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Patho 2 > Pulmonary - Exam 2 > Flashcards

Pulmonary - Exam 2 Flashcards

1
Q

adequate gas exchange needs adequate (4 things)

A
  1. ventilation
  2. perfusion
  3. distribution of ventilation
  4. ability for diffusion of CO2 and O2 across alveolar-capillary membrane
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2
Q

normal lung function depends on the maintenance of these 3 things

A
  1. PO2
  2. PCO2
  3. arterial pH
    WITHOUT EXCESSIVE CARDIAC OR PULMONARY WORK
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3
Q

lung structure is comprised of

A

airway and alveoli

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4
Q

airways are categorized into

A

23 generations

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5
Q

conducting airways are numbers __-___ and have no

A

0-16, have no gas exchange

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6
Q

conducting airways are made up of (3)

A
  1. trachea - 0
  2. segmental bronchi - 1-3
  3. bronchioles (non-respiratory) - 4-16
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7
Q

respiratory bronchioles are where ___ takes place and are __-___

A

gas exchange, 16-23

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8
Q

respiratory bronchioles are broken down into (2)

A
  1. resp. bronchioles - 17-20

2. alveolar ducts - 21-23

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9
Q

alveoli function to INC

A

SA in lungs

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10
Q

alveoli are the site of

A

gas exchange

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11
Q

we have about ___ alveoli in the adult lung

A

300-500 million

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12
Q

O2-CO2 exchange occurs via ____ across the alveolar capillary membrane

A

diffusion

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13
Q

alveoli have THIN (.5-1.0 micrometer) membranes in order to ensure

A

distribution of O2 to RBC

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14
Q

V/Q =

A

ventilation/perfusion ratio, the ratio of ventilation to blood flow

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15
Q

what determines gas exchange in lungs

A

V/Q ratio

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16
Q

we can inc PO2 by giving O2, NOT by INC ___ to parts of the lung

A

ventilation

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17
Q

normal V/Q

A

1, PO2 = 100, PCO2 = 40

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18
Q

V/Q <1 (what we see clinically) has ___ ventilation and ___ perfusion

A

DEC ventilation, normal perfusion

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19
Q

V/Q >1 (less common) has ____ ventilation and ____ perfusion

A

normal ventilation, DEC perfusion (O2 is there, not able to attach to RBC)

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20
Q

with R-L shunt V/Q is

A

zero (alveoli filled with fluid)

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21
Q

examples of V/Q = 0

A

PNA, palm edema

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22
Q

with V/Q = 0, R-L shunt, PO2 doesn’t respond to

A

oxygen

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23
Q

dead space is ventilated but NOT

A

perfused

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24
Q

with INC dead space you have more air to clear from conducting airways and thus less

A

alveolar ventilation (less air to participate in gas exchange)

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25
Q

4 causes of hypoxemia

A
  1. V/Q <1
  2. hypoventilation (INC CO2)
  3. R-L shunt
  4. diffusion defect (thick alveoli)
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26
Q

hypercapnia is

A

INC CO2

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27
Q

2 causes of hypercapnia

A
  1. hypoventilation

2. dec V/Q

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28
Q

2 things that affect distribution of ventilation

A
  1. dec distensability (dec compliance, inc stiffness)

2. airway obstruction

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29
Q

compliance formula

A

change in volume/change in pressure

30
Q

with restrictive disorders compliance

A

DEC (stiffer)

31
Q

resistance formula

A

change in pressure/flow

32
Q

extrathoracic upper airway obstructions are __ issues

A

inspiratory (stridor)

33
Q

inhaling through a straw is like a ____ obstruction

A

extra thoracic upper airway

34
Q

intrapulmonary airway obstruction is obstruction in the

A

lower lungs, bronchioles

35
Q

with intrapulmonary airway obstruction air can flow in but

A

airway above obstruction collapses on expiration (expiratory wheezes)

36
Q

ex of intrapulmonary airway obstruction

A

asthma/COPD

37
Q

atelectasis is the collapse of

A

alveoli (sever obstruction that collapses lungs)

