Pulmonary Physiology and Pathology Flashcards
1
Q
three most important structures of resporatory system
A
- lungs - gas exchange
- muscles of respiration - move air in and out.
- brain - regulates the process
2
Q
structures of the rest system
A
upper
* larynx and above - oral cavity, nasopharynx, oropharynx
lower
* trachea and below - primary bonito, lungs
3
Q
respiratory mucosa
A
- mucous membranes that line the respiratory tract
- protection: film of mucous that coats and protects underlying cells
- immune support: manually captures debris/traps pathogens, mucins/proteoglycans, bacterial interface
- lubricant: regurgitates stuff stuck in resp tract from aspierations
4
Q
structures of rest system
A
nasal cavity pharynx larynx trachea bronchi bronchioles ALVEOLI (gas exchange) Lungs Pleuroa *all others are movement of air
5
Q
nasal cavity
A
turbinates warm, moisten and filter air
- breathing through mouth makes you more susceptible to infectons
6
Q
pharynx
A
throat, shared by rest and digestive
- naso, oro, laringo
- uvula blocks food into nasal cavity
- epiglottis blocks food into lungs
7
Q
larynx
A
vocal chorts
- tighter = high pitch
- looser = lower pitch
8
Q
trachea
A
wind pipe
- cartilage rings keep it open
9
Q
bronchi
A
- right = wider
and straighter - aspirations happen on the right most of the time
10
Q
alveoli
A
gas exchange
- surface area gives lots of areas for gas exchange
- emphysema, destroys alveoli
- SERFACTANT: decreases surface tension. keeps alveoli walls open and from sticking together
11
Q
lungs
A
last for form in embryonic process
- right is larger, 3 lobes
- left smaller, 2 lobes
12
Q
serous membranes
A
- around heart, lungs and GI
- higs organs, serous fluid, and lines cavity
13
Q
pleura
A
- pa = pressure in alveoli
- pb = barometric pressure, outside the body
- pip = intrapleural pressure
- pressure gradient, air flows from high to low
- parietal (outside) and visceral (inside) with serous fluid in between
- Pa = pip –> collapsed lung
- Pb = pip –> collapsed lung
- Pip always needs to be < Pa to keeps lungs inflated. Pip needs to be negative pressure
14
Q
mechanics of breathing
A
- alveolar surface tension - surfactant (decreases surface tension)
- elastic properties of the lung and chest wall - elastic recoil (expiration) & compliance (inhilation)
- ariway resistence
* all 4 decrease work to breathe
15
Q
4 steps - mechanics of breathing
A
- ventilation - of lungs
- diffusion - of o2 from the alveoli into the capillary blood (air into blood)
- perfusion - of systemic capillaries with oxygenated blood (blood flow)
- diffusion - of o2 from systemic capillaries into the cells
* diffusion of co2 occurs in reverse order
16
Q
Medulla and Pons
A
- medulla - normal rest rate
- pons - increase or decreases the rate as needed
PONS
1. apneustic center = increased inspiration - stimulates neurons to promote inspiration via external intercostals and the diagohragm
2. pneumotaxic center = increased expiration - stimualted neurons to promote expiration via the intercostals and rectus abdominous
17
Q
chemoreceptors
A
co2
- central chemoreceptors = medulla and measure co2
- peripheral chemoreceptors = aorta and carotid bodies and increase co2
- both detect increased levels in co2 and then stimulate increase in Respiratory rate
18
Q
ventilation
A
mechanical movement of air or gas into and out of the lungs
- minute volume = vent rate x volume of air per breath
- alveolar ventilation = how much gas exchange
19
Q
conducting airways of ventilation
A
nasopharynx oropharynx larynx trachea bronchi bronchioles (reactive airways)
20
Q
gas exchange
A
alveoli
- epithelial cells
