Week 9 Flashcards
What traps dust and smoke
hair and mucus
What prevents food and liquid from entering lower respiratory tract
epiglottis
Where does conducting zone start and end
trachea to bronchus
where does respiratory zone begin
bronchioles with alveoli
where does gas exchange occur at
respiratory zone (bronchioles with alveoli)
What prevents alveoli walls from collapsing and sticking together
slightly oily surfactant
What monitors PaCO2
Central chemoreceptors in medulla oblongata
what monitors PaO2 and blood pH
Peripheral chemoreceptors in carotid and aortic arch
What is respiratory failure
when lungs fail to oxygenate arterial blood adequately to prevent carbon dioxide retention
hypoxemia
partial pressure of oxygen <60mmHg
Reduced PaO2 in arterial blood
Leads to tissue hypoxia
hypoxemia AKA
type I respiratory failure
hypocapnia
partial pressure of carbon dioxide > 50 mmHg
hypocapnia AKA
type II respiratory failure
Mild symptoms of hypoxemia
Decreased mental power, visual, tachypnea
profound symptoms of hypoxemia
CNS, CVS, Respiratory
Tissue hypoxia
inadequate cellular oxygenation
tissue hypoxia effects
CNS, Myocardium, Renal, Vascular
CNS effect of tissue hypoxia
hypoxic ischemic encephalopathy
How to identify respiratory failure
Vital signs, GCS, Respiratory findings
How to stabilize patients with respiratory failure
airway, breathing, circulation
what needs to be investigated for respiratory failure
arterial blood gas, CXR, CT scans
ABG is taken from ___
radial, brachial, femoral arteries
lung cancer symptoms related to __
primary lesion, intrathoracic spread, distant metastasis, paraneoplastic (unusual hormone expression)
ways to diagnose lung cancer
CXR, CT scan, PET scan, biopsy
what is the most common screening test for lung cancer
CXR
radiological findings for lung cancer
- coin lesions
- large irregular masses
- alveolar consolidation
stage 1 of lung cancer signs
tumor is 1-4cm
stage 2 of lung cancer signs
tumor is 3-7cm, may be in lymph nodes / surrounding tissues
stage 3 of lung cancer signs
tumor is 3-7cm, disease in more than 1 lymph node / surrounding tissues
stage 4 of lung cancer signs
metasized cancer
NSCLC stage I
local disease
NSCLC stage II
resectable
NSCLC stage IIIa
locally advanced resectable
NSCLC stage IIIb
locally advanced unresectable
NSCLC stage IV
far advanced
diff types of NSCLC
- adenocarcinoma
- squamous cell carcinoma
- large cell carcinoma
diff types of small cell lung carcinoma
- combined small cell carcinoma
- oat cell carcinoma
what is the lung test function to diagnose asthma
spirometry
factors of asthma
wheezing
dyspnea
cough
chest tightness
increased probability of asthma
- > 1 symptom
- worsens at night
- varying intensities
- multiple triggers
decreased probability of asthma
- isolated cough
- chronic sputum
- dyspnea with giddiness & paresthesia
- chest pain / stridor
goals of asthma treatment
- control symptoms
- maintaining lung function
- prevent exacerbations, asthma death
- minimize side effects
main determinants of oxygen delivery are __
cardiac output, hemoglobin & arterial oxygen saturation
most common cause of hypoxemia
mismatch between ventilation & perfusion
causes of hypercapnia are __
neurological, lungs & blood flow
ABG measures
amount of O2 & CO2 dissolved in arterial blood
NCS
nerve conduction study
EMG
electromyography
surgical evaluation of lung cancer done via __
VATS & thoracotomy
asthma involves inflammation of ___
airways
allergic asthma onset caused by __
childhood, atopy, eczema, food/drugs
non allergic asthma onset caused by __
obesity, adult, smoking
adult onset caused by __
late onset, female, no allergies
persistent airflow limited asthma onset caused by __
persistent chronic asthma
cellular involvement of allergic asthma
eosinophils & inflammation
cellular involvement of non allergic asthma
neutrophils, inflammation
cellular involvement of adult onset asthma
paucigranulocytic
cellular involvement of chronic asthma
airway wall remodelling
cellular involvement of asthma with obesity
less eosinophilic
AIR
anti-inflammatory reliever
MART
maintenance & reliever therapy
SABA
short acting beta agonists
triage escalation for asthma only occurs if __ are present
drowsiness, confusion, silent chest
genetically determined COPD / COPD-G
alpha-1 antitrypsin deficiency
COPD from infections / COPD-I
childhood, tuberculosis, WHIV
COPD-A
childhood asthma
COPD-D
COPD from abnormal development
COPD-P
biomass and pollution exposure COPD
COPD-C
cigarette smoking COPD
COPD-U
COPD of unknown causes
chronic bronchitis causes
inflammation & excess mucus
emphysema causes
alveolar membrane breakdown
biomarkers involved in systemic inflammation of COPD
IL-6, IL-1beta, TNF-alpha
dyspnea signs before considering COPD
progressively worse over time esp with exercise
follow up assessments after spirometry
pharmacology, alternative diagnosis, interventional procedures
spirometry assesses for __
airflow obstruction severity
COPD classification workflow
- spirometry confirmation
- airflow obstruction assessment
- exacerbation / symptom assessment
ABE assessment involves ___
exacerbations, mMRC, CAT
mMRC
modified medical research council
COPD medication categories
short acting bronchodilators
long acting bronchodilators
combination inhalers
LAMA
long acting muscarinic antagonist
ICS
inhaled corticosteroid
LABA
long acting beta2-agonist
Group E treated using
LABA + LAMA (+ICS if blood eos > 300)
Group A treated using
A bronchodilator
Group B treated using
LABA + LAMA
what factors strongly favor ICS initiation
> 2 exacerbations annually
blood eosinophils > 300 microlitre
concurrent asthma
what factors strongly prohibit ICS initiation
repeated pneumonia
blood eosinophils < 100 microliter
mycobacterial infections
5A’s to quite tabacco
ask, advice, assess, assist, arrange
if patient is not viable for bullectomy, ELVR, LVRS, what can they consider?
lung transplant
interventions of bronchodilators
LABA, LAMA
interventions of corticosteroid containing regimens
LABA, LAMA, ICS
interventions of anti-inflammatory non-steroids
roflumilast
interventions of mucoregulators
N-acetylcysteine, carbocysteine, erdosteine
breakdown of alveoli wall is due to __
loss of surface area for gas exchange, pulmonary capillaries, elastic fibers
altered ventilation-perfusion ratio
decreased support for small bronchi
a post-bronchodilator FEV1/FVC ___ confirms the
presence of persistent airflow limitation
< 0.70
COPD surgery includes ___
bullectomy, lung volume reduction strategy
