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Pathophysiology > Respiratory Disorders > Flashcards

Respiratory Disorders Flashcards

1
Q

Trachea structures

A

elastic tissue
C-shaped rings of cartilage
smooth muscle cells

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2
Q

Bronchial tree progression

A

primary bronchi
secondary bronchi
bronchioles
alveolar ducts

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3
Q

Do bronchioles have cartilage?

A

no

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4
Q

Bronchioles have …. cellls and ….relaxes them.

A

smooth

SNS

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5
Q

Alveoli are the … for inspired air. They are lined by a …. They are the site for …. with three structures particpating:
Alveoli contain … and … which prevents infections.

A

end-point
single layer of epithelial cells (type I)
gas exchange
basement membrane, epithelial wall, capillary wall
elastic fibers
macrophages

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6
Q

Alveoli contain a thin layer of ….The inner surface is covered by …
This is produced by … cells and acts as a ….
This covering prevents …. and reduces …. by decreasing ….

A 
water
surfactant
type II cells 
detergent 
collapse of alveolus during expiration
efforts to expand lungs during inspiration
surface tension of water
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7
Q

Surfactant consists of …. and spreads as a …. it reduces … of alveolar fluid at air-liquid interface.

A

lipoproteins
thin film at air-liquid interface
surface tension

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8
Q

Surfactant is produced …. premature babies …. and because of this they have difficulty breathing and respiratory failure. Reduced surfactant levels occur in …, …., and …..

A 
late in fetal development
do not have enough of it 
pulmonary edma
lung injury
some genetic disease
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9
Q

Lung or pulmonary compliance is …

It depends on…

A

ability of the lungs to expand
elastic properties of lung tissue
alveolar surface tension
thorax anatomy and flexibility

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10
Q

Airflow direction during inspiration and expiration depends on … which is which law? When atmospheric pressure is higher than air pressure in alveoli what happens?
When air pressure in alveoli is higher than atmospheric pressure, what happens?

A

air pressure gradient
Boyles law
inspiration-air moves from atmosphere to lungs
expiration-air moves from lungs into atmosphere

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11
Q

How is hypoxemia defined? When does it occur?

A

under 80 PO2

high elevations and causes CNS changes

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12
Q

How is hypercapnia defined? What causes it?

A

over 60 PCO2 (respiratory distress)

drugs that depress respiratory center and by large airway obstruction

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13
Q

What controls ventilation? and how?

A

chemoreceptors

stimulate respiratory centers and detect changes in levels of CO2, O2, H in blood or CSF

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14
Q

Where are central chemoreceptors located? Where are peripheral chemoreceptors located?

A

medulla

carotid bodies and aortic bodies

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15
Q

Central chemoreceptors respond…. to slight increase in …. or decrease in ….

A

quickly
PCO2 in blood
pH in CSF

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16
Q

Peripheral chemoreceptors respond … to decreased …. and decreased ….

A

changes in arterial blood
PO2
Ph

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17
Q

Hypercapnia is when there is increased ….levels in blood. CO2 easily diffuses into CSF–> which lowers …. which stimulates….–> ….rate and depth of respirations which may lead to hyperventilation. This is a condition of …. and ……depression.

A 
PCO2
pH
respiratory center
increases 
respiratory acidosis 
nervous system
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18
Q

Hypocapnia is decreased … in blood. This may be caused by …. and is a condition of respiratory….

A

PCO2
hyperventilation
alkalosis

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19
Q

Each gas in a mixture moves along its partial pressure gradient, independent of other gases which is which law?

A

Daltons

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20
Q

Factors affecting diffusion of gases?

A

partial pressure gradient
thickness of respiratory membrane
total surface area available
ventilation perfusion ratio

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21
Q

If part of the alveolar wall is destroyed like in …. surface area will be reduced and there will be less …

A

emphysema

exchange

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22
Q

Ventilation and perfusion need to … for maximum gas exchange.

A

match

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23
Q

O2 binding/release to Hb is dependent on …..

