Patho exam 3 (ch 21-25) Flashcards

1
Q

Upper airway structures

A

nasopharynx, oropharynx, laryngopharynx

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2
Q

Lower airway structures

A

larynx, trachea, bronchi, bronchopulmonary segments, terminal bronchioles, alveoli

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3
Q

Type I alveolar cells

A

epithelial structural cells

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3
Q

Type I alveolar cells

A

epithelial structural cells

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4
Q

type II alveolar cells

A

produce surfactant

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5
Q

surfactant

A

phospholipid that can lower surface tension and facilitate gas exchange

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6
Q

alveolar macrophage

A

phagocytize foreign particles damaged by smoking and inhalation of silica

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7
Q

what does the autonomic nervous system control

A

bronchi and bronchiole muscles

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8
Q

parasympathetic stimulation

A

mediated by acetylcholine leads to constriction of muscle

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9
Q

sympathetic stimulation

A

leads to relaxation of the smooth muscle

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10
Q

airway resistance

A

relationship between pressure and flow

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11
Q

airway resistance is influenced by

A

airway radius and pattern of gas flow

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12
Q

factors that decrease airway radius

A

mucus, bronchospasm, stress, pulmonary deconditioning, age

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13
Q

lung compliance

A

lung expandability and ease of lung inflation

–> provides estimate of airway resistance and elasticity of lung

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14
Q

why does lung compliance decrease?

A

increase in chest wall rigidity
reduced mobility of the ribs
partial contraction of inspiratory muscles
loss of elastic fibers in the lung

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15
Q

hypoventilation

A

air delivered to alveoli is insufficient to provide O2 and remove CO2

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16
Q

hypoventilation results in an increase of

A

pulmonary CO2

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17
Q

causes of hypoventilation

A
Morphine
Barbiturates
Obesity
myasthenia gravis
obstructive sleep apnea
chest wall damage
paralysis of respiratory muscles
surgery of the thorax or abdomen
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18
Q

hyperventilation

A

increase in air entering alveoli leads to decreased CO2

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19
Q

3 important factors of pulmonary disorders

A
  1. inflammation
  2. edema
  3. excess mucous production
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20
Q

obstruction

A

small airway + resistance to expiration

increase resistance to airflow

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21
Q

restriction

A

reduced lung volume + resistance to inspiration + reduced compliance

22
Q

Obstruction conditions in wall of lumen

A

asthma, bronchitis

23
Q

obstruction from loss of parenchyma

A

emphysema

24
Q

diseases cause by obstruction of the airway lumen

A

bronchiectasis, bronciolitis, CF, epiglotitis, croup

25
Q

asthma characterization

A

non-reversible airway obstruction, inflammation, increased sensitivity

26
Q

asthma symptoms

A

wheezing, cough, tightness of chest, sputum production

27
Q

most common chronic disease in children

A

asthma

28
Q

predisposing factors of asthma

A

family history, genetic issue causing smaller airway, chromosome 5, 11, 14, hay fever/eczema, allergies

29
Q

intrinsic asthma

A

non allergic, adult onset

30
Q

Extrinsic asthma

A

allergic, pediatric, IgE mediated response

31
Q

asthma diagnosis

A

radiographic - hyperinflation
sputum examination - charcot-leyden crytals, eosinophils, curschmann spirals
pulmonary function - forced expiratory volume decreases

32
Q

asthma treatment

A

avoid triggers, allergen immunotherapy, environmental control

33
Q

asthma medications

A

O2 therapy, nebulizer, B2 agonists, corticosteroid, leukotriene modifiers, mast cell inhibitors

34
Q

acute bronchitis

A

acute inflammation of the trachea and bronchi

35
Q

chronic bronchitis

A

type B COPD, “blue bloater”, persistent and irreversible

36
Q

cause of chronic bronchitis

A

smoking, repeated airway infections, genetics, inhalation of irritants

37
Q

chronic inflammation and swelling of the bronchial mucosa resulting in scarring

A

chronic bronchitis

38
Q

pathogenesis of chronic bronchitis

A

hyperplasia of bronchial mucous gland, increased bronchial wall thickness/resistance, pulmonary hypertension

39
Q

chronic bronchitis clinical manifestations

A

shortness of breath, excessive sputum, chronic cough, edema, cyanosis

40
Q

chronic bronchitis chest x-ray

A

increased bronchial vascular markings, congested lung, evidence of previous infection

41
Q

chronic bronchitis management

A

smoking cessation, bronchodilator therapy, reduce exposure to irritants, rest, hydration, physical conditioning

42
Q

emphysema

A

obstruction related to loss of lung parenchyma

43
Q

emphysema - abnormal permanent enlargement of the ______ ________ accompanies by destruction of ________ ____ without obvious fibrosis = ________

A

gas-exchange airways, alveolar walls, honeycombing

44
Q

honeycombing in emphysema

A

loss of elastic recoil, bronchioles are likely to collapse

45
Q

type A COPD

A

emphysema, pink puffer

46
Q

hereditary cause of emphysema

A

low alpha-antitrypsin activity

47
Q

causes of emphysema

A

smoking, air pollution, environmental/occupational hazards, a1-antitrypsin deficiency

48
Q

alpha 1 antitrypsin

A

liver protein, protects the lungs by neutralizing elastase

49
Q

what happens in emphysema

A

release of proteolytic enzymes from inflammatory cells that damages alveoli

loss of elastic tissue in lung causing small bronchioles

50
Q

emphysema clinical manifestation

A

dyspnea, shortness of breath, pursed lip breathing, cough, digital clubbing

51
Q

bullae

A

peripheral blebs, staple of COPD

52
Q

emphysema diagnosis

A

physical manifestations, pulmonary function test (decreased FEV increased TLC), chest x-ray showing hyperinflation,

53
Q

emphysema treatment

A

O2 therapy, medications: B2 agonists, anticholinergic bronchodilators, cough suppressant, antimicrobial, corticosteroids