Respiratory System Pathology Flashcards
1
Q
Anatomy Overview: Trachea, Bronchi, Bronchioles, and Alveoli
A
- Trachea
~ Carries air from the pharynx to the
bronchi. - Bronchi
~ Carries air from the trachea to the
bronchioles. - Bronchioles
~ Carries air from the bronchi to the
alveoli. - Alveoli
~ Thin sacs lined wth capillaries.
~ Site of gas exchange between the
environment and the body
2
Q
Function of the Respiratory System
A
- Ventilation
~ Mechanically move air in and out of
the system (inspiration/expiration)
> Moving volume - Respiration
~ Exchange of gas between the
environment and the body with the
Alveoli
~ Exchange of gas between blood and
the cells
3
Q
Mechanisms for Ventilation: Inspiration
A
- Active!
- Due to increased volume of thoracic cavity.
~ Contraction of External Intercostals
~ Contraction of Diaphragm
~ Contraction of Scalenes
> Expands lungs and airways
> Creates negative pressure inside
cavity
4
Q
Mechanisms for Ventilation: Expiration
A
- Passive!
- Due to decreased volume of thoracic cavity.
~ Relaxation of Muscles
~ Contraction of Internal/Innermost
Intercostals (forced expiration):
blowing candles for example
> Lungs and airways return to
normal size
> Creates positive pressure inside
cavity
5
Q
What Drives Respiration?
A
- Diffusion
~ Driven by partial pressure gradient
> PO2 in alveoli higher than in the
pulmonary capillaries.
• O2 moves into capillaries.
> PCO2 in the alveoli lower than in
the pulmonary capillaries.
• CO2 moves out of capillaries.
6
Q
Test for Ventilation
A
- Spirometry
~ Vital Capacity
> Maximum volume of air that can
be expelled after deep inspiration.
~ FEV1 (one second forced expiratory
volume)
> Max volume of air that can be
expelled after deep inspiration in
the first second
7
Q
Test for Respiration
A
- Pulse O2/CO2
~ Persons with poor gas exchange
would have reduced O2 and elevated
CO2 in the blood
~ Normal Pulse 02 = 95-100%
saturation.
> Numbers are an estimate.
> 92% is a concern.
~ Some evidence that those with darker
skin have more inaccurate estimates.
> 95% is more like 92% in some
persons.
8
Q
Signs of Normal Respiratory Function
A
- Unlabored
- Shallow
- Rate = 12-20 breaths per minute
- Equal Expansion
9
Q
What drives changes in ventilatory rate?
A
- Levels of CO2 and 02 in the blood.
~ Chemoreceptors for CO2 located in
the medulla.
~ Chemoreceptors for 02 and CO2 in
the carotid artery and aorta.
~ Body is more sensitive to changes in
CO2 than O2.
> Fluctuations in CO2 have greater
effect on body’s pH levels
• If CO2 is too high, alters pH =
body is more acidic
> Ex.: Hyperventilation and breath
holding
10
Q
General Signs and Symptoms of Respiratory Conditions
A
- Dyspnea
~ Shortness of Breath
~ Often due to interference of gas
exchange in the lungs. - Cough
~ Body’s mechanism for clearing
material from the respiratory system.
~ Causes
> Environmental/Allergen Irritation
> Increased Mucus Production -
Infection/ Allergen - Cyanosis
~ Bluish tint to skin, nails, and lips
~ Result of poor O2 saturation of the
blood - Abnormal Breathing Pattern
~ Increased Rate and Depth
> Indicates low O2 levels
> Indicates high CO2 levels
~ Decreased Rate and Depth
> Can indicate CNS injury
> Opioid overdose - Thorax Pain with or without referred pain to the neck and/or shoulders.
- Increased Heart Rate
- Increased Blood Pressure
11
Q
Asthma and its triggers
A
- Partial blockage of the bronchi/bronchioles
~ Often some degree of blockage is
present even when asymptomatic. - Triggers: Cause inflammatory response.
~ Allergens
~ Infection
~ Air Temperature
~ Emotional State
~ Exercise (Exercise Induced
Bronchospasm)
12
Q
Asthma: S&S and Management
A
- S&S
~ Dyspnea
~ Tight Chest
~ Fatigue
~ Wheezing
~ Prolonged Expiration
~ Cyanosis
~ Coughing
~ Tachypnea - Management
~ Assess Airway
~ Victim should rest in a position of
comfort.
~ Reassure Victim
~ Administer rescue medication (inhaler)
~ If victim doesn’t improve, quickly
activate EMS!
13
Q
Prevention of Exercise Induced Asthma
A
- Warm-up followed by exercise for 10-15 minutes to induce small attack.
- After attack there’s usually a refractory period when the person can exercise at desired levels without another attack
- Refractory period can last a few hours
14
Q
Asthma Diagnosis
A
- Favorable response to beta-agonist medications.
~ Stimulate beta-agonist receptors on
the smooth muscle of the of the
respiratory system.
> Stimulation triggers relaxation of
smooth muscle.
