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Anatomy and Phyisology > HLTH 2501: obstructive lung diseases > Flashcards

HLTH 2501: obstructive lung diseases Flashcards

1
Q

cystic fibrosis

A

is an inherited disorder that involves several mutations to the CFTR and also a protein involved in chloride ion transport into the cell membrane

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2
Q

CFTR

A

cystic fibrosis transmembrane conductance regulator

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3
Q

major effect of cystic fibrosis

A

exocrine glands cause abnormally thick secretions often obstructing passageways in the lungs and pancreas

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4
Q

obstruction in the lungs due to cystic fibrosis

A

mucus obstructs the airflow in the bronchioles, causing air trapping or atelectasis; infections are also common here due to the stagnant mucus that is good for bacterial growth

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5
Q

common causative organisms for secondary infections in cystic fibrosis

A

P aeruginosa and S aureus

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6
Q

what will eventually develop with cystic fibrosis?

A

respiratory failure or right-sided CHF

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7
Q

cystic fibrosis in the digestive tract

A

in infants, the small intestine is blocked by mucus at birth; in the pancreas and liver, the ducts of the exocrine glands become blocked, leading to a deficit of pancreatic enzymes and bile in the intestine, resulting in malabsorption and malnutrition; damage to the islets of Langerhans may also occur, leading to diabetes mellitus

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8
Q

meconium ileus

A

occurs in newborns with cystic fibrosis, in which the small intestine is blocked by mucus

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9
Q

general effects of cystic fibrosis in the digestive tract

A

malabsorption, malnutrition, and dehydration

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10
Q

salivary glands and cystic fibrosis

A

are mildly affected, with secretions that are abnormally high in NaCl and mucus plugs in the submaxillary and sublingual glands

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11
Q

sweat glands and cystic fibrosis

A

they produce sweat high in NaCl content

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12
Q

what can obstruction of bile ducts in the liver result in?

A

biliary cirrhosis

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13
Q

reproductive system and cystic fibrosis

A

thick mucus may obstruct the vas deferens in males or the cervix in females, leading to sterility or infertility

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14
Q

genetical inheritance for cystic fibrosis

A

the mutated gene is CFTR and is located on the seventh chromosome and is transmitted as an autosomal recessive disorder

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15
Q

signs of cystic fibrosis

A

meconium ileus at birth, salty skin, steatorrhea, distended abdomen, failure to gain weight, chronic cough, common respiratory infections, and failure to meet normal growth milestones

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16
Q

testing for cystic fibrosis

A

can be done through genetic testing to identify the CFTR mutations at birth, sweat or stool can also be analyzed, as well as X-rays, pulmonary function tests, and blood gas analysis

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17
Q

treatment for cystic fibrosis

A

replacement of pancreatic enzymes and bile salts, a well balanced diet (high calorie, high protein, low fat, and vitamin supplementation), avoiding dehydration, intensive chest PT, bronchodilators, humidifiers, and regular moderate aerobic exercise

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18
Q

example of a pancreatic enzyme replacement drug

A

pancrelipase

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19
Q

what is often the cause of death for cystic fibrosis?

A

respiratory failure

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20
Q

lung cancer

A

is the third most common cancer in the US and is most often malignant tumors that are primary or secondary

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21
Q

why are the lungs a common site for secondary tumors?

A

because the venous return and lymphatics bring tumor cells from many distant sites in the body to the heart and then into the pulmonary circulation

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22
Q

two main groups of lung cancers

A

small cell lung cancer (13%) and nonsmall cell lung cancer (84%); differences between these groups are cellular morphology, rate of metastasis, and treatment

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23
Q

small cell lung cancer

A

the cells are smaller and round, spread rapidly, and have a higher mortality rate; often is associated with smoking and is resistant to chemo

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24
Q

nonsmall cell lung cancer

A

the cells are larger, the spread is less aggressive, and responds well to chemo

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25
Q

subtypes of nonsmall cell lung cancer

A

adenocarcinoma, squamous cell carcinoma, and large cell carcinoma

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26
Q

the most common type of lung tumor

A

bronchogenic carcinoma; this arises from the bronchial epithelium

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27
Q

squamous cell carcinoma

A

usually develops in the epithelial lining of a bronchus near the hilum and projects into the airway