A

PO2, PCO2, temperature, plasma pH

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24
Q

Spirometry

What does it test specifically?

A

pulmonary function test

pulmonary volumes and airflow times

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25
Lower respiratory tract infections
pneumonia | TB
26
Pathophysiology of pneumonia
infection inflammation of alveolar sacs fluid accumulation that may be pus difficulty breathing and reduced oxygen exchange
27
Classification of pneumonia is based on..
causative agent anatomic location of infection pathophysiologic changes epidemiologic data
28
Etiology of TB
mycobacterium TB transmitted by oral droplets from persons with active infection
29
Mycobacterium TB characteristics
``` aerobic, slow growing can survive in dried sputum for weeks somewhat resistant to drying and disinfectants destroyed by UV light, heat, alcohol multidrug resistant normal immune response may not occur ```
30
Two stages of TB
primary and secondary
31
Primary or latent infection of TB is where the individual has been .... does not have .... is .... and cannot transmit disease.
exposed active disease asymptomatic
32
Secondary infection or reinfection of TB is where the person has .... can ..... and is highly ... when there is close personal contact over a period of time.
active infection spread to others infectious
33
Process of primary infection of TB: When microbe first enters lungs it is .... by macrophages which produces local .... If cell-mediated immunity is adequate, a ... will be formed at the site of inflammation. With this, bacteria is .... by connective tissue. ....develops in the center. .... is formed which contains .... and it will be .... on radiogram. This ....may remain viable in a dormant stage for years. If cell-mediated immunity is inadequate, it will .... and destroy lung tissue which will progress to...
``` engulfed inflammation granuloma walled off necrosis tubercle live bacilli calcified calcified tubercle reproduce TB disease ```
34
Process of secondary or reinfection of TB: Occurs when .... which can be from ..., ..., ..., .... ....microbes invade or new infection occurs. Microbes begin to ... and infect lungs. They form large areas of .... which causes ..... and ..... ...is common. Cavitation promotes spreading into other parts of lung and infection may spread to ..... Symptoms or signs include:
``` cell-mediated immunity is impaired stress, malnutrition, HIV, age dormant reproduce necrosis cavitation erosion hemoptysis (blood in sputum) pleural cavity cough, low grade fever, night sweat, weight loss, fatigue ```
35
Diagnostic tests for TB are for .... and indicated by a positive Mantoux skin test which tests which type of hypersensitivity? Can often see ... on X-ray. For active infections of TB to diagnose one has to do .... or .... Treatment involves ... and .... with long-term treatment and a combo of drugs.
first exposure or primary infection Type 4 calcification stain sputum or chest radiography looking for cavitation sputum culture and sensitivity of microbes to drugs
36
Positive Mantoux TB test can occur if someone ...
currently has TB has been exposed in the past has received the BCG vaccine which is not administered in the U.S.
37
Asthma is a .... and occurs in persons with ...
bronchial obstruction | hypersensitive airways
38
Two types of asthma
extrinsic | intrinsic
39
Extrinsic asthma involves acute episodes triggered by ..... reaction to allergen. Intrinsic asthma involves .... tissue in airway which initiates attack.
type I hypersensitivity | hyperresponsive
40
Mechanism of Asthma: ....released from mast cells which produces a pathophysiologic change in .... It causes inflammation of ... with ...., bronchoconstriction due to contraction of ... and increased ... which obstructs airways either partially or totally.
``` histamine bronchi and bronchioles mucosa with edema smooth muscle cells secretion of thick mucus ```
41
Partial obstruction of airways produces .... | Total obstruction of airways leads to ...
air trapping and hyperinflation of lungs | atelectasis or non-aeration of tissue
42
Atelectasis
section collapses in the lung
43
Asthma manifestations
``` hypoxia respiratory alkalosis respiratory acidosis metabolic acidosis respiratory failure ```
