Unit 12 Patho Flashcards
What are the four primary functions of the respiratory system?
1) Exchange of gases between the atmosphere and the blood.
2) Homeostatic regulation of body pH
3) Protection from inhaled pathogens and irritating substances
4) Vocalization
What is the definition of cellular respiration?
The intracellular reaction of oxygen with organic molecules to produce carbon dioxide, water, and energy in the form of ATP.
The exchange of air between the atmosphere and the lungs is known as what? Inspiration vs. Expiration?
Ventilation or breathing.
Inspiration is movement of air in the lungs. (alveolar pressure decreases)
Expiration is the movement of air out the lungs (alveolar pressure increases)
The respiratory system consist of what three structures in ventilation and gas exchange?
1) The conducting system or airways
2) The alveoli
3) The bones and muscles of the thorax and abdomen
What is the role of the airways?
What are the three conditioning components components of the airways
The conducting system from external environment to the exchange surface of the lungs
1) Heating
2) Adding water vapor
3) Filtering out foreign material
What are alveoli and what is the role of the alveoli?
Alveoli are a series of interconnected sacs and their associated pulmonary capillaries.
These structures form the exchange surface, where oxygen moves from inhaled air to the blood, and carbon dioxide moves from the blood to air that is about to be exhaled.
What are the bones and muscles of the thorax the surround the lungs?
{together the bones and muscles are called the thoracic cage}
–The ribs and spine form the sides and top of the cage.
–The Diaphragm forms the floor of thorax
The internal and external intercostal muscles connect the 12 ribs. Additional muscles, include the SCM and scalenes.
The thorax is a sealed container with three membranous bags or sacs, what are they?
One pericardial sac which surrounds the heart.
The other two bags, the pleural sacs, each surround a lung.
-The esophagus and thoracic blood vessels and nerves pass between the pleural sac.
What does the upper respiratory tract consist of?
Mouth, nasal cavity, pharynx and larynx.
What does the lower respiratory tract consist of?
Trachea, two primary bronchi and their branches, and the lungs.
(also known as “thoracic portion” of the respiratory system because it is enclosed in the thorax)
What is external respiration?
The movement of gases between the environment and the body’s cells.
What are the 4 processes of external respiration?
Exchange 1: Ventilation- the exchange of air between atmosphere and lungs (inspiration and expiration)
Exchange 2: Exchange of O2 and CO2 between the lungs and blood
-Transport of O2 and CO2
Exchange 3: Exchange of gases between blood and the cells
What is the pathway that air takes?
Nose and mouth -> Pharynx -> Larynx
-> Primary bronchi (2) -> Secondary bronchi -> bronchioles
What is Cystic Fibrosis?
A genetic condition that causes dysfunction of the CFTR channel causing inadequate ion secretion decreasing fluid movement in the airways and thickened mucus that cannot be cleared, leading to lung infection.
What are the two types of Alveolar cells?
What is surfactant?
Type 1 (95%)
- Large, thinner cells that allow rapid gas exchange
Type 2 (5%)
- Smaller, thicker cells responsible for synthesis, storage, and secretion of pulmonary surfactant.
-Surfactant decreases surface tension and facilitates expansion of alveoli.
Which lung has three lobes?
Right lung
Which lung has two lobes?
Left lung
Describe the flow of Pulmonary Circulation.
Pulmonary circulation begins with the pulmonary trunk which receives low-oxygenated blood from the right ventricles.
(The pulmonary trunk divides in 2 pulmonary arteries, one to each lung)
Oxygenated blood from the lungs returns to the left atrium through the pulmonary veins.
What is bulk flow?
Flow that takes place from regions of higher pressure to regions of lower pressure, and a muscular pump creates pressure gradients.
Describe Boyle’s Law.
An inverse relationship between pressure and volume.
When volume increases, pressure decreases and vise versa.
What is Tidal volume (TV)?
quiet breathing
What is Inspiratory Reserve Volume (IRV)?
After “quiet breathing” you take in as much additional air as possible
What is Inspiratory Capacity (IC) ?
Tidal volume (TV) + Inspiratory Reserve Volume (IRV)
What is Expiratory Reserve Volume (ERV)?
After normal exhalation, exhale as much air as possible
What is Residual Volume (RV)?
The Remaining air in lungs and airways after maximal expiration.
What is Functional Residual Capacity (FRC)?
Expiratory Reserve Volume (ERV) + Residual Volume (RV)
What is Vital Capacity (VC)?
