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Pathophysiology > module 11 general concepts in altered pulmonary function > Flashcards

module 11 general concepts in altered pulmonary function Flashcards

1
Q

general concepts in altered pulmonary function

A 
hypoventilation and hyperventilation
hypoxemia and hypoxia 
acute respiratory failure
alterations in pulmonary vasculature
pulmonary malignancy
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2
Q

obstructive pulmonary disease

A

inc. airway resistance develops in localized regions d/t
- obstruction of airway from inc. sputum production
- mucosal hypertrophy and edema
- loss of structural integrity
- narrowing of airway from bronchial small muscle contraction
- - during expiration air leaves following path of least resistance -> maldistribution of gas

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3
Q

hypoxemia

A

deficient levels of blood oxygen

- low PaO2 or Hgb saturation

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4
Q

hypoxia

A

dec. in tissue oxygenation
- hypoxic hypoxia
- anemic hypoxia
- circulatory hypoxia
- histotoxic hypoxia

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5
Q

hypoxic hypoxia

A

dec PaO2 despite normal O2 carrying capacity

  • high altitude
  • hypoventilation
  • airway obstruction
    • O2 therapy adequate tx
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6
Q

anemic hypoxia

A

dec. O2 carrying ability r/t low Hgb

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7
Q

circulatory hypoxia

A

dec. blood flow/CO
- shock
- cardia arrest
- blood loss
- thyrotoxicosis
- CHF

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8
Q

histotoxic hypoxia

A

toxic substances prevent tissue oxygenation

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9
Q

normal VQ

A

from pulmonary artery -> alveolocapillary membrane w/ full alveoi, able to have gas exchange -> pulmonary vein

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10
Q

low VQ

A

pulmonary artery -> alveolocapillary membrane
impaired ventilation -> minimal gas exchange
-> pulmonary vein w/ hypoxemia

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11
Q

shunt (very low) V/Q

A

pulmonary artery -> alveolocapillary membrane
blocked ventilation-> collapsed alveoli -> no gas exchange
-> pulmonary vein w. hypoxemia (higher)

Blood goes from R - L side of heart with out passing through ventilated area of lungs

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12
Q

High V/Q

A

impaired perfusion -> alveolar dead space
-> hypoxemia
no blood flow to a ventilated alveoli

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13
Q

anatomical shunts

A

VSD
ASD
patent ductus arteriosus

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14
Q

intrapulmonary shunts

A

alveoli perfused but not ventilated

  • localized pneumonia
  • ARDS
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15
Q

acute respiratory failure defined as

A

disturbed gas exchange -> abnormal arterial blood gas values

  • PaO2 < 60
  • PaCO2 > 50
  • pH < 7.30
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16
Q

acute respiratory failure 3 contributing factors

A
  • failure of respiration (oxygenation) -> hypoxemia with normal/ low CO2
  • failure of ventilation -> hypercapnia
  • Combination resp and ventilatory failure

general r/t poorly matched V/Q -> hypoxemia

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17
Q

acute respiratory failure pahtogenesis

A

can develop from any abnormality in

  • airways
  • alveoli
  • CNS/PNS
  • resp. muscles
  • hypoperfusion
  • chest wall
  • diaphragm
  • pleural space
18
Q

acute resp failure and ventialtion

A

ventilatory demands > ventilatory capacity

19
Q

acute resp. failure s/s general

A 
hypoxia
hypercapnia
HA
dyspnea
confusion
dec. LOC
restless
agitation
dizzy
tremors
initial HTN -> hypoTN and inc. HR
20
Q

acute resp. failure early s/s

A

rapid, shallow breathing

inc. inspiratory muscle movement

21
Q

acute resp. failure late s/s

A 
cyanosis 
nasal flaring 
retractions
cool, clammy skin
dysrhythmia 
dec. cap refill
22
Q

pulmonary HTN

A

sustained increase in pulmonary artery pressure > 25mmHg
constricted vessels in lungs
hypertrophy of RV

23
Q

primary pulmonary HTN

A

idiopathic
rare, rapily progressive
women > men
associated with portal HTN, HIV, appetite suppressing drugs

24
Q

secondary pulmonary HTN

A 
vasoconstrictive
obstructive
obliterative (loss of capillary bed) 
inc. left atrial pressure
inc. pulmonary blood flow
inc. resistance to blood flow
25
Q

pulmonary HTN s/s

A

often asymptomatic until significant damage done d/t distensibility of capillaries and ability to recruit more.

  • exercise intolerance
  • syncope
  • inc. dyspnea
  • chest pain on exertion
  • fatigue
  • hemoptysis
  • pulmonary edema
26
Q

pulmonary venous thromboembolism

A 
>90% from veins of lower extremities
virchow's triad 
- venous stasis
- hypercoagulability
- intimal injury 
Causes V/Q mismatch (dead space) 
- alveoli is adequate but no blood flow
27
Q

thrombotic embolism

A

blood clots develop in venous system, predominately in thighs and legs

28
Q

fat embolism

A

globules of fat secondary to fx of pelvis or long bones

29
Q

amniotic fluid embolism

A

collections of fluid, hair, or other debris r/t complicated labor

30
Q

air embolism

A

venous access through IV catheters

31
Q

tumor embolism

A

fragment from malignant tissue

32
Q

foreign material embolism

A

foreign bodies

  • bullets
  • sutures
  • catheter tips
  • PO meds injected IV
33
Q

septic embolism

A

infected tissue or related substances

34
Q

parasitic embolism

A

parasites present in lung vasculature

35
Q

lobes associated with pulmonary embolism

A

lower lobes d/t increased blood flow

36
Q

pulmonary embolism s/s

A 
restless
apprehension
anxiety
dyspnea
inc. HR
inc RR
sudden dyspnea and chest pain 
medium to massive PE can worsen into HF, shock, or respiratory arrest
37
Q

pulmonary malignancies

A 
85% r/t tobacco smoke 
large cell: 10-15%
small cell: 15-20%
squamous cell: 20-30%
adenocarcinoma: 35-40:%
- 32% of cancer deaths in men, 25% in women
38
Q

pulmonary malignancy s/s

A

vague
asymptomatic till advanced stage
intrathoracic vs extrathoracic

39
Q

highest risk for pulmonary malignancy

A

started smoking before 25
one or more packs a day for 20 years
work with asbestos
> 50 y/o

40
Q

intrathoracic malignancy s/s

A 
dyspnea
cough
chest pain
hemoptysis
inc. sputum
hoarsness
phrenic nerve -> paralysis of hemidiaphragm on affected side 
-> pneumonia, atelectasis
41
Q

extrathroacic malignancy s/s

A 
wt loss
fatigue
anorexia
anemia
clubing
facial and upper extremity edema with vena cava compression

Pathophysiology (80 decks)

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