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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
lung irritant receptors location and function
located between airway epithelial cells, respond to irritants and causes airway constriction with rapid shallow breathing
26
lung Juxtacapillary receptors (J-recptors)
located in alveolar wall, responsible for rapid shallow breathing associated with pulmonary edema or embolism
27
The effects of gas exhange on pna
there is impaired diffusion of oxygen into cappillaries which causes hypoxemia, HR tachy, respiratoy alkalosis d/t stimulation of pulmonary receptors, hypercapnia
28
congestion phase of pna
4-24 hours, initial inflammatory response kicks in
29
red hepatization phase of pna
48 hours, extravasation of RBCs, fibrin into alveoli, tissue is firm and red
30
Gray hepatization phase of pna
72 hours-1 wk, fibrin accumulates and granulates
31
s/s of pna
increased HR, increased temp, rales, rhonchi (mucus in bronchi), decreased breath sounds over consoliation, E to A changes, dull percussion , resp alkalosis
32
Bacterial pna
acute, bacterial infection of lung, more common in adults than children
33
which bacteria is responsible for community acquired bacterial pna?
streptococcus pneumoniae or Haemophilus influenzae
34
which bacteria is responsible for hospital acquired bacterial pna?
gram negative rods like pseudomonas or gram positive like staph
35
which is more prevalent, community or nosocomial bacterial pne?
community
36
viral pna
inflammatory disease of lungs
37
viral pna causes
flu, RSV, Cytomegalovirus, varicella, Rubeola
38
Mycoplasma pna
acute interstitial pna caused by extensive infection of lungs and bronchi of lower lobes
39
how often do we see mycoplasma pna? and in which age group?
epidemics occur every 4-5 years, in men more than women, prevalent in children
40
what will WBC look like with mycoplasma?
normal
41
Bronchiolitis and which age group?
inflammation of bronchioles, out pouching, usually seen in babies
42
Bronchiolitis causes
viral, chlamydia, eye, nose inoculation, day care exposure
43
Bronchiolitis s/s
anorexia, cough, cyanosis, expiratory wheezing, fever, inspiratory crackles
44
Bronchiolitis ABG
hypoxemia, hypercapnia, acidemia
45
Bronchiolitis tests
infant pulmonary studies, CXR, resp viral cultures
46
Asthma, Cystic fibrosis, chronic bronchitis, emphysema, bronchiectasis are all which kind of disorder?
obstructive
47
Thoracic cage disorders, adult resp distress syndrome, sarcoidosis are all which kind of disorder
restrictive
48
Acute Bronchitis
acute inflammation of bronchi caused by irritants or infection (cigarette smoking)
49
distinguishing characteristic of acute bronchitis?
obstruction of airflow
50
Acute bronchitis s/s
fever, fatigue, rales, rhonchi, wheezing, no pulmonary consolidation, pharynx infected, cough
51
chronic bronchitis
inflammation of the bronchial walls with hypertrophy of goblet cells, BLUE BLOATER
52
chronic bronchitis s/s
cough present for at least 3 months out of year for 2 successive years, BLUE BLOATER, cyanosis, Rhonchi, hypercapnia, hypoxemia
53
chronic bronchitis V/Q mismatch results (what happens with ventilation)
hypoventilation of alveoli d/t trapping hypoxemia, hypercapnia (blue bloater)
54
Emphysema
destruction of alveoli walls, elasticity of airspaces is gone, PINK PUFFER
55
Emphysema s/s
tachypnea, barrel chest, dyspnea even at rest, decreased breath sounds, normal ABG
56
Emphysema V/Q mismatch results (what happens with ventilation)
not prominent d/t loss of capillaries with alveoli
57
Centrilobular and Panacinar
two type of emphysema
58
Centrilobular emphysema
associated with smoking, affects resp bronchioles and alveolar ducts
59
Panacinar emphysema
associated with genetics, destruction and enlargement of alveoli distal to terminal bronchioles
60
Bronchiectasis
abnormal, chronic permanent dilation of large bronchi
61
causes of bronchiectasis
airway obstruction (tumor), congenital abnormalities, infection (TB), cystic fibrosis, exposure to toxic gases
62
classic signs of bronchiectasis
halitosis (because of all the stuff they cough up), Hemoptysis (because of the break down of the wall
63
Asthma
reactive airway disease that causes episodic reversible airway obstruction
64
asthma obstruction is caused by what?
