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HES 311 > week 9-2 > Flashcards

week 9-2 Flashcards

1
Q

ventilation- perfusion ratio

A

the amount of air getting to the alveoli relative to amount of blood getting there

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2
Q

respiratory system will always match

A

ventilation and perfusion

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3
Q

obstructive lung disease

A
  • ventilation is obstructed(usually due to increased resistance to airflow)
  • asthma
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4
Q

restrictive lung disease

A

-reduced lung compliance- increase- stiffness- limited expansion
-pulmonary fibrosis

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5
Q

vascular disorder that impairs gas exchange

A
  • pulmonary edema
  • pulmonary embolism
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6
Q

increased resistance to airflow due to ???

A

reduced airways radius

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7
Q

obstructive lung disease volume levels statis

A

-increase in residual volume and increase in expiratory reserve volume
decrease in inspiratory reserve volume

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8
Q

restrictive lung volume levels

A

decrease expiratory and inspiratory reserve volume

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9
Q

Dynamic force vital capacity (FVC) Obstructive

A
  • blowing out is harder
  • takes a lot longer to get the air out
    -FEV1 is lower (<0.7)
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10
Q

Dynamic force vital capacity (FVC) restrictive

A

-can’t get as much air exchange in the lung
-FEV1 is higher (0.75-0.9)
-shorter breaths

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11
Q

FEVi/FVC = (normal)

A

0.8

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12
Q

Flow-Volume Loops in Obstructive

A

All flow rates diminished, Volumes:
increased RV; Decreased VC, IRV, ERV

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13
Q

Flow-Volume Loops in restrictive

A

Flow rates normal, Lung volumes:
Decreased RV, VC

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14
Q

Which of the two lead to an increased residual
volume due to ‘air trapping’?

A

obstructive

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15
Q

Which of the two display a more normal flow rate
but an inability to fully inflate the lungs?

A

restrictive

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16
Q

asthma

A
  • bronchial obstruction due to hypersensitive and/or hyperresponsive immune response
    -reversible but chronic asthma can cause irreversible damage (COPD)
    -Allergic (extrinsic) or Non-Allergic (intrinsic)
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17
Q

asthma universal response

A
  • Inflammation & edema of
    mucosa
  • Bronchoconstriction
  • Increased secretion of thick
    mucus within airways
18
Q

asthma symptoms

A
  • Coughing, wheezing,
    shortness of breath
  • Rapid breathing
  • Rapid heart rate
  • Cough up thick mucus
19
Q

Allergic (Extrinsic)

A
  • more commonly manifests in childhood
  • hypersensitivity reaction triggers an immune response
  • triggered by inhaled allergens such as dust mite allergens
20
Q

reduced alveolar elastic recoil (emphysema)

A

airways are tethered to surrounding alveoli. when alveoli inflate airways are forced to dilate also
(radial traction)

21
Q

nonallergic (intrinsic)

A
  • More commonly manifests in
    adulthood
  • Hyperresponsive reaction to
    certain stimuli
  • Triggered by factors such as
    anxiety, stress, exercise, cold air,
    dry air, hyperventilation, viruses,
    smoke, other irritants.
22
Q

the first stage of asthma

A

-sensitized mast cells within the respiratory mucosa regonize antigen
- release of chemical mediators
- inflammation bronchoconstriction,
edema, increased mucus secretions
- also stimulates vagus nerve- reflex bronchoconstriction

23
Q

The second stage (within a few hours)

A
  • Increased leukocyte infiltration
     Increased release of chemical mediators
     Prolonged inflammation, epithelial
    damage bronchoconstriction, and
    airway obstruction (partial or total)
24
Q

Partial Obstruction

A
  • some air passes through the obstruction
  • less ability to move air out resulting in air trapping. attempting to forcefully expire can lead to collapse of the bronchial wall
  • Residual Volume Increases  Less fresh air
    inspired, harder to cough out mucus
  • Air trapping & hyperinflation over time can
    stretch out alveoli and cause loss of elasticity
25
Q