44
When does respiratory alkalosis, acidosis, metabolic acidosis and respiratory failure occur in asthma?
initially due to hyperventilation due to decreased ventilation decrease in aerobic metabolism fatigue in respiratory muscles
45
COPDs
emphysema chronic bronchitis bronchiectasis
46
COPD is the ...in airways. This is ....tissue degeneration and is .... damage. Respiratory failure may occur due to ... and .... It may lead to development of cor pulmonale which is ...
``` obstruction progressive irreversible hypoxia and hypercapnia right sided HF due to lung disease ```
47
Emphysema is the destruction of ... due to the breakdown of ... This leads to ....air spaces in alveoli. Contributing factor is a deficiency in ...
alveolar walls elastin large, permanently inflated alveolar air spaces alpha1 antitrypsin
48
Alpha1 antitrypsin is a ... inhibitor. It inhibits .... | When there is a deficiency what happens?
protease elastase genetic mutation damage of it
49
Elastase is ..., ...., ...
enzyme that destroys elastin released by neutrophils during inflammation released by some pathogenic bacteria
50
Emphysema changes the lungs by
loss of pulmonary capillaries surface area of gas exchange small bronchi collapsing fibrosis and thickening of bronchial walls (narrowed airways)
51
A loss of elastic fibers in the lungs affects.... Loss of surface area for gas exchange and pulmonary capillaries alter... Narrowed airways interferes with...
lung recoil during expiration ventilation-perfusion ratio expiratory airflow
52
In emphysema there will be a progressive difficulty with .... which means there will be air ...., increase in ....volume, ... of lungs, .... of ribs in an inspiratory position, increased .... of thorax, and ...diaphragm on radiograms.
``` expiration trapping residual overinflation fixation anterior-posterior (barrel chest) flattened ```
53
Signs and symptoms of emphysema
dyspnea even at rest hyperventilation with prolonged expiratory phase pink puffers (hyperventilation and pink face color) Clubbed fingers secondary polycythemia fatigue, weight loss
54
Chronic bronchitis is a disease from .... The damage is .. and ...
smoking, air pollutions | irreversible and progressive
55
Changes in bronchi with chronic bronchitis?
mucosa is inflamed and swollen hypertrophy and hyperplasia of mucous glands (increased production of mucous secretions) fibrosis and thickening of bronchial wall low blood O2 levels
56
Signs and symptoms of chronic bronchitis
``` dyspnea frequent thick and purulent secretions constant productive cough hypoxia hypercapnia fatigue weight loss ```
57
Emphysema is known as ..... and chronic bronchitis is known as ...
pink puffers | blue bloaters
58
Bronchiectasis is ... Usually secondary to .... Arises from .... Leads to .... of muscle and elastic fibers in bronchial walls which .... them. ....is accumulated and areas become ....
permanent dilation of medium-sized bronchi cystic fibrosis or COPD, childhood infection or congenital weakness of bronchial wall recurrent inflammation and infection weakening dilates fluid infected
59
Bronchiectasis signs and symptoms
chronic cough | production of large amounts of purulent foul-smelling sputum
60
Restrictive lung disorders are a group of disorders with .... and reduced ... Two groups: First group has .... of chest wall which .... examples: Second group is caused by .... affecting the supporting framework of lungs not alveoli or airways. Example:
``` impaired lung expansion total lung capacity abnormality limits or impairs lung expansion kyphosis or scoliosis, polio, ALS, botulism, muscular dystrophy diseases idiopathic pulmonary fibrosis ```
61
Pneumonconioses is a .... lung disorder. It is ... and results from .... to irritating particles like ..., ... ,.... Inflammation leads to development of ... and loss of .... of lungs. Onset is ... where ... develops first.
``` restrictive chronic long-term exposure asbestos, coal dust, silica, fungal spores fibrosis functional areas insidious dyspnea ```
62
Vascular disorders include
pulmonary edema | pulmonary embolism
63
Pulmonary edema, fluid accumulates in ... it can result from many primary conditions like..., ..., ..., ... It reduces ...of oxygen in blood and interferes with .... as a result of reduced surfactant.
