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Patho Exam 2 > Respiratory System > Flashcards

Respiratory System Flashcards

1
Q

gas exchange occurs within the (3 respiratory system parts)

A

gas exchange occurs within respiratory bronchioles, alveolar ducts, and alveoli

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2
Q

describe alveoli

A

alveoli are thin-walled, balloon-like structures surrounded by pulmonary capillaries.

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3
Q

describe the alveolus’ role in gas exchange

A

air enters the alveolus on inspiration, air moves across the alveolar membrane to the capillaries to the RBCs where CO2 is exchanged from the RBCs to the alveolus and expired out of the body

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4
Q

if the PO2 (pressure of oxygen in the arterial blood) is between 90-100 mmHg, how oxygenated is the body?

A

If the pressure of oxygen in the arterial blood (PO2) is within 90-100 mmHg, Hgb is maximally saturated with oxygen therefore the tissues remain oxygenated

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5
Q

describe ventilation

A

ventilation is the process of inspiring and expiring air via the pulmonary airways

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6
Q

describe perfusion

A

perfusion is the movement of blood through the pulmonary circulation providing oxygen to all parts of the body (between the alveoli and the capillaries!)

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7
Q

describe the ventilation-perfusion (V-Q) ratio

A

the ratio of the amount of air reaching the alveoli to the amount of blood reaching the alveoli; ideal is that they are equal

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8
Q

describe a shunt

A

an area with perfusion but NO ventilation = no O2 exchange for the increasing amount of CO2 in the alveoli

usually caused by respiratory issues, anything that prevents the oxygen from the outside to reach the blood vessels

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9
Q

describe a dead space

A

an area with ventilation but NO perfusion = breathing in oxygen but no capillaries to pick it up to take it to places like brain, foot
most common example is a pulmonary embolism

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10
Q

what is hypercapnia

A

the main stimulus to breathing, an increased level of CO2 in the blood tells us to breath - this is NORMAL

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11
Q

what is hypoxic drive

A

hypoxic drive is when the peripheral chemoreceptors sense low levels of O2 and take over as the stimulus of breathing - this is due to chronic elevation of CO2

ex: patient with COPD

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12
Q

where are the central chemoreceptors located

A

the central chemoreceptors are located near the respiratory center in the medulla

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13
Q

where are the peripheral chemoreceptors located

A

the peripheral chemoreceptors are located in the common carotid arteries

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14
Q

what are baroreceptors and where are they found

A

baroreceptors are located in the aortic arch and the carotid artery

baroreceptors can send signals to (1) ANS if the systolic BP drops then (2) stimulates the SNS to increase heart rate and respiratory rate

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15
Q

describe dyspnea

A

perceived or feeling of SOB or difficulty breathing, labored breathing

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16
Q

describe coughing

A

a neurally-mediated reflex that protects the lungs from accumulation of secretions and entry of irritating substances

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17
Q

describe hemoptysis

A

bloody sputum but different from hematemesis which is vomiting blood

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18
Q

describe atelectasis

A

collapse of the alveoli = affects perfusion

19
Q

describe hypoxia

A

insufficient oxygen levels in the blood to meet the needs of the tissues

20
Q

describe pneumonia

A

inflammation of the lung tissues (alveoli and bronchioles)

21
Q

name the 4 classifications of pneumonia

A
  1. community-acquired (CAP)
  2. hospital-acquired (HAP)
  3. ventilator-associated (VAP)
  4. within those who are immunocompromised
22
Q

name the 5 etiologic causes of pneumonia

A
  1. bacteria
  2. viral
  3. inhalation of chemicals
  4. aspiration of oropharynx contents
  5. other infectious agents like fungi
23
Q

what is considered a major risk factor to developing pneumonia?