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28
Q

adenocarcinomas

A

are from glands that secrete mucin and are found on the periphery of the lung, making them harder to detect in the early stages

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29
Q

oat cell carcinoma

A

are located near a major bronchus in the central part of the lung; tend to be invasive and metastasize early

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30
Q

mesothelioma

A

has received attention from legal firms as it may be caused by asbestos exposure

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31
Q

pleural mesothelioma

A

most often affects the pleura surrounding the lungs; usually is fatal

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32
Q

first change in the lungs for lung cancer

A

is metaplasia which is a change in the epithelial tissue often associated with smoking or chronic irritation, leaving the tissue vulnerable to irritants and inflammation

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33
Q

second change in the lungs for lung cancer

A

dysplasia or carcinoma in situ develops

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34
Q

common site for tumors spreading from the lungs

A

brain, bone, and liver

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35
Q

effects of tumors in the lungs

A

obstruction of airway flow causing abnormal breath sounds and dyspnea, inflammation that causes a cough, vulnerability to secondary infections, pleural effusion, paraneoplastic syndrome, and systemic effects of cancer

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36
Q

paraneoplastic syndrome

A

may accompany bronchogenic carcinoma when the tumor cell secretes hormones or hormone like substances such as ADH or adrenocorticotropic hormone

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37
Q

what do tumors on the periphery of the lung often result in?

A

hemothorax (blood in the pleural space), pneumothorax (air in the pleural cavity), and pleural effusion (fluid in the pleural cavity)

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38
Q

risk factors for developing lung cancer

A

smoking, second hand smoke, genetic factors, chronic obstructive pulmonary disease, exposure to carcinogens such as silica, vinyl chloride, or asbestos

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39
Q

4 possible categories of signs of lung cancer

A

those related to the direct effects of tumor on the respiratory structures, those representing the systemic effects of cancer, those caused by associated paraneoplastic syndromes, and those resulting from metastatic tumors at other sites

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40
Q

early signs related to respiratory involvement of lung cancer

A

persistent cough, dyspnea, wheezing, hemoptysis (coughing up blood), pleural effusion, pneumothorax, hemothorax, chest pain, hoarseness, facial or arm edema, headache, or atelectasis

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41
Q

systemic signs of lung cancer

A

weight loss, anemia, and fatigue

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42
Q

paraneoplastic syndrome signs of lung cancer

A

is indicated by the signs of an endocrine disorder related to the specific hormone secreted

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43
Q

signs of a metastasis of lung cancer

A

specific to the site; ex. bone spread can cause bone pain or a pathologic fracture

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44
Q

diagnostic testing for lung cancer

A

X-ray, CT, MRI sputum cytology, or biopsy; helical CT and MRI are most effective

45
Q

treatment for lung cancer

A

radiofrequency ablation, surgery, radiosurgery, immunotherapy, chemo, radiation, and photodynamic therapy

46
Q

radiofrequency

A

can treat lung cancer via destroying single, small tumors

47
Q

radiosurgery

A

uses multiple focused beams to destroy a tumor; not actually surgery

48
Q

photodynamic therpay

A

a chemical is injected and migrates to tumor cells, where it is activated by laser light and destroys the cancer cells

49
Q

aspiration

A

involves the passage of food, fluid, vomitus, drugs, or other foreign materials into the trachea and lungs

50
Q

what lung is often the location for aspirated material?

A

the right lung because it descends at a steeper angle?

51
Q

what usually prevents aspiration from happening?

A

a cough will remove materials from the upper tract and the vocal cords and epiglottis prevent entry

52
Q

common effect of aspiration

A

obstruction of passageways; can be through direct obstruction or an irritant causing inflammation

53
Q

what is the result of obstruction due to aspiration?

A

interference with gas exchange and a risk for developing pneumonia

54
Q

what happens when a large object causes obstruction?

A

the trachea is blocked and so is airflow and this is life-threatening

55
Q

what happens when solid objects are lodged in a bronchus?