Total Obstruction

A

Mucus plugs completely block airflow through
the narrowed airway
* Air distal to the block diffuses out but is not
replaced  Non-aeration and atelectasis of the
whole section distal to the block
* Hypoxemia causes local vasoconstriction in
pulmonary blood vessels (pulmonary
hypertension)  increased work load of right
side of the heart

26
Q

Asthma Treatment

A

-Determine triggers and avoid them if possible
* Good ventilation is key
* Keep healthy to avoid illness
* Swimming is a great sport, walking
* Inhaler if needed or prophylactically
* E.g. Salbutamol  a Beta-2 adrenergic agonist  Bronchodilation
* Other meds: anti-inflammatories (corticosteroids), inhibitors of chemical
mediator release, long-acting bronchodilators

27
Q

Asthma is considered an Obstructive Pulmonary
Disease. Which of the following functional
measures would you expect to see?

A

Lower FEV1 (forced expiratory volume in the first second of expiration)

28
Q

the end goal of asthma

A

MINIMIZE THE NUMBER AND SEVERITY OF ACUTE ATTACKS

29
Q

chronic obstructive pulmonary disease

A

-a group of chronic respiratory disorders that causes airways obstruction and progressive tissue degeneration
-irreversible and progressive damage to the lungs
-develops over time and usually in people over 40
-causes by smoking

30
Q

emphysema

A
  • the destruction of alveolar walls
    due to smoking or genetics
31
Q
  1. breakdown of alveolar walls
A

decrease SA for gas exchange
- loss of pulmonary capillaries alongside the alveolar wall breakdown
- altered ventilation perfusions ratio
- loss of elastic fibers– decreased elastance/ increased compliance
- decreased radial traction- collapse of small airways

32
Q
  1. increases mucus production
A
  • due to chronic inflammation and infection
    leads to thickening and fibrosis of the bronchial walls
33
Q
  1. progressive difficulty with expiration
A
  • air trapping and increased residual volume
    -overinflation of lungs
    -ribs remain in inspiratory position and increased anterior-posterior diameter
34
Q

Consequences of Advanced Emphysema

A
  • chronic hypercapnia (high CO2 levels in the blood)  Results in more Hypoxic drive
  • frequent and more sever infection because secretion are more difficult to remove
    -pulmonary hypertension and cor pulmonale in later stages
35
Q

Emphysema symptoms

A

 Subtle at first, but permanent damage is being done
- Dyspnea upon exertion at first then at also rest
- Hyperventilation with a prolonged expiratory phase
- Hyperinflation leading to barrel chest
-

36
Q

Emphysema - Diagnosis

A

Diagnosis is based on chest x-rays and pulmonary function tests
- Increased residual volume and TLC, decreased vital capacity,
and inspiratory & expiratory reserve volume
- FEV1 and FVC reduced

37
Q

emphysema Treatment

A
  • Avoid irritants and infection
  • Immunizations (flu and pneumonia)
  • Pulmonary rehab and breathing techniques
  • Bronchodilators, antibiotics, O2 therapy
38
Q

Chronic Bronchitis

A
  • Chronic irritation of the bronchi due to exposure to inhaled irritants
  • Cigarette smoke
  • Industrial or environmental pollution
  • Exposure leads to inflammation and frequent infections
  • Result is swollen airways with increased mucus production
39
Q

Chronic Bronchitis – Treatment

A
  • Reduce exposure to irritants, treat infections promptly
  • Vaccination – flu, pneumonia
  • Expectorants & chest therapy to help with expelling mucus
  • Bronchodilators
  • Low-flow forced O2
40
Q

Chronic Bronchitis – Diagnosis

A

Diagnosis
* Symptoms
* Chest X rays
* Blood gases

41
Q

chronic symptoms of bronchitis

A
  • Chronic ‘productive’ cough
  • Secretions are thick and purulent
  • Most severe in the morning
  • Dyspnea
  • Hypoxia, hypercapnia

HES 311 (23 decks)

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