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Pathohysiology > Pulmonary Disorders > Flashcards

Pulmonary Disorders Flashcards

1
Q

type I alveolar cells

A

alveolar structure

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2
Q

type II alveolar cells

A

surfactant production

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3
Q

what is the main site of gas exchange between the circulatory and respiratory systems?

A

alveoli

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4
Q

what is the amount of blood around alveoli?

A

about 100 mL

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5
Q

what is compliance?

A

a measure of the distensibility of the lungs and chest wall

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6
Q

what is elastic recoil?

A

a measure of the ability of the lung to return to its resting size.

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7
Q

As compliance increases, the lungs are

A

easier to stretch (less elastic)

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8
Q

As compliance decreases, the lungs are

A

harder to stretch (more elastic)

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9
Q

what is the purpose of surfactant?

A

to break up water molecules in order to reduce surface tension so that it’s easier for alveoli to inflate

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10
Q

what is a normal V/Q?

A

~0.8-0.9

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11
Q

v=

A

rate at which gas enters and leaves the lung

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12
Q

Q=

A

the amount of blood flowing through a capillary

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13
Q

what happens with chronic reduced ventilation?

A

perfusion will decrease and a new “normal” V/Q is reached.

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14
Q

where are the control centers for respiration in the brain?

A

the pons and medulla

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15
Q

under normal conditions. what is the primary regulator of respiration?

A

co2 content

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16
Q

what is normal respiration mediated by?

A

CO2 content
pH
O2 concentration
blood pressure

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17
Q

Low blood pressure ____respirations

A

increases

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18
Q

high blood pressure ___ respiration

A

decreases

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19
Q

what are the functions of the lung?

A 
Gas exchange 
maintain pH 
regulate body temp
initiate  immune responses
metabolism
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20
Q

signs and symptoms of pulmonary disease

A 
dyspnea 
hypoventilation 
hyperventilation 
cough 
hemoptysis 
cyanosis 
chest pain 
clubbing 
abnormal sputum
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21
Q

dyspnea

A

sensation of uncomfortable breating

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22
Q

orthopnea

A

dyspnea when a person is lying down

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23
Q

hypoventilation leads to

A

hypercapnia

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24
Q

hyperventilation leads to

A

hypocapnia

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25
Q

hemoptysis

A

coughing up blood

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26
Q

clubbing

A

a change in the shape of the fingers/toes

common with hypoxia

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27
Q

hypoxemia vs hypoxia

A

hypoxia is in the tissues and hypoxemia is in the blood

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28
Q

restrictive pulmonary disease

A

an condition that restricts the amount of air into the lungs or the diffusion of gases across the alveolar membrane
vital capacity is often decreased

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29
Q

obstructive pulmonary disease

A

a difficulty in the expiration of air from the lungs

forced expiration volume decreased

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30
Q

open pneumothorax

A

sucking chest wound
hole in the chest wall
gas can go in and out so lung will collapse
the chest wall will expand and so will the lung along with it

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31
Q

tension pneumothorax

A

lung laceration
one way valve
more air enters pleural space during inspiration but doesn’t leave with expiration
chest will get bigger and stay bigger and can compress the heart
most lethal
one side of the chest would appear bigger than the other

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32
Q

what happens in abscess formation and cavitation?

A

abscess is formed and then colsolidation takes place which is filling of alveoli with flyud and pus which leads to necrosis and then there is cavitation which is the blank space left afterwards

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33
Q

pulmonary fibrosis

A

excessive amounts of fibrous or connective tissue in the lung.

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34
Q

chest wall restriction

A

compromised chest wall causes by congenital deformation or obesity

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35
Q

flail chest

A

instability of a portion of the chest wall due to broken ribs

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36
Q

what are examples of restrictive disorders

A

pulmonary fibrosis
pulmonary edema
atelectasis
aspiration pneumonia

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37
Q

pneumonconiosis

A

lung damage due to inhalation of fine inorganic particles

part of pulmonary fibrosis

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38
Q

Pneunoconiosis

A

exposure to dust

part of pulmonary fibrosis

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39
Q

pulmonary edema

A

fluid accumulation in air spaces of the lungs

40
Q

what causes pulmonary edema?