A

it can lead to non aeration and collapase of the area distal to the obstacle

56
Q

ball-valve effect

A

occurs due to obstruction from solid objects, in which air can pass down on inspiration but not out on expiration, leading to a buildup of air

57
Q

what happens when a dried bean causes obstruction?

A

it can swell and become more firmly lodged

58
Q

what happens when a sharp, pointed object is aspirated?

A

it can traumatize the mucosa and initiating an acute inflammatory response that creates more obstruction; the inflammation can also trigger bronchoconstriction

59
Q

what happens when fatty foods are aspirated?

A

can cause inflammation and edema and if not removed, it can cause a granuloma or fibrous tissue to develop

60
Q

aspiration pneumonia

A

occurs when inflammation occurs due to chemicals, predisposing the development of infection later

61
Q

potential complications of aspiration

A

respiratory distress syndrome, pulmonary abscess if microbes are present, and systemic effects if toxic materials are absorbed into the blood

62
Q

who is aspiration common in?

A

young children

63
Q

what materials can cause a thin film to spread over the lungs?

A

those contains hydrocarbons such as turpentine

64
Q

what materials can cause inflammation in the delicate lung tissue if aspirated?

A

baby powder

65
Q

who are at high risk for aspiration problems?

A

children with tracheoesophageal fistula or cleft palate

66
Q

why may aspiration occur?

A

when the swallowing or gag reflex is depressed, following anesthesia or stroke, those in a coma, those with neurologic damage, or some drugs

67
Q

why does a lying down position increase the risk for aspiration?

A

because the gravitational force is of no value in moving food quickly and completely down the esophagus, causing residual liquid to remain in the mouth and drip into the trachea

68
Q

cafe coronary

A

occurs when aspiration occurs when combining eating with talking

69
Q

signs of aspiration

A

coughing, choking, marked dyspnea, stridor, hoarseness, wheezing, tachycardia, tachypnea, nasal flaring, marked hypoxia, no sounds, and possibly cardiac or respiratory arrest

70
Q

aspiration treatment

A

heimlich maneuver back blows, using a finger probe, and sometimes energy tracheotomy

71
Q

heimlich maneuver

A

used to treat aspiration; stand behind the victim with encircling arms, position a fist, thumb side against the abdomen below the serum, place the other hand over the fist and thrust forcefully inward and upward

72
Q

back blows for aspiration

A

administered between the infant’s shoulder blades while the bod is supported over an arm or leg, with the head lower than the trunk

73
Q

sleep apnea

A

occurs when pharyngeal tissues collapse during sleep, leading to repeated, momentary cessation of breathing

74
Q

who is commonly affected by sleep apnea?

A

men, those with obesity, and increasing age

75
Q

how is sleep apnea diagnosed?

A

the partner will notice loud snoring sounds with intermittent gasps for air

76
Q

complications of sleep apnea

A

chronic hypoxia, fatigue, type 2 diabetes, pulmonary hypertension, right side CHF, cerebrovascular accident, erectile dysfunction, depression, and daytime sleepiness

77
Q

how to prevent sleep apnea?

A

avoid alcohol and sleeping pills

78
Q

treatment for sleep apnea

A

continuous positive airway pump (CPAP), oral appliances, and sleeping in a supine position

79
Q

CPAP

A

continuous positive airway pump which delivers humidified room air at a pressure that maintains open airway

80
Q

asthma

A

is a disease that involves periodic episodes of severe but reversible bronchial obstruction in persons with hypersensitive or hyperresponsive airways

81
Q

what may frequent asthma attack lead to?

A

irreversible damage in the lungs and chronic asthma (chronic obstructive lung disease)

82
Q

2 types of asthma

A

extrinsic asthma and intrinsic asthma

83
Q

extrinsic asthma

A

involves acute episodes triggered by a type I hypersensitivity reaction to an inhaled antigen

84
Q

what can cause extrinsic asthma?

A

allergens and is often associated with a family history of allergic conditions like allergic rhinitis or eczema

85
Q

intrinsic asthma

A

is onset during adulthood and other types of stimuli (not allergens) trigger a hyperresponsive response of tissues in the airway

86
Q

what can cause intrinsic asthma?

