HLTH respiratory review Flashcards
4 bones forming sinuses in the nasal cavity
frontal, ethmoid, sphenoid, and maxillary
upper respiratory tract mucosa epithelium
pseudostratified columnar with cilia with mucus secreting goblet cells
how does smoking change the respiratory mucosa?
replaces pseudostratified columnar with simple squamous and impairs the function of cilia
what leads to mouth breathing?
inflamed pharyngeal tonsils
palatine tonsils
are lymphoid tissue in the posterior portion of the oral cavity
natural flora in the respiratory tract
upper tract has natural flora but lungs are sterile
right vs left bronchi
the right is larger and straighter
how does the epithelium change throughout the respiratory tract?
upper is pseudostratified columnar, then simple columnar, then simple cuboidal near the terminal bronchioles
function of surfactant
reduces surface tension and prevents collapse of the alveoli during expiration
lobes in right and left lungs
right has 3, left has 2
structure of ribs (false vs true)
first 7 are true and attach to the sternum, next 3 are attached to the 7th ribs and are false, and last 2 are attached to the vertebrae and are floating
boyle’s law
as the size of the thoracic cavity decreases, the pressure inside increases (hence air will move out)
quiet inspiration
involves contraction of the diaphragm and the external intercostal muscles
quiet expiration
muscles relax and this process is passive, requiring no cellular energy
forced inspiration
requires additional energy and muscular activity by accessory muscles
forced expiration
requires additional energy and the abdominals contract
compliance
refers to the ability of the lungs to expand and depends on the elasticity of the tissues
tidal volume
amount of air entering lungs with each normal breath
residual volume
amount of air remaining in the lungs after forced expiration
inspiratory reserve
maximum amount of air that can be inhaled past normal quiet inspiration
expiratory reserve
maximum amount of air that can be expired following a passive expiration
vital capacity
maximum amount of air expired following a maximal inspiration
total lung capacity
is the total volume of air in the lungs after maximal inspiration
central chemoreceptors
respond to an increase in PaCO2 or a decrease in pH
peripheral chemoreceptors
respond to decreased oxygen levels in the blood
hypercapnia
refers to high CO2 levels
how does respiration change with high CO2 levels?
respirations increase in both rate and depth
dalton’s law
each gas in a mixture moves according to its own partial pressure gradient and is independent of other gases
how much of O2 is released from hemoglobin in the blood?
25%
what does CO2 attach to in hemoglobin?
an amino acid, making it carbaminohemoglobin
ratio of bicarbonate to carbonic acid
20:1
sneezing
is a response to irritation in the upper respiratory tract
coughing
is a result of nasal dripping into the oropharynx or irritation of the lower respiratory tract
productive cough
refers to removing irritating materials from the lower respiratory tract
yellow-green sputum
indicates bacterial infection
rusty or dark coloured sputum
is a sign of pneumococcal pneumonia
pus-containing sputum
indicates bronchiectasis
thick and sticky sputum
can indicates cystic fibrosis or asthma
hemoptysis
is blood containing sputum that is associated with pulmonary edema
eupnea meaning and rate
refers to breathing rate and normal is 10-18 per minute
kussmaul respirations
are deep, ‘air hungry’ respirations and are associated with acidosis or strenuous exercise
labored respirations
are often associated with airway obstruction
wheezing
can indicate obstruction in the small airways
stridor
is a high pitched crow sound and is associated with obstruction in the upper airways
rales
light, bubbly or crackling sounds associated with serous secretions
rhonchi
are deeper and harsher sounds associated with thick mucus
absence of breath sounds meaning
can indicate a collapsed lung (atelectasis)
dyspnea
refers to discomfort and trouble breathing
severe dyspnea signs
nostril flaring, use of accessory muscles, and retraction of muscles above the ribs
pleural pain
results from irritation or inflammation of the parietal pleura
why does hypoxia lead to acidosis?