A

heart disease
capillary injury (increased permeability to toxic gases)
decreases plasma proteins
pulmonary hypertension

41
Q

what are clinical manifestations of pulmonary edema?

A

dyspnea
hypoxemia
rales or rattles
pink frothy sputum may be expectorated

42
Q

atelectasis

A

occurs when you are given pure oxygen

collapse of lung tissue (deflated alveoli)

43
Q

what causes atelectasis?

A

compression caused by tumors, fluids, or air in the pleural space
absorption (when trapped air in the lungs is absorbed like when given pure oxygen or from anesthesia)
surfactant impairement like too low surfactant

44
Q

what are the symptoms of atelectasis?

A 
similar to pulmonary infection 
dyspnea
cough 
fever 
x-ray shows collapse area
45
Q

what do you treat atelectasis?

A

you need to treat the condition that caused the problem and reinflate the tissue with deep breathing.

46
Q

aspiration pneumonia

A

food and/or stomach acid sucked into the lungs which causes alveolar damage from inflammation
can occur in surgeries

47
Q

how do we prevent aspiration pneumonia?

A

patient should receive no food or drink before procedure that may cause vomiting

48
Q

what is the problem with obstructive disorders?

A

Getting air out of the lung
decreased FEV1,
takes longer for air to come out

49
Q

what are common signs and symptoms for obstructive disorders?

A

diseases in which the bronchi are chronically obstructed which requires more force and more time to fully expire
dyspnea
wheezing

50
Q

what are some common obstructive disorders?

A

asthma
chronic bronchitis
emphysema
cystic fibrosis

51
Q

what is the cause of asthma?

A

bronchospasm and mucus closing the bronchi

generally related to viral infection, allergies, exposure to pollutants, or exercise

52
Q

what causes bronchi constriction?

A

histamine
bradykinin
leukotrienes

53
Q

what are different types of asthma?

A

extrinsic

intrinsic

54
Q

extrinsic asthma

A

caused by allergy or some obvious cause

55
Q

intrinsic asthma

A

not allergy related
can be exercise induced, emotion induced, or random attacks
may be related to a decrease NO synthesis in the bronchi

56
Q

what are symptoms of asthma?

A

wheezing

distended stomach due to forcing air into lungs/stomach

57
Q

what occurs early on during an asthma attack?

A

respiratory alkalosis due to increased ventilation

58
Q

what happens late during an asthma attack?

A

respiratory acidosis due to poor ventilation

59
Q

what causes chronic bronchitis?

A

chronic irritation of the bronchi from cigarette smoke or other pollutants

60
Q

what is the course of chronic bronchitis?

A

chronic irritation to the bronci
swelling of the mucosal lining of the bronchi
increased mucus production
recurrent respiratory infections due to the thick mucus and inhibition of ciliary function
pulmonary hypertension due to low oxygen in the alveoli
heart failure and systemic edema

61
Q

what are clinical manifestations of chronic bronchitis?

A 
decreased exercise tolerance 
productive cough 
wheezing 
shortness of breath 
decreased FEV1
decreased vital capacity 
hypoxemia
polycythemia 
hypercapnia pulmonary hypertension which leads to right heart failure which then leads to systemic edmea
blue bloater
62
Q

what are treatments for chronic bronchitis?

A

bronchodilators
expectorants
antibiotic to treat and prevent infection
stop smoking and/or move to an area with better air quality

63
Q

emphysema

A

chronic exposure to an irritant that causes chronic inflammation of the lungs
the resulting scar tissue has low amounts of elastin which means you lose your recoil action

64
Q

what is the genetic component of emphysema?

A

the protein alpha1-antitrypsin inhibits many proteolytic enzymes involved in inflammation so a defect in this enzyme causes excessive inflammation and thus emphysema

65
Q

what are clinical manifestations of emphysema?

A 
labored breathing due to destruction of the alveolar septum and loss of elastic fibers in the lung 
dyspnea on exertion 
increased breathing rate 
decreased FEV1
increased residual volume
increased functional residual capacity
66
Q

how do you treat emphysema?

