Pulmonary III: Pulmonary Vasculature Physiology/Pathology Flashcards
Pulmonary circulation is _______ resistance, _______ pressure, and _______ compliance.
low; low; high
Causes of decreased DLCO (4)
Emphysema, Pulmonary Vascular Disease, Interstitial lung disease, Anemia
Causes of increased DLCO (4)
Polycythemia, Early CHF, asthma, alveolar hemorrhage
Causes of low V/Q and shunt (3)
congenital heart abnormalities, pulmonary disorders, pathologies resulting in transudate or exudate in the alveoli
Classic CXR findings in PE
Hampton’s Hump, Westermark’s Sign
Classic EKG findings in PE
S1 Q3 T3
Factors contributing to DLCO (3)
Surface Area, Membrane thickness, Hgb
In ___-capillary PH, the PCWP is
pre
Name the type: PH 1
Pulmonary Arterial Hypertension
Name the type: PH 2
PH due to left heart disease
Name the type: PH 3
PH due to lung disease/hypoxia
Name the type: PH 4
Thromboembolic Pulmonary Hypertension
Name the type: PH 5
PH with unclear or multifactorial mechanisms
Treatment for PE
Anticoagulation; consider thrombolytics, IVC filter, or thrombectomy
Treatment of PAH
Treat underlying cause, correct hypoxia, pulmonary vasodilators, consider antigcoagulation, lung transplantation
West Zone __: blood flow occurs during the entire cycle
3
West Zone __: flow through the vessels only occurs during systole
2
West Zone __: PA>Pa such that pulmonary vasculature is compressed and there is minimal blood flow
1
What disease pattern? Decreased FEV1/FVC
Obstructive
What disease pattern? Decreased FRC
Restrictive
What disease pattern? Expiratory-Inspiratory flow volume loop is shifted to the left
Obstructive
What disease pattern? Expiratory-Inspiratory flow-volume loop is shifted to the right
Restrictive
What disease pattern? Flatter compliance curve
Restrictive
What disease pattern? Increased FRC
Obstructive
What disease pattern? Normal/Slightly increased FEV1/FVC
Restrictive
What disease pattern? Steeper compliance curve
Obstructive
What exam finding? Bronchovesiclar and bronchial breath sounds in abnormal regions of the lung suggest ______.
replacement of air-filled space with solid tissue or fluid
What exam finding? Caused by airways obstructed with mucus or secretions; continuous rumbling or snoring sounds
rhonchi
What exam finding? Caused by disruptive air flow in the airways; discontinuous , more frequently during inspiration
Crackles/rales
What exam finding? Continuous high pitched muscial sound during expiration caused by high airflow through a normal airway
Wheezes
What exam finding? Egophony is caused by _______.
compressed or fluid filled areas
What exam finding? Musical inspiratory sounds caused by central airway obstruction within the thorax, loudest over the trachea
Stridor
What exam finding? Pneumothorax, large air-filled bulla, and emphysema will result in _____ upon percussion
hyper-resonance
What exam finding? Tactile fremitus is _______ in conditions that have excess air in the lungs, fluid in the pleural space or obstructed bronchus
decreased
What exam finding? Tactile is _____ in lung consolidation with water, pus, or blood.
increased
What exam finding? The trachea is pulled toward in conditions of ________.
atelectasis, scarring/fibrosis
What exam finding? The trachea is pushed away in conditions of _______.
large pleural effusion, tension pneumothorax
What exam finding? Water or other fluid in the lung will result in ____ upon percussion
dullness
What obstruction? flattening of both expiratory and inspiratory curves
Fixed
What obstruction? flattening of expiratory loop
Variable intrathoracic
What obstruction? Flattening of the inspiratory loop
Variable extrathoracic
Which type of pulmonary edema? Commonly caused by pneumonia or ARDS
Non-cardiogenic
Which type of pulmonary edema? Left atrial pressure is elevated
Cardiogenic/Hydrostatic
Which type of pulmonary edema? Most commonly caused by heart failure
Cardiogenic/Hydrostatic
Which type of pulmonary edema? Most commonly caused by injury to microvascular endothelium that increases efflux of plasma proteins and fluid
Non-cardiogenic
Which type of pulmonary edema? Presents more slowly
Non-cardiogenic
Which type of pulmonary edema? Responds to diuretic treatment
Cardiogenic/Hydrostatic