because of anaerobic metabolism that leads to production of lactic acid
surface tension meaning
the ability for fluid to reduce its surface area by forming droplets
most common pathogen causing the common cold
rhinovirus
common cold
is a viral infection of the upper respiratory tract which is spread by respiratory droplets
secondary infections of the common cold
pharyngitis, laryngitis, or acute bronchitis and usually are caused by microorganisms invading necrotic mucus membranes
sinusitis
is usually a secondary bacterial infection to a cold or allergies, in which one or more of the paranasal sinuses is obstructed
causative organisms for sinusitis
pneumococci, streptococci, or Haemophilus influenza, as well as fungi or viruses
signs of sinusitis
pressure in the sinus cavities causes pain and headache, nasal congestion, fever, and sore throat
laryngotracheobronchitis
is a common viral infection in young children aged 3 months to 3 years which begins as an upper respiratory infection
signs of laryngotracheobronchitis
nasal congestion, cough, barking cough, hoarse voice, and inspiratory stridor
epiglottis causative organism
haemophilus influenzae type B
epiglottis signs
swelling of the epiglottis and larynx, appearing as a red ball, fever, sore throat, difficulty swallowing, drooling, and inspiratory stridor
influenza
aka flu which is a viral infection of the upper and lower respiratory tracts and has 3 types
flu vs cold
flu has a more acute onset, along with fever, fatigue, and aches
causative organism in scarlet fever
A β-hemolytic streptococcus (Streptococcus pyogenes)
scarlet fever
is a bacterial upper respiratory tract infection
signs of scarlet fever
fever, sore throat, chills, vomiting, abdominal pain, strawberry tongue, and rash
bronchiolitis
lower respiratory tract viral infection common in young children aged 2 to 12 months, causing inflammation and necrosis in the small bronchioles
causative agent of bronchiolitis
respiratory syncytial virus (RSV), a myxovirus
signs of bronchiolitis
wheezing, dyspnea, rapid and shallow respirations, cough, rales, chest retractions, and fever
pneumonia
may develop as a primary acute infection or secondary to aspiration or inflammation in the lungs when cilia are impaired and may be caused by a bacteria, virus, or fungi
common pneumonia-nosocomial infectious agents
often are gram-negative bacteria like klebsiella pneumoniae or pseudomonas aeruginosa
lobar pneumonia causative agent
S. pneumoniae
lobar pneumonia
begins as congestion in the alveolar walls, followed by accumulation of a solid mass called consolidation, causing rusty coloured sputum; gas exchange is impaired and infection may spread to involve the pleura
signs of lobar pneumonia
acute onset, fever, chills, dyspnea, tachypnea, tachycardia, rales, rusty coloured sputum, and productive cough
consolidation
is present in lobar pneumonia and involves the accumulation of neutrophils, fibrin, and RBCs that form a solid mass in the alveolar exudate
complications of lobar pneumonia
hypoxia can lead to metabolic acidosis, dehydration can occur, and infection may spread to the pleura
bronchopneumonia
involves a diffuse pattern of spreading in the lower lobes, beginning in the bronchial mucosa and spreading to the alveoli and pooled secretions in the lungs are common, impairing gas exchange
signs of bronchopneumonia
gradual onset with fever, cough, rales, and productive cough with yellow-green sputum
Legionnaires’ disease
a type of bacterial pneumonia that often in spread in spas and nosominal areas due to preference for warm and moist environments and resides in macrophages in its host
causative organism for legionnaires’ disease
gram-negative bacterium, Legionella pneumophila
primary atypical pneumonia
is atypical because it involves interstitial inflammation and is caused by a virus or mycoplasma
causative agent of primary atypical pneumonia
mycoplasma pneumoniae which is a small bacteria that lacks a cell wall or influenza A, B, an adenovirus, or RSV
mycoplasmal pneumonia
is common in older children and young adults and is transmitted by aerosol
viral pneumonia
infection begins in the upper tract mucosa and descends to involve the lungs, in which exudate is diffuse, with little forming in the lungs
signs of viral pneumonia
unproductive cough, hoarseness, sore throat, headache, and fever
pneumocystis carinii pneumonia
is an atypical pneumonia common in AIDS patients that causes necrosis, diffuse intestinal inflammation, and damage to alveoli
signs of pneumocystis carinii pneumonia
unproductive cough and difficulty breathing
unique characteristics of COVID
rapid and firm attachment to lung cells and cytokine storm
COVID virus
enveloped, ss, positive-sense RNA virus
SARS
