Respiratory Flashcards
Disease states that alter the elastic properites of lung tissue, resulting in changes to it
Compliance
Normal, quiet breathing
Eupnea
- Decreased oxygen in the blood
- Results from inadequate gas exchange
- PaO2 < 85%, give oxygen
Hypoxemia
_____ : inflammation, mucus secretion, obstruction of airway
_____: abnormal enlargement of gas exchange airways accompanied by destruction of alveolar walls
_____: hypersensitivity, mucus production, bronchoconstriction, obstruction of air flow
Chronic Bronchitis
Emphysema
Asthma
_____ is characterized by lungs that are difficult to inflate
- Will see incrased or normal ratio of FEV/FVC
- Decreased compliance is best indicator
- Residual volume and total lung capacity are generally decreased
Restrictive Lung Disease
Blood pooling into the pleural cavity
Seen in chest injury, surgery, malignancies, vessel rupture
Hemothorax
The site of gas exchange
Alveoli
Causes of ARDS
-
often unknown but associated increased risks include
- pneumonia
- near drowning
- toxins
- IDC
- infection
- trauma
- septic shock
_____ is an increase in blood pressure in the blood vessels of the lung that can lead to shortness of breath, dizziness, fainitng and edema
- secondary to increased volume pressure of blood or narrowing/obstruction of vessels
- can lead to pulm edema/ pleural effusion
- may result in cor pulmonale
Pulmonary Hypertension
The process of moving air into the lungs, available for gas exchange
Ventilation
Lymph fluid coming into pleural cavity
Occurs in trauma, infection, malignant infiltration
Chylothorax
- Increased CO2 in the blood
- Results from inadequate alveolar ventilation
- Hypoventilation is the most common cause
Hypercapnia
(Normal is 38-42 mmHg)
Leads to a decreased surface area for gas exchange (decreased A)
Emphysema
Atelectasis
Pneumothorax
_____ is characterized by an increased airway resistance
The small the radius of airway, the larger the resistance
_____ (ratio) is decreased in this disorder
Obstructive Lung Disorders
FEV1/FVC
Air enters but does not leave pleural space
trachea deviation can be seen on injured side
Tension pneumothorax
Air-filled blebs/blisters on lung surface form and rupture, allowing air to enter the pleural space
Can occur in smokers
Spontaneous pneumothorax
Primary or secondary emphysema?
- Caused by inability of body to inhibit proteolytic enzymes in lung (from exposure to toxins or cigarette smoke)
- Results from inherited deficiency of a1-antitrypsin that inhibits the action of proteolytic enzymes
- Secondary
- Primary
Lung tissue remains uninflated at birth
- Often due to insufficient surfactant
- often seen in premature births
- Treated w/ exogenous surfactant to help open airways and allow for good gas exchange
Primary Atelectasis
Movement of respiratory gases occurs by _____
Diffusion
Blood supply to the alveoli
Perfusion
Exudate that comes from inflammatory processes or immune responses
Occurs from infections, malignancies, RA, lupus
Empyema
- Some alveoli have no ventilation due to an obstructed airway, therefore no gas excahnge occurs in that alveoli
- Pulmonary venous blood has gas partial pressures due to mixed venous return blood
- leads to hypoxema
- Ex. airway obstruction, bronchoconstriction, pulmonary edema
“Shunt”
- Transudate (fluid from different cells)
- Occurs in people with
- CHF, renal failure, nephrosis, liver failure
- possibly caused by loss of albumin that changes osmotic pressure and leads to a collection of fluids
Hydrothorax
Obstructive airway disorders include _____, _____, _____
Chronic bronchitis
Asthma
Emphysema
Restrictive Lung Disorders include _____, _____, and _____
*generally there is a problem with the lung tissue itself rather than the airways
Pulmonary Fibrosis
Pulmonary Edema
Pneumonia
-
Characterized by
- acute lung inflammation
-
diffuse alveolocapillary injury (increased permeability)
- causes severe pulmonary edema
- Injury initiates a massive inflammatory response, futher damaging lung tissue
- Decreased lung compliance increases work of breathing
- Leaded to decreased surfactant, increased surface tension, and atelectasis
Acute Respiratory Distress Syndrome
Leads to an increased thickness of the partition between air and blood (increased X)
Pulmonary fibrosis
Air enters pleural space as a result of chest wall injury (trauma) or punctures (stab, gunshot wounds)
Secondary pneumothorax
Ventilation but no matching blood supply (perfusion) to participate in gas exchange
Occurs because of occlusion of blood supply to that alveoli
Ex. PE, emphysema
“Dead Space”
- Right ventricular enlargement (right sided HF)
- Secondary to pulmonary hypertension caused by disorders of lungs or chest wall
Cor Pulmonale
_____ may be restrictive as well as obstructive
_____ causes incrased fluid secretions
_____ and _____ form a COPD
- Emphysema
- Chronic bronchitis
- chronic bronchitis and emphysema
Decreased concentrations of oxygen in inspired air compromising the concentration gradient (decreased DC)/ difference in partial pressure
Altitude
CO2 poisoning
Anesthesia
What is…
- Tachypnea
- Dyspnea
- Apnea
- Cheyne-Stokes
- Kussmaal respirations
- Tachypnea- increased respiratory rate
- Dyspnea- sensation of breathlessness/difficulty breathing
- Apnea- cessation of respiration
- Cheyne-Stokes - a waxing and waning tidal volume with periodic apnea
- Kussmaal respiration- rapid and deep ventilation (metabolic acidosis, seen in DKA)
Adult lungs that have previously been inflated -> collapse
- Airway obstruction (tumors, mucous plug, exudate)
- Lung compression (pneumothorax or pleural effusion)
- Increased lung recoil (decreased surfactant)
Secondary Atelectasis
Ineffective cough reflex results in poor alveolar expansion and obstruction. Increased viscosity of sputum leads to obstruction
_____ reduces surface tension and needs to constantly be replenished by normal ventilation
Surface tension tends to collapse alveoli, the ideal is to avoid having the wet sides of alveoli stick together and to keep the lungs and alveoli open
Surfactant
