Pulmonary Flashcards
Dyspnea that occurs during heart failure when an individual when an individual is recumbent
Orthopnea
Occurs when individuals with pulmonary or cardiac disease awake at night gasping for air and must sit up or stand to relieve the dyspnea
Paroxysmal nocturnal dyspnea
Which type of nerves that innervate the chest wall, diaphragm and abdominal musculature regulate cough patterning and sensitivity?
Somatosensory
The expectoration of blood or bloody secretions from the lower respiratory tract
hemoptysis
Respirations that are characterized by a slightly increased ventilatory rate, very large tidal volume, and no expiratory pause
Kussmaul respirations
High pitched sounds made during inspiration
stridor
Whistling sounds on expiration
wheezing
Breathing commonly caused by disorders such as pulmonary fibrosis that stiffen the lungs or chest wall and decreased compliance, resulting in small tidal volumes and rapid ventilatory rate
restricted breathing
Resiprations that are characterized by by alternating periods of deep and shallow breathing. Apnea lasts 15 to 60 seconds is followed by ventilations that increase in volume until a peak is reached and then cycles back to apnea.
Cheyne-Stokes respiration
Inadequate alveolar ventilation in relation to metabolic demands caused by alterations in pulmonary mechanics or in the neurologic control of breathing.
hypoventilation
Hypoventilation can result in what pH imbalance?
Respiratory acidosis
Alveolar ventilation that exceeds metabolic demands is called…
hyperventilation
Hyperventilation can result in what pH imbalance?
Respiratory alkalosis
A bluish discoloration of the skin and mucous membranes caused by increasing amounts of desaturated blood or reduced hemoglobin in the blood.
Cyanosis
What makes carbon monoxide poisoning so dangerous?
Hemoglobin binds to the carbon monoxide instead of binding to oxygen
The selective bulbous enlargement of the end of a digit resulting in nail bed hypertrophy
clubbing
Increased CO2 concetnratoin in the arterial blood caused by hypoventilation of the alveoli
hypercapnia
What is the difference between hypoxemia and hypoxia?
Hypoxemia is reduced oxygenation of arterial blood caused by respiratory alterations. Hypoxia (ischemia) is c reduced oxygenation of cells in tissues that may be caused by alterations in other systems as well.
High latitude, low O2 mixture, suffocating
Decrease in inspired O2
Inadequate gas exchange, that is, hypoxemia in which PaO2 is -50 mm HG with a pH
Respiratory Failure
This results from the fracture of several consecutive ribs causing paradoxical movement of the chest with breathing. The unstable portion of the chest wall moves inward and during expiration it moves outward impairing movement of gas in and out of the lungs.
Flail chest
Which autosomal dominant gene has been linked to primary pneumothorax?
folliculin
In this type of pnemothorax air pressure in the pleural space equals barometric pressure because air that is drawn into the pleural space during insipration is forced back out during expiration
Open pneumothorax (communicating pneumothorax)
In this type of pneumothorax the site of pleura rupture acts as a one way valve, permitting air to enter on inspiration but preventing its escape by closing during expiration
Tension pneumothorax
Pleural effusions that occur in response to inflammation, infection, or malignancy and involves inflammatory processes that increase capillary permeability
Exudative effusion
Exudative effusions that occur in association with pneumonia are called
parapneumonic effusions
The presence of pus in the pleural space and develops when the pulmonary lymphatics become blocked leading to an outpouring of contaminated lymphatic fluid into the pleural space.
Empyema
Hemmorrhage into the pleural space
Hemothorax
Milky fluid containing lymph and fat droplets that is dumped by lymphatic vessels into the pleural space instead of passing from the GI tract to the thoracic duct.
Chylothorax
This is characterized by decreased compliance of lung tissue
Restrictive lung disorders
This atelectasis is caused by the external pressure exerted on lung tissue, such as occurs with tumors, or by fluid or air in the pleural space.
Compression atelectasis
This atelectasis results from gradual absorption of air from obstructed or hypoventilated alveoli or from inhalation of concentrated oxygen or anesthetic agents.
Absorption atelectasis
This atelectasis results from decreased production or inactivation of surfactant. usually due to premature birth, ARDS, anesthesia, or mechanical ventilation.
Surfactant impairment.
The persistent abnormal dilation of the bronchi that may result from a genetic predisposition or be caused by a defect in the host.
Bronchiectasis
This type of bronchial dilation has bronchi that become large and balloon-like
Saccular
A diffuse inflammation of the small airways or bronchioles, most common in children and is associated with RSV or toxic gases.
Bronchiolitis
An excessive amount of fibrous or connective tissue in the lung caused by formation of scar tissue after active pulmonary disease. It is commonly caused by autoimmune disorder (RA, scelrosis, sarcoidosis) or inhalation of harmful substances.
Pulmonary fibrosis
A side effect of prolonged exposure to high concentrations of supplemental oxygen that cause a severe inflammatory response mediated primarily by oxygen free radicals.
Oxygen toxicity
This type III hypersensitivity response is an allergic inflammatory disease caused by repeated inhalation of organic particles or fumes such as bacteria, fungi, yeasts, mycobacteria, animal proteins and chemicals.
Hypersensitivity pneumonitis
What is common in a hypersensitivity pneumonitis?
Granuloma formation
Excess water in the lung most commonly caused by left-sided heart disease
pulmonary edema
Pulmonary edema occurs when the flow of fluid out of the capillaries…
exceeds the lymphatic system’s ability to remove it causing alveolar flooding
A rare life threatening complication that can occur after relief of upper airway obstruction (e.g. postextubation laryngospasm after anesthesia, epiglottitis, laryngeal tumor, or obstructive tonsils). Attempted inspiration against the occluded airway creates intrathoracic negative pressure causing increased venous return eventually leading to pulmonary edema.
