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EXAM 2: Pathophysiology > respiratory disorders (pt 1) > Flashcards

respiratory disorders (pt 1) Flashcards

Compare and contrast etiologies, pathophysiology, and manifestations of various respiratory infections/diseases (influenza, pneumonias, tuberculosis, & lung cancer). Describe differences in respiratory illness in small children (laryngeotracheobronchitis, epiglottitis, & bronchiolitis). Differentiate between disorders of lung inflation (pleural effusion, pleural abnormalities, pneumothorax, & atelectasis).

1
Q

what is the main function of the lungs?

A

exchange of O2 and CO2

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2
Q

what are the 4 components of gas exchange?

A

system of open airways

expansion of the lungs

adequate SA for gas diffusion

adequate blood flow through capillary bed

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3
Q

INFLUENZA
influenza ___ + ____ are seasonal, whereas ___ is just a cold

one of the most common causes of ______ respiratory tract infections

risk ____________ with kids and older adults

A

A, B
C
acute
increases

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4
Q

INFLUENZA: manifestations (8)

A

fever and chills
muscle aching
headache
nasal discharge
nonproductive cough
sore throat
GENERAL MALAISE
viral pneumonia (as a complication)

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5
Q

INFLUENZA:
etiology
patho

A

E: virus (inhalation of droplets)

P: upper airway infection = targets and kills mucous-secreting (defense), ciliated (moves mucous) and other cells

essentially, can’t cough up secretions/bacteria

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6
Q

PNEUMONIA
inflammation of _______ and ________ (______ resp)

A

alveoli, bronchioles
lower

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7
Q

PNEUMONIA
Etiology (5)

A

infectious or noninfectious agents (viral and bacterial*) (aspiration: fluid/gastric/bacteria)

community acquired: outside of healthcare

hospital-acquired: not present on admission (intubation)

immunocompromised: opportunistic (cancer, transplant, immunosuppressed)

streptococcus: inc the cause of bacterial

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8
Q

PNEUMONIA
Pathophysiology: (4 parts)

A

colonization of pathogen =
inflammation (bronchial alveolar/membranes break down) =
fluid accumulation in alveoli =
impaired gas exchange

lower lungs

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9
Q

PNEUMONIA
manifestations (8)

A

SOB
increased sputum production
pleuritic pain (sharp pain w inhale/cough)
cough
signs of infection

chest x-ray (see infiltrates)
sputum culture
crackles (esp in lower lobes)

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10
Q

TUBERCULOSIS
infection caused by ____________ tuberculosis

A

mycobacterium

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11
Q

TUBERCULOSIS
Etiology: (1)
Patho: (5 parts)

A

E: airborne droplets (travel and stay for a long time = contagious)

P: inhalation of bacillus = cell-mediated immune response = T cells stimulate macrophages (engulf bacteria, don’t kill) = kept in granuloma = ghon focus lesions (latent)

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12
Q

TUBERCULOSIS
primary: (1 part)
secondary: (2 parts)

A

1: develops in previously unexposed person and becomes dormant // asymptomatic/latent

2: reinfection with TB breaks open ghon lesions and spreads to blood/lungs OR impaired immune system = symptomatic

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13
Q

TUBERCULOSIS
manifestations (4)

A

fever
night sweats
productive cough or hemoptysis
anorexia

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14
Q

what does surfactant do?

A

lines the inside of alveoli to keep them from collapsing with exhalation

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15
Q

what is the most common cause of cancer death?

A

lung cancer

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16
Q

LUNG CANCER
risk factors (3)
pathophysiology (

A

RF: cigarette smoke, asbestos, genetic predisposition

P: normal cells => malignant (metaplasia turns to carcinoma)

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17
Q

LUNG CANCER TYPES:
non-small cell: (3)

A

adenocarcinoma: most common, non-smokers, women

large cell

squamous

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18
Q

LUNG CANCER TYPES:
non-small cell: ADENOCARCINOMA
prevalence:
population:
location:
growth:

A

most common overall
non-smokers, young adults, women
start in outer alveoli glands
slow growing

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19
Q

LUNG CANCER TYPES:
non-small cell: SQUAMOUS
prevalence:
population:
location:
growth:

A

25-30%
smokers and men
central/bronci
moderately fast, local spread

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20
Q

LUNG CANCER TYPES:
non-small cell: LARGE CELL
prevalence:
population:
location:
growth:

A

10-15%
smokers
mostly peripheral or central
rapid growth and metastasis

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21
Q

LUNG CANCER %’s
small cell:
non-small cell:

