Respiratory Pathophys Flashcards
What is COPD?
Chronic Obstructive pulmonary disorder
- A progressive chronic lung diseases that limit air flow and gas exchange
What is chronic bronchitis characterised by?
- chronic inflammation of bronchi
- excess mucus production
- chronic productive cough
- blue bloaters
How is emphysema characterised?
- abnormal permanent enlargement of the airsick distal to terminal bronchioles due to damage to alveolar walls (air sacs) within the lung
- pink puffers
Name 3 causes of COPD
- smoking
- LT exposure to industrial pollution, indoor air pollution
- chemical fumes
- genes
What is type 1 respiratory failure?
- failure in O2 exchange, hypoxemia, most common with acute lung diseases e.g pulmonary oedema and pneumonia.
What is type 2 respiratory failure?
-hypercapnia- body cannot remove carbon dioxide from the body
Name 3 causes of type 2 respiratory failure
- Drug overdose
- chest wall abnormality
- COPD
- severe asthma
Type 2 respiratory failure:
- Should PaCO2 be more or less than 6.7kPa?
- What should normal PaCO2 levels be?
- More
- 6.0kPa
What is meant by a V/Q mismatch?
When a part of your lung receives oxygen without blood flow or blood flow without oxygen
What does ventilation mean in the V/Q ratio?
Ventilation- the volume of air you breathe in which moves into and out of the mouth
What does Perfusion mean in the V/Q ratio?
Perfusion- is defined as the flow of blood through tissues
If COPD affects ventilation, will the V/Q be low or high?
Low- can cause a mismatch between ventilation and perfusion
If heart failure affects perfusion will the V/Q be high or low?
High- can cause a mismatch between ventilation and perfusion.
V/Q mismatch in Asthma- When person is totally well, V/Q=1. As bronchospasm increases, less air gets to________, therefore V/Q<1. If the condition worsens and some airways become fully________ (bronchospasm plus excess mucus), V/Q= __
- alveoli
- closed
-0
What is a Shunt?
- where under-ventilated areas of the lungs can cause a shunt where venous blood returns to the heart without collecting its normal oxygen quota.
What conditions causes a shunt?
- Pneumonia
- Atelectasis- collapsed part of lung or lung
- Severe Pulmonary Oedema
What is the normal V/Q ratio?
0.8
When does a silent unit occur?
when little or no ventilation and perfusion are present, such as in the case of pneumothorax and (ARDS) Acute Respiratory Distress Syndrome
What does Left Ventricular Failure cause?
- Causes blood to back-up pulmonary veins into lungs, causing fluid to build up into lungs (pulmonary oedma)
Name 5 Symptoms of Pulmonary Oedema
- SOB
-DIB
-anxiety - Pale
-Pink frothy sputum
-Hypoxia - Peripheral Oedema
-Orthopnoea (inability to lie flat down due to breathlessness)
What is ARDS?
- a form of non-cardiogenic pulmonary oedema that can quickly lead to acute respiratory failure
- a result of acute lung injury- which leads to increased vascular permeability causing pulmonary oedema
- characterised by acute, severe hypoxia which is not caused by left ventricular failure.
Name 5 direct injuries that cause ARDS
- pneumonia
- aspiration of gastric secretion
- drowning
- PE
- Trauma (severe chest injury)
- inhalation injury (e.g smoke inhalation)
Name 4 indirect injuries that cause ARDS
- Sepsis
- massive blood transfusion reaction
- acute pancreatitis
- severe burns
What is the exudative phase of ARDS?
- first 24hrs, with hyperaemia.
- leakage of fluid into the alveoli plus haemorrhage and infiltration of neutrophils.
What is the Proliferative phase of ARDS?
- 14 days after injury
- persistent hypoxaemia and reduced lung compliance.
- thrombi form in the small blood vessels of the lungs.
what is the fibrotic phase of ARDS?
- 3 weeks into injury.
- widespread pulmonary fibrosis, loss of the normal lung structure and worsening lung compliance.
What is pneumonia?
- infection by bacteria or viruses that causes inflammation of the lung parenchyma.
Name 4 symptoms of pneumonia
- cough w phlegm- green or yellow or blood stained- may smell.
-fever and chills (sweating and shivering) - SOB
- Chest pain- gets worsen when breathing or coughing.
What happens during an asthma episode?
- bronchoconstriction, bronchospasm, increased mucus production and mucosal oedema.
Pathophys- Asthma (1)
- Mucus layer swells in reaction to _________ creating an amorphous shape in the lumen.
- Glands within the _______ layer produce more mucus which gets secreted into the lumen.
- space within the lumen- air passages in the lungs massively _______= SOB/DIB/Chest Tightness.
-Due to constriction and increased production of mucus/fluids by the glands, _____ are produced = ________/popping on auscultation.
- Inflammation
- muscosa
- decreased
- bubbles
-wheezing
Pathophys Asthma (2)
- Job of ____ is recognise and pick up foreign particles, they are in same family of anti-bodies to fight infection.
- In asthma attack IgE go in search of a ______ _____.
- Mast Cell carries pockets of _______.
- This ‘wakes up’ the mast cell so the pockets of histamine open and flows into the ____ ____, causing allergic reactions such as sneezing and watering eyes.
- When the body released too much histamine that are not proportinate to the number of foriegn bodies, this is when an ______ ______ is caused.
- IgE
- Mast Cell
- Histamine
- Blood Flow
- Allergic reaction.
