Lung

Question 1

Conducting airways

Answer 1

• trachea, bronchi, bronchioles, terminal bronchioles
• acinus-consist of respiratory bronchioles, alveolar ducts, and alveoli

Question 2

vasculature

Answer 2

• lungs have dual blood supply: pulmonary and bronchial arteries
• Pulmonary arteries give way to an investing network of capillaries

Question 3

Type I and II pneumocytes

Answer 3

Alveolar walls are perforated by numerous pores and Kohn

Question 4

Macrophages

Answer 4

Few lie free within the alveolar sac

Question 5

Alveolar gas Exchange

Question 6

Atelectasis (collapse)

Answer 6

The loss of lung volume caused by inadequate expansion of air spaces
the airways and air sacs within the lung collapse or don’t expand properly. Shunting of inadequately oxygenated blood from pulmonary arteries into veins resulting in a ventilation-perfusion imbalance and hypoxia (low oxygen concentration

Question 7

3 forms of atelectasis based

Answer 7

• resorption
• compression
• contraction

Question 8

resorption/obstructive

Answer 8

-caused by obstruction of conducting airway (e.g. mucus plug, foreign bodies, neoplasm).
- most common type of atelectasis
- The air that is already present gradually becomes reabsorbed, and alveolar collapse follows

Question 9

compression

Answer 9

passive or relaxation occurs with the accumulation of fluid, blood, or air within the pleural cavity

Question 10

contraction

Answer 10

occurs when there are fibrotic changes in the lung and pleura cavity

Question 11

mediastinal shift

Answer 11

(could be upper or lower) A clinical and radiological marker that helps determine the etiological cause of the underlying pathology

Question 12

Resorption/Obstructive con’t

Answer 12

• Increased lung density
• Mediastinum and tracheal shift toward the affected lung
• Ipsilateral elevation of the diaphragm
• Narrowing of rib interspace

Question 13

Compression (passive or relaxation)

Answer 13

• Generally assoc with the accumulation of fluid, blood, or air within the pleural cavity that mechanically collapses the adjacent lung
• Clinically most significant
• Cause mediastinal shift away from atelectasis
• frequently occurs with the pleural effusion (most commonly by congestive heart failure (CHF)

Question 14

Compressed atelectasis can be caused by _______________?

Answer 14

air leaking into the pleural cavity (pneumothorax)

Question 15

Basal atelectasis

Answer 15

Results from the elevated position of the diaphragm which is observed in bedridden patients, patients with ascites, and during and after surgery.

Question 16

Compression “passive or relaxation” con’t (summary?)

Answer 16

• increased pressure collapses the airway(s)
• Mediastinum and tracheal shift away from the affected lung
• Air increase overall lucency of the hemithoraz
• balanced-reduction in blood flow

Question 17

Compression “passive or relaxation” con’t (summary?)

Answer 17

• increased pressure collapses the airway(s)
• Mediastinum and tracheal shift away from the affected lung
• Air increase overall lucency of the hemithorax
• balanced-reduction in blood flow

Question 18

How is a contraction caused?

Answer 18

It’s caused by the fibrosis of the lung parenchyma preventing expansion

Question 19

Changes due to contraction can be __________ or ___________________ ____________________.

Answer 19

local; generalized

Question 20

How can fibrosis be caused?

Answer 20

radiation, infection, toxic injury, or system disease

Question 21

Contraction con’t

Answer 21

• Occurs as a result of scarring or fibrosis
• Reduced lung expansion
• Common etiologies include granulomatous disease, necrotizing pneumonia, and radiation fibrosis

Question 22

What is ARDS?
(Acute Respiratory Distress Syndrome)

Answer 22

It’s defined as respiratory failure occurring within a week of known clinical insult with bilateral opacities on chest images

Question 23

How is the level of severity of ARDS determined?

Answer 23

degree of changes in oxygenated arterial blood (anoxemia, hypoxemia, and dyspnea)

Question 24

What are some characteristics of severe ARDS?

Answer 24

rapid onset of life-threatening respiratory insufficiency, cyanosis, and severe arterial hypoxemia that doesn’t respond to oxygen therapy

Question 25

Explain DAD

Answer 25

Diffuse alveolar damage is the histological manifestation of ARDS in the lungs. it is associated with primary pulmonary disease and severe systematic inflammatory disorder such as sepsis

Question 26

List the most common trigger of ARDS

Answer 26

• pneumonia (35% - 45%)
• sepsis (30%-35%)
• aspiration
• trauma
  —>brain injury, abdominal surgery, multiple fractures, pancreatitis, and transfusion reaction

Question 27

ARDS is related to respiratory distress syndrome. T/F?

Answer 27

False

Question 28

Pathogenesis of ARDS * read over*

Answer 28

• alveolar-capillary membrane is compromised by injury to the endothelial and epithelial cells
• As early as 30 minutes after acute insult, interleukin 8 (IL-8) (a potent neutrophil chemotactic) and activating agents synthesis are increased by pulmonary macrophages

Question 29

Gas exchange takes place in the ____________.

Answer 29

alveoli

Question 30

Atelectasis is most commonly caused by _____________.

Answer 30

obstruction

Question 31

Acute respiratory distress syndrome (ARDS) results in what substance accumulating in the lungs?

Answer 31

fluid

Question 32

Which of these is a possible symptom of ARDS?
A. Difficulty breathing
B. Mental Confusion
C. Low blood pressure
D. All of the above

Answer 32

D. all of the above