Obstructive and restrictive Pulmonary Disease Flashcards
What are the characteristics of COPD
- progressive airway obstruction that is not fully reversible
- gas exchange is normal
- always hyperinflated (difficulty getting air out)
- Decreased elastic recoil
- age of onset: middle aged to older adults
COPD Rx
- Pharmacological FOCUS:
1. smooth mm relaxation
2. reduce airway inflammation - O2 therapy: but not for pts with pulmonary HTN, CHF
What is bronchitis
What is the key feature of bronchitis
inflammation of the lining of your bronchial tubes. Key feature is excess mucus production in bronchioles
Main cause of emphysema
smoking
Result of emphysema
Destruction of air spaces distal to the terminal bronchiole + destruction of alveolar septa
- causes merging of alveoli into larger air spaces - which leads to decreased surface area for gas exchange
loss of airways and capillaries as well
Emphysema Impact
Difficulties with exhalation
- Damaged alveoli = old air becomes trapped
- Decreased space available for O2-rich new air
- Hyperventilation flattens diaphragm
- now at mechanical disadvantage
Emphysema Rx
Can slow down progression but can’t reverse damage
What is bronchiectasis
irreversible destruction (necrosis) + dilation of airways with chronic bacterial infection
Bronchiectasis causes
CF
TB
Endobronchial tumour
Bronchiectasis characteristics:
- excess mucus leading to SOB
- eventually alveoli replaced with scar tissue - due to chronic inflammation
Bronchiectasis Rx
- bronchodilators, antibiotics, corticosteroids
- secretion clearance
What is interstitial lung disease
Progressive scaring leading to stiffness and decreased lung compliance (not airway obstruction)
Interstitial lung disease S&S
- dyspnea
- severe O2 desaturation (cyanosis)
- clubbing of fingers and toes
- decreased exercise tolerance
Interstitial lung disease Rx
- O2 therapy
- lung transplant
- pulmonary rehab
- Cessation of exposure (known cause)
What causes pulmonary fibrosis
2/3 no know cause
1/3 TB
Inhaling harmful particles
Pulmonary fibrosis pathology
Fibrosis = scaring in lungs
Damage to bronchioles and alveoli - greatly decreased gas exchange
Pulmonary fibrosis Rx
- Radiation therapy
- Meds
Pneumoconiosis is also referred to as ___
coal worker’s lung
What is tuberculosis
Infectious, inflammatory systemic disease that affects the lungs
Tuberculosis cause
Inhaling airborne particles - myocobacterium tuberculosis
Tuberculosis may disseminate to involve what other organs/structures?
involve kidneys, growth plates, meninges, avascular necrosis of hip joint, lymph nodes + other organs
Tuberculosis testing
TB skin test: inject in forearm
- determines if body’s immune response has been activated by TB before
Tuberculosis S&S
- Productive cough 3+ weeks
- Weight loss
- Fever
- night sweats
- Fatigue
- Bronchial breath sounds
Tuberculosis result
Granulomas in lung tissue
Tuberculosis Rx
- Medical MGMT: 10 drugs
- PT: Thorough history + self-protection (masks, etc.)
What is pleural effusion?
Abnormal accumulation of fluid in the pleural space
Pleural effusion types
- Transudate - commonly due to to heart or renal failure - low protein, clear
- Exudate - formation of fluid by inflammation or disaese (infection or cancer of pleura) - opaque
Pleural effusion S&S
- SOB
- chest pain
- percussion – dull
- Decreased or ABSENT breath sounds
- may hear a pleural rub
Pleural effusion Chest xray findings
Possible mediastinal shift
What is pulmonary edema
Increased fluid in extravascular spaces of the lungs
Pulmonary edema possible causes
- Increased hydrostatic pressure d/t heart or kidney failure - pushes fluid out of vessels
- Increased alveolar permeability - drug induced, ARDS, inhalation of noxious gas
Pulmonary edema presentation
- Stiff lungs - increased work of breathing
- Dyspnea
- Classic symptom: cough that produces a frothy pink tinged sputum
Pulmonary edema auscultation
Fine crackles
Pulmonary embolus S&S
- bloody sputum
- dyspnea
- Increased RR
- cyanotic
What is cystic fibrosis
- inherited autosomal disorder affecting ALL EXOCRINE GLANDS
Effects of cystic fibrosis
- defective Cl- : excretion and Na+ absorption = THICK MUCUS
- recurrent chest infections
- consolidation
- atelectasis
- thickened bronchial walls
Cystic fibrosis Dx
- Family history, gene testing (autosomal recessive disease, need 2 copies of abnormal gene)
- Sweat test - chloride content of sweat
Cystic fibrosis S&S
- respiratory symptoms most common
- finger clubbing
- breathlessness
- delayed puberty
- skeletal maturity
- infertility in males
- symptomatic steatorrhea
- diabetes mellitus
- liver disease
- osteoporosis
Cystic fibrosis Rx
- airway clearance techniques
- bronchodilators
- aggressive antibiotics
_____ accounts for 95% of arterial occlusive disease
peripheral arterial disease
What is the underlying cause of peripheral arterial disease
atherosclerosis
Peripheral arterial disease S&S
- *occur distal to site of narrowing or obstruction
- intermittent claudication
- acute ischemia (pallor, pain paralysis, pulseless)
- ulceration and gangrene
- skin (shiny, thin, hairless) often occurs in feet
Peripheral arterial disease outcome measure
Decreased mobility d/t pain + loss of function or loss of limb (leading cause of limb loss in adults)
What is the difference between peripheral arterial disease and peripheral vascular disease
Vascular: problem with both veins and arteries
Arterial: just arteries
Underlying cause of peripheral vascular disease
Artherosclerosis
Peripheral vascular disease S&S
- intermittent claudication
- Decreased pulses
- ulcers
- cool skin
- limit mobility
- pain or loss of function of limb
- Pain with PA, most often in calf