Breathing in as much as possible then blowing it all out as fast as possible.
Tidal volume (TV ) + Inspiratory Reserve Volume (IRV) + Expiratory Reserve Volume (ERV)
What is total lung volume?
Tidal volume (TV) + Inspiratory Reserve volume (IRV) + Expiratory Reserve volume (ERV) + Residual Volume (RV)
What are the principle muscles for inspiration?
The Diaphragm and External Intercostals
What are the accessory muscles for inspiration?
SCM,
Scalenes, and
Pectoralis Minor
What are the “Quiet breathing” muscles for expiration?
Diaphragm,
passive recoil of lungs, and
rib cage
What are the active (forced) muscles for expiration?
Internal Intercostals and
Abdominals
Describe the movement of the Thoracic cage and Diaphragm.
At rest: Diaphragm is relaxed
Inspiration: Diaphragm contracts and flattens, Thoracic volume increase
Expiration: Diaphragm relaxes, thoracic volume decreases
What is Forced Expiratory Volume (FEV)?
the amount of air you blow in “X” seconds
What is Forced Expiratory Flow (FEF)?
How much air you can press out
What is Hypoxia?
Lack of oxygen
What is Hypercapnia?
Excess amount of Carbon Dioxide
Describe the pathway for gas exchange and transport.
O2 enters airway -> O2 enters the blood at alveolar-capillary interface
-> O2 is transported in blood dissolved, in plasma or bound to hemoglobin -> O2 diffuses in cells -> CO2 diffuses out of cells -> CO2 is transported dissolved, bound to hemoglobin -> CO2 enters alveolar-capillary interface -> CO2 leaves airway
What are the general signs and symptoms of Respiratory Pathologies?
Cough,
Dyspnea,
Chest pain,
Cyanosis,
Altered breathing patterns
What are examples of Upper Respiratory Infection (Nose, sinuses, throat or larynx)?
Common cold,
Influenza, and
Covid-19
Describe the Common cold, and S&S.
-Caused by viral pathogens Primarily (Rhinovirus)
-Droplet transmission
-Mild to moderate illness
S&S:
Cough,
Sore throat,
Nasal symptoms,
Increased mucus
Describe the Flu, and S&S.
-Caused by viral pathogens (Influenza)
-Droplet transmission
-Mild to severe illness
S&S:
Fever
Chills
Cough
Sore Throat
Nasal Symptoms
Increased mucus
Muscle or body aches
Headaches
Fatigue
Occasional vomiting or diarrhea
Describe COVID-19, and S&S.
-Caused by viral pathogens (SARS-COV2)
-Droplet transmissions
-Mild to severe illness
S&S:
Fever or chills
Cough
SOB/difficulty breathing
Fatigue
Muscle or body aches
Headache
New loss of taste or smell
Sore throat
Nasal symptoms
Nausea, vomiting, or diarrhea
What are examples of Lower Respiratory Infections (airways, lungs)?
Bronchitis
Pneumonia
What is Bronchitis?
-Inflammation of bronchial tubes
-Usually caused by an upper respiratory infection
-S&S: Cough, Chest soreness, fatigue, mild headache, mild body aches, sore throat
What is Pneumonia? (Just def.)
Infection of one or both lungs causing the alveoli to fill with fluid or pus.
What is the etiology of Pneumonia?
-Bacterial, viral, fungal infection
-Aspiration
What are some risk factors associated with Pneumonia?
-Hospitalization, chronic disease, smoking, or other toxins
-Difficulty swallowing
Pneumonia may involve: (types of pneumonia)
-One or more lung (Lobar pneumonia)
-Bronchioles and Alveoli (Bronchopneumonia)
What are some clinical features associated with pneumonia?
Systemic- Fever, Chills, Fatigue
Local- Cough, Dyspnea, Tachypnea, and Hemoptysis
What is Tuberculosis (TB)?
Infectious, inflammatory systemic disease affecting the lungs
What is the etiology for TB?
Droplet infection of mycobacterial tuberculosis
What are potential risk factors for TB?
Poverty, Overcrowding, inadequate health service, poor nutrition, children, geriatrics, and immunocompromised individuals
What is Latent TB infection?
When a person can have the TB infection in the body but is not sick, and has no signs and symptoms and cannot spread the bacteria to others. May develop active TB disease if untreated.
What is Active TB infection?
Active TB spreads, causing sickness, may occur immediately after infection or years later. Individuals with active TB are infectious.
What are clinical features for TB?
