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PTRS 826 Exam 2 > Obstructive Lung Disease > Flashcards

Obstructive Lung Disease Flashcards

1
Q

Function of the following structures: trachea, carina, R/L main stem, lobar bronchi, segmental bronchi, subsegmental bronchi

A

They’re the tubes of the respiratory system

They carry gas

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2
Q

Function of the following structures: terminal bronchioles, respiratory bronchioles, alveolar ducts, alveolar sacs

A

Exchange units of the lungs

Exchagen O2 for CO2

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3
Q

Structure:

300 million clusters in the adult lung

SA of a tennis court

Elastic

A

Alveolar sacs

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4
Q

Describe Chronic Obstructive Pulmonary Disease (COPD)

A

FLOW of air is IMPEDED; trouble getting air OUT

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5
Q

Describe Restrictive Lung Disease (RLD)

A

VOLUME of air REDUCED, trouble getting air IN

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6
Q

Disease: affects both the MECHANICAL function and gas EXCHANGE of the respiratory system

A

COPD

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7
Q

Disease: LONG expiratory time; I:E of 1:4+

A

COPD

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8
Q

Disease Risk Factors:

Smoking

Air Pollution

Familly Hx

Occupational Dusts

A

COPD

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9
Q

Disease Physical Symptoms:

Dyspnea on Exertion

Fatigue

Chronic Cough

Wheezing/Rhonchi

Expectoration of Mucus

A

COPD

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10
Q

Disease loss of normal elastic recoil and bronchial tubes collapse

A

COPD

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11
Q

Describe the PFT changes with COPD

A

Decreased ERV

Increased RV and FRC

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12
Q

With COPD both the _____________ and __________ of the respiratory system is affected

A

efficiency, function

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13
Q

COPD Pathophysiology: ______1_____ bronchial lumen; ___2___ mucus production, _____3_____ of the mucosal lining (thickening) due to repeated ______4______. ____5____ (constriction) of bronchial smooth muscle. Respiratory muscles must work ____6____. Enlarged ____7____ is already inflated (___8___ chested). Must overcome _____9_____ to airflow obstruction. Alveolar ventilation is _____10______.

A
  1. Decreased
  2. Increased
  3. Inflammation
  4. Infection
  5. Spasm
  6. Harder
  7. Thorax
  8. Barrel
  9. Resistance
  10. Decreased
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14
Q

List the signs and symptoms of COPD (4)

A
  1. Hypoxemia (for most)
  2. Polycythemia (increased RBC and visocisty = increased resistance)
  3. Cor Pulmonale (R sided heart failure)
  4. Respiratory Failure (frequent cause of death for COPD)
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15
Q

List the Tx for COPD (3)

A
  1. Remove irritant/afflicting agent
  2. Inhaled medications (albuterol, anti-cholinergics, corticosteroids, antibiotics)
  3. Exercise training
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16
Q

List the disease grouped under COPD

A
  1. Emphysema
  2. Chronic Bronchitis
  3. Asthma
  4. Cystic Fibrosis

** Conditions can be separate or co-exist

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17
Q

Disease:

Alveolar/Parenchymal Disease

Lung function altered [elastic recoil, collapse of airways w/exhalation and chronic airflow obstruction]

Abnormal PFTx & CXR

A

Emphysema

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18
Q

Disease: Enlargement of air spaces distal to terminal bronchioles, loss of elastic fibers, and destruction of alveolar septal walls

A

Alveolar/Parenchymal Disease

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19
Q

Type of Emphysema: destruction of more proximal or central alveoli

A

Centriacinar

20
Q

Type of Emphysema: destruction of more distal alveoli

A

Panacinar or Panlobular

21
Q

Term: Stretched out alveoli that are at risk for blowing out

A

Panlobular

22
Q

Centrilobular emphysema affects _____1_____ _____2_____ sparing distal avleoli, worse in the __3__ __4__, particularly the _____5_____. Most common in ___6___. Closely associated with ____7____.

A
  1. Respiratory
  2. Bronchioles
  3. Upper
  4. Lobes
  5. Apices
  6. Men
  7. Smoking
23
Q

Panlobular emphysema affects airspaces _____1_____ to the respiratory bronchiole. ___2___ ____3____ most affected. Generally due to a ___4___ deficiency (alpha1 antitrypsin)

A
  1. Distal
  2. Lower
  3. Lobes
  4. Protein
24
Q

List the components of the lung affected by EMPHYSEMA (3)

A
  1. Respiratory Bronchioles
  2. Alveolar Ducts
  3. Alveolar Sacs
25
Q

Disease Clinical Features

Dry non-productive cough

“Skin and Bones”

All energy used to breath

Absent/Decreased breath sounds w/auscultation

Increased expiratory phase

A

Emphysema

26
Q

Disease: Pink Puffer

A

Emphysema

27
Q

Disease: Chronic productive cough for 3 mo/yr OR for > 2 consecutive years

A

Chronic bronchitis

28
Q

Disease:

