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Pathophysiology > Ventilation Disorders > Flashcards

Ventilation Disorders Flashcards

1
Q

dead space

A

areas of the lungs that involve inhalation but no gas exchange happens

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2
Q

ventilation failure

A

alveolar cannot do effective gas exchange
-decreased respiratory rate, TV, increased dead space

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3
Q

hypoventilation

A

inadequate delivery of air to the alveoli, inadequate O2, CO2 is not removed
-hypercapnia (CO2>45)

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4
Q

hyperventilation

A

increased air entering the alveoli, decreased CO2 hypocapnia (CO2<35)

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5
Q

hypoxemia

A

deficient blood O2, low arterial O2 and Hb saturation
-measured by ABGs, O2 saturation

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6
Q

hypoxia

A

decreased O2 in tissues, doesn’t involve blood
-can be from hypoxemia or poor perfusion/circulatory hypoxia, or poor uptake of O2 by tissues (histotoxic hypoxia)

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7
Q

t/f: pneumothorax only affects people with existing lung disorders

A

false

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8
Q

pneumothorax

A

ruptured blister/pocket in the lungs

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9
Q

pneumothorax types

A

-primary: idiopathic, healthy people
-secondary: disease related (asthma, emphysema, Tb, risk factors)
-traumatic: penetrating injury (GSW, stabbing, impaling), open or closed

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10
Q

pneumothorax manifestations

A

tachycardia, decreased/absent breathing sounds on affected side, chest pain on affected side, dyspnea, asymmetric chest wall expansion!!!!

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11
Q

pneumothorax diagnosis

A

chest radiograph, ECG, ABGs

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12
Q

pleural effusion

A

accumulated fluid or pus in the pleural cavity from other disease processes

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13
Q

pleural effusion manifestations

A

vary by effusion size/cause: dyspnea, cough, inhalation pain, diminished breath sounds, dullness with percussion

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13
Q

pleural effusion diagnosis

A

testing on transudates, exudates, blood (hemothorax), pus (empyema)

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13
Q

pleural effusion treatment

A

treat underlying cause

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14
Q

tension pneumothorax

A

serious, life-threatening, CLOSED
-air enters during inspiration but can’t exit during expiration
-same side (ipsilateral) lung collapses, trachea/heart shift to opposite side

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15
Q

asthma

A

airway obstruction from inflammation and constriction
-increased airway reactivity to stimuli

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16
Q

nonallergic/intrinsic asthma

A

less common: exercise, stress, exposure to irritants
-non-atopic, usually adult onset

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17
Q

allergic/extrinsic asthma

A

inflammatory response from IgE’s as a response to specific antigens
-atopic, child-onset

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18
Q

process of allergic/extrinsic asthma

A

IgE mediated: B-cells>plasma cells>IgE release>mast cell and histamine release
-family history of allergy, attacks associated with seasons/environment

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19
Q

asthma manifestations

A

wheezing, tachypnea, dyspnea, coughing, chest tightness, sputum production, anxiety

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20
Q

severe asthma attacks

A

use of accessory muscles during respiration, intercostal muscles, inspiratory wheezing, tachypnea/tachycardia, PEFR<80

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21
Q

status asthmaticus

A

severe asthma that does not respond to bronchodilators
-life-threatening

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22
Q

asthma diagnosis

A

history, sputum test, pulmonary function tests, ABG, chest radiography

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23
Q

asthma treatment

A

prevention, drug therapy, desensitization, bronchodilators, corticosteroids, O2 therapy

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24
Q

COPD

A

bronchitis (B), emphysema (A)
-primarily from smoking

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25
Q

bronchitis (type B)

A

chronic inflammation/swelling of bronchial mucosa that causes scarring
-fibrosis of mucus membranes
-hyperplasia, hypertrophy of goblet cells
-increased bronchiole wall thickness

26
Q

bronchitis diagnosis

A

repeated infections from mucus, inhalation of chemicals, genetics
-diagnosed symptomatically
-productive cough>3 months per 2 or more years
-non-reversible damage
-chest radiographs, pulmonary function tests, ABG tests, ECGs, physical exam for polycythemia, cyanosis

27
Q

bronchitis manifestations

A

obesity, shortness of breath, excessive sputum, chronic cough, excess bodily fluids, pulmonary vasoconstriction (alveolar hypoxia), pulmonary hypertension, RVH (cor pulmonale) compensation

28
Q

bronchitis “blue bloater”

A

hypoxemic patient with systemic edema from RHF, pursed lip breathing, gynecomastia, raised shoulders from trying to breathe

29
Q

bronchitis treatment

A

block disease progression, optimal respiratory function, optimal activity levels, drug treatment, O2 therapy, quitting smoking

30
Q

emphysema (type A)

A

destructive changes to the alveolar walls, abnormal enlargement of air sacs
-deficiency of a1 activity in lungs from smokers or genetic

