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zFoundations of Pathophysiology > Topic 7 - Acute and Chronic Pulmonary Disease > Flashcards

Topic 7 - Acute and Chronic Pulmonary Disease Flashcards

1
Q

What are some symptoms of COPD?

A

hunched over, thin, pursed lips, overdeveloped SCM

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2
Q

Why is performing overhead tasks a problem for people with COPD?

A

weakened muscles

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3
Q

What are the three diseases which make up COPD?

A

asthma, bronchitis, emphysema

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4
Q

What does FEV1 mean?

A

forced expiratory volume after 1 sec

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5
Q

What does FVC mean?

A

forced vital capacty

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6
Q

What is TLC?

A

total lung capacity

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7
Q

What is RV?

A

residual volume, amount of air left in lungs after a breath out

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8
Q

Why would people with COPD have acidic blood?

A

increased levels of CO2

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9
Q

Why would people with COPD have high amounts of carbon dioxide?

A

inability to remove CO2 from lungs during expiration

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10
Q

Why would people with COPD have low amounts of oxygen?

A

inability to get oxygen in

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11
Q

Why would people with COPD have high amounts of bicarbonate?

A

acts as a buffer to the abnormally acidic blood

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12
Q

What are some medications to achieve and maintain lung function?

A

reliever, preventer, symptom controller, combination (symptom controller and preventer)

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13
Q

What is the pleura?

A

encases each lung, consists of a pleural cavity filled with pleural fluid

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14
Q

What is the role of pleural fluid?

A

lubrication

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15
Q

Is the pressure inside the lungs lower than outside?

A

the intrapleural pressure is lower than atmospheric presure

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16
Q

How many lobes does the right lung have?

A

3: upper, middle, lower

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17
Q

How many lobes does the left lung have?

A

2: upper, lower

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18
Q

What are the fissures of the right lung?

A

oblique, horizontal

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19
Q

What is the fissure of the left lung?

A

oblique

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20
Q

What are the two unique features of the left lung?

A

cardiac impression, aortic arch impression

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21
Q

What are the divisions of the upper, middle and lower lobes of the the right bronchopulmonary segment?

A

Upper: apical, anterior, posterior
Middle: lateral, medial
Lower: apical, medial basal, anterior basal, lateral basal, posterior basal

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22
Q

What are are divisions of the upper, and lower lobes of the left bronchopulmonary segment?

A

Upper: apical, anterior, posterior, lingular (superior, inferior)
Lower: apical, anterior basal, lateral basal, posterior basal

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23
Q

What is an obstructive pulmonary disease?

A

characterised by an increase in resistance to airflow owing to complete or partial obstruction at any level

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24
Q

What is restrictive pulmonary disease?

A

characterised by reduced expansion of lung paranchyma with decreased lung capacity

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25
Q

What are the characteristics of an obstructive lung disease?

A

low FEV1/FVC ratio, low FEV1

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26
Q

What are the characteristics of a restrictive lung disease?

A

normal FEV1/FVC ratio, decreased FEV1, decreased FVC

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27
Q

What is the definition of COPD?

A

presence of airflow obstruction that is not fully reversible

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28
Q

What is the definition of asthma?

A

episodes of widespread but variable airflow obstruction that is reversible either spontaneously or with treatment

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29
Q

What is type 1 resp failure?

A

low oxygen

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30
Q

What is type 2 resp failure?

A

low oxygen, high carbon dioxide

31
Q

What is the pathological definition of emphysema?

A

permanent enlargement of airspaces distal to terminal bronchioles and destruction of alveolar tissue

32
Q

What are the causes of emphysema?

A

smoking or a1 antitrypsin deficiency

33
Q

What is progressive chronic dyspnoea?

A

breathlessness out of proportion to the level of activity

34
Q

What are the signs and symptoms of emphysema?

A

hunched posture, weight loss, dyspnoea, cough, pursed lip breathing

35
Q

Why is there a characteristic hunched posture?

A

recruitment of accessory inspiratory muscles, abdominal contents push on diaphragm, giving it a mechanical advantage - allows dome to contract and descend

36
Q

Why is weight loss a symptom of emphysema?

A

increased energy consumption, breathlessness affects eating

37
Q

When does emphysema show itself?

A

after 1/3 of lung paranchyma is damaged

38
Q

How does death occur if a person has emphysema?

A

type 2 resp failure, right sided heart failure, pneumothorax

39
Q

What is bullae?

A

overstretched alveoli causing burst or rupturing –> pneumothorax, buildup of positive pressure

40
Q

What is the clinical definition of chronic bronchitis?

A

persistent cough with sputum production for at least three months in at least 2 consecutive years in the absence of any other identifiable cause; chronic inflammation by inhaled subatance

41
Q

How does smoking affect chronic bronchitis?

A

interferes with ciliary action, damage to airway epithelium, inhibits bronchial and alveolar leukocytes

42
Q

How does death occur by chronic bronchitis?

A

right sided heart failure, cardiac failure, respiratory failure

43
Q

What are the effects of chronic bronchitis on lungs?

