Quiz 1c Flashcards
3 main portions of respiratory system
- Upper airway
- Lower airway
- Terminal alveoli
How many generations of airways are there?
26
5 parts of upper airway
- Nasal cavities
- Sinuses
- Pharynx
- Tonsils
- Larynx
3 parts of lower airway (conducting airway)
- Trachea
- Bronchi
- Nonrespiratory bronchioles
Describe differences between R and L lungs
R: bigger, 3 lobes
L: 2 lobes, lingula, cardiac notch
3 “or”s to classify pulmonary disease
- Acute or chronic
- Obstructive or restrictive
- Infectious or noninfectious
Term for coughing up blood
Hemoptysis
DOE
Dyspnea on exertion
Shortness of breath
Dyspnea
Pt can’t sleep flat - sign of pulm and cardiac diseases
Orthopnea
Nail beds swollen and rounded
Clubbing
Increased respiratory rate
Tachypnea
5 common sites for referred pain
- Chest
- Ribs
- Upper trap
- Shoulder
- T spine
Pulmonary pain increases with ______________
Inspiratory movements
________ pleura is sensitive to pain; _______ pleura is not sensitive to pain
Parietal (rib cage lining); visceral (lines lungs)
Outermost of the pleural membranes
Parietal
Thin serous membrane tissue layer than sticks to lung surface
Visceral
What’s between visceral and parietal pleura?
Pleural cavity
Dificient oxygenation of arterial blood
Hypoxemia
Caused by respiratory alterations
Hypoxemia
Causes cell death
Hypoxemia
Normal PaO2 of blood
80-100
Accumulation of fluid in the tissues and air spaces of the lung
Pulmonary edema
Most commonly caused by heart disease, especially left ventricular disfunction (LVF)
Pulmonary edema
Inflammation affected the parenchyma of the lungs
Pneumonia
Pneumonia at the level of the lobes
Lobar pneumonia
Pneumonia at the level of bronchioles and alveoli
Bronchopneumonia
4 etiologies of pneumonia
- Bacterial
- Viral
- Inhalation
- Aspiration
Vaccination of this condition is recommended for those over 65, or with chronic disorders, HIV, or poorly controlled DM
Pneumonia
4 stages of recovery of pneumonia
- Consolidation
- Red hepatization
- Gray hepatization
- Resolution
Starts 24 hours after contact with infection; fluid displaces some of the air
Consolidation
Blood leaks into air leaks (stage of p)
Red hepatization
Caused by breakdown of accumulated RBC (stages of P)
Gray hepatization
Can see discolored or bloody sputum; infection is clearing (stages of p)
Resolution
PCP
Pneunocystis carinii pneumonia
Parasitic infection seen in AIDS
PCP
First indicator of conversion from HIV to AIDS
PCP
Infectious, inflammatory systemic disease that affects lungs and may disseminate to involve lymph nodes and other organs
TB
Characterized by granulomas, caseous necrosis and cavity formation
TB
TB: primary infection involves:
Spreads to:
Then travels to:
- Middle or lower lung area
- Bronchopulmonary lymph nodes
- Bloodstream
When do signs of TB usually appear?
Late - usually after one year
Lung atelectasis
Collapsed lung
_________ resistant TB is a problem
Multidrug
Etiology of TB
Inhalation of infected airborne particles
How long do TB meds need to be taken?