22
Q

LUNG CANCER TYPES:
SMALL CELL
prevalence:
population:
location:
growth:

A

15%
SMOKING (strongest link)
Central (near bronchi)
very aggressive early metastasis

23
Q

LUNG CANCER: manifestations (4)

A

asymptomatic until very advanced

local irritation and obstruction of the airway: SOB, cough, higher risk for lower resp infection

24
Q

lung cancer easily metastasizes because the ________ system is closely intertwined

25
what are the most common causes of illness in infancy/childhood? why?
acute respiratory disease immune systems are'nt very strong small airways
26
RESP ILLNESS IN CHILDREN upper airway infections (2)
laryngeobronchitis (viral croup) epiglottitis
27
RESP ILLNESS IN CHILDREN lower airway infections (1)
acute bronchiolitis aka RSV
28
RESP ILLNESS IN CHILDREN: croup Cause: patho: (4) age group: onset features: (3)
parainfluenza virus infection = mucosal edema = upper airway obstruction = increased work to breathe (WOB) 3 months to 5 years gradual stridor, barking cough, lowgrade fever (@ night)
29
RESP ILLNESS IN CHILDREN: epiglottitis Cause: patho: (3) age group: onset: features: (10)
C: bacterial (strep, S. aureus, S. pneumoniae) P: infection = inflammation = airway obstruction A: 2 - 6 yrs O: sudden and rapid F: pallor, dysphagia, muffled voice, drooling, fever, extreme anxiety, irritability, stridor, nasal flaring, suprasternal notch retractions
30
RESP ILLNESS IN CHILDREN: bronchiolitis (RSV) Cause: patho: (6) age group: onset features: (6)
C: VIRAL (RSV) P: infection = inflammation and edema = obstruction of small airways = necrosis in lower airways = air trapping = ventilation issues A: younger than 2 O: gradual F: wheezing/crackles/rales tachypnea, cough, increased EXPIRATORY effort, breathlessness, retractions
31
why does intrapleural pressure have to be negative?
keeps the lung from collapsing
32
LUNG INFLATION DISORDERS: pleural effusion Etiology: (4) patho: S/S: (4)
E: bacterial, viral, pulmonary infarction, malignancies P: abnormal collection of fluid in the pleural activity M: crackles/diminished, SOB, pleuritic pain, hypoxemia (d/t dec SA)
33
abnormal collection of fluid in the pleural activity
pleural effusion
34
PLEURAL EFFUSION: types of fluid transudate: exudate: parapneumonic: empyema: chylothorax:
T: clear, with heart/kidney failure or malignancy E: opaque fluid with inflammatory cells from infection P: common, d/t bacterial infection E: infection C: milky. lymph fluid, trauma, inflammation, malignancy
35
LUNG INFLATION DISORDERS: spontaneous pneumothorax E: P:
E: without cause/injury P: air-filled blood/blisters on the surface of the lung rupture = air enters pleural cavity = pressure equalizes = lung collapses = ventilation/perfusion mismatch = impared gas exchange (hypoxia)
36
LUNG INFLATION DISORDERS: tension pneumothorax E: P:
E: severe truama or infection = inc pressure in pleural cavity (heart and lungs affected) P: air can enter pleural space, but not exit = progressive air accumulation = intrathoracic pressure pressure = compression of collapsed lung = mediastinum shift = compressed great vessels = decreased venous return = obstructuve shock + cardiac arrest
37
LUNG INFLATION DISORDERS: trauma pneumothorax E: P:
E: direct injury to chest area // penetrating (broken ribs or stab, GSW) or non-penetrating (fall, bast, or MVA) P: lung injury = air enters pleural space = loss of neg. pressure = lung collapse = hypoxia
38
LUNG INFLATION DISORDERS: pneumothorax manifestations (7)
pain SOB tachypnea absent/diminished breath sounds tachycardia hypotension subcutaneous emphysema
39
LUNG INFLATION DISORDERS: pleuritis ?/P: E: (3) M: (3)
?: inflmmation of the pleura E: viral/bacterial infection, autoimmune, trauma M: sharp pleuritic CP (worse with deep breaths/cough) (usually bilateral), pleural friction rub, localized tenderness
40
LUNG INFLATION DISORDERS: pleuritis ?: E: (3) P: (3) M: (5)
