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clincial pathophysiology > pulmonary disorders > Flashcards

pulmonary disorders Flashcards

1
Q

what is a pulmonary embolism

A

a blockage in one or more of the pulmonary arteries in your lungs

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2
Q

what is virchow’s triad and what makes it up

A

the perfect environment for a pulmonary embolism
- hypercoagulability
- vascular damage
- circulatory stasis

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3
Q

what are the signs and symptoms of pulmonary embolism

A

SOB
chest pain
dyspnea
tachypnea
tachycardia
shock

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4
Q

what is pulmonary hypertension

A

pressure in the blood vessels leading from the heart to the lungs is too high

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5
Q

signs and symptoms of pulmonary hypertension

A

SOB
fainting
dizziness
chest pressure
tachycardia

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6
Q

what is cor pulmonale and what causes it

A

right-sided heart failure caused by a primary lung disorder

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7
Q

describe the pathogensis of cor pulmonale

A

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

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8
Q

what is the most common cause of cor pulmonale

A

COPD

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9
Q

what are the clinical manifestations of cor pulmonale

A

SOB
chest pain
severe fatigue
exercise intolerance
warm/moist skin
peripheral edema

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10
Q

what is an anatomical dead space

A

refers to the volume of ventilated air that does not participate in gas exchange
- nose, pharynx, trachea, bronchi

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11
Q

what is ventilation

A

the flow of air into and out of the alveoli

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12
Q

what is perfusion (Q)

A

the flow of blood to alveolar capillaries

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13
Q

what is a shunt

A

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)

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14
Q

what is an acute respiratory disorder

A

a failure of the respiratory system to add oxygen to the blood and remove CO2 and represents a life threatening occurrence

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15
Q

what are three types of acute respiratory disorders

A

acute respiratory distress syndrome (ARDS)
acute respiratory failure (ARF)
covid-19

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16
Q

what is acute respiratory distress syndrome (ARDS)

A

respiratory failure in critically ill patients
acute onset of cardiogenic pulmonary edema and hypoxemia caused by alveolar inflammation or infection requiring mechanical ventilation

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17
Q

what are common causes of acute respiratory distress syndrome

A

near drowning
heroin
infections (most common)
trauma (burns, chest trauma)
shock

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18
Q

what is respiratory failure

A

failure of gas exchange due to heart or lung failure

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19
Q

what is the difference between ARDS and ARF

A

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

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20
Q

what is covid-19 and what causes it

A

an infectious disease caused by the SARS virus (severe acute respiratory syndrome)

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21
Q

what is the pathogensis of covid-19

A

viral entry
macrophage activation
pro inflammatory cascade
acute lung injury
respiratory failure

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22
Q

what are the stages of covid-19

A

1) asymptomatic stage (initial 1-2 days of infection)
2) upper airway and conducting airway response
3) hypoxia, progression to ARDS

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23
Q

what are treatments for covid-19

A

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

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24
Q

what is the main function of the respiratory system

A

remove appropriate amounts of CO2 from blood and add appropriate amounts of oxygen leaving the pulmonary circulatory system

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25
Q

what is hypoxemia

A

decreased arterial oxygen supply (PaO2 of 92% or lower)

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26
Q

what is hypoxia

A

decreased oxygen content in the tissues

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27
Q

what is hypercapnia

A

increased CO2 in the blood

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28
Q

what are the signs and symptoms of hypoxia

A

restlessness
headache
confusion
tachycardia
anxiety
dyspnea
severe cyanosis
low HR (severe)

29
Q

what are the signs and symptoms of hypoxemia

A

headache
dyspnea
tachycardia
wheezing
coughing
confusion
cyanosis (severe)

30
Q

what is stridor

A

construction in the airways leading to a whistling noise

31
Q

how does the purse lip breathing technique help

A

helps control rate and volume
prolonged expiration of air
keeps airway open during exhalation and excretion of CO2

32
Q

what is cyanosis

A

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%

33
Q

what is pleural effusion

A

excess fluid between the layers of the pleura outside the lungs

34
Q

what are the causes of pleural effusion

A

heart problems
cancer
pneumonia
pulmonary embolism

35
Q

what is pneumonia

A

disorder of inflammation of the bronchioles and alveoli
dead cell and debris then build up creating pus and filling parts of the small airways