6-9 mo
How to ID TB on xray
Usually round dot
Inflammation of the trachea and bronchi
Acute bronchitis
Acute bronchitis results from (2)
Chemicals and viral infections
If no treatment, acute bronchitis can lead to
Pneumonia
3 disorders COPD refers to
- Obstructive bronchitis
- Emphysema
- Asthma
Goal of COPD treatment
Improve PaO2 and decrease CO2 retention; prevent resp infection
Productive cough lasting 3 mo
Chronic obstructive bronchitis
Main causative agent of COB
Smoking
______________ tends to produce collapse of tissue
Forced expiration
Obstruction results from changes in lung tissue rather than mucus
Emphysema
Inflammation of airways causing bronchospasm with SOB and wheezing
Asthma
Caused by increased reaction of AW to various stimuli
Asthma
For exercise induced asthma, use ___________ prior to exercise
Bronchodilators 20-30 min
Nonallergic, adult onset asthma; secondary to chronic infections
Intrinsic asthma
Allergic asthma
Extrinsic asthma
Progressive form of obstructive lung disease characterized by irreversible destruction and dilation of AWs associated with chronic bacterial infections
Bronchiectasis
Pus bags
Bronchiectasis
Severe inflammation of the lower airways caused by viral infection
Bronchiolitis
Children under 2 are most commonly affected
Bronchiolitis
Episodes of cessation of breathing occurring at transition from NREM to REM with repeated wakenings
Sleep apnea
Sleep apnea defined as…
More than 5 cessations for at least 10 sec each per hour
Role of CPAP
Keeps alveoli inflated so pt gets better gas exchange
Limit lung expansion
Restrictive lung diseases
Autoimmune disease of CT with excessive collagen deposition in skin and internal organs
Scleroderma
Granulomas throughout body - a collection of macrophages surrounded by lymphocytes taking nodular form
Sarcoidosis
Excessive fibrous tissue in lung that replace normal tissue due to chronic inflammation
Pulmonary fibrosis
Multiple rib fractures or fx of the sternum, may cause paradoxical movement of chest
Flail chest
1 or more fxs of adjacent ribs on the same side
Flail chest
Group of disorders resulting from inhalation of industrial substances
Pneumoconiosis
Smaller dust particle =
More dangerous
Produces mucosal injury via hot gases
Smoke inhalation
________________ injury in upper airway produces edema and obstruction
Thermal
Inherited disease of exocrine glands
CF
CF: altered __________ and __________ channels
Chloride; sodium
Dehydration with increased viscosity of secretions from mucous glands
CF
Collapse resulting from removal of air from obstructed or hypoventilated alveoli
Obstructive-absorptive type atelectasis
Lung collapse due to air, blood or fluid filling the pleural space
Compressive type
Pulmonary edema is not a
Disease
Fluid in the lungs which leak into interstitial tissue and in alveoli
Pulmonary edema
Result of injury to the lung by a variety of disorders
ARDS
Acute respiratory distress syndrome
Fluids, proteins and cells leak from the capillary; leads to PE and alveolar collapse
ARDS
Mortality rate of ARDS
50-70%
Most frequent cause of CA death in the US
Lung cancer
Two classification of lung CA
Small cell lung CA 20%
Non small cell lung CA 90%
4 types of primary malignant lung tumors
SCLC: oat cell
NSCLC: squamous cell carcinoma, adencarcinoma, large cell carcinoma
Lung CA spreads to
Bone
Cells become so dense that there is almost no cytoplasm
Oat cell (small cell)
Type of lung CA w poorest prognosis
Large cell
2 types of lung CA that develop near hilum
Small cell, squamous cell
2 types of lung CA that arise in periphery
Adenocarcinoma, large cell
Central lung CA tumors ____________
Obstruct airflow
Peripheral lung CA tumors only produce pain when
Pleura is affected
Lung CA tumors of apex invade __________
Brachial plexus
Lodging of a blood clot in a pulmonary artery
Pulmonary embolism
Consider the possibility of pulm embolism following ____ and _____ surgery
Hip and knee
Signs/symptoms of atelectasis (6)
- Dyspnea
- Tachypnea
- Cyanosis
- Fever
- Dec BP
- Shock
8 signs/symptoms of CF
- Fatty stools
- Meconium ileus at birth
- Prolapse of rectum (rectocele)
- Risk of impaction
- Chronic cough and sputum production
- Increased risk of infection
- Reduced o2-co2 exchange
- Acidosis
8 signs/symptoms of COB
- Cough with mucus
- Cyanosis
- Prolonged expiration
- Recurrent infection
- SOB
- Hypoxemia
- Hypertrophy of mucus producing cells
- Air trapping