?: incomplete expansion of the lung E: airway obstruction, lung compression, increased recoil of lung (d/t loss of surfactant) P: primary with newborn ( lung never inflated (lack of surfactant d/t premature b4 25-28 wks or gestational DB) secondary (NB's establish a resp sys and then develop impaired expansion) or acquired (adults, airway obstruction) M: tachypnea tachycardia dyspnea diminished lung sounds diminished chest expansion
41
OBSTRUCTIVE AIRWAY DISORDERS asthma RF: E: (2 types) P: M: (6)
RF: chronic disorder of the airway RF: COPD, severe infections, smoking, allergies E: atopic (intrinsic: allergen exposure, type I) OR non-atopic (extrinsic: infection, exercise, stress, hyperventilation) P: type 1 hyperresponsiveness (acute + late phase) M: tachypnea dyspnea + cough chest tightness wheezing (expiratory) accessory muscle breathing severe symptoms d/t respiratory acidosis
42
OBSTRUCTIVE AIRWAY DISORDERS asthma acute phase patho
primarily bronchoconstrictive
43
OBSTRUCTIVE AIRWAY DISORDERS asthma late phase patho
mucous and edema
44
OBSTRUCTIVE AIRWAY DISORDERS chronic obstructive pulmonary disease ?: RF (3) E (1) P (4 parts) M (3)
?: chronic recurrent obstruction of airflow in the pulmonary airways RF: chronic cough, sputum, SOB E: Smoking P: inflammation and fibrosis of the bronchial wall + hypersecretion of mucous = loss of elastic lung fibers and alveolar tissue = obstructed airflow and mismatch of ventilation and perfusion M: cough, sputum, SOB, fatigue, exercise intolerance, frequent exacerbations
45
OBSTRUCTIVE AIRWAY DISORDERS + COPD emphysema ? RF (2) E (2) P (6) M (4)
?: enlargement of airspaces and destruction of lung tissue RF: genetics (small %), repeated exposure (smoking) E: breakdown of elastin by proteases + tissue damage = inflammation P: irritant exposure = inflammatory response = release of proteases = elastin and fiber breakdown = destruction of alveolar walls + air trapping M: pink puffer = no cyanosis pursed lip breathing cough mucous barrel chest
46
OBSTRUCTIVE AIRWAY DISORDERS + COPD chronic bronchitis ? (1) RF (3) E P (4 parts) M (5)
?: increased mucous production and obstruction of the major and small airways RF: smoking, recurring infections, chronic hypoxemia E: chronic irritation (bronchi are always swollen with mucous) P: irritant exposure = bronchial inflammation = increased mucous production = frequent infections M: blue bloater = cyanosis chronic productive cough (3+ mnths) exercise intolerance CP and SOB
47
what is air trapping?
air becomes trapped in the lungs due to incomplete exhalation, leading to hyperinflation of the lungs
48
OBSTRUCTIVE AIRWAY DISORDERS cystic fibrosis (CF) ? RF E P (4 parts) M
?: autosomal recessive disorder RF: family history E: single gene mutation P: impaired Cl transport = increased Na/H2O absorption = abnormal thick and sticky resp tract secretions = airway obstruction M
49
OBSTRUCTIVE AIRWAY DISORDERS interstitial lung disease ?: RF: E: (2) P: (4 parts) M: (5)
?: stiff non-compliant lung RF: E: acute/insidious onset, inflammatory conditions P: injury to alveolar epithelium = inflammatory response = inflammatory and immune cells accumulate and cause damage to lung tissue = replacement of normally functioning lung tissue w fibrous scar tissue M: dry cough, tachypnea, dyspnea, cyanosis, no wheezing or indication of airway obstruction
50
PULMONARY EMBOLISM ? P M
?: develops when a blood-borne substance lodges in the pulmonary artery P: bloodborne substance breaks off and travels to BVs in the lung M: depends on size and location, wide range from asymptomatic to CV collapse
51
PULMONARY HYPERTENSION ? P M
?: elevation of pulmonary circulation pressure P: pulmonary a narrows = increase in RV pressure = right-sided heart failure M: SOB, fatigue, CP, dizziness
52
ACUTE RESPIRATORY FAILURE ? P (2 kinds) M (3)
?: failure in gas exchange d/t heart and/or lung failure P: hypoxemic respiratory failure (ventilation/perfusion mismatch and impaired diffusion) hypercapnic/hypoxemic resp failure (decreased resp drive = resp acidosis = cerebral vasodilation and hypoxia) M: signs of hypoxemia, acidosis, compensation

EXAM 2: Pathophysiology (7 decks)

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