Module 8 Respiratory Flashcards
1
Q
Ventilation
A
- Air movement from upper to lower resp
2
Q
Ventilation Steps
A
- Deep breath
- Engage diaphragm & intercostal muscles
- Air into trachea
- Bronchi main, primary, secondary)
- Bronchioles (terminal, respiratory)
- Alveolar ducts
- Alveolar sac
2
Q
Perfusion
A
- Movement of CO2 blood
- From the right side of heart
- Into lung to gas exchange site
- O2 blood back to left side of heart
3
Q
Gas Exchange
A
- Ventilation & perfusion meeting point
Occurs at alveolar-capillary membrane
4
Q
Alveolar-Capillary Membrane Composition
A
- Pneumocytes (epithelial cell of lung)
- Endothelial cells
- Interstitial tissue
5
Q
Respiratory Failure
A
- Failure of ventilation/perfusion
- Mismatch of ventilation/perfusion
6
Q
Influencing Factors of Pneumonia
A
- Dose & virulence of organism
- Host susceptibility
- Impaired local defense mechanisms
- Muco-ciliary apparatus injury
- Alveolar macrophage interference
- Fluid/secretion accumulation in alveoli
- Immunocompromised
7
Q
Pneumonia
A
- Inflammation of lung
- Via secondary infection
8
Q
Pneumonia Diagnosis
A
- Chest x-ray
- Bloodwork (increased WBC count)
- Blood & sputum culture
9
Q
Pneumonia Presentation
A
- Cough
- Fever
- Chills
- Malaise
- Pain on inspiration
10
Q
Pneumonia Classification
A
- Morphological (lobar vs broncho)
- Clinical setting (hospital, immunocompromised)
11
Q
Community Acquired Pneumonia (CAP)
A
- Bacterial (streptococcus, haemophilus)
- Atypical syndrome (influenza, chlamydia)
12
Q
Aspiration Pneumonia
A
- Altered level of consciousness
- Impaired laryngeal/esophageal/gastric function
- Periodontal disease
- Stomach acid, particulate matter, anerobic bacteria aspirated
12
Q
Hospital Acquired (Nosocomial Pneumonia)
A
- Severe underlying disease
- Immunosuppressed
- Prolonged antibiotic therapy
- Invasive access devices
- Ventilated
13
Q
Immunocompromised Host Pneumonia
A
- Defense mechanisms suppressed
- Immunosuppressive therapy
- Opportunistic infectious agent
14
Q
Pneumonia Complications
A
- Abscess
- Empyema
- Septicemia (blood infection)
14
Q
Tuberculosis (TB)
A
- High morbidity & mortality
- Primarily within developing countries
- Mycobacterium causative organism
- Acid-fast bacillus
15
Q
Populations Affected by TB
A
- Poverty
- Crowded living conditions
- Chronic debilitating diseases
- Immunocompromised
15
Q
TB Infectious Patients
A
- Bacilli on lower resp tract sampling
- Increased multi-drug resistance
16
Q
TB Transmission
A
- Dependent on viable bacilli
- Aerosolization of small droplets
- Host susceptibility
16
Q
TB Skin Test
A
- Detect cellular immunity to intracutaneous agent
- Intradermal injection of protein derivative of tuberculin
17
Q
Positive TB Test Results
A
- 10mm+
- Induration 48, 72, 96 hrs
- Prior or current infection
- Prior immunization
18
Q
Chronic Bronchitis
A
- Productive cough most of week
- 3 months of year
- 2+ successive years
19
Q
Chronic Bronchitis Etiology
A
- Smoking
- Airway irritation
- Protective changes
- Hypersecretion of mucus
- Hyperplasia of submucosal glands
- Squamous metaplasia
- Airway obstruction
- Decreased ventilation
20
Emphysema
- Damage of acinus (distal lung)
- Destruction of alveolar wall
- Enlargement of airspaces
- Occurs with COPD
20
Emphysema Etiology
- Smoking
- Protases & elastases released
- Damage of elastic tissue
- Dilated distal acini
- Impaired elastic recoil
- Airflow obstruction
- Decreased ventilation
21
COPD Clinical Features
- Shortness of breath
- Chronic productive cough
- Wheezing
- Chest tightness
- Frequent cold/flu
- Low energy
- Weight loss
- Cyanotic
22
COPD Spirometry
- Decreased forced expiratory volume (FEV)
- Decreased FEV to forced vital capacity (FVC) ratio
23
COPD Complications
- Recurrent respiratory infections
- Acute respiratory failure
- Barotrauma/pneumothorax
- Pulmonary hypertension
- Heart disease
- Lung cancer
- Malnutrition/cachexia
24
Lung Cancer Risk Factors
- Smoking (duration & amount)
- Industrial hazards
- Air pollution
- Radiation
- Genetic
- Old pulmonary scars
25
Non-Small Cell Lung Cancer
- Squamous cell carcinoma
- Adenocarcinoma
25
Small Cell Lung Cancer
- Centrally located
- Hilar/mediastinal tumours
- Rapid growth
- Metastases to extrapulmonary sites
- Paraneoplastic syndrome
26
Squamous Cell Carcinoma
- Centrally located
- Grow within lumen
- Airway obstruction
- May cavitate (necrosis)
- Common in male smokers
27
Adenocarcinoma
- Peripherally located
- Common in female non-smokers
- Targeted molecular therapies available
27
Lung Cancer Presentation
- Local symptoms
- Spread to adjacent thoracic structures
- Distant metastasis
27
Lung Cancer Diagnosis
- Chest x-ray & CT
- Sputum cytology
- Bronchoscopy
- Endoscopic ultrasound guided therapy
- Transthoracic
- Pleural fluid cytology
27
Non-Small Cell Treatment
- Surgery (early stage)
- Chemo/radiation (advanced stage)
- Targeted molecular therapy (advanced stage)
- Immune therapy (advanced stage)
28
Small Cell Treatment
- Chemotherapy
- Radiation
29
Prognosis Determination
- Stage (higher = poorer)
- Subtype
30
Lung Cancer Subtypes
- Small cell carcinoma (poorer)
- Location
- Performance status of patient
- Age & sex
- Genetic changes
