pulmonary disorders Flashcards
what is a pulmonary embolism
a blockage in one or more of the pulmonary arteries in your lungs
what is virchow’s triad and what makes it up
the perfect environment for a pulmonary embolism
- hypercoagulability
- vascular damage
- circulatory stasis
what are the signs and symptoms of pulmonary embolism
SOB
chest pain
dyspnea
tachypnea
tachycardia
shock
what is pulmonary hypertension
pressure in the blood vessels leading from the heart to the lungs is too high
signs and symptoms of pulmonary hypertension
SOB
fainting
dizziness
chest pressure
tachycardia
what is cor pulmonale and what causes it
right-sided heart failure caused by a primary lung disorder
describe the pathogensis of cor pulmonale
1) lung disorder damages the lungs
2) low oxygen or hypoxia leads to pulmonary vasoconstriction which limits blood flow to alveoli
3) vascular remodeling (thickening of arteries)
4) increased pulmonary arterial pressure (>20mmHg)
5) increased right ventricular afterload
what is the most common cause of cor pulmonale
COPD
what are the clinical manifestations of cor pulmonale
SOB
chest pain
severe fatigue
exercise intolerance
warm/moist skin
peripheral edema
what is an anatomical dead space
refers to the volume of ventilated air that does not participate in gas exchange
- nose, pharynx, trachea, bronchi
what is ventilation
the flow of air into and out of the alveoli
what is perfusion (Q)
the flow of blood to alveolar capillaries
what is a shunt
pathological condition in which alveoli are perfused but not ventilated (blood get shunted away from the area without ventilation to find an area with ventilation)
what is an acute respiratory disorder
a failure of the respiratory system to add oxygen to the blood and remove CO2 and represents a life threatening occurrence
what are three types of acute respiratory disorders
acute respiratory distress syndrome (ARDS)
acute respiratory failure (ARF)
covid-19
what is acute respiratory distress syndrome (ARDS)
respiratory failure in critically ill patients
acute onset of cardiogenic pulmonary edema and hypoxemia caused by alveolar inflammation or infection requiring mechanical ventilation
what are common causes of acute respiratory distress syndrome
near drowning
heroin
infections (most common)
trauma (burns, chest trauma)
shock
what is respiratory failure
failure of gas exchange due to heart or lung failure
what is the difference between ARDS and ARF
ARDS = life threatening condition caused by injury to the capillary wall either from illness or injury (alveolar walls become leaky)
ARF = broader term that refers to failure of lungs from any causes
what is covid-19 and what causes it
an infectious disease caused by the SARS virus (severe acute respiratory syndrome)
what is the pathogensis of covid-19
viral entry
macrophage activation
pro inflammatory cascade
acute lung injury
respiratory failure
what are the stages of covid-19
1) asymptomatic stage (initial 1-2 days of infection)
2) upper airway and conducting airway response
3) hypoxia, progression to ARDS
what are treatments for covid-19
1) antiviral treatments - target specific parts of the virus to stop it from multiplying in the body
2) monoclonal antibodies - help immune system recognize and respond more effectively to virus
what is the main function of the respiratory system
remove appropriate amounts of CO2 from blood and add appropriate amounts of oxygen leaving the pulmonary circulatory system
what is hypoxemia
decreased arterial oxygen supply (PaO2 of 92% or lower)
what is hypoxia
decreased oxygen content in the tissues
what is hypercapnia
increased CO2 in the blood
what are the signs and symptoms of hypoxia
restlessness
headache
confusion
tachycardia
anxiety
dyspnea
severe cyanosis
low HR (severe)
what are the signs and symptoms of hypoxemia
headache
dyspnea
tachycardia
wheezing
coughing
confusion
cyanosis (severe)
what is stridor
construction in the airways leading to a whistling noise
how does the purse lip breathing technique help
helps control rate and volume
prolonged expiration of air
keeps airway open during exhalation and excretion of CO2
what is cyanosis
abnormal blue discoloration of the skin and mucus is membranes caused by an increased concentration of deoxygenated hemoglobin in capillary bed
SpO2 less than 85%
what is pleural effusion
excess fluid between the layers of the pleura outside the lungs