• Bronchodilation - Spirometry
~ Measurement of forced expiratory
volume within the first second (FEV1).
> FEV1 improves beta-antagonist l
meds
> FEV1 diminished with Cholinergic
meds
• Cholinergics mimic
acetylcholine action, smooth
muscle contraction.
*Causes Bronchoconstriction
• Nothing will occur for people
without asthma
15
Q
Chronic Obstructive Pulmonary Disease (COPD)
A
- Any condition which obstructs the flow of air in the bronchi and bronchioles during ventilation
- Person can usually get air in, but have difficulty getting it out.
~ Does this make sense considering the
mechanics of ventilation?
> Yes, because the airway expands
during inspiration and constricts
during expiration
16
Q
COPD - Chronic Bronchitis: Causes and Results
A
- Inflammation of the bronchi
~ Symptoms for 3 months or more in at
least 2 consecutive years - Causes
~ Recurrent Infection → trapped
bacteria
~ Chemical Irritation → cigarettes - Results
~ Increased Mucus Production
> Damaged Cilia
~ Narrowing of the Bronchi
> Swelling
> Bronchospasm
17
Q
COPD - Chronic Bronchitis: S&S and Management
A
- S&S
~ Fever
~ Chronic Productive Cough
~ Cyanosis
~ Increased Ventilatory Rate - Management
~ Removal of Irritant/Treat Infection
~ Bronchodilator
~ Cough Suppressant? No because their
cough is productive
18
Q
COPD - Emphysema: Cause
A
- Excess mucus production block the bronchioles especially during expiration
- Air is trapped in the alveoli.
- Walls of the alveoli become damaged resulting in poor respiration at the lungs.
- Causes
~ Heredity - Deficiency in protein
responsible for preserving tissue
elasticity.
~ Chemical Irritation
~ Infection
19
Q
COPD - Emphysema: S&S and Management
A
- S&S
~ Dyspnea
~ Cough
~ “Barrel Chest”
> Expansion of Alveoli causes a
rounder shape to lungs
~ Increased Ventilatory Rate - Management
~ Removal of Irritant/Treat Infection
20
Q
Cystic Fibrosis: Cause
A
- Congenital disorder of the exocrine glands characterized by the production of copious amounts (a lot) of abnormally thick mucus which accumulates in the bronchioles and alveoli
- Cause: Recessive trait, both parents must be carriers.
~ 25% Chance
~ Most common in Caucasian
population
~ 1 in every 2000
21
Q
Cystic Fibrosis: S&S and Management
A
- S&S
~ Dyspnea
~ Productive Cough
~ Increased Breathing Rate
~ Mucous tends to trap bacteria and
virus so pneumonia is common. - Management
~ Removal of Mucous
~ Bronchodilators - If pt dies, its usually due to pneumonia
22
Q
Pneumothorax: Cause
A
- Accumulation of air in the chest cavity
~ Increased pressure in the chest cavity
collapses the lung. - Cause
~ Lung Is punctured or damaged by an
external force.
~ Doesn’t allow lung to expand due to
pressure of air in the cavity - Pt will survive if they stay still
23
Q
Pneumothorax: S&S
A
- Chest Pain
- Dyspnea
- Trachea may shift toward the side of the collapsed lung.
~ Decreased pressure in affected cavity
causes a shift - Distended neck veins.
- Uneven chest wall movement.
- Reduced breath sounds heard in the affected side.
- All signs and symptoms of shock.
~ Lack of O2 to brain
24
Q
Pneumothorax: Management
A
- Treat for shock
- Place victim lying with shoulders elevated or on side of injury
~ Gravity will help to expand affected
lung - Emergency Referral
25
Q
Tension Pneumothorax
A
- Air build up in the chest cavity due to traumatic pneumothorax puts pressure on the unaffected lung reducing its function
- More serious
26
Q
Tension Pneumothorax: S&S
A
- Same as traumatic pneumothorax except dyspnea progressively worsens
- Trachea may shift away from the originally affected side
27
Q
Spontaneous Pneumothorax
A
- Pneumothorax occurring during or immediately after activity
- Lung tissue ruptures under heavy workload
28
Q
Hemothorax: Cause
A
- Bleeding within chest cavity that interferes with normal expansion of the lungs
- Cause
~ Lacerations of the chest cavity
produced by penetrating objects or
fractured ribs.
29
Q
Hemothorax: S&S and Management
A
- S&S
~ Same signs and symptoms of
pneumothorax except victim may
cough up frothy red blood. - Management
~ Same as pneumothorax with
attention to positioning
30
Q
Flail Chest
A
- Fracture of more than one rib in more than one place
~ Chest wall is unable to expand
during inspiration and contract during
expiration in the area of the fractures
> Opposite occurs
~ Reduces ventilation volumes - If there’s enough rib fractures, it’s like a pneumothorax
31
Q
Flail Chest: S&S and Management
A
- S&S
~ Chest Pain
~ Difficulty Breathing
~ Abnormal chest wall movement with
ventilation. - Management
~ Same as pneumothorax/hemothorax
with attention to positioning
