Pulmonary Patho Flashcards
Signs and Symptoms of Pulmonary Disease
Dyspnea, Orthopnea, PND, Abnormal breathing patterns, hyper/ hypoventilation, cough, abnormal sputum, cyanosis, clubbing,
Subjective sensation of uncomfortable labored breathing
Dyspnea (SOB)
Dyspnea when a person is lying down
Orthopnea
Paroxysmal nocturnal dyspnea (PND)
Dyspnea occurring at night when a person is lying down, generally w/ LV heart failure
Tachypnea
Breathing too fast
Bradypnea
Breathing too slow
Apnea
Stop breathing, fatal when sustained`
Kussmaul respirations
type of hyperventilation that is the lung’s emergency response to acidosis. Causes a labored, deeper breathing rate. It is most commonly associated with conditions that cause metabolic acidosis, particularly diabetes.
Notice fruity breath
Cheyne-Stokes respirations
Patient will take several breaths followed by a long pause before regular breathing resumes. These cycles of breathing will become increasingly deeper.
A near death breathing pattern.
Hemoptysis:
Blood in sputum
Hypoventilation:
What can this lead to?
Decreased amount of air being brought into the lungs, shallow breaths.
Hypercapnia: elevated CO2, leading to acidosis
Hyperventilation:
Too much breathing, deep breaths
Hypocapnia: decreased CO2, leading to alkalosis
Cyanosis:
Acute hypoxia, due to lack of O2. Blue coloration in finger tips, lips etc.
Clubbing:
Chronic hypoxia, long term chronic respiratory issues
Hypercapnia:
excessive CO2 in the bloodstream, typically caused by inadequate respiration. Decreased pH (respiratory acidosis)
Hypoxemia
What is an example of this?
an abnormally low concentration of oxygen in the blood. Ventilation-perfusion abnormalities
Eg: Shunting- sending blood flow elsewhere when one area does not have good gas exchange
Hypoxemia vs hypoxia
-ima = “in the blood”
in any tissue
What has occurred when the lungs have lost the ability to perform gas exchange
Acute respiratory failure
Excess water or fluid in the lungs
not a disease, but an outcome due to something else (trauma, inflammation etc.)
Pulmonary edema
what are the ways that pulmonary edema forms?
LV dysfunction
Blockage of lymph vessels
Increased capillary permeability
What is Aspiration?
What structure should stop this?
Where does this typically occur?
- Passage of fluid and solid particles into the lungs
- Epiglottis didn’t do its job
- Typically occurs in the Rt. lung (due straighter angle compared to Lft.)
Atelectasis:
alveoli collapse
Compression atelectasis
An external blockage compressing the airway
eg: tumor presses the airway that’s blocks it
Absorption atelectasis
the alveoli becomes closed off and all the air it contained is absorbed out and into the blood stream
Surfactant impairment
increase surface tension due to lack of surfactant leading to collapse
What can help the pore of Kohn open to allow another entrance into the alveoli
Deep breathing
Bronchiolitis
children
adults
Inflammatory obstruction of the small airways
- Most common in children (RSV)
- Occurs in adults with chronic bronchitis, in association with a viral infection, or with inhalation of toxic gases
Respiratory syncytial virus (RSV)
A common, and very contagious, virus that infects the respiratory tract of most children before their second birthday. For most babies and young children, the infection causes nothing more than a cold.
Bronchiolitis obliterans
An inflammatory obstruction of the bronchioles. They become damaged and inflamed by chemical particles (vaping), bronchiolitis, and particularly after organ transplants.
Leads to extensive scarring that blocks the airways.
Pneumothorax:
whole lung collapses, disrupting the negative air pressure surrounding the lung
Open pneumothorax:
spontaneous or secondary- hole in lung through visceral and parietal.
Pressure now = Pb pressure (external).
Tension pneumothorax:
tear in the visceral OR parietal and trapped in the pleura cavity (One way valve).
Pip becomes > Pb
builds air pressure, compressing lung
trachea and heart are shifted due to the pressure
Spontaneous pneumothorax:
random spontaneous rupture or tearing of visceral layer (inside)
Secondary pneumothorax:
rupture or tearing of parietal layer (outside) or visceral layer (inside) due to something external tearing
Pleural effusion:
fluid build up
Transudative effusion:
clear fluid, due to hydrostatic response
Exudative effusion:
inflammation response causing fluid to build in the plural space
Hemothorax:
blood accumulation, trauma
Empyema:
yellow/ green purulent, from major bacterial infection
Chylothorax:
“chylo” = lymph, damage from lymph
Frail Chest
Instability of a portion of the chest wall
Caving (inhalation) or heaving (exhalation) of lung. Think of the pressures occurring during breath.