severe acute respiratory syndrome that occured in 2003, causing flu-like symptoms, dry cough, marked dyspnea, and hypoxia
SARS causative agent
SARS CoV which is an RNA associated coronavirus
tuberculosis
bacterial infection associated with poverty and homelessness affecting the lungs and is caused by mycobacterium tuberculosis
Mycobacterium
is a slow growing bacillus this is resistant to drying and disinfectants due to cell wall and can live in dried sputum for weeks
TB primary infection
is when the bacteria enters the lungs and is engulfed by macrophages, causing a local inflammatory reaction often in the upper lungs and the formation of granulomas
granuloma
lymphocytes and macrophages cluster together at the site of inflammation and surround the pathogen which may still be alive
tubercle
refers to a granuloma with an alive mycobacterium, causing cessation necrosis to develop and cheesy necrosis in the centre
Ghon complexes
tubercle/granuloma complexes in the lungs and lymph nodes
miliary or extrapulmonary TB
is a rapidly progressive form in which multiple granulomas affect the lungs, spread into the circulation, and affect other organs and tissues; common in children and those who are immunocompromised
secondary infection of TB
occurs years later when the bacillus escapes the granuloma when the individual is immunocompromised, causing cavitation
cavitation
is the formation of a large opening in the lung caused by secondary TB, eroding the bronchi and vessels, causing the spread of the infection to other areas
signs of secondary TB
anorexia, malaise, fever, fatigue, weight loss, prolonged cough that gets worse and often is productive, and purulent sputum that often contains blood
causative organism for histoplasmosis
histoplasma capsulatum which is a fungus
histoplasmosis
fungal infection common in AIDS patients in which the pathogen is found inside macrophages, in which this presents similarly to TB (primary and secondary stage which involves granulomas and cavitation)
signs of histoplasmosis
cough, fever, fatigue, and night sweats
anthrax
is a bacterial infection of the skin, respiratory tract, and GI tract in humans and cattle
causative agent for anthrax
is a gram-positive bacillus that forms white-greyish spores
signs of skin anthrax
blisters that may itch, swelling, and painless open skin sore with black centre often on the face, neck, arms, or hands
signs of respiratory anthrax
fever, chills, chest discomfort, shortness of breath, cough, headache, sweats, and body aches
GI form of anthrax
fever and chills, neck swelling, sore throat, painful swallowing, hoarseness, nausea, vomiting, headache, and fainting
is what infection may a child take a sitting/tripod position?
epiglottis
cystic fibrosis
is an autosomal recessive inherited disorder due to a genetic mutation on the CFTR gene on the 7th chromosome, causing a defect in exocrine glands that produce abnormally thick mucus, affecting the lungs and pancreas
how does CF affect the lungs?
mucus obstructs airflow in the bronchioles, causing air trapping and damage to the bronchial walls, and providing excellent conditions for infection; eventually right-sided CHF will develop
meconium ileus
refers to the small intestine being blocked by mucus at birth in infants with CF
how does CF affect the digestive tract?
meconium ileus is present at birth, pancreatic secretions are blocked, bile ducts may be blocked, and a result malabsorption, malnutrition, and dehydration develop
how are the salivary glands affected by CF?
secretions are abnormally high in NaCl and mucus may block the submaxillary and sublingual glands
how are the sweat glands affected by CF?
abnormally high concentrations of NaCl
how is reproduction affected by CF?
mucus may obstruct the vas deferens or the cervix, causing infertility
signs of cystic fibrosis
meconium ileus at birth, salty skin, steatorrhea, distended abdomen, chronic cough, failure to gain weight, and fatigue
usual cause of death in CF
respiratory failure or right sided CHF (cor pulmonale)
lung cancer
leading cause of cancer deaths and third most common cancer; common for primary and secondary tumors, and benign tumors are rare here; 2 groups small cell and non-small cell
small cell lung cancer
cells are small and round, the cancer spreads rapidly, often is associated with smoking, is resistant to chemo, and mortality is higher
non-small cell lung cancer
cells are larger, the spread is less, and the cells are responsive to chemo
subtypes of NSCLC
adenocarcinoma, squamous cell carcinoma, and large cell carcinoma
most common type of malignant lung cancer
bronchogenic carcinoma
squamous cell carcinoma
usually develops from the epithelium of a bronchi near the hilum and projects into the airway
what types of lung cancer are harder to detect?