what are the causes of pleural effusion
heart problems
cancer
pneumonia
pulmonary embolism
what is pneumonia
disorder of inflammation of the bronchioles and alveoli
dead cell and debris then build up creating pus and filling parts of the small airways
what causes pneumonia
infectious agents
what is pulmonary edema and what causes it
lungs filled with fluid
lung congestion
causes: fluid overload, heart failure
what is atelectasis and what causes it
an avoidable state where the alveoli don’t fill properly/incomplete lung expansion
causes: immobility, mucus plug, external pressure
what is pneumothorax
condition where air has entered normally closed pleural space (and expanded this space) driving pleural pressure up toward atmospheric pressure
what are obstructive airways disorders characterized by
progressive declining lung function
airflow obstruction
abnormal chronic
inflammatory response
airway remodeling
what is airway remodeling
cells that shouldn’t be there show up
what is chronic/refractory asthma characterized by
chronic airway inflammation
airway hyper-responsiveness
airway obstruction
massive immune response
airway remodeling
genetics
what is the inflammatory cascade
cause construction of epithelium
immune response is totally out of control
what does refractory/chronic asthma cause
there is a “pro-inflammatory” Th2 response
activation of eosinophils and phagocytes which exacerbates allergies causing type-1 hypersensitivity reactions
what are the clinical manifestations of asthma
SOB
chest tightness
wheezing
troubling sleeping
what is the third leading cause of death worldwide
COPD
two major categories of COPD
emphysema and chronic bronchitis
what is emphysema
gradual damage of lung tissue (destruction of alveoli)
chronic infection in COPD leads to?
overproduction of mucus
chronic airway inflammation
reduced gas exchange
remodeling
emphysema clinical manifestations
barrel chest
high CO2 retention
purse lip breathing
dyspnea
anxious
thin appearance
poor diffusion
fewer metabolic issues then chronic bronchitis
chronic bronchitis clinical manifestations
recurrent cough
hypoxia
high incidence in smokers
leads to right sided heart failure
what is the normal anterior/posterior diameter
1:2
effects of COPD
increased risk of cardiovascular disease
depression and anxiety
osteoporosis
overproduction of EPO from hypoxia
what is bronchiectasis
permanent and abnormal dilation of the bronchi, bronchioles (uncommon type of COPD)
what is cystic fibrosis and how do you treat it
genetic disease causing the mutilation of the cystic fibrosis transmembrane conductance regulator (treatment is lung transplant)
what is obstructive sleep apnea
the brain sends a signal to the muscles and the muscles make an effort to take a breath bit muscles are unsuccessful because the airway is obstructed
most common sleep related disorder
obstructive sleep apnea
what are interstitial lung disorders
umbrella term for problems with the lungs themselves can be related to the expansion rate of the lungs or total volume the lungs can hold
what is idiopathic pulmonary fibrosis
most common form of ILD
starts with chronic cough and dyspnea
dilation of bronchi
alveolar remodeling
no cure (lung transplant)
what are extrinsic restrictive lung diseases
problems outside of the lungs place pressure on the lungs or paralysis of muscles that help with breathing
what do pulmonary function tests measure
lung volume
capacity
rates of flow
gas exchange
diagnostic and determination for the best treatments
what is forced expiratory volume 1 (FEV1)
volume of air forcefully exhaled in 1 second
one of the most important factors
what is forced vital capacity (FVC)
volume of air forcibly exhaled after deepest breath possible
FEV1/FVC ratio
volume of air that once can forcefully exhale
what is total lung capacity
volume of gas in the lung at the end of a full inspiration
~6 liters in a healthy adult
what is residual volume (RV)
the volume of air remaining in the lungs after maximal exhalation
what is the diffusing capacity for carbon monoxide (DLCO)
measures the ability of gas to transfer from the alveoli across the alveolar epithelium and the capillary endothelium to the red blood cells
- helps determine the underlying disorder and tell the severity
what is functional residual capacity (FRC)
the volume of air in the lungs after a normal, passive exhalation