A

swollen and boggy, excessive mucous, heavy casts, pus-filled bronchi

44
Q

What is the definition of asthma?

A

chronic inflammation of the airways involving mast cells, eosinphils, T-cells, macrophages, neutrophils and epithelial cells; inflammation causes recurrent episodes of wheezing, breathlessness, chest tightness and coughing esp at night and morning; variable airflow obstruction that is often reversible; hyperresponsive bronchioles

45
Q

What is meant by hyper responsive bronchioles?

A

requires less stimulus to trigger a response as the person ages or as the condition worsens

46
Q

What are the symptoms of asthma?

A

constriction, congestion, cough/sputum, distress, asymptomatic between attacks

47
Q

What are the classifications of asthma?

A

atopic, non atopic, persistent, intermittent

48
Q

What is the pathway of atopic asthma?

A

antigen –> mast cell –> chemical mediators –> histamine (bronchoconstriction, increased secretions), leukotrienes (prolonged bronchoconstriction, increased secretion, increased vascular permeability), open mucosal intercellular junction (ncreased antigen access)

49
Q

What is the pathology of airflow obstruction

A
  • smooth muscle hypertrophy and hyperplasia = thickening
  • inflammatory cells infiltrate = narrowing
  • oedema
  • goblet cells and mucus glands hyperplasia
  • mucous hypersecretion
  • protein deposition including collagen = remodelling = stiffer
  • epithelial desquamation = shedding
50
Q

What is COPD?

A
  • presence of airflow obstruction that is not fully reversible –> inflammation, fibrosis, remodelling
  • poor exercise tolerance/deconditioning
51
Q

What is bronchiectasis?

A

permanent dilation of bronchi + bronchioles = destruction of muscle and elastic tissue leading to necrotising infection

  • normal clearing methods impaired –> stagnating secretions, pooling of secretions, lungs don’t clear
  • foul-smelling sputum (bacteria), exacerbations precipitated by UTRI’s
52
Q

What is the management of bronchiectasis?

A

antibiotics, physio

53
Q

What is resorption?

A

airway obstruction, excessive secretion, occurs with asthma, chronic bronchitis, bronchiectasis, post operatively

54
Q

What is compression?

A

compression of lung tissue, pneumothorax/effusion, surgery, seen in patients with heart failure, abnormal elevation of diaphragm

55
Q

What are pulmonary infections?

A

inflammation –> bacteria, viruses, other organisms

secretion accumulation

56
Q

What is pneumoitis?

A

inflammation of lung paranchyma due to chemical or physical agents

57
Q

What is pneumonia?

A

pulmonary defence mechanisms impaired or decreased host resistance
compromised clearing mechanisms

58
Q

What are the classifications of pneumonia according to origin?

A
  • community acquired

- hospital acquired

59
Q

What are the primary, secondary and atypical classification?

A
  • primary - intact immune system, sudden onset, usually community acquired
  • secondary - impaired immune system, ill/elderly
  • atypical - often viral (Legionella, mycoplasma), problem with immune system
60
Q

What are the classifications based upon anatomical location?

A
  • lobar - entire anatomic lobe, classic progression

- broncho - entire lobe isn’t filled

61
Q

What is a complication of pneumonia?

A

lung abscesses

62
Q

What is a lung abscess?

A

fluid filled cysts, no oxygenation

63
Q

What occurs during red hepitisation?

A

neutrophils and fibrin fill alveoli, exudation of RBC, rusty sputum, red airless lungs

64
Q

What occurs during grey hepitisation?

A

increase fibrin, degeneration of WBC/RBC, fibrin, exudate

65
Q

What are the pleural conditions?

A

pleural effusion, emphysema, pneumothorax

affect the lining of the lungs

66
Q

What is a pleural effusion?

A

serous fluid collection in pleural space

67
Q

What is a pneumothorax?

A

air in pleural space, can be spontaneous/traumatic

68
Q

What are the vascular conditions?

A

thrombosis, embolism, pulmonary oedema, right suded heart failure

69
Q

Thombosis

A

coagulation of blood, intravascular, formed by interaction of blood vessel walls (endothelium), blood (platelets), plasma coagulants (clotting system)

70
Q

Embolism

A

‘clot on holidays’

travels in bloodstream from origin

71
Q

How is an embolism prevented?

A

early ambulation and anti-coagulant medication

72
Q

What is pulmonary oedema?

A
  • accumulation of fluid –> interstitial fluid
  • heavy, wet lungs
  • cardiac failure = cause
73
Q

What is left-sided heart failure?

A

left ventricle not working therefore lungs cannot empty blood into heart

74
Q

What is right-sided heart failure?

A
  • occurs due to lung disease
  • decreased blood oxygen (hypoxaemia) due to chronic lung disease –> pulmonary constriction (blood diverted from diseased areas –> narrowing of pulmonary capillaries –> hypertension –> right side of heart must work harder –> right-sided heart failure

zFoundations of Pathophysiology (10 decks)

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