bronchoalveolar cell carcinomas and adenocarcinomas
small cet/oat cell carcinoma
are located near a major bronchus usually in the middle of the lung and metastasize early on
mesothelioma
associated with asbestos and is usually fatal
how do the lungs change with cancer?
first metaplasia and cilia damage (often due to smoking), and then dysplasia/ cancer in situ develops
common sites for metastasized lung cancer?
brain, bone, and liver
paraneoplastic syndrome of bronchogenic carcinoma
the tumors secretes hormone like substances like adrenocorticotropic hormone and ADH; this can lead to blood and muscle difficulties
effects of tumors in the lungs
obstruction, inflammation, effusion, systemic effects, and paraneoplastic syndrome
risk factors for developing lung cancer
snoking, secondhand smoke, genetic factors, chronic obstructive pulmonary disease, and occupational exposure to carcinogens like silica or asbestos
early signs of lung cancer
persistent cough, dyspnea, or wheezing, hemoptysis, pleural effusion, chest pain, and hoarseness
aspiration
involves the passage of fluid, vomit, drugs, or other foreign material into the trachea and lungs, commonly leading to obstruction and/or inflammation
ball-valve effect
can occur with aspiration when inspiration passes past the obstruction, however, expiration is blocked, leading to a buildup of pressure distal to the obstruction
aspirated liquids
disperse into several bronchi and cause inflammation, leading to increased secretions and narrowed airways, and in some cases the alveoli are affected
aspiration pneumonia or chemical aspiration
can be due to inflammation of the alveoli due to aspirated liquids, predisposing to infection
common causes of aspiration
children being children, lying down, post-operative, congenital abnormalities like cleft palate, or a complication of the gag reflex
signs of aspiration
coughing and choking, stridor and hoarseness if upper airway is obstructed, wheezing, tachycardia, tachypnea, nasal flaring, hypoxia, and cardiac arrest
sleep apnea
is a result of pharyngeal tissues collapsing during sleep, leading to repeated, momentary cessation of breathing
complications of sleep apnea
pulmonary hypertension, type 2 diabetes, right sided CHF, stroke, erectile dysfunction, and depression
treatment for sleep apnea
CPAP (continuous positive airway pump)
asthma
involves periodic episodes of severe and reversible bronchoconstriction in those with hypersensitive airways
extrinsic asthma
involves acute episodes that are triggered by a type I hypersensitivity reaction to an inhaled allergen and is often genetic
intrinsic asthma
develops in adults and is when other types of stimuli (not allergens) target the airways and may be due to infections, exposure to cold, exercise, aspirin, or cigarette smoke
three changes of the respiratory tract during an asthma attack
inflammation of the mucosa, constriction of the bronchioles, and increased secretion of thick mucus
what antibody is reacted with in extrinsic asthma?
IgE
what chemical mediators are released during extrinsic asthma?
