patho quiz 5 3 Flashcards
How does the body control ventilation?
Neurologic control (respiratory center- medulla & pons), Chemical ( changes in PO O2 CO2), Mechanical (stretch receptors in bronchi & irritant receptors throughout the epithelium)
How do you control breathing?
Medullary Center, Pons, chemoreceptors, peripheral receptors, stretch receptors, irritant receptors, pain, stress, muscles, and joints
What is ventilation?
Process of moving air into the lungs and distributing air within the lungs to alveoli for maintaining of O2 and removal CO2
What is perfusion?
The second process of respiration which blood flow and distribution of blood flow at the alveolar level to allow exchange of O2 and CO2
What is the ventilation / perfusion ratio?
4L/min of alveoli ventilation to 5L/min of capillary blood flow in the lungs. V/Q 80%, 0.8
What is respiratory insufficiency?
Gas exchange is maintained at an acceptable level with much increased work of the cardiopulmonary system
What is respiratory failure?
Cardiopulmonary system inability to maintain adequate gas exchange at the pulmonary level
What is the etiology of respiratory failure?
Decreased CNS drive to breath, impaired ventilation d/t obstruction, and impaired ventilation/perfusion
What is hypoxemia?
Abnormally low O2 in the blood as a direct consequence of resp. failure
What effects does Hypoxemia have on CNS?
Restlessness, agitation, incordination, and coma and death
What are the clinical presentations of resp insufficiency vs. failure?
tachycardia, coolness, diaphoresis, pallor-cyanosis, initial increase in BP/HR, failure : hypotension and bradycardia
What is hypercapnea?
increased level of CO2 in blood. It is a direct vasodilator ( cerebral vessels > headache, flushed skin, and conjunctiva - hyperemia)
What does acidosis mean?
pH low, too much H+ ion. Resp: CO2 elevated. Metabolic: HCO3 decreased
What is the normal arterial pH?
7.35-7.45
What is the normal value of arterial PaCO2?
35-45 mm Hg
What is the normal value of arterial Bicarb (HCO2-)
22-26 mEq/L ( mmol/L)
What does alkalosis mean?
pH high, low level of H+ ion in blood, Resp: low, Metabolic: high
What are the manifestations of metabolic acidosis?
Causes HYPERKALEMIA. Drowsiness, confusion, coma, decrease Bp, dysrhythmia (K+), dilations, NVD, and pain, increased resp. (comp).
What are the manifestations of metabolic alkalosis?
HYPOKALEMIA, dizziness, irritability, nervous, confusion, Increase HR, NV, anorexia, tetany, tremor, paresthesia, seizures, decreased resp. (comp)
What is complete compensation?
both CO2 and HCO3 are abnormal in the same direction and pH is within normal range
What is partial compensation?
Both CO2 & HCO3 are abnormal in the same direction, and pH is still outside the normal range
What is combined Acidosis?
CO2 is high and HCO3 is low
What is combined Alkalosis?
CO2 is low and HCO3 is high
What are the 6 steps in diagnosis of metabolic vs. resp. acidosis or alkalosis?
Evaluate pH, analyze PaCO2, analyze HCo3, determine if balanced or unbalanced, determine if CO2 or HCO3 matches the alteration, and decide if the body is attempting to compensate
What are the values of resp. failure?
PaO2 less than or equal to 50 mmHg (hypoxemia) or PaCO2 greater than or equal to 50 mmHg with pH less than or equal to 7.25
What causes respiratory failure?
pneumonia, COPD, atelectasis, CHF, sepsis, drugs, neuro disorders
What is the treatment of resp. failure?
O2 and ventilator support
What is hemoptysis?
coughing up blood
What is clubbing a sign of?
chronic resp. disease
What is paroxysmal nocturnal dyspnea?
awakening from deep sleep with severe shortness of breath
What is orthopnea?
unable to lie flat because of breathing
What is obstructive lung disease?
difficulty exhaling, decreased FEV1 and FEV1/FVC, increase in breathing, use of accessory muscles of exhalation, and intrapulmonary problem
What is restrictive lung disease?
difficulty inhaling, decreased FVC? Caused by stiff lung (fibrosis), neuro, muscular, skeletal, normal ventilation during sleep
What is Chronic Obstructive Pulmonary Disease?
obstruct pathway of normal alveolar ventilation either by spasm of the airways, mucus secretions, or changes in airway and/or alveoli
COPD is a comb of what 3 diseases?
chronic bronchitis, emphysema, and asthma
What is chronic bronchitis?
bronchial inflammation with hypertrophy and hypersecretion of bronchial mucous glands
What causes chronic bronchitis?
inhalation of chemical or physical irritants, such as tobacco smoke, smog, viral or bact. Infections
How is chronic bronchitis dx?
productive cough for 3 months of each year for 2 consecutive years
What are the signs and symptoms of chronic bronchitis?
productive cough, increased work of breathing, dyspnea
What is pts. With chronic bronchitis called?
blue bloater
What is emphysema?
nonreversible obstructive disease characterized by the destruction of alveolar walls and connective tissue. Terminal airways collapse during expiration. Secretions are retained.
What are the causes of Emphysema?
inhalation of irritants (tobacco smoke) and genetic (rare)
What are the s/s of emphysema?
dyspnea, barrel chest, non-productive cough
What are pts. With emphysema called?
pink puffers
What is barrel chest?
A & P diameter is equal to transverse diameter
How do you treat emphysema?
improve ventilation (bronchodilators & breathing exercises), Promote secretion removal (hydration & humidification), and prevent complications
What is asthma?
intermittent airway obstruction d/t bronchospasm and increase mucous secretions. Hyper-responsiveness of airways after exposure to irritating stimuli (exercise, change in temp., emotional stress, animal dander, fumes)
What are the s/s of asthma?
wheezing, cough, hyperventilate, dyspnea, and anxiety