``` alveoli and interstitial area left sided HF leading to pulmonary HBP hypoproteinemia (due to liver or kidney disease) inflammation of lungs blockage in lymphatic drainage diffusion lung expansion ```
64
Why does left sided HF and pulmonary hypertension lead to pulmonary edema?
increases in hydrostatic capillary pressure.
65
Why does hypoproteinemia lead to pulmonary edema?
decreases in osmotic pressure of plasma
66
Why does inflammation in lungs result in pulmonary edema?
increases in permeability of capillaries
67
Signs and symptoms of pulmonary edema
``` cough orthopnea rales hemoptysis frothy, blood-tinged sputum ```
68
Expansion disorders
``` atelectasis pleural effusion pneumothorax ARDS acute respiratory failure ```
69
Atelactasis is ..... Alveoli become .... and collapse caused by ... or ... It leads to ... in gas exchange and ... It interferes with .... through the lung. Both ... and ... are altered.
``` nonaeration or collapse of lung or part of lung airless inflammation or atrophy decreased hypoxia blood flow ventilation and perfusion ```
70
Mechanisms of atelactasis
``` obstructive or resorption compression due to increased surface tension contraction postoperative ```
71
Compression atelectasis
mass/tumor exerts pressure on part of the lung
72
Increased surface tension of alveoli
prevents expansion of lung
73
Contraction atelectasis
fibrotic tissue in lungs or pleura may restrict expansion and lead to collapse
74
Pleural effusion is the presence of ... which causes increased .... , ... of pleural membranes and ... cohesion during inspiration.
excessive fluid in pleural cavity pressure separation decreased
75
Transudative effusions are ... effusions or .... | They result from ... in hydrostatic pressure and .... in osmotic pressure.
watery hydrothorax increase decrease
76
Exudative effusions contain ... and ... and respond to ....
proteins WBCs inflammation
77
Pneumothorax is ....in pleural cavity and leads to... | It can be a .... pneumothorax or a ....or a...
``` air atelectasis closed simple or spontaneous open ```
78
Closed pneumothorax air can... | Simple or spontaneous...
enter pleural cavity from internal airways--no opening in chest wall. tear on surface of the lung
79
Open pneumothorax is ....
atmospheric air enters pleural cavity through and opening. "sucking wound"
80
Secondary pneumothorax is associated with .... it can be a rupture of .... on lung surface ...by a tumor ....cavitation
underlying respiratory disease emphysematous bleb erosion tubercular
81
Tension pneumothorax is the .... form. It results from ... or .... pneumothorax. With each respiration, air ... in pleural cavity. Increase in pleural pressure =
most serious closed or open accumulates atelectasis
82
ARDS or Adult (acute) respiratory distress syndrome
shock lung or wet lung or stiff lung | results from injury to alveolar wall and capillary wall
83
ARDS' injury to alveolar wall leads to ... which increases permeability of capillary wall, increases ... and ... in interstitial area and alveoli and damages ....producing cells.
release of chemical mediators fluid and protein surfactant-producing
84
Most common presdisposing condition for ARDS
sepsis
85
ARDS signs and symptoms
``` dyspnea restlessness rapid, shallow respiration increased HR decreased PO2 combo of respiratory and metabolic acidosis ```
86
Acute respiratory failure is the ... of many pulmonary conditions. May be from what disorders? Blood gases are .... PaO2 and ...PaCO2. Respiratory arrest may follow.
``` end-result emphysema acute respiratory disorders many NM diseases Combo of chronic and acute disorders decreased increased ```
87
Two types of broad lung cancers
small cell | non-small cell
88
Small cell lung cancer comes from..
oat cells
89
Non-small cell includes
squamous cell | adenocarcinomas
90
Large cell carcinoma is regarded as
everything else
91
Squamous cell carcinoma = | from ... cells that fill-in cells after epithelium is damaged.
epithelial cells | reserve
92
Adenocarcinomas= | ...cell carcinomas
mucus producing cells | bronchoalveolar

Pathophysiology (20 decks)

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