Respiratory Disorders: Pneumonia Flashcards
What is pneumonia? What’s another name for it?
Inflm of the lung
Pneumonitis
Pneumonia occur in the ______ resp tract. What structures?
lower resp tract
alveoli and bronchioles = finer a/w
T or F: Pneumonia is always infectious.
F: infectious or non-infectious
Pneumonia is the most common ________ _______
nosocomial infection
Etiology of Pneumonia (4)
- several microbe
- usually bacteria
- noxious fumes
- aspiration
What microbes cause pneumonia? What bacteria commonly cause pneumonia?
bacterias, viruses, or fungi
streptococcus pneumoniae
Example of noxious fumes.
toxic fumes from a fire causing damage when inhaled
What is aspiration? Example?
anything besides air getting into the lungs
Ex: inhaling water into the lungs causing damaging effects or gastric content
What are the two classifications of Pneumonia?
- infectious
2. non-infectious
What are the types of infectious pneumonia? (3) Explain. Which one is most common?
- pneumococcal (most common): refers to bacterial colony
- community acquired: acquired from people in the community
- nosocomial: acquired in the hospital setting esp immunocompromised elders
What is an example of non-infectious pneumonia?
Aspiration Pneumonia–> caused by anything but air such as inhaling toxic fumes
Patho: Mucociliary blanket compromised. What is it? How does it work?
The mucociliary blanket is a thin film lining the surface of epithelial cells in the a/w that contains cilia and goblet cells producing mucus providing a defense mechanism.
Cilia beats synchronously in the opposite direction to airflow in order to expectorate mucus containing foreign debris.
If compromised, bacteria and foreign debris enter the lungs
What can compromises mucociliary blanket or what group of individuals have compromised mucociliary blanket? (3)
immunocompromised individuals, trauma, and smoking
What makes the lung an ideal place for bacteria?
Injurious agents _______ and _______ when it get into the lungs of individuals with compromised mucociliary blanket.
Environment is warm and moist
establishes
proliferate
What is impaired after bacteria establish and proliferate in the LRT?
infection establishes in LRT–> inflm–> edema–>impaired gas exchange
How is gaseous exchange (GE) impaired?
- edema –> increase prod. of exudate–> obstructs a/w–> impede GE between alveoli and capillaries
What is GE?
GE = inhaled oxygen moves from the alveoli to the blood in capillaries, and carbon dioxide moves from the blood in the capillaries to the air in the alveoli.
OR
O2 moves from lung to bloodstream and CO2 moves from bloodstream to lungs
How does edema affect alveoli? Explain Alveoli.
Alveoli have thin layer of fluid lining the surface in which gas diffused into or out of the blood or alveoli
W/ edema, the layer increases and become thicker –> increase diffusion distance
What are the four stage of pneumococcal pneumonia? Explain the main actions in each.
- edema–> increase proteins + microbes
- red hepatization –> RBC, PMN, and capillary congestion
- grey hepatization–> phagocytosis
- resolution
Explain the first stage of Pneumococcal Pneumonia. What kind of exudate is occuring.
Purulent exudate containing lots of proteins (eg antibodies), fluids and cells, and microbes, and pneumococci.
In this stage, alveoli become filled with protein-rich edema fluid containing numerous organisms.
Explain the second stage of Pneumococcal Pneumonia.
Marked capillary congestion, leading to massive outpouring of polymorphonuclear (PMN) leukocytes and RBC.
Defense cells activate when microbes proliferate.
PMN ingest bacteria and cause damage to capillaries
Why is the 2nd stage called red hepatization?
Red is d/t the presence of erythrocytes in alveoli from inflm, hyperemia, and exudate.
Hepatization is d/t the affected part of lung resembling the consistency of liver –> soft and flaccid
What is PMN leukocytes?
polymorphonuclear leukocytes is a group of leukocytes that have polymorphous nuclei –> nucleus have different shapes (eg trilobular)
What is typical pneumonia? Example? Explain the effects on alveoli.
Typical Pneumonia is caused by bacterial infection eg Pneumococcal Pneumonia.
When bacteria proliferate, it takes up space in alveoli (where there are least resistance) causing inflm and exudation and fluid into air-filled spaces
What is Atypical Pneumonia? Explain effect on alveoli. Where is it confined?
Atypical Pneumonia is caused by viral and mycoplasma infections but there is a lack of alveolar infiltration = empty alveoli.
largely confined to the alveolar septum and pulmonary interstitium
Viruses must get into host cells to replicate but bacteria replicate anywhere.
What is lobar pneumonia?
refers to the consolidation of part or all of a lung lobe
What is a bronchopneumonia?
refers to a patchy consolidation involving more than one lobe
granules are inflamed
What is consolidation in the lungs?
Air-filled sac is replaced with fluids that has been solidified
Manifestations of Pneumonia (4)
- dyspnea
- productive cough
- pleuritic pain
- elevated fevers
Manifestations are _____ and have ______ variation
- acute
2. wide
What is benefits of productive coughs?
body is able to remove exudate by coughing and bring up expectorate eg sputum and clear the a/w
What is the speed of air when coughin?
One cough ranges from 100-160 km/hr on average
Why is the coughing reflex important?
protect against aspiration into tracheobronchial tree by bringing up whatever is lodged in the a/w
What is pleuritic pain? What does it refer to?
sudden and intense sharp, burning, and stabbing pain when inhaling and exhaling
refers to the pleura membrane
What is elevated fever?
Fever with a temperature higher than expected in general
Diagnosis of Pneumonia (3)
- hx and px
- chest x-ray
- sputum analysis
What is found in chest x-ray?
very ________ and most _____ approach
consolidation is present = solidification of fluids, microbes, inflm debris, exudate, or cells
revealing
direct
What is sputum analysis?
collect sputum sample to be analyzed to identify microbes
Treatment of Pneumonia (2)
- antibiotic if bacterial to eradicate bacteria
2. supportive
What is the 3rd stage of pneumococcal pneumonia? How long after stage 2 does this stage begin? Why is it grey?
arrival of macrophages that phagocytose PMN, RBC, inflm debris, and microbes.
2-3+ days after stage two (depending on tx)
Grey b/c there is less capillary congestion but still takes on the consistency of the liver (hence hepatization)
What is the 4th stage of pneumococcal pneumonia?
There ______ and _______ _______ is intact and are no longer ___________
individuals gradually makes a full recovery
defense and IR
compromised