histamine, kinins, and prostaglandins
second stage of extrinsic asthma attack
eosinophils release additional chemical mediators such as leukotrienes, resulting in prolonged inflammation, constriction, and mucosa damage
air trapping
can occur with asthma when air passes into the area distal to the obstruction but only some is expired; this leads to increased residual volume and potential collapse of a bronchial wall
status asthmaticus
is a persistent asthma attack that does not respond to therapy, and may be fatal leading to hypoxia, acidosis, cardiac arrhythmias, and a depressed nervous system
chronic asthma
aka COLD; frequent attacks cause the bronchial walls to thicken and fibrous tissue develops
causes of asthma
often are genetic are related to family history of asthma, eczema, and hay fever; may also be caused by a viral infection, sedentary lifestyle, and increased exposure to allergens
signs of an asthma attack
coughing, wheezing, dyspnea, inability to speak tightness in chest, labored breathing, thick mucus, tachycardia, hypoxia, and initial respiratory alkalosis, followed by respiratory acidosis
pulsus paradoxus
refers to the pulse differing on expiration and inspiration and is a sign of asthma attack
function of the mutated protein in CF
is helps to transport chloride into the cell
chronic obstructive pulmonary disease
is a group of chronic respiratory disorders that are characterized by progressive tissue destruction and obstruction of airways
types of COPD
emphysema, chronic bronchitis, and chronic asthma
complications of COPD
respiratory failure (due to right sided CHF or cor pulmonale), hypoxia, or hypercapnia
emphysema
involves the destruction of alveolar walls and septae, leading to large, permanently inflamed alveoli spaces
cause of emphysema
can be due to a defect of alpha1-antitrypsin, genetic, and cigarette smoking
alpha1-antitrypsin
is a protein present in body tissues and fluids and inhibits the activity of proteases (released during inflammation and can cause tissue damage)
changes in the lungs during emphysema
the breakdown of the alveolar wall, fibrosis and thickening of walls, and difficulty with breathing develops
effects of the breakdown of alveolar walls
decreased surface area, decreased pulmonary capillaries, and loss of elastic fibres
blebs or bullae
are air filled spaces present in emphysema
complications of emphysema
pneumothorax, hypercapnia, hypoxia, increased risk for infection, pulmonary hypertension, cor pulmonale, and secondary polycythemia
signs of emphysema
dyspnea, barrel chest, hyperventilation with prolonged expiration, clubbed fingers, anorexia, and fatigue
chronic bronchitis
irreversible and progressive changes in the bronchi due to irritation from smoking or exposure to pollution
how do the bronchi change with chronic bronchitis?
mucosa is inflamed and swollen, hypertrophy and hyperplasia of the mucus gland, increased secretions, and fibrosis and thickening of walls
pink buffer
is used to characterize emphysema and includes signs of dyspnea, hyperventilation, and overinflation
blue bloater
is used to characterize chronic bronchitis and includes signs of lower oxygen levels, cyanosis, and edema
signs of chronic bronchitis
constant productive cough, tachypnea and shortness of breath, thick secretions, cyanosis, secondary polycythemia, weight loss, and cor pulmonale signs
bronchiectasis causes
is a secondary problem that develops in those with CF or COPD, more specifically from childhood infections, aspiration, or a weakness in the bronchial wall
bronchiectasis
is a dilation and widening of the bronchial walls that arise from recurrent inflammation and infection, causing fluid to accumulate and cause frequent infections
how do the bronchial walls change in bronchiectasis?
walls dilate, loss of cilia, metaplasia, fibrosis, and progressive obstruction
signs of bronchiectasis
chronic cough, excessive amounts of purulent sputum, rales, foul breath, dyspnea, hemoptysis, and anemia
restrictive lung disorders
refers to a group of disorders in which expansion is impaired and total lung capacity is reduced and includes two groups (chest wall limits expansion or tissues limit expansion)
causes of restrictive lung disorders due to chest wall limiting expansion
kyphosis, scoliosis, MD, ALS, poliomyelitis, or botulism
causes of restrictive lung disorders due to tissue damage
pulmonary fibrosis and occupational diseases due to inhaled particles
pneumoconiosis
are chronic restrictive lung disorders resulting from long-term toxic inhaled particles such as asbestos in which normal defences such as cilia and mucus are damaged
pathophysiology of pneumoconiosis
inflammation and fibrosis develop, in which tissues are progressively damaged, alveoli become nonfunctional, and infections are common, contributing to the damage