A

antibiotic
deep breathing
oxygen
stop exposure to irritant

67
Q

cystic fibrosis

A

chloride channel defect

cant add enough water to secretions in digestive, repro, and respiratory tracts

68
Q

what are clinical manifestations of cystic fibrosis?

A 
poor digestion 
recurrent respiratory infections 
destruction of normal lung structure 
wheezing, coughing, and gasping for air
elevated sodium in sweat
heart failure due to pulmonary edema 
infertility
69
Q

what are treatments for cystic fibrosis?

A

respiratory therapy
replace digestive enzymes
antibiotics to treat and prevent infection
cyclooxygenase inhibitors to decrease inflammation
increase cAMP

70
Q

pneumonia

A

infection of lower respiratory tract

pulmonary consolidation

71
Q

what are the different types of pneumonia?

A 
community acquired (streptococcus pneumoniae) 
hospital acquired pneumonia (psuedomonas aeruginosa) 
viral pneumonia
72
Q

tuberculosis

A

M. tuberculosis
airborne transmission
caseous necrosis

73
Q

pulmonary embolism

A

occlusion of a portion of the pulmonary vascular bed by a thrombus, embolus, tissue fragment, lipids, or an air bubble

74
Q

how do pulmonary embolisms alter V/Q ratio?

A

it increases it

75
Q

what causes pulmonary embolisms?

A

clots that form in the deep veins of the leg or pelvis

76
Q

what are factors that increase embolus?

A 
venous stasis 
smoking 
pregnancy, oral contraception (estrogen)
traumatic injury 
dehydration 
numerous genetic defects in the blood clotting system
77
Q

what are clinical manifestations of pulmonary embolism?

A 
hypoxemia
pulmonary hypertension 
pulmonary edema 
inflammation of the lung 
decreased cardiac output 
right heart failure 
chest or pleural pain 
dyspnea
tachypnea
tachycardia
78
Q

how do you treat pulmonary embolism?

A

anticoagulants
TPA can be used in extreme cases (tissue plasminogen activator)
fiber optic cable with suction device to remove the clot

79
Q

pulmonary hypertension

A

above 20mmhg

80
Q

cor pulmonale

A

pulmonary heart disease

81
Q

pulmonary heart disease

A

secondary to pulmonary hypertension

82
Q

pulmonary hypertension creates chronic pressure overload in the ______ ventricle

A

right ventricle

causes right ventricular enlargement

83
Q

restrictive lung disease result in which lung volumes?

A

normal FEV
decreased TLC (lung can’t get big)
decreased IRV
normal RV

84
Q

obstructive lung disease results in which lung volumes?

A 
decreased FEV1 
normal TLC
large FRC
large RV 
shifting everything up so it takes longer to empty
85
Q

what is an example of both restrictive and obstructive lung disease?

A

obesity

inflammation makes it obstructive and the pressure from the fat makes it restrictive

86
Q

smoking induces ____ and increases weight gain

A

IR

87
Q

how can you know where a problem is located on a baby?

A

breathing sounds

88
Q

what are the different types of breathing sounds?

A

snoring noise which is common for nasopharyngeal obstructions
the stridor sound which is harsh and vibratory caused by turbulent flow through a partially obstructed airway

89
Q

inspiratory stridor

A

common with extrathoracic airway obstructions

voicebox and up (glottis)

90
Q

expiratory stridor

A

Common with intrathoracic airway obstructions

below voice box (subglottis)

91
Q

what does a weak or hoarse voice suggest?

A

possible laryngeal problems

92
Q

what does a cough indicate?

A

an irritant

93
Q

croup

A

acute laryngotracheobroncitis

causes seal like barking cough

94
Q

who is the coup common in?

A

children from 6 to 5 years

more common in boys

95
Q

what is croup cause by?

A 
a virus (some time of influenza or RSV)
you hear inspiratory strider
96
Q

what does the coup usually follow?

A

an episode of rhinorrhea, sore throat, and fever

97
Q

what are severe cases of the croup treated with?

A

nebuliz

Pathohysiology (16 decks)

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