Pulmonary Disorders Flashcards
1
Q
type I alveolar cells
A
alveolar structure
2
Q
type II alveolar cells
A
surfactant production
3
Q
what is the main site of gas exchange between the circulatory and respiratory systems?
A
alveoli
4
Q
what is the amount of blood around alveoli?
A
about 100 mL
5
Q
what is compliance?
A
a measure of the distensibility of the lungs and chest wall
6
Q
what is elastic recoil?
A
a measure of the ability of the lung to return to its resting size.
7
Q
As compliance increases, the lungs are
A
easier to stretch (less elastic)
8
Q
As compliance decreases, the lungs are
A
harder to stretch (more elastic)
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
10
Q
what is a normal V/Q?
A
~0.8-0.9
11
Q
v=
A
rate at which gas enters and leaves the lung
12
Q
Q=
A
the amount of blood flowing through a capillary
13
Q
what happens with chronic reduced ventilation?
A
perfusion will decrease and a new “normal” V/Q is reached.
14
Q
where are the control centers for respiration in the brain?
A
the pons and medulla
15
Q
under normal conditions. what is the primary regulator of respiration?
A
co2 content
16
Q
what is normal respiration mediated by?
A
CO2 content
pH
O2 concentration
blood pressure
17
Q
Low blood pressure ____respirations
A
increases
18
Q
high blood pressure ___ respiration
A
decreases
19
Q
what are the functions of the lung?
A
Gas exchange maintain pH regulate body temp initiate immune responses metabolism
20
Q
signs and symptoms of pulmonary disease
A
dyspnea hypoventilation hyperventilation cough hemoptysis cyanosis chest pain clubbing abnormal sputum
21
Q
dyspnea
A
sensation of uncomfortable breating
22
Q
orthopnea
A
dyspnea when a person is lying down
23
Q
hypoventilation leads to
A
hypercapnia
24
Q
hyperventilation leads to
A
hypocapnia
25
hemoptysis
coughing up blood
26
clubbing
a change in the shape of the fingers/toes
| common with hypoxia
27
hypoxemia vs hypoxia
hypoxia is in the tissues and hypoxemia is in the blood
28
restrictive pulmonary disease
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
29
obstructive pulmonary disease
a difficulty in the expiration of air from the lungs
| forced expiration volume decreased
30
open pneumothorax
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
31
tension pneumothorax
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
32
what happens in abscess formation and cavitation?
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
33
pulmonary fibrosis
excessive amounts of fibrous or connective tissue in the lung.
34
chest wall restriction
compromised chest wall causes by congenital deformation or obesity
35
flail chest
instability of a portion of the chest wall due to broken ribs
36
what are examples of restrictive disorders
pulmonary fibrosis
pulmonary edema
atelectasis
aspiration pneumonia
37
pneumonconiosis
lung damage due to inhalation of fine inorganic particles
| part of pulmonary fibrosis
38
Pneunoconiosis
exposure to dust
| part of pulmonary fibrosis
39
pulmonary edema
fluid accumulation in air spaces of the lungs
40
what causes pulmonary edema?
heart disease
capillary injury (increased permeability to toxic gases)
decreases plasma proteins
pulmonary hypertension
41
what are clinical manifestations of pulmonary edema?
dyspnea
hypoxemia
rales or rattles
pink frothy sputum may be expectorated
42
atelectasis
occurs when you are given pure oxygen
| collapse of lung tissue (deflated alveoli)
43
what causes atelectasis?
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
what are the symptoms of atelectasis?
```
similar to pulmonary infection
dyspnea
cough
fever
x-ray shows collapse area
```
45
what do you treat atelectasis?
you need to treat the condition that caused the problem and reinflate the tissue with deep breathing.
46
aspiration pneumonia
food and/or stomach acid sucked into the lungs which causes alveolar damage from inflammation
can occur in surgeries
47
how do we prevent aspiration pneumonia?
patient should receive no food or drink before procedure that may cause vomiting
48
what is the problem with obstructive disorders?