Cough (>/ 3 weeks),
Chest pain,
Hemoptysis,
Weakness/fatigue,
Weight loss/ loss of appetite,
Fever/chills/night sweats
What do Obstructive Lung Diseases include? (Def. and pathologies)
Conditions that cause problems with exhaling air from the lungs. “Patients can get are in but CANT get air out”
Includes:
COPD (Chronic Bronchitis, Emphysema),
Asthma,
Cystic Fibrosis
What do Restrictive Lung Diseases include? (Def. and pathologies [Has 3 different types of disorders])
Conditions that cause problems with expanding their lungs fully making it difficult to fill lungs during inhalation.
Includes:
Intrinsic Disorders- Sarcoidosis, pneumoconiosis, TB, interstitial lung disease
Extrinsic (chest wall) Disorders- Scoliosis, kyphosis, obesity, pleurisy, rib fracture
Neuromuscular Disorders- Paralysis of diaphragm and/or accessory muscles
What is COPD (Chronic Bronchitis)?
Chronic inflammation of the bronchi
What is the etiology of COPD (Chronic Bronchitis)?
Smoking, air pollutants, genetic factors, respiratory infections
What are the clinical features for COPD (Chronic Bronchitis)?
Excessive production of mucus and cough,
Cyanosis; Peripheral edema (Blue bloaters,
Pulmonary hypertension,
Shortness of breath (SOB)
What are the pathogenesis for COPD (Chronic Bronchitis)?
-Inflammation and scarring of bronchial lining
-Walls of bronchi thicken and lumen fulls with mucus infiltrated with plasma cells, macrophages, and lymphocytes
-Swollen mucous membrane and thick sputum obstruct the airways, impaired ciliary function reduces mucous clearance
What is COPD (Emphysema)?
A lung condition caused by damage to the alveoli
What are the etiology of COPD (Emphysema)?
Smoking, air pollutants, genetic factors
What are the clinical features for COPD (Emphysema)?
-Dyspnea (initially with exertion only, then at rest), Barrel chest
- Little cough or sputum production
- Thin, forward flexed presentation, excessive use of accessory muscles
(NO CYANOSIS, NO PULMONARY HYPERTENSION, NO PERIPHERAL EDEMA)
What is the pathogenesis for COPD (Emphysema)?
Irritants of smoke=> Inflammatory cells into alveoli; Proteolytic enzymes released from leukocytes destroy alveolar walls. Enlargement of the airspaces distal to the terminal bronchioles with destruction of the alveolar walls.
(Just think of destruction of the alveolar walls)
What is Asthma? (Def. and the two types)
A reversible obstructive lung disease, inflammation and increased reactivity of smooth muscle airways to various stimuli.
Two main types:
Extrinsic (allergy)
Intrinsic (non-allergy)
What are the etiology for Asthma?
Genetic, air pollution, environmental exposures (pollen, mold, dust)
What are the clinical features for Asthma?
Chest tightness, WHEEZING on expiration, cough, dyspnea
What is the pathogenesis for Asthma?
Acute inflammatory response, bronchial smooth muscle contraction, increased vascular permeability, edema, think mucus production, impaired mucocillary function
What is Sarcoidosis?
A disease characterized by the growth of granulomas in any part of the body, most commonly the lungs and lymph nodes.
What are the etiology for Sacroidosis?
Unknown, possible genetic predisposition triggered by bacteria, dust, chemicals
What is the pathogenesis for Sarcoidosis?
Infiltration of T lymphocytes produce granulomas that build up in the lungs, lymph nodes, eyes, skin, heart or other organs
What is Laryngeal Cancer?
Cancer the often forms in squamous cells in the lining of the larynx
What are clinical features of laryngeal cancer?
Persistent sore throat or cough,
trouble or pain with swallowing,
ear pain,
lump in neck or throat,
change or hoarseness of voice
What are the risk factors for laryngeal cancer?
Smoking and alcohol abuse
Where are the metastasis for laryngeal cancer?
May spread to nearby tissues, thyroid, trachea, esophagus, lymph nodes in neck, carotid artery, upper spinal column
What is lung cancer?
Cancer in the lungs, leading cause of cancer deaths between men and women.
What are the clinical features for lung cancer?
Incidence rises with age (above 40)
-cough, dyspnea, chest pain, weight loss
What are the risk factors for lung cancer?
Smoking, genetics, environmental or occupational exposures
Where are the metastasis for lung cancer?
Liver and brain most common, bone, kidney adrenals
(70% of patients dx /c lung CA have metastasis)
