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Patho > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Ventilation

A

flow of air into and out of the lungs

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2
Q

Perfusion

A

flow of blood through pulmonary cappillaries

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3
Q

Diffusion

A

Transfer of gases between the alveoli and pulmonary capillaries

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4
Q

Anatomic dead space

A

volume of air in the conducting airways (nose, trachea) that is moved with each breath but does not participate in gas exchnge

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5
Q

Alveolar dead space

A

air contained in the lung which does not participate in gas exchanged

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6
Q

Physiologic dead space

A

sum of anatomic and alveolar dead spaces

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7
Q

Shunting

A

the movement of blood from the right side of the heart to the left side of the heart without being oxygenated

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8
Q

Physiologic shunting

A

occurs when there is impaired movement of air (ventilation) or blood flow (perfusion)

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9
Q

Anatomic shunt

A

occurs when blood moves from the venous to the arterial side of the circulation without moving though the lungs

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10
Q

V-Q mismatch

A

occurs when there is a perfusion without ventilation or ventilation without perfusion

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11
Q

V-Q ratio when perfusion is without ventilation

A

low, atelectasis

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12
Q

V-Q ratio when ventilation is without perfusion

A

high, PE

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13
Q

pO2

A

the level of dissolved oxygen in plasma

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14
Q

what happens to hemoglobin saturation when it leaves the left side of the heart?

A

it drops

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15
Q

Oxygen-Hemoglobin dissociation curve when it shifts to right

A

increase in tissue metabolism (reduced affinity of hemoglobin for oxygen) d/t fever, acidosis, pulmonary insufficiency, severe anemia, exercise!

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16
Q

Oxygen-Hemoglobin dissociation curve when it shifts to left

A

decrease in tissue metabolism (increased affinity of hemoglobin for oxygen) d/t alkalosis and decreased body temp

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17
Q

Dorsal group location and function

A

located in medulla and controls inspiration

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18
Q

ventral group location and function

A

located in medulla and active when an increase in respirations is needed

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19
Q

Pneumotaxic center location and function

A

located in upper pons and can turn respirations off, controls rate and resp volume

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20
Q

Apneustic center location and function

A

located in lower pons and can prolong inspirations

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21
Q

chemosensitive center and what will happen if Ph is low?

A

are affected by the pH in CSF, if Ph low it will increase rest

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22
Q

Parasympathetic system

A

acetylcholine NT with muscarinc receptors ex. bronchoconstriction, pulmonary vasodilation

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23
Q

sympathetic system

A

epinephrine and norepinephrine NTs with B2 adrenergic receptors ex. Broncial smooth muscle relaxation, pulmonary vasoconstriction

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24
Q

lung stretch receptors location and function

A

in smooth muscle, respond to changes in pressure, control the stretch of a lung

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25
Q

lung irritant receptors location and function

A

located between airway epithelial cells, respond to irritants and causes airway constriction with rapid shallow breathing

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26
Q

lung Juxtacapillary receptors (J-recptors)

A

located in alveolar wall, responsible for rapid shallow breathing associated with pulmonary edema or embolism

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27
Q

The effects of gas exhange on pna

A

there is impaired diffusion of oxygen into cappillaries which causes hypoxemia, HR tachy, respiratoy alkalosis d/t stimulation of pulmonary receptors, hypercapnia

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28
Q

congestion phase of pna

A

4-24 hours, initial inflammatory response kicks in

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29
Q

red hepatization phase of pna

A

48 hours, extravasation of RBCs, fibrin into alveoli, tissue is firm and red

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30
Q

Gray hepatization phase of pna

A

72 hours-1 wk, fibrin accumulates and granulates

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31
Q

s/s of pna

A

increased HR, increased temp, rales, rhonchi (mucus in bronchi), decreased breath sounds over consoliation, E to A changes, dull percussion , resp alkalosis

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32
Q

Bacterial pna

A

acute, bacterial infection of lung, more common in adults than children

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33
Q

which bacteria is responsible for community acquired bacterial pna?

A

streptococcus pneumoniae or Haemophilus influenzae

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34
Q

which bacteria is responsible for hospital acquired bacterial pna?

A

gram negative rods like pseudomonas or gram positive like staph

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35
Q

which is more prevalent, community or nosocomial bacterial pne?

