Patho exam 3 (ch 21-25)

Question 1

Upper airway structures

Answer 1

nasopharynx, oropharynx, laryngopharynx

Question 2

Lower airway structures

Answer 2

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

Question 3

Type I alveolar cells

Answer 3

epithelial structural cells

Question 3

Type I alveolar cells

Answer 3

epithelial structural cells

Question 4

type II alveolar cells

Answer 4

produce surfactant

Question 5

surfactant

Answer 5

phospholipid that can lower surface tension and facilitate gas exchange

Question 6

alveolar macrophage

Answer 6

phagocytize foreign particles damaged by smoking and inhalation of silica

Question 7

what does the autonomic nervous system control

Answer 7

bronchi and bronchiole muscles

Question 8

parasympathetic stimulation

Answer 8

mediated by acetylcholine leads to constriction of muscle

Question 9

sympathetic stimulation

Answer 9

leads to relaxation of the smooth muscle

Question 10

airway resistance

Answer 10

relationship between pressure and flow

Question 11

airway resistance is influenced by

Answer 11

airway radius and pattern of gas flow

Question 12

factors that decrease airway radius

Answer 12

mucus, bronchospasm, stress, pulmonary deconditioning, age

Question 13

lung compliance

Answer 13

lung expandability and ease of lung inflation

–> provides estimate of airway resistance and elasticity of lung

Question 14

why does lung compliance decrease?

Answer 14

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

Question 15

hypoventilation

Answer 15

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

Question 16

hypoventilation results in an increase of

Answer 16

pulmonary CO2

Question 17

causes of hypoventilation

Answer 17

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

Question 18

hyperventilation

Answer 18

increase in air entering alveoli leads to decreased CO2

Question 19

3 important factors of pulmonary disorders

Answer 19

1. inflammation
2. edema
3. excess mucous production

Question 20

obstruction

Answer 20

small airway + resistance to expiration

increase resistance to airflow

Question 21

restriction

Answer 21

reduced lung volume + resistance to inspiration + reduced compliance

Question 22

Obstruction conditions in wall of lumen

Answer 22

asthma, bronchitis

Question 23

obstruction from loss of parenchyma

Answer 23

emphysema

Question 24

diseases cause by obstruction of the airway lumen

Answer 24

bronchiectasis, bronciolitis, CF, epiglotitis, croup

Question 25

asthma characterization

Answer 25

non-reversible airway obstruction, inflammation, increased sensitivity

Question 26

asthma symptoms

Answer 26

wheezing, cough, tightness of chest, sputum production

Question 27

most common chronic disease in children

Answer 27

asthma

Question 28

predisposing factors of asthma

Answer 28

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

Question 29

intrinsic asthma

Answer 29

non allergic, adult onset

Question 30

Extrinsic asthma

Answer 30

allergic, pediatric, IgE mediated response

Question 31

asthma diagnosis

Answer 31

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

Question 32

asthma treatment

Answer 32

avoid triggers, allergen immunotherapy, environmental control

Question 33

asthma medications

Answer 33

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

Question 34

acute bronchitis

Answer 34

acute inflammation of the trachea and bronchi

Question 35

chronic bronchitis

Answer 35

type B COPD, "blue bloater", persistent and irreversible

Question 36

cause of chronic bronchitis

Answer 36

smoking, repeated airway infections, genetics, inhalation of irritants

Question 37

chronic inflammation and swelling of the bronchial mucosa resulting in scarring

Answer 37

chronic bronchitis

Question 38

pathogenesis of chronic bronchitis

Answer 38

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

Question 39

chronic bronchitis clinical manifestations

Answer 39

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

Question 40

chronic bronchitis chest x-ray

Answer 40

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

Question 41

chronic bronchitis management

Answer 41

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

Question 42

emphysema

Answer 42

obstruction related to loss of lung parenchyma

Question 43

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

Answer 43

gas-exchange airways, alveolar walls, honeycombing

Question 44

honeycombing in emphysema

Answer 44

loss of elastic recoil, bronchioles are likely to collapse

Question 45

type A COPD

Answer 45

emphysema, pink puffer

Question 46

hereditary cause of emphysema

Answer 46

low alpha-antitrypsin activity

Question 47

causes of emphysema

Answer 47

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

Question 48

alpha 1 antitrypsin

Answer 48

liver protein, protects the lungs by neutralizing elastase

Question 49

what happens in emphysema

Answer 49

release of proteolytic enzymes from inflammatory cells that damages alveoli loss of elastic tissue in lung causing small bronchioles

Question 50

emphysema clinical manifestation

Answer 50

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

Question 51

bullae

Answer 51

peripheral blebs, staple of COPD

Question 52

emphysema diagnosis

Answer 52

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

Question 53

emphysema treatment

Answer 53

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