31
Q

emphysema process

A

proteolytic enzyme release>damaged alveoli>decreased surface area>airway collapse, destruction of elastic lung fibers
-smoking>elastase release>decreased or deficient a1 activity>destruction

32
Q

centrilobular emphysema

A

respiratory bronchioles affected

33
Q

paraseptal emphysema

A

alveolar ducts affected

34
Q

panacinar emphysema

A

acinus affected

35
Q

emphysema manifestations

A

cyanosis progression, dyspnea, thin body, shortness of breath, clubbing, barrel chest

36
Q

emphysema diagnosis

A

history, findings, pulmonary function tests, radiographs, ABGs, ECGs

37
Q

emphysema treatment

A

nutrition, drug therapy, O2, quitting smoking

38
Q

emphysema “pink puffer”

A

thin appearance, near-normal PO2/PCO2 from compensation, accessory muscle use, O2 therapy, pursed lip breathing

39
Q

bronchiectasis

A

recurrent pus infection/inflammation of bronchial walls leading to dilation
-destroyed bronchial walls, obliteration of small bronchioles

40
Q

bronchiectasis manifestations

A

hemoptysis, fever, night sweats, crackles, rhonchi, halitosis, pallor, clubbing

41
Q

bronchiectasis diagnosis

A

history, radiograph, pulmonary function tests, ABGs, tomography

42
Q

bronchiectasis treatment

A

antibiotics, bronchodilators, chest percussion/postural drainage

43
Q

cystic fibrosis

A

autosomal-recessive (aa) disorder of the exocrine glands secreting mucus
-obstructive disorder
-low survival age/rate

44
Q

cystic fibrosis process

A

mutations in CFTR gene make thick respiratory tract secretions and grow bacteria

45
Q

cystic fibrosis manifestations

A

productive cough, thick sputum, recurrent infections, bronchitis, pneumonia, bronchiectasis, RHF, exercise intolerance, clubbing, dyspnea, crackles, tachypnea, pancreas dysfunction

46
Q

cystic fibrosis diagnosis

A

ABG measurements, pulmonary function tests, sputum cultures, chest radiography, genetic testing

47
Q

cystic fibrosis treatment

A

bronchodilators, postural drainage, forced expiration, antibiotics, heart-lung transplant

48
Q

restrictive pulmonary disorders

A

from restricted expansion of lungs from alterations in the pleura, chest wall, or NM function
-decreased TLC, VC, FRC, RV
-low PaO2, normal/low PaCO2 and alkalosis

49
Q

fibrotic interstitial diseases

A

diffuse interstitial lung disease
-fibrosis, thickening of alveoli from an immune response following lung injury

50
Q

occupational lung diseases

A

from inhalation of toxic gases/mass
-pneumoconiosis: lung disease from inorganic dust particles (coal-mining, lead-poisoning)

51
Q

sarcoidosis

A

abnormal protein granulomas in the lung, immunologic
-symptoms: large lymph nodes, generalized systematic inflammation

52
Q

hypersensitivity pneumonitis

A

type 3 hypersensitivity reaction, allergic alveolitis from toxins, usually in non-smokers

53
Q

pulmonary embolism

A

3 risks for DVT, occludes BV in pulmonary circuit, blood clots travel to respiratory system from venous system, deathly
-treatment: supplemental O2, activity limitations, heparin, thrombolytics, embolectomy

54
Q

pulmonary hypertension

A

from emphysema, COPD, increased arterial pressure>25
-primary (unknown), secondary (COPD)
-small pulmonary vessels thicken, fibrotic walls, muscle hypertrophy, hemorrhage, tissue necrosis

55
Q

pulmonary hypertension manifestations

A

RHF, cor pulmonale, RV hypertrophy

56
Q

pulmonary hypertension treatment

A

control underlying disease, can’t be resolved if chronic, lung transplant, vasodilators/diuretics, prostacyclin

57
Q

ARDS

A

alveolar damage, pulmonary edema, bilateral infiltrates, hypoxemia
-causes: COVID, pneumonia, drug overdose, embolism, coagulation, surgery, sepsis, shock, trauma, near-drownings
-alveoli, lung collapse

58
Q

ARDS diagnosis

A

ABGs, radiographs, blood/urine cultures, pulmonary function tests

59
Q

treatment

A

doesn’t respond to O2 if lung collapses, antibiotics, bronchodilators, corticosteroids, diuretics, PEEPs

60
Q

spirometry test

A

test for ARDS, atelectasis, post-op testing
-test is a deep, slow deep breath, SMI, slow inspiration hold

61
Q

ARF

A

from ARDS, meds, NM weakness, chest wall deformities/trauma, lung disease
-manifestations: hypoxia, compensation, confusion, tremor, hypotension, tachypnea, tachycardia, unconsciousness

62
Q

ARF diagnosis

A

ABGs, PaO2<60, PaCO2>50, chest radiography showing white areas

63
Q

ARF treatment

A

airway opening, alveolar ventilation, mechanical ventilation, treatment of the underlying condition

Pathophysiology (15 decks)

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