1. type 1 alveolar cells = alveolar structure. where diffusion of respiratory gasses occur
2. type II alveolar cells = surfactant production - Dust cells = macrophages that live in alveoli
21
Q
pulmonary circulation
A
pulm pressure is lower than systemic circulation
- right side of heart = less pressure
- 1/3 pulmonary vessels filled with blood at any moment
- pulmonary artery divides and entered the lung at the hilus
- each bronchus and bronchiole has an accompanying artery or ateriole
22
Q
alveocapillary membrane
A
- formed by the shared alveolar and capillary walls
- gas exchange occurs across this membrane
- membrane formed by type 1 pneumocytes
23
Q
ventilation-perfusion ratio
A
VQ rate
= airflow and blood flow to alveoli
- more airflor = more blood
- less airflow = less blood
24
Q
oxygen transport
A
- o2 bound to hemoglobin
- diffusion across alveolocapillary membrane
- dissolved in plasma
- hemoglobin = 4 henes (iron)
- oxyhemoglobin = oxygen-loaded hemoglobin. predominantly protein in red blood cells
- iron binds with o2 = bright red
25
Q
carbondioxide transport
A
- dissolved in plasma
- bicarbonate (HCO3) - carries majority of CO2. buffer for ph levels. neutralizes acid in blood
- cabaminohemoglobin - co2 in blood
26
Q
hypoxic pulmonary vasoconstriction
A
- caused by low alveolar PO2 (oxygen)
- blood is shunted to other, well-ventilated portions of the lungs (better ventilation/profusion)
- if hypoxia affects all segments of the lungs, the vasoconstriction can result in pulmonary hypertension
27
Q
acidemia
A
acidic blood
- causes pulmonary artery constriction
acidic blood –> pulmonary artery constriction –> pulmonary hypertension
28
Q
signs/symptoms of pulmonary disease
A
- dyspnea = painful, labored breathing –> shortness of breath
- orthopnea = dyspnea when a person is lying down
- paroxysmal nocturnal dyspnea = left ventricular failure, CHF patients, extra blood flow from lower extremities
- tachypenea = fast resp
- bradypnea = slow breathing
- apnea = no breath
- kussmal = hyperpnea, acidic blood, increased rest rate to get rid of co2
- Cheyne-stoles resp = periods of apnea and hyperpnea (end of life brainstem shutting down)
29
Q
more signs/symptoms of pulmonary disease
A
- hypoventilation = decreased resp
- hypercapnia = increased co2
- hyperventilation = increased resp
- hypocapnia = decreased co2
- cough = expel foreign object
- abnormal sputum = hemoptysis - blood, infection, TB, prolonged cough
- cyanosis = hypoxia, blueing
- clubbing = chronic loss of o2
30
Q
pulmonary edema
A
- heart dysfunction - increased pulmonary capillary hydrostatic pressure
- injury to blood vessel lining - movement of fluid and plasma proteins from capillary to interstitial space and alveoli
- blockage of vessels - inability to remove excess fluid from interstitial space - accumulation of fluid in space
31
Q
aspiration
A
passage of fluid and solid particles into lungs
- more often in right side
32
Q
atelectasis
A
lung collapses
- compression atelectasis = tumor, fungal growth causes obstruction, compresses airway
- absorption atelectasis = partial lung collapse. obstruction leads to collapse of lung
33
Q
smoking
A
induces chronic irritation
- metaplasia. not permanent
- more at risk of infection w metaplasia
34
Q
bronchiolitis
A
- inflamm obstruction of small airways
- most common in children
35
Q
bronchiolitis obliterans
A
- exaggerated, persistent bronchiolitis
- too much inflamm causes tissue damage
- dyspnea
- ## obliterates normal tissue
36
Q
pleural abnormalities
A
PENUMOTHORAX = lung collapses
- open pneumothorax - pip = pb. stabs, punctures, MVA
- tension pneumothorax - microscopic tear in pleura between pa and pip. creates a one way valve for air.
