Respiratory 1 (USE THIS LATEST EDITION!) Flashcards
chronic hypoxemia
- pulmonary hypertension
- Right ventricular hypertrophy
- Polycythemia
- Hypercapnia
polycythemia
increase in hemoglobin
hypercapnia
increase in Co2
Atelectasis
partial or complete collapse of the lung
what causes atelectasis?
compression of the lung when fluid or air accumulates in the pleural cavity
What does atelectasis result in
resorption, compression, contraction
pulmonary hypertension results in
increased work, right heart failure (cor pulmonale), occlusion of lumen of pulmonary arteries
large pulmonary emboli lead to
right heart failure and death
pulmonary emboli arise in… and pass through
deep leg veins, venous circulation to heart and pulmonary arteries
in a clinical setting, pulmonary emboli is marked by
venous stasis= CHF, prolonged bed rest or sitting
liver cirrhosis and pulmonary emboli lead to
thrombo-emboli
pulmonary emboli can be caused by
cancer, fractures, childbirth, foreign material
what causes pulmonary edema
left ventricular heart failure
2 wats Pneumonia spreads
air space spread (bacteria) interstitial spread (viral)
pneumonia classification (SIACH pneumonic)
1 Community acquired 2 Hospital acquired (nosocomial) 3 acquired in Special environments 4 Immunosuppressed 5 Aspiration
Bronchopneumonia
acute bacterial pneumonia on bronchi, spread to adjacent alveoli
- filled with exudate
- affected areas consolidate
Lung of bronchopneumonia looks
firm, airless, dark red or gray
FADrg pneumonic
Where is pus formed in bronchopneumonia?
peripheral bronchi
lobar pneumonia
microorganisms colonize distal alveolar air spaces, not bronchi; rapid spread to alveolar air spaces and bronchioles lead to acute inflammatory exudate limited by pulmonary fissures
2 organisms of lobar pneumonia?
strep. pneumoniae and klebsiella
appearance of lobar pneumonia?
consolidated and airless
Can ppl with lobar pneumonia recover with normal structure and fxn?
YES!
Community acquired pneumonia is what percent strep. pneumoniae
33%
How do you diagnose hospital acquired pneumonia?
bronchial lavage with expectorated sputum; infection 2+days after hospitalization; incidence is 5% of admitted
What is the most lethal form of viral interstitial pneumonitis?
influenza
Staph aureus of viral interstitial pneumonitis leads to
STAPH AUREUS SUPER INFECTION
What kind of pneumonia is in the immunosuppressed?
fungal pneumonia
Examples of fungal pneumonia organisms
CAP
candida, aspergillus, pneumocystic jirovecii(alveoli filled with fine, foamlike material)
What type of pneumonia spreads through alveoli to involve whole lobes?
lobar type
What kind of pneumonia is spread from tracheobronchial infection?
bronchopneumonia
atypical pneumonia causes
interstitial inflammation
different organisms that cause community acquired pneumonia . most common is
strep pneumonia
most hospital acquired cases of pneumonia are due to
gram neg organisms
specific environmental exposure associated with..
legionnaire disease and fungal pneumonias
what pneumonia results in both chemical and infective damage to lungs
aspiration pneumonia
opportunistic mycobacteria, viruses, fungi and protozoa are most often in
immunosupresssed
Bronchiectasis
permanent abnormal dilation of bronchial tree due to chronic infection with inflammation and necrosis of bronchial wall
Symptoms of Bronchiectasis
recurrent cough + hemoptysis, purulent sputum
Airway of bronchiectasis is how many times larger?
5-6x
What causes a bacterial lung abcess
bronchiectasis
Chronic Obstructive Airway Diseases
Asthma (narrowing)
emphysema (loss of elastic recoil)
chronic bronchitis (narrowing)
Astma Extrinsic Type (immune, atopic) mediated by
type 1 hypersensitivity, response with IgE on mast cells
sputum of asthma extrinsic type
charcot-leyden crystals and curshmann spirals
emphysema
permanent dilation of any part of the respiratory acinus; weakened and collapsed air sacs with excess mucus; can lead to pneumothorax
What is the pink puffer (pink complexion) associated with?
emphysema
Exhalation becomes active; increased anteriorposterior diameter of the chest (barrel chest); increased total vital capacity occurs in
emphysema
Emphysema and proteases
there is an imbalance b/w proteases and their inhibitors
smoking and emphysema
smoking increases release of protease (elastase) from neutrophils and macrophages; inactivates alpha antitrypsin which destroys the alveolar wall
congenital emphysema
lack of protease inhibitors
chronic bronchitis
airway obstruction due to luminal narrowing +mucus plugging
What causes airway narrowing?
chronic bronchitis and asthma
What causes loss of recoil in the lungs
emphysema
What is a chronic inflammatory response in airways, leading to reversible airways obstruction?
asthma
muscle spasms, mucous plugging, and mucosal edema cause
airway obstruction
generalized emphysema is
permanent dilation of the respiratory acinus with destruction of tissue in the absence of scarring
emphysema is caused by
unregulated extracellular protease (secreted from inflammatory cells) activity
2 patterns of generalized edema
centrilobular and panacinar
airways show mucus hyper secretion with gland hyperplasia in
chronic bronchitis
many patines with chronic bronchitis also have
asthma and emphysema components
pulmonary hypertension and right sided heart failure are common in patients with
COPD
