Pulmonary Patho - restrictive lung diseases, ABG and V/Q Flashcards
what is there a decrease of in restrictive lung disease?
decrease in lung tissue compliance
what is atelectasis? what are the three different types? what are each caused by?
- lung collapse
1. compression = due to external pressure
2. obstruction = obstruction to alveoli or poor ventilation
3. surfactant impairment = not enough surfactant produced
in what individuals is atelectasis common in? what are clinical manifestations of it?
- post surgery and immobilized individuals
- leukocytosis, dyspnea, fever
what is bronchiectasis? what does it usually occur in conjunction with? what is it commonly associated it?
- abnormal chronic dilation of the alveoli
- occurs in conjuction with diseases that cause bronchial inflammation
- commonly associated with systemic disorders
what is the primary symptom of bronchiectasis? what complications is the disease associated with? what other two symptoms are common?
- productive cough
-lower resp tract infections and found smelling sputum - hemoptysis and clubbing
what is bronchiolitis? what age group is commonly affected by it? in adults what does it usually occur with?
- inflammation of the bronchioles
- common in children
- in adults it usually occurs with chronic bronchitis
in a healthy adult, what can cause bronchiolitis?
viral resp tract infection and inhalation of toxic gases
what can bronchiolitis be a serious complication of? what can it lead to? what does this condition cause?
- stem cell and lung transplant
- can lead to bronchiolitis obliterans
- condition causes tissue scarring
what are the clinical manifestations of bronchiolitis?
non productive cough, low grade fever, use of accessory muscles to breath, increased ventilatory rate
what is pulmonary edema? what are the three common causes of it?
- water in the lungs
1. left sided heart disease
2. capillary injury,
3. obstruction in lymph system
what are the clinical manifestations of pulmonary edema? what are the symptoms of severe edema?
hypoxemia, dyspnea, pink frothy sputum, hypoventilation, hypercania
what is acute respiratory distress syndrome? (ARDS)? what does is result from?
- acute inflammation to the lungs and alveocapillary injury
- pulmonary injury or systemic inflammation
what are the phases that ARDS progresses through?
- exudative
- proliferative
- fibrotic
within what time frame does the exudative phase occur? what occurs during this phase?
- 72 hours
- release of pro inflammatory cytokines
- decrease in ventilatory rate, surfactant, and tidal volume
within what time frame does the proliferative phase occur? what is there a proliferation of? what other significant issue occurs?
- 4 to 21 days
- there is a proliferation of T2 pneumocytes, fibroblasts and myofibroblasts
- progressive hypoxemia
within what time frame does the fibrotic phase occur? what is fibrosis? what occurs during this phase? what can the fibrosis do in severe cases?
- within 14 to 21 days
- fibrosis is scarring of connective tissue
- fibrosis of the lungs
- in severe cases the scar tissue can obliterate important lung structures
what is ventilation?
air going into the lungs
what is perfusion?
blood flow to the tissues
how is the V/Q ratio at the apex of the lung different from the base?
- APEX: greater ventilation and less perfusion (wasted ventilation)
- BASE: greater perfusion and less ventilation (wasted perfusion)
BUT BOTH V AND Q ARE GREATER AT THE BASE BECAUSE OF GRAVITY
what is the V/Q ration used for?
to asses the efficiency of gas exchange in different regions of the lung
what is alveoli like in the apex of the lung?
the alveoli are larger in the apex of the lung
what are normal values for pH, PaO2, PaCO2, bicarbonate, base excess and lactate in the blood?
- pH = 7.35 - 7.45
- Pa oxygen = 10.3 - 13. 5
- Pa CO2 = 4.7 - 6.0
- Bicarbonate = 22 -28
- BE = -2 to +2
- Lactate = .5 - 1
if a patient has low PaO2 but normal PaCO2, what does this indicate?
it indicate type 1 respiratory failure
if a patient has low PaO2 but high PaCO2, what does this indicate?
indicates type 2 respiratory failure
if you have low pH and high PaCo2, what does this indicate?
it means the body is retaining CO2 and not converting it to bicarbonate
what does a raised bicarbonate level indicate? what disease is this usually common in?
- carbon dioxide retention
- common in COPD
what would ABG look like in a patient with respiratory alkalosis? what diseases in this common in?
- high pH
- low Carbon Dioxide
- hyperventilation and pulmonary embolism
how can you differentiate between a patient with pulmonary embolism and one with hyperventilation?
- patient with hyperventilation also has increased levels of oxygen
- patient with pulmonary embolism has decreased oxygen level
