Pathology of the Airways and Lungs Flashcards
Acute Respiratory Distress Syndrome (ARDS)
Sudden respiratory failure due to fluid accumulation in the alveoli. Fatal in 25-40% of people. May not regain full lung function for a year.
Etiology: Inflammation of the lungs due to various causes allows fluid from blood vessels in the lungs to leak into alveoli.
Signs & symptoms: SOB, labored and rapid breathing, hypotension, confusion, fatigue, cough, fever.
Treatment: Supplemental O2 and mechanical ventilation. Treat underlying condition.
Asthma
Chronic inflammation of airways.
Etiology: Airway hypersensitivity to various stimuli.
Signs & symptoms: Mild - Wheezing, chest tightness, and SOB. Severe - dyspnea, flaring of nostrils, diminished wheezing, anxiety, cyanosis, and inability to speak.
Treatment: Anti-inflammatory agents and bronchodilators. PT includes airway clearance, breathing exercises, relaxation, endurance, and strength training.
Atelectasis
One or more lung collapses or does not inflate properly
Etiology: Conditions that prevent deep breathing and coughing, including post-op pain, pleural effusion, tumor, ARDS, asthma, COPD, and cystic fibrosis.
Signs & symptoms: Cyanosis, SOB, increased RR, and increased HR.
Treatment: Deep breathing, changing positions, airway clearance. Positive end-expiratory pressure or continuous positive airways pressure devices. Supplemental O2, nebulized bronchodilators, and mucolytic agents.
Bronchiectasis
Progressive obstructive lung disease that produce abnormal dilation of a bronchus.
Etiology: Usually due to chronic infections, aspiration, cystic fibrosis, or immune system impairment. Bronchial walls weaken and permanent dilation occurs.
Signs & symptoms: Productive cough, hemoptysis, weight loss, anemia, crackles, wheezes, and loud breath sounds.
Treatment: Antibiotics, bronchodilators, expectorants, and mucolytics.
Bronchitis
Inflammation of bronchi and hypertrophy of the mucus secreting glands. Insufficient oxygenation due to mucus blockage.
Etiology: Cold viruses or exposure to smoke or pollutants.
Signs & symptoms: Productive cough for 3 months over the course of 2 years. Wheezing, dyspnea, cyanosis, and increased pulmonary artery pressure. Cough worse in morning and in damp weather and frequent respiratory infections.
Treatment: Antibiotics, bronchodilators, anti-inflammatories.
Chronic Obstructive Pulmonary Disease (COPD)
Narrowing of bronchial tree that blocks airflow. Emphysema and chronic bronchitis make up COPD. Progression of disease includes alveolar destruction and air trapping. Increased total lung capacity with decreased RV.
Etiology: Long term smoking or exposure to smoke. Other air irritants.
Signs & symptoms: Excessive mucus production, chronic productive cough, wheezing, SOB, fatigue, and reduced exercise capacity.
Treatment: Bronchodilators, inhaled steroids, supplemental O2, and antibiotics (if bacterial infection present). Surgery for lung volume reduction, bullectomy, and lung transplant. Airway clearance, breathing exercises, and endurance/strength training.
Cystic Fibrosis
Production of thick, sticky mucus that leads to life-threatening lung infections, obstructs the pancreas, and inhibits normal digestion and absorption of food.
Etiology: Autosomal recessive genetic disease of the exocrine glands.
Signs & symptoms: Salty tasting skin, persistent and productive cough, frequent lung infections, wheezing, SOB, poor growth/weight gain.
Treatment: Antibiotics, nutritional supplements, pancreatic enzyme replacements, mucolytics, bronchodilators. PT includes airway clearance, breathing techniques, assisted cough, and ventilatory muscle training. General exercise to improve strength and endurance.
Emphysema
Alveolar walls destroyed and turned into large, irregular pockets with holes in the walls. Bronchioles collapse during exhalation, not letting air escape from lungs. Alveoli overinflated, increasing dead space in lungs.
Etiology: Smoking
Signs & symptoms: SOB, wheezing, chronic coughing, orthopnea, barrel chest, increased use of accessory muscles, increased RR, fatigue, and reduced exercise capacity.
Treatment: Bronchodilators, inhaled steroids, supplemental O2, and antibiotics. Surgery includes lung volume reduction, bullectomy, or lung transplant. Airway clearance, breathing exercises, and endurance/strength training.
Pleural Effusion
Buildup of fluid in pleural space, making it hard to breath and sometimes causing atelectasis.
Etiology: Pleuritis caused by viral infection, pneumonia, pulmonary embolism, and autoimmune diseases such as lupus and rheumatoid arthritis.
Signs & symptoms: SOB. If fluid infected, dry cough, fever, and chills.
Treatment: Treat underlying condition.
Pneumonia
Inflammation of the lungs.
Etiology: Usually bacterial, viral, fungal, or parasitic infection.
Signs & symptoms: Fever, cough, SOB, sweating, shaking chills, chest pain, headache, muscle pain, and fatigue.
Treatment: Variable. Antibiotics, antiviral, and antifungals. Rest and drinking liquids.
Pulmonary Edema
Fluid collects in alveoli. Acute pulmonary edema is a medical emergency.
Etiology: Often occurs when L ventricle is unable to pump blood adequately. Pressure increases inside L atrium and in pulmonary veins and capillaries, causing fluid to be pushed through the capillary walls into alveoli. In non-cardiac edema, fluid leaks from alveoli capillaries into alveoli.
Signs & symptoms: SOB, feeling of suffocating or drowning, wheezing, anxiety, coughing, sputum, chest pain (if cardiac cause), rapid/irregular pulse.
Treatment: Variable but usually supplemental O2 and medications.
Pulmonary Embolism (PE)
Artery in lungs becomes blocked.
Etiology: Blood clots from LEs.
Signs & symptoms: Sudden onset of SOB, chest pain that becomes worse with deep breathing, coughing, eating or bending, coughing up bloody sputum. Wheezing, LE swelling, excessive sweating, rapid or irregular pulse, and lightheadedness or fainting.
Treatment: Anticoagulants and thrombolytic agents given promptly can reduce risk of death. Surgery to remove clot or insert a filter into inferior vena cava.
Pulmonary Fibrosis
Irreversible scarring of alveoli, making tissue stiff and less flexible, making breathing difficult.
Etiology: Most cases, cause unknown.
Signs & symptoms: SOB, especially during or after physical activity. Dry cough, which occurs when disease is advanced and irreversible damage has occurred. Fatigue, unexplained weight loss, and aching muscles and joints.
Treatment: Corticosteroids and immunosuppresive agents initially. Lung transplant with advanced disease. Supplemental O2 and pulmonary rehab.
Restrictive Lung Dysfunction
Abnormal reduction in lung expansion and pulmonary ventilation.
Etiology: Abnormal lung parenchyma, abnormal pleura, and disorders affecting ventilatory pump function.
Signs & symptoms: Dyspnea on exertion, persistent non-productive cough, increased RR, hypoxemia, decreased VC, abnormal breath sounds, and reduced exercise tolerance.
Treatment: Variable depending on etiology. Supplemental O2, mechanical ventilation, pulmonary rehab.
