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Pathophysiology > Final Exam- Pulmonary > Flashcards

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
Q

What leads to dead space

A

blood supply obstruction
shunting

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26
Q

What are the 2 types of respiratory failure

A

hypercapnic
hypoxemic

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27
Q

CO2 and pH in Hypercapnic respiratory failure

A

high CO2
low pH (not compensated)

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28
Q

Mechanisms of hypercapnic respiratory failure

A

respiratory disorder that affects ventilates
CNS disorder (brainstem injury)
chest well disorder (muscle damage)
neuromuscular disorder (myasthenia gravis)

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29
Q

What is seen with hypoxemic respiratory failure

A

shunting
diffusion limitation
alveolar hypoventilation
VQ mismatch

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30
Q

Condition where part of the chest wall is unstable from a trauma/CPR

A

flail chest

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31
Q

Manifestations of Flail chest

A

SOB (hypoxia/hypercapnia)
inward movement on inspiration
outward movement on expiration

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32
Q

Term for collapsed lung

A

pneumothorax

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33
Q

Primary vs Secondary pneumothorax

A

from a bleb rupture (in healthy ppl)
vs
chest trauma, CPR, mechanical ventilation, iatrogenic

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34
Q

What is the mechanism of an open pneumothorax

A

air fils in pleura on inspiration and leaves on expiration
drops negative pressure
lung collapses

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35
Q

What is the mechanism of a tension pneumothorax

A

air goes in pleural space after an injury but doesn’t leave
shifts the heart/trachea

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36
Q

Manifestations of pneumothorax

A

tachypnea
chest pain (sharp when breathing)
decreased breath sounds on affected side

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37
Q

Term for excess fluid in pleural space

A

pleural effusion

38
Q

What diagnostic test is used for pleural effusion

A

diagnostic thoracentisis- to determine infection

39
Q

Term for watery fluid in pleural effusion

A

transudative

40
Q

Term for WBCs and plasma protein fluid in pleural effusion

A

exudative

41
Q

Term for passage of fluid, food, or gastric fluids into lungs

A

aspiration

42
Q

Term form collapse of alveoli

A

atelectasis

43
Q

When does atelectasis occur

A

after surgery
immobile patients
patients with pneumonia

44
Q

Term for persistent dilation of bronchi

A

bronchiectasis

45
Q

What are causes or bronchiectasis

A

excess mucus, aspiration, CF

46
Q

How does bronchiectasis occur

A

accumulation of mucus wides the airway
impacts gas exchange

47
Q

Term for inflammatory obstruction of bronchioles

A

bronchiolitis

48
Q

Causes of bronchiolitis

A

respiratory infection (RSV)
inhaled toxic gas
repeated infections

49
Q

Manifestations of bronchiolitis

A

hyper inflated chest
respiratory distress

50
Q

What is the mechanism of pulmonary fibrosis

A

chronic inflammation leads to changes in lung tissue
less compliance in lungs leading to ventilation issues

51
Q

Manifestation of pulmonary fibrosis

A

coarse crackles

52
Q

Term for excess water in lungs

A

pulmonary edema

53
Q

What is a predisposing factor to pulmonary edema

A

left sided heart failure due to increased capillary hydrostatic pressure

54
Q

Manifestations of pulmonary edema

A

crackles
pink frothy sputum

55
Q

Condition where there is damage to lungs from pneumonia, smoke inhalation, trauma that triggers an inflammatory response

A

acute lung injury

56
Q

What are the criteria to get diagnosed with acute lung injury

A

bilateral infiltrate on chest radiography
low O2
not from heart failure

57
Q

What determines an ARDS diagnose

A

acute lung inflammation + diffuse alveolocapillary injury

58
Q

What are the 3 phases of acute lung inflammation/ARDS

A

exudative phase (72 hrs)
proliferative phase (4-21 days)
fibrotic phase (14-21 days)

59
Q

Manifestations of acute lung inflammation/ARDS

A

leukocytosis
rales, rhonchi, wheezing
white out on X-ray

60
Q

Chronic airway disorder from constricted airways that affect ventilation

A

asthma

61
Q

Manifestations of an asthma attack

A

expiratory wheeze
exercise intolerance
diminished breath sounds

62
Q

Status asthmaticus

A

severe bronchospams that don’t react to treatment –> leads to hypoxemia/hypercapnia –> eventually intubated

63
Q

Diagnostic criteria for chronic bronchitis

A

hyper secreted mucus
chronic but productive cough that lasts 3 months

64
Q

What is the mechanism of chronic bronchitis

A

inflammation leads to airway edema
this increased goblet cells
fibrosis of smooth muscle impaired ciliary
airways narrow

65
Q

Manifestations of chronic bronchitis

A

blue bloater (cyanotic color)
polycythemia (elevated RBS w/o enough O2)
Hi pCO2
cor pulmonale

66
Q

Term for abnormal permanent enlargement of gas-exchange airways

A

emphysema

67
Q

What are the pathological effects of emphysema on the body

A

alveoli are enlarged/destroyed
loss of elastic recoil

68
Q

Manifestations of emphysema

A

pursed lip breathing
pink puffer (skin)
alveolar changes seen on X-ray
polycythemia
cor pulmonale

69
Q

What diseases are included in COPD

A

chronic bronchitis
emphysema
asthma

70
Q

Manifestations of COPD

A

barrel chest
clubbing of nails
chronic SOB

71
Q

What are risk factors for obstructive sleep apnea

A

excessive weight (on neck)
narrowed airways

72
Q

Manifestations of obstructive sleep apnea

A

apneic pauses while sleeping
snoring
daytime sleepiness
chronic mouth breathing

73
Q

Term for infection of lower respiratory tract

A

pneumonia

74
Q

Risk factors for pneumonia

A

immunosuppression, lung disease, smoking, intubation

75
Q

Sources of pneumonia infection

A

inhaled from someone’s cough/sneeze
inhaled aerosolized contaminated water
bacteremia

76
Q

Pneumonia manifestations

A

fever
pleural pain
hemopytsis (coughed up blood)
rales/rhonchi lung sounds

77
Q

How is pneumonia diagnosed

A

xray, sputum culture, urine antigen test for legionella

78
Q

Tuberculosis is pneumonia caused by a ________________

A

bacteria

79
Q

What is often formed with TB/ what happens

A

lesions (tubercle)
tissue necrosis leads to scar tissue around the tubercle

80
Q

Manifestations of tuberculosis

A

weight loss
night sweats
hemoptysis

81
Q

Diagnostic testing for tuberculosis

A

AFB culture, xray to check for cavities in lungs

82
Q

Term for localized destruction of lung tissue

A

lung abscess

83
Q

What causes a lung abscess

A

aspiration

84
Q

Manifestations of lung abscess

A

fever
foul-smelling sputum
hemoptysis

85
Q

Diagnostic test for lung abscess

A

CT to see walled of area of pus in lungs

86
Q

Term for full/partial occlusion of pulmonary vessel by a clot

A

pulmonary embolism

87
Q

Pulmonary embolisms commonly start as ___________________

A

DVT in leg that migrates

88
Q

Risk factors for pulmonary embolism

A

limited mobility
oral contraceptives

89
Q

Manifestations of pulmonary embolism

A

acute SOB
chest pain
R. heart enlargement on ultrasound

90
Q

Diagnostic test for pulmonary embolism

A

CT w/ contrast
ultrasound
check D dimer levels

91
Q

What number designates pulmonary artery hypertension

A

mean arterial pressure that is greater than 25 at rest

Pathophysiology (9 decks)

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