Pulmonary Part 1 (Exam 3) Flashcards
functions of the lungs
perfuse body tissue with oxygen required for metabolism
remove CO2 from blood
maintain normal ranges of PaO2 and PaCO2
the lung filter about ___________ liters of air per day at rest
7500
every cardiac cycle, the entire volume of blood in the body must pass through the
pulmonary circulation
norma respiratory rate
15 breaths per minute
breath
inflation and deflation of the lungs
occurs in response to pressure in the pleural space
pressure in the pleural space is controlled by
the striated diaphragm
ventilation must match
perfusion
gas exchange occurs via
simple diffusion
pressure gradient
increase in volume of the lung leads to a decrease in pressure in intra alveolar space
in order to inhale air, the diaphragm must overcome
the force of elastic recoil
airflow resistance
equation for pressure in alveoli
P = 2T/r
surfactant
reduces surface tension on alveoli so they don’t crush each other
pulmonary arteries
receive deoxygenated blood from right ventricle
pulmonary veins
send newly oxygenated blood from alveolar capillaries to left atrium
bronchial circulation receives ____________ from ____________________ in order to perfuse ______________
oxygenated blood
left ventricle
all lung structures
does the lymphatic system continue into alveolar space?
No!
fluid must move to terminal bronchioles to drain
FEV1
forced expiratory volume in the first second of expiration
FVC
forced vital capacity
total amount of air that can be exhaled during a forced expiration
obstructive lung disease
inability to get air out of the lungs
FEV1/FVC less than 70-75%
increase of FEV1 greater than 12% after bronchodilator
restrictive lung disease
inability to get enough air into the lungs
all expiratory volumes reduced
COPD
reduced diffusing capacity of the lungs for carbon monoxide
nonspecific defenses of the lung
cough/mucociliary transport
ciliated epithelium
secretions
cellular defenses (lung epithelium, monocytes, alveolar macrophages)
protease inhibitors and antioxidants
specific defenses of the lung
B cell antibody
antigen presentation to lymphocytes
T cell mediated via cytokines
Non-lymphocyte cellular response (mast cells/eosinophils)
in respiratory acidosis pH is __________
the primary disturbance is ___________
the innate compensatory response is ________________
decreased
increased PaCO2
Increased HCO3
compensation for metabolic disturbance can be accomplished _________ by ___________________ but metabolic compensation of a respiratory disturbance occurs ____________
rapidly
alteration in breathing
slowly
acute respiratory acidosis
hypoxemia and hypercapnia
can be fatal
chronic respiratory acidosis
persistent increase in PaCO2 and decrease in PaO2
Asthma risk factors
atopy
genetics
smoking
previous viral respiratory infection
obesity
Main abnormality of Asthma
heightened reactivity of airway to potentially harmless stimuli
3 effects caused by Asthma
luminal obstruction
airway inflammation
bronchoconstriction
airway inflammation leads to
an increase in airflow resistance
in asthma, does ventilation match perfusion?
NO
leads to hypoxemia
hyper inflammatory response of asthma can lead to
increase mucous secretion
damage to epithelium and airway walls
alter in muscle tone and ability
what is activated after inhalation of allergens in asthma?
mast cells and eosinophils
in asthma, inflammatory cells are produced by epithelial cells that drive
airway fibrosis and tissue remodeling
signs and symptoms of asthma
SOB
fewer breaths per minute due to inc work of breathing
tachycardia
wheezing/cough
chest tightness
hypoxemia
hypercapnia
reduced pulmonary function tests
In obstructive disorders, the FEV1/FVC ratio is
decreased
pharmacotherapeutics for asthma
bronchodilators
inhaled corticosteroids
monoclonal antibodies (block inflammatory mediators)
two types of COPD
bronchitis
emphysema
difference between bronchitis and emphysema
bronchitis - inflammation in airways, reversible
emphysema - destruction of alveoli, not reversible
difference between bronchitis and asthma
causes are different!
asthma - allergens
bronchitis - gases, smoking, etc.
chronic inflammation of COPD is caused by
noxious particles or gas
Chronic bronchitis
chronic obstruction in airways
impairment in clearing of secretions
in which COPD is the ventilation/perfusion ratio impacted?
bronchitis
more likely to have hypoxemia
signs and symptoms of chronic bronchitis
thick, purulent cough
wheezing
ronchi in expiration/inhalation
hypoxemia at rest
polycythemia (inc hematocrit)
reduced pulmonary function tests
if patient is chronically hypoxemic in chronic bronchitis, this can cause
tachycardia and pulmonary hypertension
cardiac effects due to chronic bronchitis
right heart enlargement/failure
elevated jugular pressure on cardiac exam
emphysema
loss of alveolar capillary bed
loss of supporting structures
destruction of terminal respiratory units
In emphysema __________ are destroyed by ________________
lung parenchyma
endogenous or exogenous oxidants
in emphysema, ______________ inhibit __________________ function which allows for a abnormal amount of circulating protease and continuous irreversible damage to _________________
oxidants
protease inhibitors
elastin and collagen fibers
deficiency of alpha 1 antitrypsin
in smokers can increase the chance of developing emphysema
in emphysema, there is increased
lung compliance
sign and symptoms of emphysema
decreased breath sounds
hyperinflations and increased chest diameter
pulmonary HTN
reduced pulmonary function tests
polycythemia
in emphysema, there are decreased breaths sounds due to
decreased breath flow and hyperinflation of lungs
is the ventilation/perfusion ratio impacted in emphysema?
only initially
one will exhibit respiratory acidosis and PO2/PCO2 levels will appear normal initially