A

the flu = the virus can alter pulmonary immune defenses (lowering the resistance) leading to the development of secondary pneumonia

24
Q

describe the pathway of pneumonia attacking the respiratory system

A

causative agent enters the upper airways (nose, pharynx, larynx) = reaches the lungs/URT = causative agent adheres to respiratory epithelial cells then 1 of the 3 things happen:

  1. stimulates inflammatory response = typical s/s of inflammation
  2. resp cells secrete mucus = in hopes to cough up mucus with bacteria
  3. resp cells are irritated by foreign substance = dry cough

THEN the mucus plus the inflammatory response = exudative fluids and accumulate in the alveoli = hear crackles through stethoscope b/c alveoli are drowned = s/s: SOB (hypoxia)

25
Q

at what time is it considered HAP and not CAP (2)

A

hospital-aqcuired =

  1. 48 hours after hospital admission
  2. if someone has been in a long-term care facility for 14 days or more prior to hospital admission
26
Q

what is the most common causative agent for CAP?

A

Streptococcus pneumoniae

27
Q

what is the most common causative agent for HAP?

A

Staphylococcus aureus; particularly MRSA

28
Q

what is the most common causative agent for VAP?

A

MRSA and VRE (vancomycin-resistant enterococcus)

29
Q

what is the most common causative agents for pneumonia within immunocompromised people?

A
  1. S. aureus
  2. Aspergillus
  3. Candida
30
Q

what are examples of obstructive lung disorders?

A
  1. asthma
  2. COPD
  3. bronchiectasis
31
Q

obstructive lung disorders are caused by conditions that limit which kind of airflow?

A

expiratory airflow

32
Q

what are examples of restrictive lung disorders?

A
  1. pulmonary fibrosis

2. thoracic cage deformities

33
Q

restrictive lungs disorders are caused by conditions that limit which kind of airflow?

A

limits lung expansion (inspiratory airflow)

34
Q

indicator of hypercapnia

A

PCO2 is greater than 45 mmHg

35
Q

usual cause of hypercapnia…

A

bradypnea, asphyxiation, aspiration, pneumonia, pulmonary edema

36
Q

how does someone get chronic hypercapnia

A

develops over period of time to individuals with progressive hypoxic lung disease

37
Q

describe chronic hypoxia

A

aka hypoxemia, diminished level of oxygen in the blood

38
Q

major cause of COPD plus others

A

smoking

others:
- genetic predisposition
- IV drug users
- exposure to occupational dusts and chemicals

39
Q

what is the stimulus to breathing for someone with COPD

A

low level of O2

40
Q

3 manifestations of COPD (s/s)

A
  1. absent during the early phase
  2. dyspnea - usually the 1st symptom
  3. cough or wheezing
41
Q

what are the 3 types of COPD?

A
  1. chronic bronchitis
  2. emphysema
  3. chronic asthma
42
Q

etiology of chronic bronchitis

A
  1. smoking & recurrent respiratory infections = hypersecretion of mucus in large airways leads to…
    1. sputum over production
    2. affectation of small airways

THEN from (2) affectation of small airways

  • -> increased mucus production = plugging of the airways resulting in hypoxia which leads to…
    1. cyanosis (BLUE BLOATER)
    2. stimulation of pulmonary arterial vasoconstriction
THEN from (2) stimulation of pulmonary arterial vasoconstriction
--> increased resistance to pulmonary artery --> affectation of the R ventricle (can't excrete blood) --> R ventricle hypertrophy = affectation of R atrium, SVC, IVC --> congestion & edema
= R VENTRICLE HEART FAILURE (cor pulmonale)
43
Q

etiology of emphysema

A

SIMPLY: smoking and inherited deficiency of a1 antitrypsin

smoking =

  1. attraction of inflammatory cells = release of elastase
  2. diminishes a1 antitrypsin activity (normally antitrypsin inhibits the release of elastase)

= end result: elastase –> destroys elastic fibers in the lungs –> loss of lung elasticity –> alveoli permanently become hyperinflated –> remain oxygenated –> PINK PUFFER

note: in late-stage emphysema, patient may become cyanotic

44
Q

etiology of chronic asthma

A

allergy triggers immune response/reaction
= bronchial constriction (dyspnea; chest tightness)
= inflammation (bronchial edema)
= increase size of goblet cells (increase mucus production = cough)

THEN narrowing of the airway s/s = wheezing, dyspnea, chest pain, use of accessory muscles, increase resp rate

Patho Exam 2 (3 decks)

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