Pulmonary disorder Primer

Question 1

Conduction zone

Answer 1

moves/warms/moistens/filters air; air resistance-smooth muscle contraction

Question 2

Respiratory zone

Answer 2

Gas exchange

Question 3

Pulmonary ventilation

Answer 3

Inspiration-pulls gases into lung, active, requires energy

Exhalation-forces gasses out, passive, relies on elastic recoil

Question 4

Boyle’s Gas Law

Answer 4

As diaphragm goes down, volume increases and pressure decreases

Question 5

Asthma

Answer 5

Increased responsiveness of bronchial tree to stimuli
Wheezing during expiration, cough, dyspnea
Triggers-Allergies, genetics; nonspecific like cold air/smoke/exercise
Cascade of events:inhalation of allergen>binds to IgE on mast cell>trigger exocytosis (histamine/leukotrienes)>airway hyper responsiveness

Question 6

COPD

Answer 6

Airway disease w/parenchymal destruction, abnormal inflammatory response
Chronic inflammation, recoil decreases, small airway collapse
Chronic bronchitis/emphysema

Question 7

Chronic bronchitis

Answer 7

Excessive bronchial mucus, daily productive cough >3 months in 2 years
“blue bloaters”

Question 8

Emphysema

Answer 8

Abnormal permanent enlargement of air space distal to terminal bronchiole
Destruction of alveolar walls w/ fibrosis
“pink puffers”

Question 9

Pulmonary fibrosis/interstitial lung disease

Answer 9

More than 130 disorders
Nonmalignant/noninfectious but serious
Hard to get air in/restrictive
3 ways: parenchyma damaged; walls of alveoli inflames (can include bronchioles/capillaries); scarring/fibrosis in interstitial/lungs stiff

Question 10

PFT gold standard for pulmonary disease

Answer 10

FEV

Question 11

Normal FEV/FVC

Answer 11

FEV-4.0
FVC-5.0
%80

Question 12

Obstructive FEV/FVC

Answer 12

Low FEV/FVC/%

FEV much lower then FVC

Question 13

Restrictive

Answer 13

Low FEV/FVC, normal-high %

FEV/FVC similar numbers

Question 14

FEV % formula

Answer 14

FEV/FVC*100%

Question 15

COPD severity ranges

Answer 15

In patients with % less than 70
1 mild: FEV>80% predicted
2 moderate: 50%

Question 16

Peak flow

Answer 16

<80% of PB=poor control

<50=severe exacerbation

Question 17

Peak flow zones

Answer 17

Green: good control, FEV/FEF >80%

Yellow: use b2 agonist, change med if persistent, FEV or PEF 50-80%

Red zone: medical alert, b2 agonist, ED; FEV or PEF <50%