Respiratory Flashcards
Genetic disorder resulting from deficiency of alpha1-antitrypsin, a protective agent for the lung; increases patients risk for developing panacinar emphysema even in absence of smoking.
alpha1-antitrypsin deficiency
Disease with multiple precipitating mechanisms resulting in a common clinical outcome of reversible airflow obstruction
Asthma
Chronic, irreversible dilation of the bronchi and bronchioles that results from a destruction of muscles and elastic connective tissue; dilated airways become saccular and are a medium for chronic infection.
Bronchiectasis
A disease of the airways defined as the presence of cough and sputum production for at least a combined total of 3 months in each of 2 consecutive years
Chronic bronchitis
Disease state characterized by airflow limitation that is not fully reversible, sometimes referred to as chronic airway obstruction or chronic obstructive lung disease
Chronic obstructive pulmonary disease - COPD
A precipitous drop in the saturation of hemoglobin with oxygen
Desaturate
A disease in the airways characterized by destruction of the walls of overdistended alveoli
Emphysema
Patient-activated medication canister that provides aerosolized medication that the patient inhales into the lungs
Metered-dose inhaler
Increase in the red blood cell concentration in the blood; in COPD, the body attempts to improve oxygen carrying capacity by producing increasing amounts of RBCs
Polycythemia
Pulmonary function tests that measure specific lung volumes (e.g., FEV1, FVC) and rates (FEF 25-75%); may be measured before and after bronchodilator administration
Spirometry
Most patients with COPD present with overlapping signs and symptoms of which two distinct disease processes?
Emphysema and chronic bronchitis
Lung parenchyma
Any form of lung tissue, including bronchioles, bronchi, blood vessels, interstitium, and alveoli
People with this disease commonly become symptomatic during the middle adult years, and the incidence of the disease increases with age.
COPD
Two examples of NORMAL decreases in lung function that occurs with age
Vital capacity, and forced expiratory volume in 1 second (FEV1)
Pathophysiology of COPD
Airflow limitation both progressive and associated with lungs’ abnormal inflammatory response to noxious particles or gases.
The inflammatory response occurs throughout: the proximal and peripheral airways,
lung parenchyma, and pulmonary vasculature.
BC of chronic inflammation and body’s attempt to repair it, changes and narrowing occur in the airways.
In the proximal airways (trachea and bronchi greater than 2mm diameter), changes include: increased number of goblet cells and enlarged sub mucosal glands, both leading to hyper secretion of mucus.
In the peripheral airways (bronchioles less than 2mm diameter), inflammation causes thickening of airway wall, peribronchial fibrosis, exudate in airway, and overall airway narrowing (obstructive bronchiolitis).
Over time, the ongoing injury-and-repair process causes scar tissue formation and narrowing of the airway lumen.
-inflammatory and structural changes also occur in the lung parenchyma (respiratory bronchioles and alveoli).
Alveolar wall destruction leads to:
loss of alveolar attachments and a decrease in elastic recoil
Finally, the chronic inflammatory process affects the pulmonary vasculature and causes:
Thickening of the lining of the vessels and hypertrophy of smooth muscle, which may lead to pulmonary hypertension.
- processes r/t imbalances of substances (proteinases and antiproteinases) in the lung may also contribute to airflow limitation.
- When activated by chronic inflammation, proteinases and other substances may be released, damaging the parenchyma of the lung.
- These parenchymal changes may also occur as a consequence of inflammation or environmental or genetic factors.
