Respiratory Disorders Flashcards

Question

Small Lung Cell Cancers

Answer 1

Rare to do surgery after diagnosis Highly malignant Tumors arise from the neuroendocine cells of the bronchial epithelium Grow in clusters and may be able to secrete hormonally active product Highest associated with smoking Often metastasized on diagnosis Paraneoplastic syndrome - SIDAH Total 2yr survival is 20-40%

Answer 2

Central bronchi - diagnosed with sputum culture Common in men and smokers Metastasizes slower than others Paraneoplastic syndrome - hypercalcemia

Answer 3

Bronchiolar and alveolar Common in women and non smokers Pleural fibrosis and scarring Poorer prognosis than squamous - easy metastasis Paraneoplastic syndrome - hematologic disorders

Answer 4

Periphery of the lung Hard to diagnose Poor prognosis; spreads early

Answer 5

Cough, wheeze, SOB Anorexia, weight loss Hemoptysis Dull pain increasing with invasion into pleura Hoarseness - laryngeal nerve involvement SVC syndrome - tumors compression of superior vena cava interrupting blood flow Pleural effusion Metastasis to brain, bone, liver Paraneoplastic syndromes

Answer 6

Not related to metastasis - caused by substances secreted by the tumor Weakness and wasting of proximal muscles - pelvic and shoulder girdles Anorexia Cachexia Fever Hypercalcemia Hematology disorders - DIC, migratory thrombophlebitis

Answer 7

Inadequate amount of 02 Disease of the respiratory system Dysfunction of the neurological system Alterations in circulatory function Produces it effects through tissue hypoxia - compensatory mechanisms to adapt Hypoxia with 99% o2 sat due to severe anemia Cyanosis without sign and symptoms of hypoxemia due to too much Hgb

Answer 8

Cyanosis Tachycardia Vasoconstriction - increase in BP Personality changes, restlessness, uncoordinated muscle movements, euphoria, impaired judgement, delirium, stupor, coma Chronic - increased ventilation, pulmonary vessel vasoconstriction, increased production of RBC

Answer 9

``` Hypoventilation Mismatching of ventilation and perfusion Increase in metabolic rate and high carbohydrate diet Activity Fever Disease ```

Answer 10

Acid base balance problems Kidney, NS, and cardiovascular function Respiratory depression and altered mental status

Answer 11

Compression of lung by fluid accumulation = pleural effusion Complete or partial collapse due to air in the pleural cavity = pneumothorax Collapse of a segment of the lung = atalectasis

Answer 12

abnormal collection of fluid in the pleural cavity Capillaries filter into parietal space Interstitial spaces in lungs and peritoneal cavity Transudate: hydrothorax - CHF, renal failure, nephrosis, liver failure Exudate: bacterial pneumonia, viral infection, pulmonary infection Purulent: empyrean - infection of the pleural cavity Chyle: chylothorax - milky lymph fluid accumulation - trauma, inflammation malignancy Sanguineous: hemothorax - aneurysm rupture, injury, surgery

Answer 13

``` Decreased Lung expansion Dullness on percussion Diminished breath sounds Hypoxemia may occur Dyspnea Tachypnea Pleuritic pain, WBC increase, fever ```

Answer 14

Air in the pleural space causing partial or complete lung collapse SOB Dyspnea Hypoxemia Ipsilateral = affected side

Answer 15

Rupture of an air filled bleb on the surface of the lung Allows atmospheric air to enter the pleural cavity and lung collapses of its own recoil Primary - healthy person; non smoker Secondary - underlying lung disease (emphysema, asthma, TB, sarcoidosis, CF) ``` ipsilateral chest pain Tachypnea Dyspnea Asymmetry of the chest Hyper-resonant percussion Decreased or absent breath sounds over area of pneumothorax ```

Answer 16

Penetrating or non penetrating chest injury Fractured or dislocated ribs that penetrate the pleura - hemothorax may accompany Medical procedures, central line insertion, intubation, CPR complication

Answer 17

Intrapleural pressure becomes greater than atmospheric pressure Air can enter but cannot leave Complication of mechanical ventilation Laceration of lung and pressure on SVC - cardiac and respiratory compromise Pleural space increases in size, mediastinum compression, tracheal shift, pressure on SVC

Answer 18

Pleuritic pain with abrupt onset Causes Viral infections Pneumonia Pain characteristics Unilateral Pain with DB May be referred to shoulder

