Respiratory pathophysiology lecture/slides5

Question 1

Infectious respiratory diseases

Answer 1

­ Upper
­ Upper Respiratory Infection (URI)
­ Lower
­ Bronchiolitis (RSV)
­ Pneumonia
­ SARS/MERS
­ TB
­ Fungal diseases

Question 2

Obstructive lung diseases (Cannot get the air out of the lungs)

Answer 2

­ Cystic fibrosis
­ Cancer
­ Aspiration pneumonia
­ Asthma
­ Emphysema
­ Chronic bronchitis

Question 3

Restrictive lung diseases (Cannot get the air into the lung)

Answer 3

­ Chest wall abnormalities
­ Connective tissue abnormalities

Question 4

Vascular disorders

Answer 4

Pulmonary edema
­Pulmonary embolism

Question 5

Expansion disorders

Answer 5

­ Atelectasis
­ Pleural effusion
­ Pneumothorax

Question 6

UPPER RESPIRATORY INFECTION

Answer 6

Acute inflammatory process that affects mucus membrane of the upper respiratory
tract
Includes one or more of the following problems
­ Rhinitis
­ Pharyngitis
­ Laryngitis
­ Sinusitis
Symptoms
­ Low-grade fever, malaise, sore throat, discharge
Etiology
­ > 200 different viruses have been implicated
­ Can get secondary bacterial infection

Question 7

LOWER RESPIRATORY INFECTIONS

Answer 7

Pneumonia
6th leading cause of death in US; incidence
highest in elderly
Etiology
­ Common bacteria: pneumococcus
­ Viral most common in children
­ Community acquired:
­ Pneumococcus
­ Nosocomial
­ Pseudomonas, MRSA
­ Fungi – Coccidiomycosis (Valley Fever)
­ Trauma to lungs
­ Foreign body aspiration

Question 8

TUBERCULOSIS

Answer 8

TB incidence began increasing in the late 1980’s
­ HIV population → opportunistic infections
­ Increase in low socio-economic and homeless population
­ Doctor complacency
­ Drug company complacency
­ Patient non-compliance
Mycobacterium tuberculosis is quite resistant to eradication and can live in an inactive
form for long times
­ Example = dried sputum
Very contagious via air droplets

Question 9

Signs and symptoms can include: fever, chills,
night sweats, productive cough, loss of appetite,
weight loss, and fatigue.

Answer 9

TB

Question 10

LUNG CANCER

Answer 10

Broadly classified into two types
­ Non-small cell
­ Small cell
Based upon the microscopic appearance of the tumor

Question 11

2 types COPD

Answer 11

Chronic Bronchitis (COPD)
Bronchiectasis (COPD)

Question 12

Chronic Bronchitis (COPD)

Answer 12

Chronic inflammation of mucus membrane
­ Defined as a chronic mucus producing cough
most days of the month, three months of the
year for two successive years without other
underlying disease to explain the cough
­ Hyperplasia of mucosa & destruction of cilia
­ Results in a chronic, deep, productive cough
­ Long term smoking, certain environmental
factors such as textile dust fibers
­ Symptoms
­ Productive cough, SOB, wheezing

Question 13

Bronchiectasis (COPD)

Answer 13

­ Permanent, irreversible dilation & distortion of
bronchi
­ Complication of cystic fibrosis
­ TB
­ Takes years to develop
­ Primarily in the lower lobes
­ Symptoms
­ Chronic productive cough

Question 14

COPD

Answer 14

Emphysema
­ Destructive disease of alveolar septa
­ Permanent & irreversible
­ Non-functioning alveoli
­ Chest x-ray shows: translucent appearing
lungs, flattened diaphragm, &
cardiomegaly
­ Clubbed fingers
Increased lung compliance
Decreased lung elasticity

Question 15

ASTHMA

Answer 15

Chronic inflammatory disorder
associated with airway hyper-
responsiveness leading to recurrent
episodes
Often reversible airflow limitation
Prevalence increasing in many
countries, especially in children

Question 16

Triggers
­ Allergens
­ Exercise (EIA)
­ Especially in cold weather
­ Air pollutants
­ Occupational factors
­ Respiratory infections
­ viral
­ Chronic sinus and nose problems
­ Drugs and food additives
­ NSAIDs, ß-blockers, ACEi, dye, sulfites
­ Gastro-esophageal reflux disease (GERD)
­ Psychological factors

Answer 16

ASTHMA

Question 17

RESTRICTIVE DISEASES AND OTHER
PATHOLOGY

Answer 17

Characterized by decreased airway compliance
Two groups of diseases
­ Abnormalities of chest wall which limits lung expansion
­ Includes:
­ Kyphosis
­ Scoliosis
­ Polio
­ ALS
­ Muscular dystrophy
­ Burn scar
­ Disease affecting lung tissue that provides supporting framework
­ Includes:
­ Occupational diseases (pneumoconiosis)
­ Idiopathic pulmonary fibrosis (autoimmune disease)
­ Pulmonary edema
­ Acute respiratory distress syndrome (ARDS)

Question 18

RESTRICTIVE LUNG DISEASES

Answer 18

Pulmonary edema
­ Fluid collection (edema) in all lung tissues
­ Affects gas exchange
­ Affects lung expansion
­ Key = pulmonary capillary pressure increases &
fluid moves into alveoli
­ Capillaries rupture & get bloody sputum
(hemoptysis)
­ True medical emergency
Etiology
­ Left sided heart failure
­ Inhalation of toxic gases
­ Lymphatic blockage (e.g. from tumor)

Question 19

VASCULAR DISORDERS

Answer 19

Pulmonary Emboli
­ Clot of foreign matter that occludes artery in
pulmonary system
­ Size of embolus & general health of patient
determine degree of damage and amount of
symptoms
Thrombus (most common)
­ Air, fat, bacteria, tissue
­ Large bone fractures can result in fat emboli
Risk increased by CHF, lung disease, stasis
with varicosities
90% originate from deep veins (primarily in
leg)

Question 20

EXPANSION DISORDER

Answer 20

Atelectasis
­ Collapsed pulmonary tissue
­ Results in degrees of hypoxia
Causes:
­ Pleural effusion
­ Obstruction of the bronchial tree
­ Obstruction leads to absorption atelectasis
­ Compression atelectasis

Question 21

PLEURAL EFFUSION

Answer 21

Pathophysiology = fluid separates the
two pleural membranes
Lungs do not expand properly during
inspiration since there is no cohesion
between —- lung/visceral pleura/
parietal pleura
Types:
­ Transudates = hydrothorax
­ Blood = hemothorax
­ Pus = empyema

Question 22

PNEUMOTHORAX

Answer 22

Collection of air or gas in pleural
cavity resulting in collapse (either
partial or full) of lung
­ Spontaneous pneumothorax
­ Open pneumothorax — usually secondary
to trauma
­ Tension pneumothorax