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Pathophysiology > Respiratory Dysfunction > Flashcards

Respiratory Dysfunction Flashcards

1
Q

What is tidal volume?

A

Amount of air that moves in and out of the lungs with each breath, 500 mL

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2
Q

What is residual volume?

A

Volume of air remaining in the lungs after maximal expiration, 1200 mL

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3
Q

What is the inspiratory reserve volume (IRV)

A

Maximum amount of air that can be inspired after reaching the end of a normal, quiet inspiration, 3000 mL

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4
Q

What is the expiratory reserve volume, (ERV)

A

Maximum amount of air that can be exhaled after reaching the end of a normal, quiet inspiration, 1100 mL

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5
Q

What is vital capacity

A

amount of air that can be exhaled from the point of maximal inspiration, 4600 mL

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6
Q

What is the formula for vital capacity?

A

IRV + TV + ERV

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7
Q

What is the inspiratory capacity

A

The amount of air a person can breathe in beginning at the normal expiratory level, 3500/3600 mL

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8
Q

What is the formula for inspiratory capacity

A

TV + IRV

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9
Q

What is the total lung capacity?

A

sum of all volumes in the lungs, 5800/6000 mL

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10
Q

What is the ratio for ventilation-perfusion?

A

V/Q

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11
Q

What is a low VQ

A

Shunting= decreased ventilation, normal perfusion

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12
Q

What is a high VQ

A

Dead air= normal ventilation, decreased perfusion

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13
Q

What are the mechanics of breathing?

A

Rise in carbon dioxide (CO2) stimulates medulla oblongata, efferent nerve impulses to diaphragm and intercostal muscles to contract.

Negative pressure in lungs which allows air to enter airways and alveoli. The lungs fill until the stretch receptors in bronchioles and bronchi send afferent nerve impulses to medulla.

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14
Q

What would happen if the impulses are turned off?

A

It allows the diaphragm and intercostal muscles to relax, which pushes air out of the alveoli and airways

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15
Q

What are mechanisms of defense?

A 
Constant temperature,
Nasal hairs & turbinates,
Mucous,
Macrophages,
Receptors
(Irritant
Stretch
J )
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16
Q

What is the difference between pulmonary ventilation and alveolar ventilation

A

Pulmonary ventilation is the total exchange of gases between the atmosphere and the lungs.
Alveolar ventilation is the transfer of gases within the gas exchange portion of the lungs

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17
Q

What is surfactant

A

surface tension-lowering molecules that line the inner surface of the alveoli

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18
Q

What two types of sensors or receptors are involved in automatic regulation of breathing

A

Chemoreceptors and

Lung and chest wall receptors

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19
Q

What do chemoreceptors do?

A

monitor blood levels of oxygen, carbon dioxide, and pH, adjust ventilation to meet the changing metabolic needs of the body.

Input –> sensors transmit to the respiratory center —> ventilation adjusts to maintain ABG within normal range

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20
Q

What do lung and chest wall receptors do?

A

They monitor the status of breathing in terms of airway resistance and lung expansion

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21
Q

What voluntary acts are examples of voluntary regulation of ventilation?

A

Speaking, blowing, singing

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22
Q

When acts such as speaking, blowing, and singing are initiated by the motor and premotor cortex, what happens?

A

It causes a temporary suspension of automatic breathing

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23
Q

What is the most common reason for HC visits/ admissions?

A

Respiratory Tract Infections

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24
Q

What resp tract infections are the 8th leading cause of death in US

A

Pneumonia and influenza

25
Q

What is one of the deadliest disease in the world?

A

Tuberculosis

26
Q

What is a significant act that can result in respiratory dysfunction and CA

A

Cigarette smoking

27
Q

What is pneumonia?