What is the first physiological change from smoking?
Metaplasia: ciliated pseudostratified columnar epithelium are replaced by columnar epithelium
Pneumoconiosis:
a disease of the lungs due to inhalation of non-organic chemicals (often due to work place exposure) characterized by inflammation, coughing, and fibrosis
Allergic alveolitis:
environmental exposure (dog hair, pollen etc.)
Hypersensitivity pneumonitis (HP)
HP results from breathing in specific environmental allergens. A disease causing inflammation of the lung tissue. This inflammation makes breathing difficult. It can lead to irreversible lung scarring over time.
Acute respiratory distress syndrome (ARDS)
What are 3 things that can cause this?
- Respiratory failure (sudden loss of function) characterized by acute lung inflammation
- Injury to the pulmonary capillary endothelium (due to trauma/ spesis)
- Atelectasis
Atelectasis (at-uh-LEK-tuh-sis)
a complete or partial collapse of the entire lung or area (lobe) of the lung. It occurs when alveoli within the lung become deflated or possibly filled with alveolar fluid.
What can cause a pulmonary emboli?
clot in the vessels, travels from DVT
How to prevent Postoperative Respiratory Failure
Frequent turning, deep breathing, early ambulation, air humidification, and incentive spirometry
COPD =
chronic obstructive pulmonary disease
Asthma
Chronic inflammatory disorder resulting from hyper-responsiveness of the airways
Emphysema
Abnormal permanent enlargement of the gas-exchange airways accompanied by destruction of alveolar walls without obvious fibrosis
Loss of gas exchange for surface area
Loss of elastic recoil- have a hard time exhaling
Chronic bronchitis
Hypersecretion of mucus and chronic productive cough that lasts for at least 3 months of the year and for at least 2 consecutive years
Fibrosis
a pathological wound healing in which connective tissue replaces normal tissue. Leads to scar tissue.
Pneumonia
Inflammation of lung (alveoli)
Community-acquired pneumonia
Streptococcus pneumoniae
Hospital-acquired (nosocomial) pneumonia
bacterial
viral
Pneumococcal pneumonia (bacterial)
Viral pneumonia
Airborne transmission
can take of the macrophage leading to tubercle formation
Tubercle formation
Necrosis
Tuberculosis (Tb)
Due to: Mycobacterium tuberculosis
Acute bronchitis
How does it differ form pneumonia?
Acute infection or inflammation of the airways or bronchi.
Commonly follows a viral illness
Similar symptoms to pneumonia but does not demonstrate pulmonary consolidation and chest infiltrates
acute laryngotracheobronchitis “Croup”
An upper airway infection that blocks breathing and has a distinctive barking cough.
Croup generally occurs in children.
Symptoms include fever, hoarseness, and labored or noisy breathing.
Pulmonary embolism (PE)
Occlusion of a portion of the pulmonary vascular bed by a thrombus, embolus, tissue fragment, lipids, or an air bubble
impairing profusion
commonly arise from DVT
Pulmonary hypertension
Mean pulmonary artery pressure above normal
Pulmonary venous hypertension
CHF: LV failure, blood sits in the heart, backs up into vessels of the lung
Pulmonary hypertension due to a respiratory disease or hypoxemia
-COPD- bad ventilation that leads to excessive shunting and vasoconstriction
Pulmonary hypertension due to thrombotic or embolic disease
PE- blood is blocked onto capillary bed and pressure builds behind the clot
Pulmonary heart disease is primarily due to:
right ventricular enlargement (failure), Blood backs up in venous system
Secondary to pulmonary hypertension
Creates chronic pressure overload in the right ventricle (pumps blood)
Lung Cancer
Due to what?
Bronchogenic carcinomas
Most common cause is cigarette smoking
Heavy smokers have 20x greater chance of developing lung cancer
Smoking is related to cancers of the larynx, oral cavity, esophagus, and urinary bladder
Environmental or occupational risk factors are also associated with lung cancer
