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CardioPul 3 > Pathophysiology > Flashcards

Pathophysiology Flashcards

1
Q

describe the control of breathing

A
  • INCREASE pCO2 is the MOST potent stimulator of respiration
  • Decrease p02 and pH
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2
Q

describe the generations in which gas exchange occurs

A
  • Generation 0 to 16 = NO GAS EXCHANGE
  • generation 17-23 = GAS EXCHANGE OCCURS
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3
Q

whats conditions increase air flow.

A

Most RESTRICTION is due to BRONCHIOLES

–> inflammation of bronchial epithelium = bronchitis

–> secretions from epithelium = asthma, infection, decrease cilia

–> constriction of smooth muscle = asthma

–> physical blockade = tumors, aspiration

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4
Q

air resistance is most impacted by…

A
  • Radius of the airway (increase in resistance –> decrease in radius

  • affected in ASTHMA and Bronchitis (medium sized bronchioles have highest resistance
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5
Q

describe the effects of parasympathetic activation on airway resistance

A
  • Parasympathetic activation INCREASES (M3 activation) RESISTANCE
  • affected in ASTHMA and muscarinic agonists
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6
Q

describe the effects of sympathetic activation on airway resistance

A
  • Symapthetic activation DECREASES (Beta2 activation) RESISTANCE
  • Affected by epinephrine and albuterol
  • USED during emergency in acute asthma attack
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7
Q

what are the 3 disorders due to obstruction from conditions in the airway wall

A
  • asthma
  • acute bronchitis
  • chronic bronchitis
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8
Q

obstructive disorders related to loss of lung parenchyma

A
  • emphysema
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9
Q

obstructive disorders of the airway lumen

A
  • bronchiectasis
  • bronchiolitis
  • cystic fibrosis
  • acute tracheobronchial obstruction
  • epiglottitis
  • croup syndrome
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10
Q

describe the omposistion of the respiratory membrane

A

site of gas exchange

  • COMPOSITION
  • layer of fluid lining the alveolus containing surfactant
  • alveolar epithelium
  • epithelial basement membrane
  • intersitial space
  • capillary basement membrane
  • capillary endothelial membrane
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11
Q

describe the lung interstitium

A

found within the respiratory membrane

  • COMPOSITION: connective tissue, smooth muscle, lymphatics, capillaries, cells
  • FIBROBLASTS: prominent cells of the interstitium that PRODUCE collagen and elastin –> distensiblity and elastic recoil of lungs
  • Lung interstitium is very small under normal conditions but becomes ENLARGED with INFLAMMATORY CELLS and EDEMA FLUID –> interfere with gas exchange
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12
Q

describe the factors that affect gas exchange

A
  • D = diffusion of gas across respiratory membrane
  • delta P = partial pressure difference between alveoli and blood

–> affects in high altitude, restrictive lung disease, O2 mask

  • A = surface area (affected in atelectasis, tumor)
  • d = distance between the two sides of membrane (thickness)

–> affected in pulmonary edema, pneumonia

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13
Q

describe pleural effusion

A
  • Commonly seen in CONGESTIVE HEART FAILURE

–> increased pulmonary venous hydrostatic pressure - from the visceral side

  • decreased microvascular oncotic pressure
  • Due to decreased pleural pressure (atelectasis) or blockade of lymphatic drainage (tumors)
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14
Q

describe restrictive pulmonary disorders

A
  • result of DECREASED EXPANSION OF THE LUNGS due to alterations in the lung parenchyma, pleura, chest wall or neurmuscular function
  • result of lung parenchyma disorders, pleural space disorder, INFECTION or INFLAMMATINO OF THE LUNG (PNEUMONIA)
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15
Q

Hypoxic pulmonary vasoconstriction (HPV)

A
  • is unique to lungs
  • mechanisms for automatic control of pulmonary blood flow distribution

–> MATCHES VENTILATION AND PERFUSION

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16
Q

describe the perfusion relationship

A
  • Matching ventilation (V) to perfusion (Q) is important for ideal gas exchange (Average normal value of V/Q = .8)
  • V/Q = infinity (DEAD SPACE - ventilation coming in but no blood flow around it (PE))
  • High V/Q = decrease in blood flow but ventilation is still good
  • Low V/Q = increase in blood flow but decrease ventilation
  • V/Q = 0 (shunt) = abnormal alveoli ventilation, but blood flow still goes through (ASD, VSD)
17
Q

what aspect can’t be measured by spirometry

A
  • Residual volume cannot be measured by spirometry
18
Q

obstuctive lung disease

A

Obstructive lung disease

19
Q

Upper airway obstruction

A

Upper airway obstruction

20
Q

restrictive lung disease

A

restrictive lung disease

21
Q

describe clinical use of FEV1/FVC ratio

A

** USED TO DIFFERENTIATE AMONG LUNG DISEASES**

  • FEV1/FVC = .8 –> NORMAL
  • FEV1/FVC LESS .7 –> OBSTRUCTIVE LUNG DISEASE

–> FEV1 is DECREASED MORE than FVC

  • FEV1/FVC INCREASED –> RESTRICTIVE LUNG DISEASE

–> both FVC and FEV1 are decreased, but FEV1 is decreased LESS than FVC

CardioPul 3 (15 decks)

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