A

Infection of lower respiratory tract

28
Q

What is the etiology of pneumonia

A

bacteria, viruses, fungi, protozoa, parasites

29
Q

Pneumonia is the nth leading cause of death in US

A

8th leading cause

30
Q

What are the risk factors of pneumonia

A

old age, immunocompromise, alcoholism, LOC, smoking, immobility, endotracheal intubation

31
Q

What are the routes of infection

A

Aspiration: aspirate small amounts of organisms that colonized upper airways, inhalation

32
Q

What are the lines of defenses for pneumonia

A

Cough reflex: protect against aspiration into tracheobronchial tree
Mucociliary blanket: remove secretions, microorganisms, particles from respiratory tract
Alveolar macrophages: removes microorganisms and foreign particles from the lung
Immune defenses (IgA & IgG/ cell mediated immunity): destroy microorganisms

33
Q

Pneumonia is an example of what type of VQ

A

Low VQ because shunting= decreased ventilation but normal perfusion

34
Q

What are manifestations of bacterial pneumonia

A 
Fever,
Rust-colored/ blood-tinged sputum, 
Productive cough, 
pleuritic chest pain,
chills,
crackles
35
Q

What are manifestations of viral pneumonias

A

Usu mild and self-limiting, fever,
nonproductive cough, crackles,
wheezing

36
Q

How is tuberculosis spread

A

airborne infection, spread by droplet nuclei

37
Q

What is the primary cell infected with M. tuberculosis

A

Macrophages

38
Q

What is the pathogenesis of TB

A

Macrophages unable to kill organisms so they initiate a cell-mediated immune response that contains the infection, the bacilli multiplies but the infected macrophages degrade them then present antigens to helper T cells. The sensitized helper T cells stimulate macrophages to increase their concentration of lytic enzymes –> boosting ability to kill bacilli. When released, lytic enzymes damage lung tissue.

39
Q

Why does it take 3 to 6 weeks to become effective?

A

Development of cytotoxic T cells and macrophages ingest and destroy the bacilli = cell mediated immune response

40
Q

The cell mediated immune response results in what

A

development of gray-white circumscribed granulomatous lesion called Ghon focus

41
Q

What does the Ghon focus contain

A

Macrophages, T cells, Inactive TB bacteria (tubercle bacilli)

42
Q

Where is Ghon focus mainly located?

A

Subpleural area in the upper areas of lower lobes or in the lower are a of the upper lobe

43
Q

What happens when the number of organisms increase?

A

hypersensitivity reaction causes central portion of Ghon focus to become necrotic –> creating a soft, white cheese core of dead cells

44
Q

What also happens at the same time that the Ghon focus becomes necrotic

A

tubercle bacilli drain in the lymph channels to tracheobronchial lymph nodes of affected lung and cause granulomas

45
Q

What happens to the Ghon complex (lung lesion and lymph granuloma)

A

Heal, shrink, scar, visible in xrays

46
Q

What are the risk factors for TB

A

malnutrition, old age, immunocompromised, persons in homeless shelters/ crowded and confined conditions

47
Q

What percentage of people who inhale the organism actually develop TB

A

~5%

48
Q

What are the manifestations of active TB

A

chronic cough with blood tinged sputum, night sweats and fever, unexplained weight loss

49
Q

What is the diagnosis of active TB

A

X-rays, isolation, antibiotics, and resistance

50
Q

What are the manifestations of latent TB

A

Asymptomatic TB test
Cannot transmit disease
Can turn active tho

51
Q

What is secondary TB

A

reinfected or suppressed immune response causes latent TB to reactivate

52
Q

What creates cavities in secondary TB?

A

Immediate cell-mediated response walls off infection in airways but bacteria damages tissues in the airways

53
Q

What are manifestations of secondary TB

A

Low-grade fevers, ]
Easy fatigability, Anorexia,
Night sweats, and Weight loss

54
Q

What is consumption in secondary TB

A

Eventually fatal if untreated

55
Q

What is the diagnosis of active pulmonary TB

A

cultures, DNA amplification techniques,

chest radiographs

56
Q

What is the diagnosis of secondary TB

A

CT scan

57
Q

What are the newest diagnostic tests for TB

A

In vitro assays of CD4+ T cell interferon gamma

Genotyping

58
Q

Whats the gold standard for diagnosis of TB

A

Sputum sample (spit) with symptoms like coughing

59
Q

Why are tests not designed to show what type is present

A

they test for exposure not dormancy

Pathophysiology (91 decks)

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