Respiratory Flashcards
What are some characteristics of small cell lung cancer?
Tumors grow rapid and fast. Mets, worst prognosis and most common type of neuroendocrine lung tumor.
What is most coorelates with small cell lung cancer?
Smoking
What has a nonproductive cough, hemoptysis and is usually localized?
Non-small cell lung cancer
What is the process that leads to ARDS?
- Dyspnea and hypoxemia with poor response to O2
- Hyperventilating and resp alkalosis
- Decreased tissue perfusion, metabolic acidosis, organ dysfunction
- Increased work of breathing, decreased tidal volume, hypo ventilation
- Hypercapnia, resp acidosis, worsening hypoxemia
- Decreased CO, hypotension, and death
What is happening in acute resp lung disease?
Acute injury to alveolarcapillry membrane producing massive inflammation, increased cap permeability, severe pulmonary edema.
This is a result of the bronchioles filling with fluid, shunting mismatch and hypoxemia.
What are the 2 tests most typically used for diagnosis of PE?
Chest CT and d dimer
Does widespread vasoconstriction or dialation happen with a PE?
Vasoconstriction, it impends blood flow
What does a PE cause?
V/Q mismatch, with increased dead space and decreased surfactant.
What is a PE?
Alveolar dead space causing hypoxemia due to absent blood flow to a lung segment.
It is the end result of a DVT or other clot
What are the manifesto and findings on a physical exam with pneumonia?
Cough, dyspnea, fever, chills, malaise, pleuritic chest pain
Pulmonary consolidation, inspiration crackles, increase tactile fermitus, egophany, whispered pectoriloquy.
What constitutes the first line of defense in the pulmonary system?
Nasopharynx and oropharynx
What is the most common cause of lower respiratory infection?
Aspiration of oral pharyngeal secretions
What are the 2 most common bacteria in pneumonia?
Haemophilus B and
Streptococcus P
What causes pneumoconiosis?
Dust or silica
Asbestos
Coal
What is the treatment for pneumoconiosis?
Palliative care: not reversible
What are examples of extrinsic lung issues caused by restrictive lung disease?
Neuromuscular-myasthenia gravis
Severe kyphosis and obesity
What are examples of intrinsic lung issues caused by restrictive Lund disease?
Asbestosis, pneumonitis, ARDS, sarcoidosis, and pulmonary fibrosis
What is the characteristics of restrictive airway disease?
Can’t get air in
Problem is impaired diffusion throughout the alveolarcapillary membrane.
What test indicates asthma?
Pre and post albuterol treatment with a 25% improvement after albuterol.
Can you have obstruction even if you have a normal FEV1?
Yes. It only depends on the ratio
What is considered the most sensitive indicator of early airflow limitation?
FEV1/FVC ratio
What is FVC?
Total expiration over time
What is FEV1?
Total expiration in one second
Is inflammation the primary factor of emphysema of not what is?
No, the loss of air surface area and accompanying gas exchange produces the hypoxia and dyspnea.
Emphysema is a disease of what lung tissue?
Parenchyma tissue
What is the common characteristics of chronic bronchitis?
Productive cough in the am for 3 months.
Hypertrophy and hyperplasia of submucosal glans.
What does it mean when you have reached resp acidosis?
Resp failure
What is the late asthmatic phase?
4-8 hours after early response. Hyperventilating causes resp alkalosis with progression of obstruction of exploratory airflow. This puts the resp muscles at a mechanical disadvantage and leads to a fall in tidal volume with an increase of CO2 retention and resp acidosis.
What is the early asthmatic response?
Antigen exposure to the bronchial mucosa activates histamine, prostaglandins and leukotrines. This causes vasodilation, increases cap permeability and mucosa edema. Then bronchial smooth muscle contraction (bronco spasms) and mucus secretion, narrowing and obstruction of airway.
What are distinguishing characteristics of COPD?
FEV1/FVC ratio is less than 70% and it may or may not have 1 or both chronic bronchitis or emphysema
Asthma is a obstructive disorder but is not considered COPD, why?
It’s a disease of inflammation
What is a characteristic of obstructive lung disorders and name some?
They can’t get air out
Asthma, COPD, chronic bronchitis and emphysema
What can cause you to have a positive TB test without having the disease?
Bacilli calmette guerin (Bcg)- it is a type of vaccine.
Does the TST differentiate between past, latent or active forms of TB?
No
What must you do if you are positive on skin test?
Chest x rays for 1 year
How is TB transmitted, what are the 5 ways to test for TB?
Highly contagious, person to person in airborne droplets.
Test by the TB skin test, purified protein derivative(ppd), sputum culture, immunoessays and chest x rays.
What are the normal aging processes of the lungs?
Loss of elasticity, stiffening of chest wall, changed in gas exchange, and increase in flow resistance.
These changes are gradual with no adverse consequences in healthy adults.
What is v/q and what is it’s function?
The distribution of air and blood. Since air goes to top area and blood to bottom area there needs to be some way to shunt it where it needs to go. That is why we have the pulmonary circulation.
What are the 4 steps of gas transport and ventilation?
- Ventilation of lungs
- Diffusion of oxygen from the alveoli into the capillary blood
- Perfusion of systemic capillaries with oxygenated blood
- Diffusion of oxygen from systemic capillaries into the cells.
What is the purpose of gas transport and distribution?
The delivery of oxygen to the cells of the body and the removal of CO2
What are the mechanics of breathing and what is happening to the lungs during each phase?
End of expiration-diaphragm is relaxed, no airflow, chest recoil
Inspiration- diaphragm contracts, air moving in, chest recoil
End of inspiration- diaphragm contracted, cheat fully recoiled, muscular contractions maintain inflation.
What are the 4 things that help regulate breathing?
- Neurochemical control of ventilation
- Mechanics of breathing
- Has transport
- Control of pulmonary circulation
What are stretch receptors stimulated by?
Irritants and skeletal muscle
What does central chemoreceptors respond to and what happens?
Responds to an increase of CO2 and it causes increase in respiration depth and rate.
What drives sensory input and what does it increase?
Hypoxia drive; causes increase in ventilation.
What is neurochemical control of breathing?
Controls how air gets in and out of lungs.
What are the 3 neurochemical controls of breathing?
- Sensory Input
- Central Chemoteceptors
- Stretch Receptors
What is the flow of air movement?
Trachea-bronchi-bronchioles-alveolar ducts
What is the primary purpose of the pulmonary system?
Provide movement of air from the external environment to the point of gas exchange.
What are the 3 neurochemical controls of breathing?
- Sensory Input
- Central Chemoteceptors
- Stretch Receptors
