Respiratory pt 1 Flashcards
what are some conditions that can cause orthopnea
left ventricular heart failure
pulmonary edema
describe cheyne-stokes respirations
alternating apnea and hyperventilation
what is the purpose of kussmaul breathing
to unload CO2
central sleep apnea
defect in respiratory centre
what is exudative pleural effusion
fluid in pleural cavity has proteins - inflammation, infection, malignancies
true or false:
sypathetic nervous system constricts the bronchioles
false - it dilates the bronchioles
Hyperventilation
breathing very fast and deeply, exhaling more air than you take in
when does surfactant production occur
late in gestation
name some signs of dyspnea
flaring nostrils
accessory muscle use
what kind of disease would have a low forced vital capacity
restrictive
what does stridor signal
airway obstruction
apnea
temporary cessation of breathing
name 4 symptoms of ARDS
dyspnea
sever hypoxemia
decreased lung compliance
diffuse bilateral pulmonary infiltrates
what is a diffuse pulmonary infiltrates
anything more dense than air
what is hypercapnia
having too much CO2 in your blood
what triggers periods of hyperventilation with cheyne-stokes respirations
rising levels of CO2
forced vital capacity test
deep breath in and then exhale forcibly
pneumothorax
air in intrapleural space
what is dyspnea
difficulty breathing
what things can crackles in resp signmal
pneumonia
pulmonary fibrosis
what are the 4 kinds of hypoxia
anemic
ischemic
histotoxic
hypoxemic
what keeps fluid from moving into alveoli from capillaries
surfactant
obstructive sleep apnea
relaxation of muscles that support soft tissues of throat
what are the two main types of acute obstructive airway disease
acute bronchitis
asthma
what does hyperventilation result in
hypocapnia
what are teh typical treatments for asthma
bronchodilators
corticosteroids
(via a nebulizer typically)
minute ventilation test
total air in or out in one minute
what kind of disease would have a low forced expiratory volume
obstructive
what occurs with rapid deep breathing
CO2 flushed out
pH rises
what does ARDS stand for
acute/adult respiratory distress syndrome
what can a low PCO2 cause with regards to breathing
hypoventilation and can cause periods of apnea
what are the two kinds of sleep apnea
obstructive
central
describe asthma
episodic acute airway obsturction resulting from stimuli that would not elicit a response in non-asthmatic individuals
hypoxia vs hypoxemia
hypoxia: low oxygen levels in your tissues
hypoxemia: low oxygen levels in your blood
only having water in the alveoli would cause what and when
alveolar collapse during expiration
describe the early acute phase of extrinsic asthma
narrowing of airway that peaks within 15-30 mins (bronchospasm mainly)
anemic hypoxia
too few RBCs or RBCs with abnormal Hb
leakage of water, protein, inflammatory cells and RBCs into interstitum and alveolar lumen
This is known as what
hyaline membrane disease
ischemic hypoxia
blood circulation impaired
in obstructive diseases is forced expiratory volume high or low
low
what is the most important stimulus of surfactant
normal ventilation
what is the proliferative phase of lung injuries
replacement of type 1 and 2 cells
what kind of asthma typically goes into remission in early adulthood
extrinsic
what things can cause clubbing
diseases that interfere with oxygenation
what does hypoventilation result in
hypercapnia
Hyperpnea
breathing more deeply but not necessarily faster
what occurs with acute bronchitis
inc mucus secretion
inc bronchial swelling
dysfunction of cilia
= nonproductive cough and resistance to expiratory airflow
describe the air capacity values in restrictive pulm diseases and why
dec VC
dec TLC
dec FRC
dec RV d
due to limited lung expansion
damage to the alveolar epithelium and vascular endothelium causes what
leakage of water, protein, inflammatory cells and RBCs into interstitum and alveolar lumen
what tends to be the cause of intrinsic asthma
multiple resp tract infections
what can cause immediate lung collapse
any condition that equalizes intrapleural and intrapulmonary pressure
what causes RDS
surfactant deficiency
what two things does lung compliance depend on
elasticity of lung tissue
elasticity of thoracic cage
what can pulmonary function tests distinguist between
obstructive pulmonary disease
restrictive diseases
what Ig triggers extrinsic asthma
IgE
what are some obstructive pulmonary diseases
bronchitis
asthma
when does skin become blueish with hypoxia
when spo2 is under 75%
what is oxygen toxicitiy
oxygen is toxic to surfactant producing cells, and supports a high level of production of free radicals