signs of pneumoconiosis
dyspnea, cough, and increasing effort for respiration
pulmonary edema
refers to fluid collecting in the alveoli and interstitial area, interfering with gas exchange and lung expansion
causes of pulmonary edema
inflammation that increases capillary permeability, decreased osmotic pressure in capillaries (kidney or liver disease), and pulmonary hypertension (left sided CHF or sleep apnea)
mild pulmonary edema signs
cough, rales, and orthopnea
severe pulmonary edema signs
hemoptysis, frothy and bloody sputum, labored breathing, hypoxia, cyanosis, and may lead to paroxysmal nocturnal dyspnea
pulmonary embolus
is a blood clot or other mass that obstructs the pulmonary artery or a branch of it (often from the lower limbs), blocking the flow of blood through the lung tissues
effect of large pulmonary embolus
effect the cardiovascular system and may cause right-sided CHF and decreased CO and vasoconstriction occurs as a reflex mechanism, in which sudden death may occur as a result
causes of pulmonary embolus
embolus in the leg veins, many as a result of phlebothrombosis or thrombophlebitis which can be due to childbirth, CHF, dehydration, cancer, and increased coagulability of the blood; can also be due to fat emboli, vegetations from endocarditis in the right side of the heart, and amniotic fluid emboli from placenta tears
signs of a small pulmonary embolus
cough, chest pain, and dyspnea
signs of a large pulmonary embolus
chest pain, tachypnea, dyspnea, hemoptysis, fever, and sympathetic response due to hypoxia
signs of an massive pulmonary embolus
severe crushing chest pain, low BP, rapid weak pulse, and loss of consciousness
signs of a fat emboli
rash, neurologic dysfunction, and acute respiratory distress
atelectasis
is the collapse or non aeration of a lung often due to a secondary condition, leading to decreased gas exchange and hypoxia
what happens to the lungs during atelectasis?
the alveoli collapse, ventilation and perfusion are compromised, and O2 diffusion is greatly impaired (CO2 diffusion is only slightly impaired because this gas diffuses easier)
obstructive or resorption atelectasis
occurs as a result of mucus or a tumor in which air is not replaced distal to the obstruction
compression atelectasis
occurs as a result of a mass compressing the lung, in which air is preventing from entering that part of the lung; adhesion between the pleural membranes may also be impaired
increased surface tension atelectasis
can result due to pulmonary edema or respiratory distress syndrome, in which expansion is impaired
contraction atelectasis
is due to fibrosis tissue in the lungs which may lead to collapse
postoperative atelectasis
often is due to abdominal surgery and can be due to pain preventing expansion, supine position, decreased cough effort, and slow and shallow respirations due to anesthesia and analgesics
signs of atelectasis
can cause dyspnea, increased HR and respiratory rate, and asymmetrical chest expansion (due to the unaffected lung overinflating)
pleural effusion
is an accumulation of fluid between the pleural membranes and may be accompanied by pleurisy
pleurisy
aka pleuritis and is when the pleural membranes are inflamed, rough and swollen; may accompany pleural effusion
where are fluids from the pleural cavity drained by?
the lymphatics
complications of pleural effusion
can impair expansion of the lungs, can cause atelectasis, reduced venous return, and a shift of the trachea/mediastinum towards the unaffected side
transudate effusion
aka hydrothorax and is water in the pleural cavity often due to increased hydrostatic pressure or decreased osmotic pressure of the vessels, leading to a shift of fluid into this potential space
exudative effusions
are often due to inflammation or tumors, in which the fluid contains WBCs and proteins
hemothorax effusions
is blood in the pleural cavity often the result of surgery, trauma, or cancer
empyema
refers to pus in an area in the body, often in the pleural cavity and is associated with infection
signs of pleural effusion
dyspnea, chest pain, increased HR and respiratory rate, tracheal deviation, and absence of breath sounds over the affected area
pneumothorax
refers to air in the pleural cavity, preventing expansion and leading to atelectasis
hydropneumothorax
refers to both air and fluid in the pleural cavity, but more fluid
3 types of pneumothorax
closed, open, and tension
closed pneumothorax
refers to air entering the pleural cavity from an opening directly in the internal airways or visceral pleura, not through the chest wall
simple or spontaneous pneumothorax
occurs when a tear on the surface of the lung allows air to escape from inside the lung or bronchi into the pleural cavity; as the lung collapses, it conceals the leak