A

community

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36
Q

viral pna

A

inflammatory disease of lungs

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37
Q

viral pna causes

A

flu, RSV, Cytomegalovirus, varicella, Rubeola

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38
Q

Mycoplasma pna

A

acute interstitial pna caused by extensive infection of lungs and bronchi of lower lobes

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39
Q

how often do we see mycoplasma pna? and in which age group?

A

epidemics occur every 4-5 years, in men more than women, prevalent in children

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40
Q

what will WBC look like with mycoplasma?

A

normal

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41
Q

Bronchiolitis and which age group?

A

inflammation of bronchioles, out pouching, usually seen in babies

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42
Q

Bronchiolitis causes

A

viral, chlamydia, eye, nose inoculation, day care exposure

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43
Q

Bronchiolitis s/s

A

anorexia, cough, cyanosis, expiratory wheezing, fever, inspiratory crackles

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44
Q

Bronchiolitis ABG

A

hypoxemia, hypercapnia, acidemia

45
Q

Bronchiolitis tests

A

infant pulmonary studies, CXR, resp viral cultures

46
Q

Asthma, Cystic fibrosis, chronic bronchitis, emphysema, bronchiectasis are all which kind of disorder?

A

obstructive

47
Q

Thoracic cage disorders, adult resp distress syndrome, sarcoidosis are all which kind of disorder

A

restrictive

48
Q

Acute Bronchitis

A

acute inflammation of bronchi caused by irritants or infection (cigarette smoking)

49
Q

distinguishing characteristic of acute bronchitis?

A

obstruction of airflow

50
Q

Acute bronchitis s/s

A

fever, fatigue, rales, rhonchi, wheezing, no pulmonary consolidation, pharynx infected, cough

51
Q

chronic bronchitis

A

inflammation of the bronchial walls with hypertrophy of goblet cells, BLUE BLOATER

52
Q

chronic bronchitis s/s

A

cough present for at least 3 months out of year for 2 successive years, BLUE BLOATER, cyanosis, Rhonchi, hypercapnia, hypoxemia

53
Q

chronic bronchitis V/Q mismatch results (what happens with ventilation)

A

hypoventilation of alveoli d/t trapping hypoxemia, hypercapnia (blue bloater)

54
Q

Emphysema

A

destruction of alveoli walls, elasticity of airspaces is gone, PINK PUFFER

55
Q

Emphysema s/s

A

tachypnea, barrel chest, dyspnea even at rest, decreased breath sounds, normal ABG

56
Q

Emphysema V/Q mismatch results (what happens with ventilation)

A

not prominent d/t loss of capillaries with alveoli

57
Q

Centrilobular and Panacinar

A

two type of emphysema

58
Q

Centrilobular emphysema

A

associated with smoking, affects resp bronchioles and alveolar ducts

59
Q

Panacinar emphysema

A

associated with genetics, destruction and enlargement of alveoli distal to terminal bronchioles

60
Q

Bronchiectasis

A

abnormal, chronic permanent dilation of large bronchi

61
Q

causes of bronchiectasis

A

airway obstruction (tumor), congenital abnormalities, infection (TB), cystic fibrosis, exposure to toxic gases

62
Q

classic signs of bronchiectasis

A

halitosis (because of all the stuff they cough up), Hemoptysis (because of the break down of the wall

63
Q

Asthma

A

reactive airway disease that causes episodic reversible airway obstruction

64
Q

asthma obstruction is caused by what?

A

bronchospasm, increased mucus secretion and inflammation and edema of bronchial mucosa

65
Q

Extromsoc atopic asthma (type 1)

A

is triggered by something you are allergic to mediated by IgE,mast cells release histamine and prostaglandins on exposure

66
Q

Intrinsic idiopathic (type 2) asthma

A

adult onset poor prognosis

67
Q

Exercise induced asthma (EIA) triggers

A

hypocapnia, cool air

68
Q

ASA triad

A

diagnosis of asthma, nasal polops, you take asa or NSAID

69
Q

What happens to the bronchi during asthma

A

bronchi widen and lengthen on inspiration BUT collapse on expiration- you cant get air out

70
Q

why is expiration difficult with asthma?

A

edema, narrowing of airway, and mucus obstruction occurs

71
Q

what does PaO2 initially look like with asthma then what does it look like later?