36
Q

what causes pneumonia

A

infectious agents

37
Q

what is pulmonary edema and what causes it

A

lungs filled with fluid
lung congestion
causes: fluid overload, heart failure

38
Q

what is atelectasis and what causes it

A

an avoidable state where the alveoli don’t fill properly/incomplete lung expansion
causes: immobility, mucus plug, external pressure

39
Q

what is pneumothorax

A

condition where air has entered normally closed pleural space (and expanded this space) driving pleural pressure up toward atmospheric pressure

40
Q

what are obstructive airways disorders characterized by

A

progressive declining lung function
airflow obstruction
abnormal chronic
inflammatory response
airway remodeling

41
Q

what is airway remodeling

A

cells that shouldn’t be there show up

42
Q

what is chronic/refractory asthma characterized by

A

chronic airway inflammation
airway hyper-responsiveness
airway obstruction
massive immune response
airway remodeling
genetics

43
Q

what is the inflammatory cascade

A

cause construction of epithelium
immune response is totally out of control

44
Q

what does refractory/chronic asthma cause

A

there is a “pro-inflammatory” Th2 response
activation of eosinophils and phagocytes which exacerbates allergies causing type-1 hypersensitivity reactions

45
Q

what are the clinical manifestations of asthma

A

SOB
chest tightness
wheezing
troubling sleeping

46
Q

what is the third leading cause of death worldwide

A

COPD

47
Q

two major categories of COPD

A

emphysema and chronic bronchitis

48
Q

what is emphysema

A

gradual damage of lung tissue (destruction of alveoli)

49
Q

chronic infection in COPD leads to?

A

overproduction of mucus
chronic airway inflammation
reduced gas exchange
remodeling

50
Q

emphysema clinical manifestations

A

barrel chest
high CO2 retention
purse lip breathing
dyspnea
anxious
thin appearance
poor diffusion
fewer metabolic issues then chronic bronchitis

51
Q

chronic bronchitis clinical manifestations

A

recurrent cough
hypoxia
high incidence in smokers
leads to right sided heart failure

52
Q

what is the normal anterior/posterior diameter

A

1:2

53
Q

effects of COPD

A

increased risk of cardiovascular disease
depression and anxiety
osteoporosis
overproduction of EPO from hypoxia

54
Q

what is bronchiectasis

A

permanent and abnormal dilation of the bronchi, bronchioles (uncommon type of COPD)

55
Q

what is cystic fibrosis and how do you treat it

A

genetic disease causing the mutilation of the cystic fibrosis transmembrane conductance regulator (treatment is lung transplant)

56
Q

what is obstructive sleep apnea

A

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

57
Q

most common sleep related disorder

A

obstructive sleep apnea

58
Q

what are interstitial lung disorders

A

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

59
Q

what is idiopathic pulmonary fibrosis

A

most common form of ILD

starts with chronic cough and dyspnea
dilation of bronchi
alveolar remodeling
no cure (lung transplant)

60
Q

what are extrinsic restrictive lung diseases

A

problems outside of the lungs place pressure on the lungs or paralysis of muscles that help with breathing

61
Q

what do pulmonary function tests measure

A

lung volume
capacity
rates of flow
gas exchange
diagnostic and determination for the best treatments

62
Q

what is forced expiratory volume 1 (FEV1)

A

volume of air forcefully exhaled in 1 second
one of the most important factors

63
Q

what is forced vital capacity (FVC)

A

volume of air forcibly exhaled after deepest breath possible

64
Q

FEV1/FVC ratio

A

volume of air that once can forcefully exhale

65
Q

what is total lung capacity

A

volume of gas in the lung at the end of a full inspiration
~6 liters in a healthy adult

66
Q

what is residual volume (RV)

A

the volume of air remaining in the lungs after maximal exhalation

67
Q

what is the diffusing capacity for carbon monoxide (DLCO)

A

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

68
Q

what is functional residual capacity (FRC)

A

the volume of air in the lungs after a normal, passive exhalation

clincial pathophysiology (7 decks)

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