- spontaneous pneumothorax - idiopathic, tall/white/men/drinkers/smokers
- secondary pneumothorax - due to injury, trauma, disease
37
Q
tension pneumothorax
A
one way valve. every inhalation collapses the lung more and more
- tracheal deviation
- heart muscle moves over
38
Q
pleural abnormalities
A
- pleural effusion - collection of junk in intercellular space
- transudative effusion - accumulation of clear fluid
- exudative effusion - thick, goopy, non-clear
- hemothorax - blood in pip space, trauma
- empyema - pussy fluid in space, smelly
- chylothorax - lymph fluid in intercellular space. trauma, post surgery
39
Q
flail chest
A
instability of a portion of the chest wall
- trauma - lose stability of chest wall
- congenital, genetic - chest wall isn’t very stable to begin with
1. decreased pressure in thoracic cavity draws lung further into thoracic cavity
2. exhale - lung comes out into thoracic cavity
40
Q
inhalation disorders
A
- pneumoconiosis- inhalation of toxic gases - silica, asbestos, coal, exposure to toxic gases
- allergic alveolitis - hypersensitivity pneumolitis
41
Q
acute respiratory distress syndrome ARDS
A
- sepsis, major trauma
- resp failure characterized by acute lung inflammation and chronic
- injury to the pulmonary capillary endothelium
- fast within minutes to hours
- surfactant inactivation
- atelectasis - decrease in o2 exchange
42
Q
postoperative resporatory failure
A
- atelectasis
- penumonia
- pulmonary edem
- pulmonary emboli - thrombo embali, plaque, air, fat, blood clot
- prevention = frequent turning, deep breathing, early ambulation, air humidification, incentive spirometry
43
Q
common obstructive disorders
A
- asthma
- emphysema (COPD)
- chornic bronchitis (COPD)
44
Q
asthma
A
- bronchioles
- chornic inflammatory disorder of the airways
- hypersensitivity - overcompensation of smooth muscle
- inflammation results from hyperresonsiveness of the airways
- can lead to obstructon and status asthmaticus
- wheezing, dyspnea, tachypnea
45
Q
chronic bronchitis
A
- extra mucous production
- hyper secretion of mucous and chronic productive cough that lasts for at least 3 months and twice in a year
- smoking, seasonal allergies
- inspired irritants increase mucus production and the size and number of mucous glands
- thicker mucus
- harder to breath out
- increased inflammation w/o infection
- over secretion of mucous and cough
- blue bloater - cyanosis, hypoxia, increased co2, respiratory acidosis, increased resp rate, clubbing, smoking
46
Q
emphysema
A
- abnormal permanent enlargement of the gas-exchange airways accompanied by destruction of alveolar walls without obvious fibrosis
- loss of elastic recoil
- loss of surface area
- hard to breath out, REALLY hard to breath in
- pink puffer = increased co2 retention, purse lips, dyspnea, barrel chest
47
Q
penumonia
A
inflammation of the lung (alveoli)
- community-aquired pneumonia
- nocicomal
- increased inflame = white chest infiltrates
48
Q
Tuberculosis
A
- airborn transmission
- tubercle formation
- necrosis
- positive tuberculin skin test (PPD)
- induces phagocytosis/ dust cells and live sin them causes necrosis of lung tissue
- bacteria evades our own immune system
- super duper contageous
49
Q
acute bronchitis
A
- acute infection or inflammation of the airways or bronchi
- hacking cough
- commonly follows a viral illness
- similar symptoms to pneumonia but does not demonstrate pulmonary consolidation and chest infiltrates
- no white on X-ray like pneumonia
50
Q
acute laryngotrachebronchitis
A
LTB - croup
- barking cough, slow onset, crowing sounds, inspiratory stridor
51
Q
pulmonary emobolism
A
- occlusion of a portion of the pumonary vascular bed by a thrombosis, embolus, tissue fragment, air bubble
- bad blood flow clots then gets stuck in small tubules of lungs
52
Q
pulmonary hypertension
A
mean pulmonary arterial pressure above normal
- pulmonary venous hypertension - CHF
- pulmonary hypertension due to a resp disease COPD
- pulmonary hypertension due to thrombitic or embolitic disease - PE
- pulmonary hypertension due to dieseases of the pulmonary vasculature - cardio vasc disease
53
Q
pulmonary heart disease
A
primarily due to right ventricular enlargement (failure)
- pulm arteries are deoxygenated
- blood backs up in venous system
54
Q
lung cancer
A
ciagarette smoking!