air in intrapleural space
pneumothorax
describe the stage of lung injury
excessive collage deposition as lung attempts to self repair
fibrotic phase
oxygen saturation varies between what two values with cheyne-stokes respirations
90-100
can intrinsic asthma be helped with allergy shots
no
what type of drug use is controversial for lung management and not suggested early in disease
steroid use
what type of cells produce surfactant
type 2 cells
what depth of breathing would you find with tachypnea
shallow breaths
describe the stage of lung injury:
replacement of type 1 and 2 cells
proliferative phase
what things can cause cheyne-stokes respirations
anything that slows blood flow to brain
ie heart failure, brainstem diseases
what is the fibrotic phase of lung injury
excessive collage deposition as lung attempts to self repair
what is hypocapnia
low blood levels of CO2
what are the 3 phases an injured lung goes through
exudative phase
proliferative phase
fibrotic phase
is intrinsic asthma seasonal
no
what allows lungs to slide during breathing
pleural fluid
lung compliance
ease with which lungs can be distended per unit change in pressure
pleural effusion
accumulation of fluid in the pleural space
what are some common features of asthma
hyperresponsiveness/i nflammatory response in airways
what does RDS stand for
respiratory distress syndrome of the newborn
what is trasudative pleural effusion
watery fluid - disorders that increase bp or decrease capillary oncotic pressure
what does IgE do with extrinsic asthma
interacts with mast cells leading to histamine, protaglandins and leukotriene release
what is orthopnea typically caused by
increased fluid in lung that is helped by being upright
who does IRDS affect
premature babies who dont have enough surfactant
what is a eupnea tidal volume
400-800mL
what are the two phases of extrinsic asthma
early acute
late phase
resistance of respiratory passageway is determined by what
diameter of conducting tubes
what 3 pathophiological things occur with exxtrinsic asthma
constriciton of bronchial smooth muscle
increased secretion of goblet cells
mucosal swelling
of those who do recover from ARDS, most regain what percent of lung function after one year
75
what values of CO2 would you expect in someone whos hypocapnic
under 36mm Hg
describe the air capacity values in obstructive pulm diseases and why
inc TLC
inc FRC
inc RV
due to hyperinflation of lungs
what are some restrictive pulm diseases
TB
polio
pulmonary fibrosis
name 3 underlying causes of ARDS
reduced perfusion
increased capillary permeability
direct tissue/capillary insults
what things can cause tachypnea
lung disease
obesity
pulmonary embolism
describe the late phase of extrinsic asthma
peaks in 2-6 h
due to airway edema plus mucus production
what is a healthy minute ventilation (volume)
6L per min
what is the overall mortality of ARDS
32-45%
what is clubbings
selective bulbous enlargement of a distal segment of a digit
who does intrinsic asthma affect
adults, most commonly women
true or false: obstruction is intermittent and reversible for asthma and acutre bronchitis
true
bradypnea
under 12 breaths per min
what type of ventilation prevents alveolar collapse
positive pressure ventilation
histotoxic hypoxia
caused by metabolic poisons wehre you have enough O2 but cant use it
what breathing pattern can lead to atelectasis
hypoventilation
what values of CO2 would be present with hypercapnia
PCO2 over 44mm Hg
tachypnea
over 20 breaths per minute
what things can cause bradypnea
narcotic overuse
brain disorder
hypothyroidism
what is the most common presenting symptom of pleural effusion
dyspnea
what is pleurisy
the pleura become inflamed
in a restrictive disease, is forced vital capacity high or low
low
what occurs with CO2 during slow, shallow breathing
CO2 accumulates in blood
pH drops
what does surfactant do
reduce surface tension due to water molecules - prevents alveoli collapse
describe kussmaul breathing
deep, rapid breaths
what waterproofs lungs
surfactant
hypoxemic hypoxia
reduced arterial PO2
what is the most common type of asthma
extrinsic asthma
(allergic)
orthopnea
difficulty breathing when lying down
bronchospasm
constriction of bronchial smooth muscle
forced expiratory volume
pushing out as much air as possible
what are some neural influences on resp passageway resistance
parasympathetic: constirction of bronchioles (irritants, histamine)
sympathetic: dilates bronchioles - decreased resistance
what does pleurisy cause on breathing
sharp chest pain that worsens during breathing