Postobstructive pulmonary edema POPE
The most severe form of acute lung injury and is defined by the onset of bilateral infiltrates and low ratio of partial pressure of arterial oxygen
ARDS
What are the steps of ARDS to death?
ARDS leads to SIRS, leads to MODS, leads to death
A disease that is characterized by airway obstruction that is worse with expiration requiring more force or time required to expire a given volume of air, causing the emptying of the lungs to be slowed due to infiltration of the lung by inflammatory cells, release of cytokines, that cause airway damage.
Obstructive pulmonary disease
What is the unifying symptom and sign of obstructive pulmonary disease?
unifying symptom is dyspnea and unifying sign is wheezing
A chronic inflammatory disorder of the bronchial mucosa that causes bronchial hyperresponsiveness
Asthma
Untreated inflammation in a late asthmatic response can lead to long-term airway damage that is irreversible known as
airway remodeling
In asthma a pulsus paradoxus occurs, describe
a decrease is systolic blood pressure during inspiration
A severe bronchospasms that is not reversed in asthma causing worsening hypoxemia, decreased expiratory flow rates, and acidosis develops leading to potentially death this is called…
status asthmaticus
A common preventable disease characterized by airflow limitation that is not fully reversible.
COPD
A type of COPD defined as hypersecretion of mucus and chronic productive cough that continues for at least 3 months of the year for at least 2 consecutive yeras.
Chronic bronchitis
In COPD why does expiration become difficult?
expiratory airway obstruction
This side effect of COPD causes hyperexpansion of the chest which puts the muscles of respiration at a mechanical disadvantage, resulting in increased work of breathing; hypoventilation and hypercapnia.
air trapping
What are the two main signs and symptoms of COPD?
Tripod breathing position and exhaling through pursed lips
An acute infection or inflammation of the large airways or bronchi and is usually self-limiting
Acute bronchitis
Infection of the lower respiratory tract caused by bacteria, viruses, fungi, protozoa, or parasites. 8th leading cause of death in the US and is responsible for more disease and death than any other infection.
Pneumonia
In this infection the lysis of the bacteria is extremely cytotoxic and cause alveolar edema
Pneumococcal pneumonia
This infection is seasonal, usually mild and self limiting but can set the stage for a secondary bacterial infection
Viral pneumonia
What is the most common viral cause of pneumonia?
Influenza virus
What occurs in viral pneumonia that makes mucociliary clearance difficult?
sloughing of destroyed bronchial epithelium throughout the respiratory tract
An infection caused by an acid-fast bacillus that usually affects the lungs but may invade other body systems and is transmitted from person to person by inhalation of airborne droplets.
TB
A circumscribed area of suppuration and destruction of lung parenchyma and is a type of liquefactive necrosis
abscess
Inflammation causes alveoli to fill with fluid, pus, and microorganisms
Lung tissue consolidation
An occulsion or partial occlusion of the pulmonary artery or its branches by an embolus
PE
Review triad of virchow as it relates to PEs
venous stasis, hypercoagulability, endothelial injury
This is characterized by an endothelial dysfunction with overproduction of vasoconstrictors and a release of growth factors.
PAH pulmonary artery hypertension
A cancer whose primary risk factor is tobacco smoking, that has been linked to HPV types 6 and 11, and whose primary symptoms are progressive hoarseness, dyspnea, and cough
Laryngeal cancer
This is the second most common cancer in the US and the most common cause of cancer deaths.
Lung Cancers
Primary lung cancers arise from cells that line the bronchi and are therefore called
bronchogenic carcinoma
85% of all lung cancers fall into the categoy of
nonsmall cell lung carcinoma
This type of nonsmall cell lung carcinoma are typically located centrally near the hila and project into bronchi. A nonproductive cough or hemoptysis is commen. Pneumonia and atelectasis are often associated with it and chest pain is a late symptom. This cancer tends not to metastasize until late in the course of the disease.
Squamous cell carcinoma
This type of nonsmall cell lung cancer occurs more frequently in women, in nonsmokers, and Asians. It is associated with a positive faimly history such as EGFT and ALK.
Adenocarcinoma
This type of small cell lung cancer arise from the terminal bronchioles and alveoli. They are slow growing tumor with an unpredictable pattern of metastasis. Metastasis occurs early and survival rates are poor.
Bronchoalveolar cell carcinoma or adeoncarcionma in situ or minimally invasive adenocarcinoma
This type of nonsmall cell lung cancer consist of epithelial cells have lost all evidence of differentiation. The tumors commonly arise centrally and can grow to distort the trachea and cause widening of the carina.
Large cell carcinomas
This type of neuroendocrine lung tumor is the most common type of neuroendocrine tumor and has the strongest correlation with tobacco smoking. These tumors have a rapid growth, metastasize early and have the worst prognosis of all lung cancers. Symptoms include hyponatremia, cushing syndrome, hypocalcemia, gynecomastia, carcinoid syndrome, Lambert-Easton myasthenic syndrome
Small Cell Lung Carcinoma
This type of neuroendocrine lung tumor are rare, are NOT related to smoking, are slow growing, have a low potential to metastasize and are generally asymptomatic
Bronchial carcinoid tumors
overdose, sedation, defects in chest wall, large airway obstruction, asthma
Hypoventilation of the alveoli
asthma, bronchitis, pneumonia, ARDS, PE
Ventilation-perfusion mismatch
edema fibrosis emphysema
Alveolocapillary diffusion
intracardiac defects and intrapulmonary arteriovenous malformations
Decreased pulmonary capillary perfusion
