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Internal Med > Respiratory System > Flashcards

Respiratory System Flashcards

1
Q

Upper airway includes

A

nasal cavities, sinuses, pharynx, tonsils, larynx

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2
Q

Lower airway includes

A

conducting airways including the trachea, bronchi, and bronchioles

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3
Q

Ventilation

A

the ability to move the air in and out of the lungs via a pressure gradient

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4
Q

Respiration

A

the gas exchange that supplies oxygen to the blood and body tissues and removes carbon dioxide

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5
Q

Hypoxemia

A

deficient oxygenation of arterial blood

most common condition caused by pulmonary disease or injury

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6
Q

Hypoxia

A

a broad term meaning diminished availability of oxygen to the body tissues

can occur anywhere in the body, may not be relates to the pulmonary system like hypoxemia is

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7
Q

Causes of hypoxemia

A

ventilation-perfusion mismatch (asthma, pneumonia)

decreased oxygen content (high altitude, suffocation)

hyperventilation

alveolocapillary diffusion abnormality

pulmonary shunting

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8
Q

Direct measurement of arterial oxygenation

A

blood gas sampling to measure partial pressure (PaO2) and percentage saturation (SaO2)

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9
Q

Indirect measure of arterial oxygenation

A

pulse ox (SpO2)

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10
Q

Normal PaO2 level

A

80-100 mmHg

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11
Q

Normal SaO2 or SpO2 level

A

95-100%

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12
Q

SpO2 is/measures

A

percentage of hemoglobin molecules in the peripheral blood saturated with oxygen

estimation of SaO2

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13
Q

SaO2 is a measurement of

A

oxygen bound to heme protein of hemoglobin in the blood

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14
Q

The SaO2 levels are determined by

A

ABG - arterial blood gas analysis

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15
Q

T/F: Every major organ system can have secondary effects on pulmonary function and on the oxygen transport pathway

A

T

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16
Q

Signs and Symptoms of Pulmonary Disease

A

cough
dyspnea
chest pain
cyanosis
clubbing (nails)
altered breathing patterns
abnormal sputum
hemoptysis

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17
Q

Clear and watery mucus means

A

allergies nonallergic rhinitis

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18
Q

Pink or red mucus means

A

nosebleed (dry nasal passage)

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19
Q

Green or cloudy mucus means

A

viral or bacterial infection

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20
Q

Black mucus means

A

external irritants like smoke or pollution

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21
Q

Aging affects no only the functions of the lungs (ventilation and respiration) but also ____

A

ability of the respiratory system to defend itself

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22
Q

Chest wall compliance _____ with aging, due to changes in joint of the ribs and spine and collagen alterations

A

decreases

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23
Q

Increased stiffness of chest wall with aging affects

A

volume of air moved and the work of breathing

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24
Q

Elastic recoil ______ with aging

A

decreases by intermolecular collagen crosslinks

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25
Q

Diminished gas exchange with aging is primarily due to

A

increased physiological dead space

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26
Q

With aging, what happens to the cilia in the ___ respiratory tract, and what is the result?

A

upper

movement of cilia slows, becomes less effective in sweeping away mucus and debris

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27
Q

Most adults attain maximal lung function during their ____

There is a decrease in functional ability of lungs especially after age ____

A

20s

55

28
Q

Pneumonia definition

A

An acute lung injury where an inflammatory pulmonary response to the offending organism or agent

29
Q

“offending organisms” that can cause pneumonia

A

bacterial, fungal or mycoplasmal infection

inhalation of toxic casutic chemicals, smoke, dusts or gases

aspiration of food, fluids or vomitus

30
Q

Major routes of infection of pneumonia

A

airborne pathogens, circulation, sinus infection and aspiration

31
Q

The most common infections in hospitalized patients are (2)

A

hospital-acquired pneumonia and ventilator-associated pneumonia

32
Q

30% of pneumonias are ____
50% are ____ and not usually life-threatening except in the immunocompromised person
Remaining 20% are caused by ____

A

Bacteria

Viral

Mycoplasma (bacteria)

33
Q

Risk factors of pneumonia

A

lots

hospitalization, ICU, surgery, mechanical ventilation, impaired cough reflex, difficulty swallowing (dysphagia)

children < 2 or born prematurely

34
Q

examples of viral pneumonia

A

RSV and influenza

35
Q

Bacterial pneumonia examples

A

strep is most prevalent

36
Q

Most cases of pneumonia are proceeded by

A

an upper respiratory tract infection (flu)

