Pulmonary 1 (Week 13) Flashcards
eupnea
normal, effortless breathing
hyperpnea
increased rate, increased tidal volume (happens with exercise)
hypoventilation
inadequate alveolar ventilation (blockage of airway; neurological injury)
hyperventilation
alveolar ventilation exceeds metabolic demands; leads to hypercapnia
hypocapnia
decreased CO2
what happens when CO2 levels increase
as CO2 levels decrease, blood vessels in brain constrict (under local control)
-you pass out
cyanosis
bluish coloring of skin, nailbeds, mucous membranes
clubbing
bulbous enlargement of tips of fingers or toes, associated with interference with oxygenation
hypoxia
decreased O2
hypercapnia
increased arterial CO2
adalyctasis
closing off of small airways
respiratory failure
inadequate gas exchange in lungs (more CO2 than O2)
what is respiratory failure associated with
post-surgical patients
chest was restriction
chest wall is unable to expand normally due to deformity, trauma, impairment or respiratory muscles (drug overdose), excess adipose tissue
flail chest
fracture of several consecutive ribs and/or sternum (common in MVA)
pneumothorax
air enters theoretical space between pleura and chest wall and becomes a real space; lungs cant expand much
2 types of pleural effusion
transudative effusion
exudative effusion
transudative effusion
fluid diffuses from capillaries into pleura, usually due to interference with starling-landis (CHF, hypoproteinemia from liver or kidney disease)
exudative effusion
fluid diffuses into pleura usually due to inflammaton or infection
empyema
presence of pus in exudate
compression
external pressure on lungs
absorption
gradual absorption of air from alveoli not actively inflated with new air, can also be caused by certain anesthetic agents
surfactant impairment
decreased production of surfactant; can be due to premature birth, anesthesia, mechanical ventilation
causes of atelectasis
compression
absorption
surfactant impairment
pulmonary fibrosis
excessive fibrous or connective tissue in the lung wall restricting expansion
-associated with infectious processes, exposure to toxic gasses
(typically due to scar tissue formation on lung wall)
pulmonary edema
excessive fluid in lungs
pulmonary edema typically associated with
cardiovascular disease, particularly CHF
obstructive pulmonary disease
airway obstruction that is worse with expiration (permanent collapse or airways)
obsructive pulmonary disease most common in what diseases
asthma
chronic bronchitis
emphysema
asthma
excessive and/or inappropriate bronchoconstriction and inflammation
signs and sx of asthma
recurrent, episodic bouts of coughing, SOB, chest, tightness, and wheezing
most patients diagnosed with asthma by age ___
5
african americans are (more/less) likely to to die or be hospitalized due to asthma than caucasians
more
first __ years appear to be important in development of asthma
2
lower risk of asthma in children who
Hygiene Hypothesis
live on farms exposed to high levels of bacteria have large numbers of siblings early enrollment in child care exposure to cats/dogs early in life decreased antibiotic exposure
risk factors for asthma
low birth weight
male gender
parental smoking
dyspneic attacks
difficult labored breathing
characteristics of asthma
- contraction of smooth muscle
- mucosal thickening from edema and infiltration of cells
- presence of abnormally thick mucus
asthma thought to be caused by
reaction to an antigen which causes an immunologic response (does not explain all forms of asthma)
other idea: inappropriate overreaction of sympathetics
nonspecific bronchial hyper reactivity
occurrence of bronchospasm when there are stimuli that do not affect healthy airways (most likely an overreaction to sympathetics in lungs)
how is bronchial hyper reactivity measured?
measure FEV1 and its decrease after inhalation of histamine in aerosols
what is a normal FEV1
50-75% of vital capacity
bronchial hyper reactivity related to
airway inflammation
eosinophils
type of WBC
how are eosinophils related to asthma
people with asthma typically have higher numbers of eosinophils present in their airways
-correlated with degree of bronchial hyper reactivity
what population is COPD rare in
non-smokers
risk factors of COPD
cigarettes air pollution occupational exposure to dusts/gases heredity infection allergies aging
chronic bronchitis
presence of a productive cough for most days of at least 3 months during consecutive years
what do airways show in chronic bronchitis
mucous gland hyperplasia
mucous plugging
ciliated epithelia become squamous (defective mucocillary clearance)
risk factors for chronic bronchitis
live in an urban area
cigarette smoke
frequent respiratory infections in children
continued exposure to secondhand smoke
emphysema characterized by
alveolar and bronchiolar wall destruction with dilation of airways
-interferes with alveolar gas exchange and normal respiratory mechanics
causes of emphysema
smoking
pollutants
injury to epithelial cells (by inflammatory compounds)
alpha-1 antitrypsin
inhibits proteases and elastases