Proliferation of submucosal glands and globet cells

Insidious onset

Smokers cough, morning cough, continual cough

Recurrent pneumonia

A

Chronic Bronchitis

29
Q

List the response to irritants in chronic bronchitis (4)

A
  1. Contraction of bronchial smooth mm
  2. Denuded cilia
  3. Increased secretions
  4. Swelling of mucosa
30
Q

Disease Clinical Features:

Chronic productive cough

Overweight

Cyanotic Lip/Nailbeds

Rhonchi/Weezes on auscultation

Expiratory Phase Increased

Abnormal PFT and CXR

A

Chronic Bronchitis

31
Q

Describe why you shouldn’t give O2 to those with Chronic Bronchitis

A

In chronic bronchitis, the CO2 trigger to breath is gone [sensors burned out], Thus the drive to breath is based on a hypoxic drive mechanism [O2]. If they are given O2, their drive to breath will decrease b/c they demand is met by the supplemental O2

If they are SOB just slow them down and work on retraining their breathing

LOW FLOW O2 may be acceptable

32
Q

List the components of the lung affected by chronic bronchitis (3)

A
  1. Lobar bronchi
  2. Segmental bronchi
  3. Subsegmental bronchi
33
Q

Disease: Blue Bloater

A

Chronic Bronchitis

34
Q

Disease:

Reversible

Bronchospasm [wheezing, obstruction, coughing]

Younger patients

A

Asthma

35
Q

Disease:

Inflammatory disease causing SOA and DOE, wheezing, coughing

Bronchospasm/inflammation caused by hypersensitivity to extrinsic/intrinsic stimuli

Structural changes (thickening) of airways

A

Asthma

36
Q

Asthma results in _1_ _____2_____ which _____3_____ RV, thus ___4___ CO2 and ____5____ O2. There is a reduction of __6__ and __7__ ___8___. All of which are _____9_____.

A
  1. Air
  2. Trapping
  3. Increasing
  4. Increasing
  5. Decreasing
  6. FEV1
  7. Peak
  8. Flow
  9. Reversible
37
Q

List the Tx for Asthma (2)

A
  1. Trigger awareness
  2. Inhaled agents (bronchodilators, anti-inflammatory, prophylactic)
38
Q

Disease:

Caused by increased air flow and drying of airways

Can experience w/o hx of dx asthma

Prevent w/proper warm-up and pharm

Up to 30% of olympic athletes

A

Exercise Induced Bronchospasm

39
Q

Disease:

Developing pulmonary disease results in increasing hypoexmia (constricts pulmonary system)

Vasoconstriction causes pulmonary hypertension (R heart working harder due to peripheral edema)

R ventricular hypertrophy secondary to these abnormalities of lung structure/function

A

Cor Pulmonale

40
Q

Disease:

Inherited chronic disease that affects the lung and digestive system

Defective gene and protein that cause the body to produce unusually thick sticking mucus

Clogs lungs causing lung infection

Clogs pancreas and stop natural enzymes from breaking down/absorbing food

A

Cystic Fibrosis

41
Q

Disease Symptoms:

Persistent Coughing

Frequent Lung Infection

Wheezing and SOB

Salty-Tasting Skin

Poor Growth/Weight Gain

Greasy/Bulky Stools w/Difficult Bowel Movements

A

Cystic Fibrosis

42
Q

Cystic Fibrosis is caused by a dysregulation of the ___1___ protein which leads to the ____2____ of the airways to clear ___3___. Lung function progresses from ____4____ to the addition of a _____5_____ component.

A
  1. CFTR (cystic fibrosis transmembrane conductance regulator)
  2. Failure
  3. Mucus
  4. Obstruction
  5. Restrictive
43
Q

List the Tx of Cystic Fibrosis (5)

A
  1. Inhaled agents (bronchodilators, mucolytics, antibiotics)
  2. Exercise
  3. Nutrition
  4. Lung Transplant
  5. Drug Therapies
44
Q

Once a ___1___ always a ____2____. __3__ and __4__ for all. Hypoxia for _____5_____, hypercarbia for __6__. Dry cough for _____7_____, productive cough for __8__.

A
  1. COPDer
  2. COPDer
  3. SOA
  4. DOE
  5. Emphysema
  6. CB (chronic bronchitis)
  7. Emphysema
  8. CB
45
Q

Describe different breathing techniques for COPD

A

Pursed lip: creates backpressure, helps pt. get over the hump, no LT benefit

Tripod Position [elbows on table]: allow accessory mm to more efficiently lift the chest wall

46
Q

Disease: Decreased flow rates, hypercapnia, hyperinflation

A

COPD

PTRS 826 Exam 2 (10 decks)

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