Answer 19

Musc - bilateral, worse with movement and associated with contraction Bronchi - substernal, dull, worse with coughing, not affected by DB Myocardial - substernal, not affected by respirations

Answer 20

Incomplete expansion of the alveoli Causes Obstruction - anaesthesia, limited mobility, low hydration Compression - pt lying in bed, pneumothorax, pleural effusion Increased recoil - loss of surfactant Primary - lung have never fully expanded Secondary - aspiration of amniotic fluid Acquired - obstruction

Answer 21

``` Tachypnea Dyspnea Cyanosis Hypoxemia Absence of breath sounds Diminished lung expansion Intercostal retractions ```

Answer 22

Chronic inflammatory airway disorder of the pulmonary airways Not the upper airways ``` Exaggerated by hypersensitivity response Seasonal Exercise induced Drug induced Occupational ``` Bronchoconstriction, increased permeability, increased mucous production

Answer 23

Exposure to allergen, T helper stimulates B cell to differentiate in to IgE producing plasma cells IgE pairs up with allergens and binds to mast cells which release histamine Inflammatory mediators released by activated immune cells Extrinsic - type one hypersensitivity Intrinsic - no allergen component

Answer 24

Extrinsic allergen or antigen Genetic predisposition to the development of an immediate hypersensitivity reaction to common antigens Can be triggered by intrinsic factors Childhood exposure Genetics Other allergies

Answer 25

Early phase Chemical mediator release from presensitized IgE mast cells Histamine, interleukins, prostaglandins = mucosal edema, bronchospasm, wheezing, cough, dyspnea Parasympathetic response = increased permeability and mucous Late phase Inflammation and increased airway responsiveness; mediators continue to be released Epithelial damage, edema, changes in mucocilliary function, decreased clearance of secretions, increased airway responsiveness

Answer 26

``` Respiratory infection Exercise Inhaled irritants Emotions Hormones GI reflux Aspirin and NSAIDs ```

Answer 27

``` Accessory muscles SOB Dyspnea Fatigue Hypoxemia and hypercapnia Wheeze Cough Chest tightness Tachypnea Anxiety Tachycardia and increased BP Status asthmatics Respiratory failure ```

Answer 28

``` Smoking Heredity Occupational dust and chemicals Airway infections Asthma and airway hypersensitivity ```

Answer 29

Major and small airways Increased mucous production and chronic productive cough Inflammation and obstruction of the major and small airways Risk factors: smoking, men, middle age, recurrent respiratory infection Hypersecretion in large airways Hypertrophy of submucosal glands in trachea and bronchi in response to toxins Inflammation infiltration Fibrosis of bronchial wall

Answer 30

Chronic productive cough Blue bloater - hypercapnia, hypoxemia, polycythemia and right sided HF leading to fluid retention Pursed lip breathing Tripod position

Answer 31

Small airways Enlargement of airspaces and destruction of lung tissue Inflammatory response release pro teases that digest elastin and alveolar walls = loss of lung elasticity and enlargement of distal spaces Slowly debilitating with acute exacerbates Risk factors: smoking, hereditary deficits in antitrypsin

Answer 32

Barrel chest Weight loss Pink Puffer - lack of cyanosis, use of accessory muscles, pursed lip breathing Decreased breath sounds Diaphragmatic fatigue and acute respiratory failure

Answer 33

Blood borne substance lodges in branch of pulmonary artery Thrombus injected during IV infusion or DVT or oral contraceptives Fat mobilized from bone marrow after fracture Amniotic fluid entering maternal circulation after childbirth

Answer 34

Most arise from a DVT Reflex is bronchoconstriction in the affected area Ventilation without perfusion Impaired gas exchange loss of alveolar surfactant Pulmonary HTN and rt sided HF may result

Answer 35

``` Dyspnea Tachypnea Pleuritic pain Cough Sanguinous sputum Hypoxemia Tachycardia Angina Anxiety Fever Loss of consciousness Tripod position ```

Answer 36

Causes rt sided HF secondary to respiratory disease (pulmonary HTN) ``` Decreased lung ventilation Pulmonary vasoconstriction Increased workload on rt heart Decreased oxygenation Kidney releases erythropoietin = more RBC = polycythemia = blood more viscous Increased workload on the heart ``` Constriction to raise pulmonary vasc Back pressure from lungs increase heart workload on rt heart from vena cava