Respiratory Disorders Flashcards
Respiratory pathologies
Obstructive
restrictive
suppurative
Chronic bronchitis
Hypertrophy of mucus glands increasesd mucous secetion Chronic inflammatory changes Initial pathology in small airways Small airways narrow Increased wall oedema Granulation and fibrosis abandons blood gases
less breathless oedematous higher mortality poor gas exchange lots of sputum
Emphysema
Affects parenchyma distal to terminal bronchiole (acinus) Alpha1- antitrypsin deficiency Excess lysosomal elastase Enlargement of air spaces Loss of alveolar walls Destruction of capillary bed Small airways narrowed Thin atrophied walls compressed ducts compressed alveolar sacs Emphysematous Bullae Damaged alveolus- new air cant enter old air cant leave near normal blood gases
intense breathlessness
no oedema
longevity
scant secretions
Decreased work of breathing
Loss of alveolar septa
during expiration airways close sooner
air trapping (passive hyperinflation)
patient needs to maintain hyperinflation to keep airways open (dynamic hyper inflammation)
due to obstructed airways air is further trapped
intrinsic peep
hinders cardiac output and lung perfusion
decreased lung compliance
COPD symptoms
fatigue respiratory infections use of accessory muscles to breathe ortopneic cor pulmonate thin appearance wheezing pursed lip breathing chronic cough barrel chest dysphnea prolongs expiratory time bronchitis increased sputum digital clubbing
Clinical features
Insidious onset Morning cough with sputum Decreased exercise tolerance Fatigue Disturbances in sleep SOB and wheeze Secretions present on most days during the winter months Image result for central cyanosisseorank.info Cyanosis (bluish discoloration)
Lung inflammation
goblet cells proliferate
increased mucous production
death of airwat epithelium cililated cells
mucas trapped in airways serve as nidus for infection
Pneumonia
aeCOPD
Airway obstruction decreased inhaled air in alveoli and terminal bronchioles
decreased oxygenation of blood passing through lungs
chronic hypoxemia
kidneys compensate by increasing erythroproetin EPO production
increase hemoglobin and RBC synthesis
Polycythemia
hypoxic alveoli cause the pulmonary arterioles perfusing them to reflexively vasonconstriction across the entire lung increases BP within lung vasculature Pulmonary hypertension increased Workload of right ventricle hypertrophies and dilates to compensate overtime output decreases Cor pulmonale (right heart failure)
Rupture pf emphasematous bullar on surface of lung
inhaled air leaks into pleural cavity and becomes trapped
pneumothorax
Depression
loss of control
hopelessness
dyspnoea
respiratory impairment dyspnoea during moderate exertion abstention from exercise physical deconditioning dyspnoea during mild exertion further abstentation further deconditoning dyspnoea during ADLs
Treatment goals
improved quality of life
symptoms relief
management- pulmonary rehabilitation
reduced airway obstruction
drug therapy
education
breathing control
prevent and treat complication
prolong life
treatment options
self management education and smoking cessation bronchodilators inhaled corticosteroids pulmonary rehabilitation oxygen surgery
Asthma
chronic airway inflammation, narrowing of airways bronchoconstriction of the smooth muscle in the bronchi wall hypersecretion of mucous greater restriction to airflow .
Emphysema
over inflation of alveoli reduction in gasses exchange at the alveoli as decreases surface area for diffusion and increased thickness of exchange surface, muscle fatigue and flattened diaphragm