A

respiratory infections, exposure to cold, exercise, drugs like aspirin, stress, and inhalation of irritants like cigarette smoke

87
Q

what occurs during an asthma attack?

A

inflammation of the mucosa with edema, contraction of smooth muscle, and increased secretion of thick mucus in the passages; this causes obstruction of the airways

88
Q

what does the antigen react with in extrinsic asthma?

A

immunoglobulin E; this causes histamine, kinins, and prostaglandins to cause inflammation, edmea, constriction, and increased mucus secretion

89
Q

what cranial nerve is stimulated in a extrinsic asthma attack?

A

vagus X; this causes reflex bronchoconstriction

90
Q

second stage of an extrinsic asthma attack

A

occurs a few hours later and chemical mediators like leukotrienes result in prolonged inflammation, constriction, and epithelial damage

91
Q

how does an intrinsic asthma attack develop?

A

T lymphocytes are activated due to an internal antigen, causing the tissues to be hyperresponsive and for inflammation to develop

92
Q

what does partial obstruction of the small bronchi and bronchioles result in?

A

air trapping and hyperinflation of the lungs, causing residual volume to increase and a risk of the bronchial wall to collapse; coughing and removing mucus becomes difficult

93
Q

total obstruction in asthma

A

results when the mucus plug completely blocks the flow of air in the already narrowed passage; this can lead to atelectasis or non aeration of the tissue distal to the obstruction

94
Q

hypoxia and asthma

A

can arise due to partial and total obstruction; O2 demands and muscle demands; respiratory and metabolic acidosis can result; and vasoconstriction in the pulmonary vessels can also occur, increasing the workload on the right side of the heart

95
Q

status asthmaticus

A

is a persistent severe attack of asthma that does not respond to therapy; can lead to severe hypoxia, acidosis, cardiac arrhythmias and CNS depression

96
Q

chronic asthma

A

may develop from irreversible damage in the lungs when frequent and severe attacks form a pattern

97
Q

results of chronic asthma

A

bronchial walls thicken, infections are common, fibrous tissue develops in atelectatic areas, and complications following attacks are common

98
Q

causes of asthma

A

is genetic and related to a familiar history of hay fever, asthma, and eczema; viral respiratory infections may precipitate attacks; other factors are sedentary lifestyles, poor ventilation, staying indoors, air pollution, and increased exposure to allergens

99
Q

signs of asthma

A

cough, marked dyspnea and chest tightness, inability to breath, wheezing, rapid and laboured breathing, thick mucus, tachycardia, pulsus paradoxus, hypoxia, respiratory alkalosis initially followed by respiratory acidosis, and possibly respiratory failure

100
Q

pulsus paradoxus

A

is when the pulse differs on inspiration and expiration

101
Q

respiratory alkalosis and acidosis during asthma

A

first respiratory alkalosis develops due to hyperventilation, but as air gets trapped and fatigue causes decreased respiratory effort, respiratory acidosis develops

102
Q

treatment for preventing asthma

A

avoiding allergens and triggers, good ventilation, regular swimming or exercise, and prophylactic medication

103
Q

treatment during an acute asthma attack

A

controlled breathing techniques, reducing anxiety, inhalers, and glucocorticoids like beclomethasone

104
Q

inhalers

A

are bronchodilators that are usually a beta2-adrenergic agents such as salbutamol; isoproterenol and epi can also be used

105
Q

treatment for status asthmaticus

A

hospital care when the patient doesn’t respond to a bronchodilator

106
Q

prophylaxis treatment for asthma

A

leukotriene receptors such as zafirlukast or cromolyn sodium

107
Q

leukotriene receptor antagonists

A

are prophylaxis treatment for asthma, ex. zafirlukast; work to block inflammatory responses in the presence of stimuli

108
Q

cromolyn sodium

A

is prophylaxis treatment and the drug inhibits the release of chemical mediators from sensitized mast cells in the respiratory passages and also decreases the number of eosinophils

Anatomy and Phyisology (94 decks)

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