Respiratory System Flashcards
functions of respiratory system
ventilation: movement of air in and out of body
gas exchange: requires intact and non-thickened alveolar walls and minimal interstitial space without additional fluid
metabolism: decreases bradykinin and prostaglandin
location of respiratory control center
Brainstem (CN X: Vagus Nerve)
manifestations of respiratory disease
inflammatory process leads to vasodilation, increased capillary permeability and exudate/pain
common cold
viral (80% rhinovirus) and spread through respiratory droplet and highly contagious
nasal congestion, cough, mouth breathing, voice tone, sore throat, HA, fever
sinusitis
swollen membranes that prevent entry of air into sinus
can lead to inflammatory edema, preseptal cellulitis, orbital cellulitis, orbital abscess, CS thrombosis, intracranial complications
Acute (4 weeks or less) vs Chronic (12+ weeks)
air, pus, mucus stuck in blocked sinus can lead to pain, HA, tenderness, “fullness” and “pressure”
Restrictive Lung Disease
decreases lung volume and increases effort
caused by pulmonary fibrosis, neuromuscular disease, obesity and kyphosis (spine), and infection
Interstitial Pulmonary Fibrosis
group of pulmonary CT diseases which damage lung tissue and decrease elasticity
fibrosis from secondary HTN and Right Heart Failure
Idiopathic, Autoimmune, Drug/toxins, Infections, Inhalants
Occupational Lung Disease
Anthracosis (black lung) from coal mining or Silicosis or Asbestosis
Pneumoconiosis (inhalation of dust): macrophages will secrete lysozymes and lead to collagen deposition
Sarcoidosis
autoimmune/chronic non-caseous granulomas affecting mainly lung, lymph nodes, eyes, skin
Triad: pulmonary affected, skin granulomas, eye + joint lesions
Dx: Biopsy, blood test (high ACE, lysozymes, and Ca), chest x-ray
Tx: Steroids, immunosuppressants, anti-malarials, tetracycline
Pneumonia
inflammatory process secondary to infection leading to lungs fill with fluid and exudate
Dx: chest x-ray, lung auscultation, sputum culture
Tx: antibiotic, antiviral, rest and fluids
Common Causes: Rhinovirus, RSV, influenza, M pneumonia, b pertussis, c pneumoniae
Bronchial vs Lobar vs Interstitial
Tuberculosis
mycobacterium TB spread during close contact
inhaled droplet nuclei bypass upper airway defense leads to alveolar macrophages ingesting bacterium but cannot destroy them – caseating granuloma formation
90% asymptomatic primary TB
Dx: skin test, chest x-ray, sputum, PCR
Weight loss, fatigue, fever, cough, night sweats
Choroiditis > Anterior Uveitis > Sclerokeratitis
Pulmonary Edema
more fluid around alveoli that interferes with gas exchange
cardiogenic: HF
non-cardiogenic: acute respiratory distress syndrome
- widespread pulmonary inflammation causing hypoxia
- noncardiogenic PE - Atelectasis (alveolar collapse) to fibrosis (decreases function)
- caused by sepsis > aspiration of gastric acid > severe trauma, fat emboli, shock
Obstructive Respiratory Disease
airflow obstruction leading to inability to completely exhale
Cystic Fibrosis
autosomal Recessive (Whites)
chloride transport defect in cell wall leading to thick mucus and low fluids + mucus stasis
Lungs > Pancreas, Liver, Salivary Glands, Testes, Eyes
Delayed growth, recurrent pneumonia, infertility, pancreatitis
Tx: mucolytics, antibiotics, chest percussion, lung transplant, hydration
Obstructive Sleep Apnea
recurrent episodes of upper airway collapse during sleep which leads to oxygen desaturation and reduction of airflow + excessive daytime sleepiness
90%+: mild, 80-89: moderate, and less than 80% is severe
Neck (>17 men and >15 women)
Dx: Polysomnography leads on body to measure O2 levels and chest effort)
Tx: CPAP, dental appliances, sx
Stroke, HTN, CAD, T2DM, increase mortality risk
Ocular: DES and Floppy Eyelid Syndrome
Asthma
intermittent or persistent airway obstruction from chronic inflammatory disorder / bronchial hypersensitive (type 1)
risk factors associated with SES
Histamine + Leukotrienes lead to vasoconstriction in bronchioles leading to hypertrophy (Barrel chest)
Tx: bronchodilators and antiinflammatories
COPD
Emphysema: irreversible enlargement of alveolar space which decreases SA (barrel chest)
- congenital (deficiency in alpha-1 antitrypsin) or smoking/IV/drugs
Chronic Bronchitis: persistent, productive cough with excess mucus
- more than 3 mos for 2+ years
- caused by smoking> infection, environmental
- hyperplasia of bronchial mucus glands, destruction of cilia, bronchial wall thickening, fibrosis
COPD: 3rd leading death in US - inflammation of alveoli and bronchioles lead to progressive, unremitting
- PREVENTABLE
- increased mucus from chronic inflammation to losing elastic recoil to airway collapse to right CHF
Lung Cancer
1 cancer site by deaths in US
smoking (80-90%) and environmental (10-15%)
persistent productive cough with weight loss and dyspnea
Paraneoplastic Syndrome: cancer cells produce hormones
Pancoast Syndrome: shoulder and arm pain, horner’s syndrome (ptosis, anhydrosis, miosis) and hoarse voice
Ocular Manifestations
Pneumonia: Roth spot and septic retinitis
Asthma: steroid cataract and glaucoma
Emphysema: steroid cataract and glaucoma and papilledema
CF and Pancreatic Disease: macular hole, edema, retinal vascular dilation, papilledema, ON
Bronchogenic Carcinoma: metastasis to orbit, iris, choroid, retina
