Obstructive diseases Flashcards by she ign

lung – systemic venous blood before it returns to the left ventricles

filtrates

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difficulty breathing

dyspnea

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treatment for obstructive diseases are –

similar regardless of underlying pathology

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invasive procedures may be necessary for treatment of –

pleural diseases, interstitial lung diseases and malignancies

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what does spirometry measure

vital capacity, timed volumes

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– allows for air-flow studies

spirometry

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blood gases are taken from – to measure pH, pCO2, pO2

artery

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pH is determined by–

respiratory and metabolic acid production

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pCO2 is determined by –

ventilation rate

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pO2 is determined by –

ventilation rate, O2 content of inhaled air, diffusion from alveoli to pulmonary capillaries

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normal range of pH

7.35 - 7.45

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normal range of pCO2

35-45 mmHg

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normal range of pO2

80-100 mmHg

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pulse oximetry measures –

O2 saturation through skin

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compare pulse oxymetry and blood gas measurement

pulse oximetry is less accurate but quicker

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continuous flow-volume loops are useful in detecting –

laryngeal and tracheal lesions

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how can ventilation/perfusion studies be assessed?

nuclear scans

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pulse oximetry is a noninvasive test to monitor the percentage of –

hemoglobin saturated with oxygen

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nuclear ventilation/perfusion scans can detect – and also evaluate lung function in advanced COPD

pulmonary embolism

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COPD is united by presence of –

persistent airflow limitation (and dyspnea)

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COPD is caused by –

chronic bronchitis or emphysema

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what is more common chronic bronchitis or emphysema?

chronic bronchitis

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Asthmatic patients with emphysema and/or bronchitis are considered to have –

“asthmatic bronchitis”

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aging (after 20) –>

less alveoli and lung capillaries

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lung functions that are affected by aging --

compliance, lung volume, airflow, diffusing capacity

can purely age-related change lead to clinically significant symptoms

in smokers, injury due to inflammation is -- and accelerates the effects of aging

superimposed on

a key enzyme that inhibits human proteases, such as neutrophil elastase

alpha1-antitrypsin

alpha1-antitrypsin deficiency results in a susceptibility to --

alveolar injury

exposure to environmental toxins have effect similar to that of --

smoking

obesity affects --

lung mechanics

what is deconditioning?

respiratory muscle weakness

deconditioning progresses dyspnea to --

severe COPD

factors that lead to deconditioning

dyspnea --> lack of physical activity severe anxiety --> increases respiratory rate difficulty eating --> compromises muscle energy supply

where does damage occur for emphysema?

terminal part of respiratory tree

emphysema: alveoli become --

distended (can't fully empty, some break)

emphysema: terminal bronchioles lose --

elastic recoil

emphysema: terminal bronchioles collapse during --

expiration

emphysema: lungs become --

hyperinflated

emphysema: patient usually has severe dyspnea noticeable during expiration / uncomfortable sensation when breathing during exercise

pink puffer

emphysema: late hypoxemia and CO2 retention can lead to --

pneumothorax

where is the damage for chronic bronchitis?

bronchial tubes

chronic bronchitis: decreased -- of bronchi and bronchioles

lumen

chronic bronchitis due to --

inflammation, enlarged mucus gland, and fibrosis

chronic bronchitis: elastic recoil is --

usually normal

chronic bronchitis: patient feels obstruction during inspiration and expiration

blue bloater

chronic bronchitis: patient has productive cough

lasts 3 months/year for at least 2 consecutive years

chronic bronchitis: early hypoxemia and CO2 retention can lead to --

cor pulmonale (R sided failure)

normal breathing for children

12-20 breaths/min

normal breathing for resting adults

12-16 breaths/min

normal breathing for older patients

12-18 breaths/min

normal breathing for older patients in long-term care

16-25 breaths/min

sputum production in emphysema

scant (little)

sputum production in chronic bronchitis

copious and purulent

bradypnea is a form of hypoventilation with a respiratory rate of --

less than 10 breaths/min

COPD signs: weight loss occurs in many long time sufferers and --

can't be nutritionally reversed

COPD signs: -- chest diameter

increased antero-posterior

COPD signs: lung sounds

decreased and abnormal

chest x ray of COPD

hyperinflated lungs (hyperblack)

TLC in emphysema

increased

TLC in chronic bronchitis

normal or slightly decreased

RV in emphysema

increased

RV in chronic bronchitis

increased

diffusing capacity in emphysema

very decreased

diffusing capacity in chronic bronchitis

decreased

anteroposterior view of COPD lungs

darker and more vascularity

lateral view of COPD lungs

increased AP diameter flattened diaphragm increased retrosternal air space

why does oxygen therapy need to be done very carefully?

some patients rely on hypoxemia for their ventilator drive

exacerbations of COPD are associated with --

transient decreases in lung function

severe hypoxia may lead to --

angina, acute coronary syndrome, heart failure

T/F: in elderly smokers COPD may coexist with heart failure

true (cor pulmonale)

asthma is hyperreactivity of --

bronchial musculature

asthma involves airway --

inflammation and reversible obstruction

common aeroallergens

animal dander, dust mite, mold, cockroach, pollens

asthma may also be precipitated by exercise, acid reflux (aspirin), -- an dinfections

temp changes

inflammatory cells, cytokines and other -- are involved in asthma

mediators

what are targeted in treatment of asthma

histamine and leukotrienes

tachypnea

20-45 breaths/min

in mild asthma cases, -- may be the only symptoms

cough

drop in systolic P during inspiration

pulsus paradoxus

O2 saturation in hypoxemia

90%

treatment of asthma

medications and avoid causal agents

bronchiectasis

irreversible dilation of airways

bronchiectasis: destruction of muscular and elastic components of --

bronchial walls

disease of exocrine glands (may also involve salivary gland dysfunction)

cystic fibrosis

the cause of bronchiectasis following pneumonia,

tuberculosis or fungal infections

diagnosis of bronchiectasis

high resolution CT scan

most bronchiectasis patients have --

chronic cough and sputum production

complications of bronchiectasis --, recurrent pneumonia, low oxygen levels

cor pulmonale

treatment of bronchiectasis: --, bronchodilators, physiotherapy

antibiotics

occasional treatment of bronchiectasis

surgical resection

rare treatment of bronchiectasis

lung transplant

long standing hypoxemia is associated with --

poor tissue perfusion and CV complications