37
Q

Bacterial pneumonia sputum vs viral

A

bacterial - productive cough and rust-colored sputum

viral - watery sputum

38
Q

Older adults may have ___ symptoms of pneumonia

A

fewer and vague

39
Q

Treatment of pneumonia

A

antibiotics

airway clearance techniques

swallowing rehab, oral care, positioning, early mobility for aspiration pneumonia

vaccines

40
Q

Acute Bronchitis

A

inflammation of the trachea and bronchi that is short duration (1-3 weeks) and self-limiting with few pulmonary signs

41
Q

Acute bronchitis is typically caused by ___ infection

A

viral

42
Q

COPD

A

a common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and or alveolar abnormalities usually caused by significant exposure to noxious particles or gases

43
Q

COPD conditions (2)

A

chronic bronchitis
emphysema

44
Q

COPD is caused by less airflow in and out of the airways caused by what 4 changes

A

airways and sacs lose their elastic quality

walls between many of air sacs are destroyed

walls of airways become thick and inflamed

airways make more mucus than usual (clogging)

ELASTIC, DESTROYED, THICK, MUCUS

45
Q

COPD signs and symptoms

A

constant cough
shortness of breath (ADLs)
cant breathe deep
excess sputum
wheezing

46
Q

What test is used to determine presence of COPD?

A

Pulmonary Function Tests (PFTs)

47
Q

What does a spirometry measure?

A

how much air the lungs hold and how well the respiratory system is able to move air into and out of the lungs

48
Q

Medications for treatment of pneumonia

A

bronchodilators inhaled steroids, anti-inflammatory agents

49
Q

Chronic Bronchitis

A

productive cough lasting for at least 3 months per year for 2 consecutive years

inflammation and scarring of the bronchial lining

50
Q

Inflammation in chronic bronchitis leads to

A

obstructive airflow and increased *mucus production

51
Q

In chronic bronchitis, irritants cause what to happen in the bronchi?

A

they cause mucus hypersecretion and hypertrophy of mucus-producing glands

52
Q

What causes the wheezing and cough in chronic bronchitis?

A

thick sputum and swollen mucous membrane

trying to clear the airway

53
Q

Impaired ciliary function reduces ______ and increases _____

A

reduces mucus clearance

increases risk of infection

54
Q

How does obstruction during chronic bronchitis impact alveolar ventilation and PaCO2?

A

decreases alveolar ventilation and

increased PaCO2 (cant get rid of CO2)

55
Q

Emphysema

A

enlargement of the air spaces beyond the terminal bronchiole

loss of elasticity, airway collapse, gas trapping

56
Q

How is gas exchange affected in emphysema

A

air sac walls can be destroyed, resulting in larger air sacs and fewer air sacs (instead of having a lot of tiny ones)

57
Q

What is the most common type of emphysema

A

centriacinar emphysema

58
Q

Main causes of emphysema

A

main is cigarette smoking

can also happen after prolonged respiratory difficulties, a defect in elastic tissue of the lungs or in older persons whos lungs have lost their natural elasticity

59
Q

Biggest treatment of emphysema

A

stop smoking

60
Q

Asthma

A

reversible obstructive lung disease characterized by inflammation and increased reactivity of smooth muscle of the airways to various stimuli, causing bronchoconstriction and airflow restriction

61
Q

Two kinds of asthma

A

extrinsic (allergic) and intrinsic (nonallergic)

62
Q

How does asthma happen? Pathogenesis

A

airway inflammation, intermittent bronchospasm, broncho-restriction, and increased secretion production in response to allergens or irritants

63
Q

How does the immune system cause airway obstruction in asthma?

A

T helper cells secrete cytokines = inflammation

IgE present on mast cells, mediate inflammation

these cells release more toxins as they break down, causing bronchospasm and hypersecretions

64
Q

What disease would cause a nonproductive cough that fails to mobilize secretions?

A

Asthma

65
Q

Sleep-disordered breathing

A

breathing abnormalities during sleep that result in intermittently disrupted gas exchange and sleep interruption

66
Q

Obstructive sleep apnea

A

significant daytime symptoms in conjuction with evidence of sleep-related upper airway obstruction and sleep disturbance

67
Q

Overlap syndrome (OVS)

A

co-occurrence of obstructive sleep apnea and COPD

Internal Med (26 decks)

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