38
Q

example of intrapulmonary airway obstruction is _____ in emphysema

A

hyperinflation (OVERCOMPLIANT tissue stretches permanently, IPA obstruction so bad you can hardly exhale)

39
Q

increased airway resistance is from ____ and ____

A

bronchospasm and inflammation

40
Q

increased airway resistance is common in (3) diseases

A

CF, asthma, chronic bronchitis

41
Q

restrictive lung diseases are characterized by (5)

A
  1. dec compliance
  2. stuff lungs
  3. small lung vol
  4. difficult to INFLATE
  5. INC work of breathing
42
Q

list the 6 restrictive lung diseases

A
  1. PNA
  2. aspiration PNA
  3. influenza PNA
  4. TB
  5. pulmonary fibrosis
  6. pulmonary edema
43
Q

_____ is infection of the lung, filled with infected material (causes R-L shunt and dec V/Q)

A

PNA

44
Q

PNA may also cause _____ and _____ leading to ____

A

bronchospasm and INC pulmonary capillary permeability leading to pulmonary edema

45
Q

recurrent PNA is not normal, points to

A

underlying disorder like chronic lung disease (asthma, CF, immunocompromised)

46
Q

aspiration PNA is

A

inhaled foods or gastric material in the lungs which fills alveoli

47
Q

aspiration PNA is most common in those with

A

swallowing dysfunction (elderly, peds, neuro, GERD)

48
Q

____ is a common site of aspiration PNA

A

RML

49
Q

pulmonary fibrosis is caused by

A

multiple types of injury

50
Q

clubbing is a sign of which restrictive lung disease

A

pulmonary fibrosis

51
Q

pulmonary fibrosis is when

A

alveolar tissue is scarred leading to DEC lung vol and DEC compliance

52
Q

untreated ____ leads to pulmonary fibrosis

A

interstitial pneumonitis

53
Q

with pulmonary edema the fluid is in

A

the alveoli, not the capillary

54
Q

obstructive lung diseases are characterized by

A
  1. INC resistance
  2. airway obstruction
  3. narrow airways
  4. DEC expiratory flow
  5. INC effort of breathing
55
Q

list the 6 obstructive lung diseases

A
  1. asthma
  2. chronic bronchitis
  3. emphysema
  4. bronchiectasis
  5. CF
  6. pulmonary embolism
56
Q

____ is the most common chronic lung disease

A

asthma

57
Q

asthma is the

A

episodic narrowing of airways from inflammation and bronchospasm

58
Q

primary problem in asthma is

A

airway mucosal inflammation causes swelling of airway lining and mucous secretion (release of cytokines and leukotrienes)

59
Q

_____ is the primary physiologic abnormality in asthma

A

bronchoconstriction

60
Q

with chronic bronchitis there is chronic ____ and _____ of ____

A

chronic infection and inflammation of bronchi and bronchioles

61
Q

emphysema involves destruction of

A

alveolar walls (dec SA for gas exchange, dec elastic support of airways, airway obstruction, severe hyperinflation)

62
Q

_____ is when airways lose cartilaginous support, collecting infectious materials, there is an abnormal dilation of bronchi

A

bronhiectasis

63
Q

bronchiectasis is always due to

A

underlying disease

64
Q

with bronchiectasis there is a massive risk of

A

hemoptysis

65
Q

CF is autosomal

A

recessive

66
Q

with CF multiple systems are involved by the most serious clinical problem and cause of death is

A

CF lung disease

67
Q

GF gene is

A

CFTR protein (cystic fibrosis transmembrane conductance regulator protein)

68
Q

in CF the ____ in exocrine cells does not work

A

chloride channel (cilia do not work, mucus with bacteria is stuck)

69
Q

___ is a common cause of pulmonary embolism

A

DVT in femoral veins

70
Q

a massive PE can occlude all or most of the pulmonary outflow tract leading to

A

sudden RHF and death

Patho 2 (6 decks)

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