Getting air out of the lung
decreased FEV1,
takes longer for air to come out
49
what are common signs and symptoms for obstructive disorders?
diseases in which the bronchi are chronically obstructed which requires more force and more time to fully expire
dyspnea
wheezing
50
what are some common obstructive disorders?
asthma
chronic bronchitis
emphysema
cystic fibrosis
51
what is the cause of asthma?
bronchospasm and mucus closing the bronchi
| generally related to viral infection, allergies, exposure to pollutants, or exercise
52
what causes bronchi constriction?
histamine
bradykinin
leukotrienes
53
what are different types of asthma?
extrinsic
| intrinsic
54
extrinsic asthma
caused by allergy or some obvious cause
55
intrinsic asthma
not allergy related
can be exercise induced, emotion induced, or random attacks
may be related to a decrease NO synthesis in the bronchi
56
what are symptoms of asthma?
wheezing
| distended stomach due to forcing air into lungs/stomach
57
what occurs early on during an asthma attack?
respiratory alkalosis due to increased ventilation
58
what happens late during an asthma attack?
respiratory acidosis due to poor ventilation
59
what causes chronic bronchitis?
chronic irritation of the bronchi from cigarette smoke or other pollutants
60
what is the course of chronic bronchitis?
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
what are clinical manifestations of chronic bronchitis?
```
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
what are treatments for chronic bronchitis?
bronchodilators
expectorants
antibiotic to treat and prevent infection
stop smoking and/or move to an area with better air quality
63
emphysema
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
what is the genetic component of emphysema?
the protein alpha1-antitrypsin inhibits many proteolytic enzymes involved in inflammation so a defect in this enzyme causes excessive inflammation and thus emphysema
65
what are clinical manifestations of emphysema?
```
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
how do you treat emphysema?
antibiotic
deep breathing
oxygen
stop exposure to irritant
67
cystic fibrosis
chloride channel defect
| cant add enough water to secretions in digestive, repro, and respiratory tracts
68
what are clinical manifestations of cystic fibrosis?
```
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
what are treatments for cystic fibrosis?
respiratory therapy
replace digestive enzymes
antibiotics to treat and prevent infection
cyclooxygenase inhibitors to decrease inflammation
increase cAMP
70
pneumonia
infection of lower respiratory tract
| pulmonary consolidation
71
what are the different types of pneumonia?
```
community acquired (streptococcus pneumoniae)
hospital acquired pneumonia (psuedomonas aeruginosa)
viral pneumonia
```
72
tuberculosis
M. tuberculosis
airborne transmission
caseous necrosis
73
pulmonary embolism
occlusion of a portion of the pulmonary vascular bed by a thrombus, embolus, tissue fragment, lipids, or an air bubble
74
how do pulmonary embolisms alter V/Q ratio?
it increases it
75
what causes pulmonary embolisms?
clots that form in the deep veins of the leg or pelvis
76
what are factors that increase embolus?
```
venous stasis
smoking
pregnancy, oral contraception (estrogen)
traumatic injury
dehydration
numerous genetic defects in the blood clotting system
```
77
what are clinical manifestations of pulmonary embolism?
```
hypoxemia
pulmonary hypertension
pulmonary edema
inflammation of the lung
decreased cardiac output
right heart failure
chest or pleural pain
dyspnea
tachypnea
tachycardia
```
78
how do you treat pulmonary embolism?
anticoagulants
TPA can be used in extreme cases (tissue plasminogen activator)
fiber optic cable with suction device to remove the clot
79
pulmonary hypertension
above 20mmhg
80
cor pulmonale
pulmonary heart disease
81
pulmonary heart disease
secondary to pulmonary hypertension
82
pulmonary hypertension creates chronic pressure overload in the ______ ventricle
right ventricle
causes right ventricular enlargement
83
restrictive lung disease result in which lung volumes?
normal FEV
decreased TLC (lung can't get big)
decreased IRV
normal RV
84
obstructive lung disease results in which lung volumes?
```
decreased FEV1
normal TLC
large FRC
large RV
shifting everything up so it takes longer to empty
```
85
what is an example of both restrictive and obstructive lung disease?
obesity
| inflammation makes it obstructive and the pressure from the fat makes it restrictive
86
smoking induces ____ and increases weight gain
IR
87
how can you know where a problem is located on a baby?
breathing sounds
88
what are the different types of breathing sounds?
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
inspiratory stridor
common with extrathoracic airway obstructions
| voicebox and up (glottis)
90
expiratory stridor
Common with intrathoracic airway obstructions
| below voice box (subglottis)
91
what does a weak or hoarse voice suggest?
possible laryngeal problems
92
what does a cough indicate?
an irritant
93
croup
acute laryngotracheobroncitis
| causes seal like barking cough
94
who is the coup common in?
children from 6 to 5 years
| more common in boys
95
what is croup cause by?
```
a virus (some time of influenza or RSV)
you hear inspiratory strider
```
96
what does the coup usually follow?
an episode of rhinorrhea, sore throat, and fever
97
what are severe cases of the croup treated with?
nebuliz
