expiratory wheeze exercise intolerance diminished breath sounds
62
Status asthmaticus
severe bronchospams that don't react to treatment --> leads to hypoxemia/hypercapnia --> eventually intubated
63
Diagnostic criteria for chronic bronchitis
hyper secreted mucus chronic but productive cough that lasts 3 months
64
What is the mechanism of chronic bronchitis
inflammation leads to airway edema this increased goblet cells fibrosis of smooth muscle impaired ciliary airways narrow
65
Manifestations of chronic bronchitis
blue bloater (cyanotic color) polycythemia (elevated RBS w/o enough O2) Hi pCO2 cor pulmonale
66
Term for abnormal permanent enlargement of gas-exchange airways
emphysema
67
What are the pathological effects of emphysema on the body
alveoli are enlarged/destroyed loss of elastic recoil
68
Manifestations of emphysema
pursed lip breathing pink puffer (skin) alveolar changes seen on X-ray polycythemia cor pulmonale
69
What diseases are included in COPD
chronic bronchitis emphysema asthma
70
Manifestations of COPD
barrel chest clubbing of nails chronic SOB
71
What are risk factors for obstructive sleep apnea
excessive weight (on neck) narrowed airways
72
Manifestations of obstructive sleep apnea
apneic pauses while sleeping snoring daytime sleepiness chronic mouth breathing
73
Term for infection of lower respiratory tract
pneumonia
74
Risk factors for pneumonia
immunosuppression, lung disease, smoking, intubation
75
Sources of pneumonia infection
inhaled from someone's cough/sneeze inhaled aerosolized contaminated water bacteremia
76
Pneumonia manifestations
fever pleural pain hemopytsis (coughed up blood) rales/rhonchi lung sounds
77
How is pneumonia diagnosed
xray, sputum culture, urine antigen test for legionella
78
Tuberculosis is pneumonia caused by a ________________
bacteria
79
What is often formed with TB/ what happens
lesions (tubercle) tissue necrosis leads to scar tissue around the tubercle
80
Manifestations of tuberculosis
weight loss night sweats hemoptysis
81
Diagnostic testing for tuberculosis
AFB culture, xray to check for cavities in lungs
82
Term for localized destruction of lung tissue
lung abscess
83
What causes a lung abscess
aspiration
84
Manifestations of lung abscess
fever foul-smelling sputum hemoptysis
85
Diagnostic test for lung abscess
CT to see walled of area of pus in lungs
86
Term for full/partial occlusion of pulmonary vessel by a clot
pulmonary embolism
87
Pulmonary embolisms commonly start as ___________________
DVT in leg that migrates
88
Risk factors for pulmonary embolism
limited mobility oral contraceptives
89
Manifestations of pulmonary embolism
acute SOB chest pain R. heart enlargement on ultrasound
90
Diagnostic test for pulmonary embolism
CT w/ contrast ultrasound check D dimer levels
91
What number designates pulmonary artery hypertension
mean arterial pressure that is greater than 25 at rest

Pathophysiology (9 decks)

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