Obstructive Pulmonary Pathology

Question 1

Identify the 4 pathophysiologic mechanisms that contribute to obstructive lung disease.

Answer 1

Excessive secretion
Loss of radial traction
Inflammation/hypertrophy
Bronchoconstriction

Question 2

Describe the mucociliary escalator

Answer 2

Mucus is produced in the airways of the lungs. This traps foreign particles like dust or bacteria. Cilia propel trapped particles. Once mucus reaches the throat, it can be swallowed or coughed up.

Question 3

With chronic inflammation of the airways, ________ can occur.

Answer 3

Hypertrophy

Question 4

What are the phases of coughing?

Answer 4

Inhalation: deep breath

Compression: glottis closes, chest muscles contract.

Expiration: Glottis opens, forceful expiration.

Question 5

List some examples of populations that may experience an impaired cough:

Answer 5

Respiratory conditions, elderly, NM diseases, stroke, etc.

Question 6

Define airway stenosis

Answer 6

Narrowing of the airways, restricting airflow during both inhalation and exhalation.

Question 7

Define airway trapping

Answer 7

Inability to fully exhale air, leading to lung hyperinflation and difficulty with subsequent inhalations.

Question 8

List three conditions that could lead to airway trapping:

Answer 8

Asthma
Emphysema
COPD

Question 9

Identify five common obstructive pulmonary diseases:

Answer 9

Asthma
Chronic Bronchitis
Emphysema
Bronchopulmonary Dysplasia
Cystic fibrosis

Question 10

Define asthma

Answer 10

Disease characterized by increased bronchoconstrictor response to a variety of stimuli. Over time hypertrophy can occur.

Question 11

Define Chronic bronchitis

Answer 11

Occurs in response to chronic irritation of the airways (smoking). Involves hypersecretion of mucus and hypertrophy of the bronchial walls.

Question 12

Define emphysema. What are three consequences?

Answer 12

Destruction of lung parenchyma leading to a loss of elastic recoil and radial traction. Lung hyperinflation, airflow limitation, and air trapping follow.

Question 13

_________ - large air pockets form which have no effective ventilation; common in upper lobes.

Answer 13

Bullous emphysema

Question 14

What mechanisms contribute to the pathology: Bronchiectasis

Answer 14

Inflammation and excessive mucous secretion

Question 15

What mechanisms contribute to the pathology: Asthma

Answer 15

Bronchoconstriction, inflammation/hypertrophy, and sometimes excessive mucouse secretion (uncommon)

Question 16

What mechanisms contribute to the pathology: Chronic bronchitis

Answer 16

Excessive mucous secretion and hypertrophy

Question 17

What mechanisms contribute to the pathology: Cystic fibrosis

Answer 17

Excessive mucous secretion and inflammation.

Question 18

What mechanisms contribute to the pathology: Emphysema

Answer 18

Loss of radial traction

Question 19

Two ways to measure hypoxemia. Indirect and direct:

Answer 19

Indirect: Pulse ox
Direct: ABG analysis

Question 20

In a patient with barrel chest, what happens to the diaphragm sarcomere length?

Answer 20

Shortens. Diaphragm flattens.

Question 21

Why do patients with emphysema often breath through pursed lips?

Answer 21

It helps to keep some pressure in the airways, helping them stay open rather than collapsing.

Question 22

Why do people with COPD often lean over a shopping cart with elbows resting on the handle?

Answer 22

Allows them to engage accessory muscles of respiration, like the shoulder and neck muscles, to reduce work of breathing.

Question 23

List three signs and symptoms of obstructive disease that is specific to this type of condition:

Answer 23

Pursed lip breathing
Hyperinflation
Forward leaning posture

Question 24

List three lab tests that may be used to diagnose obstructive pulmonary disease:

Answer 24

Arterial blood gases (ABGs)
Complete cell count (CBC)
Sputum culture

Question 25

Two strategies to prevent obstructive pulmonary disease:

Answer 25

Nutritional support
Smoking cessation

Question 26

4 treatments for obstructive pulmonary disease:

Answer 26

Airway clearance
Oxygen therapy
Ventilatory support
Surgery