secondary pneumothorax
is associated with respiratory conditions causing a rupture of an emphysematous bleb or erosion by a tumor to cause cavitation through the visceral pleura
open pneumothorax
refers to an opening in the chest wall allowing atmospheric air to enter the cavity and can be a result of trauma or surgery
sucking wound
refers to a large opening in the chest wall causing a sucking sound due to air moving in and out
tension pneumothorax
can result from either open or closed damaged, but is unique and serious because it creates a one-way valve effect, whereas on inspiration the opening grows but closes on expiration, leading to increased pressure with each inspiration and compressing the other lung
complications of tension pneumothorax
the unaffected lung and inferior vena cava are compressed, leading to hypoxia and respiratory distress
general signs of pneumothorax
dyspnea, chest pain, atelectasis, cough, reduced breath sounds over the affected area, hypotension, and mediastinal shift
flail chest
refers to fractures of the thorax, causing potential bleeding, edema, and atelectasis; this also causes opposite movements of the lungs on expiration and inspiration
flail chest inspiration
the broken section of ribs moves inward rather than outward, limiting expansion, and compression from the affected side leads to stale and new air entering in the unaffected side
flail chest expiration
affected side is pushed outward and air from the affected side moves into the unaffected side
mediastinal flutter
occurs with flail chest when the mediastinum is pushed to and fro with breathing; this creates pressure on the inferior vena cava and impairs venous return to the heart
infant respiratory distress syndrome
refers to inadequate maturation of the lungs and surfactant before birth, leading to impaired alveolar expansion and atelectasis, as well as increased capillary alveolar permeability and thus increased fluid in the intestinal area
hyaline membrane
refers to increased alveolar capillary permeability in IRDS, causing fluid and proteins to lead into the interstitial area, further impairing gas exchange
complications of infant respiratory distress syndrome
increased effort to breathe leads to anaerobic metabolism, lactic acid, and thus acidosis; this triggers vasoconstriction and impairs cell metabolism, further impairing the production of surfactant
causes of infant respiratory distress syndrome
often is due to premature birth, but also is more common in males and those who has a C-section
early signs of infant respiratory distress syndrome
60+ per minute respirations, flaring nostrils, subcostal and intercostal retraction, rales, and low body temperature
prolonged signs of infant respiratory distress syndrome
rapid and shallow respirations, expiratory grunt, frothy sputum, cyanosis, hypoxia, and decreasing BP
adult respiratory distress syndrome
is a restrictive lung disorder due to alveolar or pulmonary capillary damage, leading to pulmonary edema and decreased surfactant production; this impairs respiration and gas exchange and may cause microthrombi to form
long term damage from adult respiratory distress syndrome
necrosis and fibrosis in the lungs
complications of adult respiratory distress syndrome
fibrosis and necrosis in the lungs, CHF, and pneumonia
causes of adult respiratory distress syndrome
prolonged shock, inhalation of irritating particles, viral infections, toxins, fat emboli, aspirations, and lung trauma
signs of adult respiratory distress syndrome
dyspnea, restlessness, rapid and shallow respirations, increased heart rate, rales, cyanosis, and productive cough with frothy sputum
acute respiratory failure
is the result of many pulmonary disorders and is present when PaO2 is less than 50 mm Hg or PaCO2 is greater than 50 mm Hg, and serum pH is decreasing
normal PaO2 and PaCO2 values
80 - 100 for O2 and 35 - 45 for CO2
respiratory insufficiency
refers to an interim state when blood gases are abnormal but cell function can continue
conditions that may lead to acute respiratory failure
chronic conditions like emphysema, chronic disorders combined with acute ones like pneumonia, CNS depression by narcotics, chest trauma, asthma, pulmonary embolism, or disorders like ALS or myasthenia gravis
signs of acute respiratory failure
rapid, shallow and laboured respirations, headache, tachycardia, hypoxia, hypercapnia, lethargy and confusion
when may the mediastinum shift towards the affected side?
atelectasis
when may the mediastinum shift towards the uneffected side?
pleural effusion
inspiration and expiration with an open pneumothorax
on inspiration, the mediastinum moves towards the unaffected side and on expiration is moves back towards the affected side
glottis
is the true vocal cords (lower ones) and the space between them