A

initially low d/t increased RR then later high d/t decreased alveolar ventilation

72
Q

V/Q mismatch with asthma

A

unoxygenated blood returns to left atrium which leads to the pulmonary artery vasoconstricting which leads to pulmonary HTN which leads to R ventricular failure

73
Q

mild asthma symptoms

A

brief wheezing once or twice per week, thick clear or yellow mucus,

74
Q

moderate asthma symptoms

A

weekly, interferes with sleep and exercise, resp distress at rest, diminished breath sounds, hyperresonance, accessory muscles used

75
Q

severe asthma symptoms

A

frequent hospitals, absent breath sounds, paO2 70, chest retractions, pulses paradoxous >10

76
Q

early asthma response, when do s/s show up and how long for recovery

A

immediate bronchoconstriction on exposure to inhaled irritant, s/s within 10-20 mins, recovery 60-90 mins

77
Q

late asthma response, when do s/s show up and how long for recovery

A

develops 3-5 hours after exposure to trigger, may last days or weeks

78
Q

Cystic fibrosis and what things are seen in sweat with this disease

A

large amounts of thick mucus, increased concentrations of sodium and chloride in sweat

79
Q

symptoms to rule in asthma

A

wheezing and dyspnea, wheezing with no URI symptoms and nocturnal dyspnea

80
Q

Cystic fibrosis is characterized by what?

A

chronic pulmonary disease, pancreatic insufficiency, (BS levels will remain high)abnormal high levels of electrolytes in sweat

81
Q

cystic fibrosis effects on pulmonary

A

block alveolar ventilation, chronic inflammation, bronchial scarring and destroys airways, reduced lung compliance (ability to stretch)

82
Q

cystic fibrosis effects on pancrease

A

pancrease duct clogs, enzymes don’t reach small intestine, decreased insulin secretion, diabetes!

83
Q

cystic fibrosis effects on liver

A

bile duct obstruction, biliary cirrhosis, portal HTN, liver failure

84
Q

cystic fibrosis effects on intestine

A

blocks digestion=failure to thrive

85
Q

cystic fibrosis effects on heart

A

R sided heart failure=cor pulmonale

86
Q

cystic fibrosis effects on reproductive system

A

sterile

87
Q

cystic fibrosis tests

A

sweat test, genetic screening, chest xray and stool testing

88
Q

sarcoidosis

A

non-infectious multisystem disease of unknown cause

89
Q

sarcoidosis s/s

A

hilar adenopathy (bila enlarged lymph nodes of lungs), pulmonary infiltrates, ocular and skin lesions, other organs may be involved

90
Q

Idiopathic pulmonary fibrosis

A

interstitial pna which leads to pulmonary fibrosis that w cant be explained

91
Q

tidal volume

A

the volume of air inspired and expired in a normal breath

92
Q

Pulsus parodoxus

A

an abnormal finding in which there is a large decrease in systolic blood pressure during inspiration.

93
Q

For a patient with a pulmonary embolus, the V/Q scan will show

A

Perfusion defects with normal ventilation.

94
Q

Ventilation refers to

A

Delivery of air to the alveoli.

95
Q

alveolocapillary membranes

A

where gas exchange takes place

96
Q

Increased parasympathetic activity results in

A

Constriction of the bronchioles

97
Q

Inspiration involves

A

Pressures within the lung that are lower than atmospheric.

98
Q

vital capacity

A

Maximal amount of air that can be taken in and exhaled with forceful expiration.

99
Q

Approximately one-third of each breath occupies dead space. This space represents

A

Volume of non-useable gas in the conducting airways

100
Q

Oxygen-Hemoglobin Dissociation curve is influenced by what?

A

pH, temp and carbon dioxide

101
Q

We blow off CO2 and H20 to make what?

A

carbonic acid, H2CO3

102
Q

what 3 things cause systemic vasodilation in order to remove metabolic waste and deliver more O2 to tissues?

A

a decrease in pH, decrease in O2 and an increase in CO2

103
Q

empyema

A

pus in pleural cavity

104
Q

if chest X-ray reveals pna in upper lobe what diseases do you think of?

A

TB or aspiration pna

105
Q

peribronchial thickening may show up on X-ray for which type of pna?

A

viral pna

106
Q

what will show on a chest X-ray for bronchiolitis?

A

flattened diaphragm, increased AP diameter, peribronchial cuffing, air trapping

107
Q

what can chronic bronchitis cause?

A

pulmonary HTN, cor pulmonale, Aascities, peripheral edema

108
Q

alpha antitrypsin deficiency

A

an inherited condition that increases your risk for lung disease (exp. emphysema)

Patho (20 decks)

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