bronchospasm, increased mucus secretion and inflammation and edema of bronchial mucosa
65
Extromsoc atopic asthma (type 1)
is triggered by something you are allergic to mediated by IgE,mast cells release histamine and prostaglandins on exposure
66
Intrinsic idiopathic (type 2) asthma
adult onset poor prognosis
67
Exercise induced asthma (EIA) triggers
hypocapnia, cool air
68
ASA triad
diagnosis of asthma, nasal polops, you take asa or NSAID
69
What happens to the bronchi during asthma
bronchi widen and lengthen on inspiration BUT collapse on expiration- you cant get air out
70
why is expiration difficult with asthma?
edema, narrowing of airway, and mucus obstruction occurs
71
what does PaO2 initially look like with asthma then what does it look like later?
initially low d/t increased RR then later high d/t decreased alveolar ventilation
72
V/Q mismatch with asthma
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
mild asthma symptoms
brief wheezing once or twice per week, thick clear or yellow mucus,
74
moderate asthma symptoms
weekly, interferes with sleep and exercise, resp distress at rest, diminished breath sounds, hyperresonance, accessory muscles used
75
severe asthma symptoms
frequent hospitals, absent breath sounds, paO2 70, chest retractions, pulses paradoxous >10
76
early asthma response, when do s/s show up and how long for recovery
immediate bronchoconstriction on exposure to inhaled irritant, s/s within 10-20 mins, recovery 60-90 mins
77
late asthma response, when do s/s show up and how long for recovery
develops 3-5 hours after exposure to trigger, may last days or weeks
78
Cystic fibrosis and what things are seen in sweat with this disease
large amounts of thick mucus, increased concentrations of sodium and chloride in sweat
79
symptoms to rule in asthma
wheezing and dyspnea, wheezing with no URI symptoms and nocturnal dyspnea
80
Cystic fibrosis is characterized by what?
chronic pulmonary disease, pancreatic insufficiency, (BS levels will remain high)abnormal high levels of electrolytes in sweat
81
cystic fibrosis effects on pulmonary
block alveolar ventilation, chronic inflammation, bronchial scarring and destroys airways, reduced lung compliance (ability to stretch)
82
cystic fibrosis effects on pancrease
pancrease duct clogs, enzymes don't reach small intestine, decreased insulin secretion, diabetes!
83
cystic fibrosis effects on liver
bile duct obstruction, biliary cirrhosis, portal HTN, liver failure
84
cystic fibrosis effects on intestine
blocks digestion=failure to thrive
85
cystic fibrosis effects on heart
R sided heart failure=cor pulmonale
86
cystic fibrosis effects on reproductive system
sterile
87
cystic fibrosis tests
sweat test, genetic screening, chest xray and stool testing
88
sarcoidosis
non-infectious multisystem disease of unknown cause
89
sarcoidosis s/s
hilar adenopathy (bila enlarged lymph nodes of lungs), pulmonary infiltrates, ocular and skin lesions, other organs may be involved
90
Idiopathic pulmonary fibrosis
interstitial pna which leads to pulmonary fibrosis that w cant be explained
91
tidal volume
the volume of air inspired and expired in a normal breath
92
Pulsus parodoxus
an abnormal finding in which there is a large decrease in systolic blood pressure during inspiration.
93
For a patient with a pulmonary embolus, the V/Q scan will show
Perfusion defects with normal ventilation.
94
Ventilation refers to
Delivery of air to the alveoli.
95
alveolocapillary membranes
where gas exchange takes place
96
Increased parasympathetic activity results in
Constriction of the bronchioles
97
Inspiration involves
Pressures within the lung that are lower than atmospheric.
98
vital capacity
Maximal amount of air that can be taken in and exhaled with forceful expiration.
99
Approximately one-third of each breath occupies dead space. This space represents
Volume of non-useable gas in the conducting airways
100
Oxygen-Hemoglobin Dissociation curve is influenced by what?
pH, temp and carbon dioxide
101
We blow off CO2 and H20 to make what?
carbonic acid, H2CO3
102
what 3 things cause systemic vasodilation in order to remove metabolic waste and deliver more O2 to tissues?
a decrease in pH, decrease in O2 and an increase in CO2
103
empyema
pus in pleural cavity
104
if chest X-ray reveals pna in upper lobe what diseases do you think of?
TB or aspiration pna
105
peribronchial thickening may show up on X-ray for which type of pna?
viral pna
106
what will show on a chest X-ray for bronchiolitis?
flattened diaphragm, increased AP diameter, peribronchial cuffing, air trapping
107
what can chronic bronchitis cause?
pulmonary HTN, cor pulmonale, Aascities, peripheral edema
108
alpha antitrypsin deficiency
an inherited condition that increases your risk for lung disease (exp. emphysema)

Patho (20 decks)

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