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Pathophysiology > Respiratory Disorders > Flashcards

Respiratory Disorders Flashcards

1
Q

Trachea structures

A

elastic tissue
C-shaped rings of cartilage
smooth muscle cells

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2
Q

Bronchial tree progression

A

primary bronchi
secondary bronchi
bronchioles
alveolar ducts

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3
Q

Do bronchioles have cartilage?

A

no

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4
Q

Bronchioles have …. cellls and ….relaxes them.

A

smooth

SNS

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5
Q

Alveoli are the … for inspired air. They are lined by a …. They are the site for …. with three structures particpating:
Alveoli contain … and … which prevents infections.

A

end-point
single layer of epithelial cells (type I)
gas exchange
basement membrane, epithelial wall, capillary wall
elastic fibers
macrophages

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6
Q

Alveoli contain a thin layer of ….The inner surface is covered by …
This is produced by … cells and acts as a ….
This covering prevents …. and reduces …. by decreasing ….

A 
water
surfactant
type II cells 
detergent 
collapse of alveolus during expiration
efforts to expand lungs during inspiration
surface tension of water
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7
Q

Surfactant consists of …. and spreads as a …. it reduces … of alveolar fluid at air-liquid interface.

A

lipoproteins
thin film at air-liquid interface
surface tension

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8
Q

Surfactant is produced …. premature babies …. and because of this they have difficulty breathing and respiratory failure. Reduced surfactant levels occur in …, …., and …..

A 
late in fetal development
do not have enough of it 
pulmonary edma
lung injury
some genetic disease
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9
Q

Lung or pulmonary compliance is …

It depends on…

A

ability of the lungs to expand
elastic properties of lung tissue
alveolar surface tension
thorax anatomy and flexibility

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10
Q

Airflow direction during inspiration and expiration depends on … which is which law? When atmospheric pressure is higher than air pressure in alveoli what happens?
When air pressure in alveoli is higher than atmospheric pressure, what happens?

A

air pressure gradient
Boyles law
inspiration-air moves from atmosphere to lungs
expiration-air moves from lungs into atmosphere

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11
Q

How is hypoxemia defined? When does it occur?

A

under 80 PO2

high elevations and causes CNS changes

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12
Q

How is hypercapnia defined? What causes it?

A

over 60 PCO2 (respiratory distress)

drugs that depress respiratory center and by large airway obstruction

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13
Q

What controls ventilation? and how?

A

chemoreceptors

stimulate respiratory centers and detect changes in levels of CO2, O2, H in blood or CSF

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14
Q

Where are central chemoreceptors located? Where are peripheral chemoreceptors located?

A

medulla

carotid bodies and aortic bodies

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15
Q

Central chemoreceptors respond…. to slight increase in …. or decrease in ….

A

quickly
PCO2 in blood
pH in CSF

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16
Q

Peripheral chemoreceptors respond … to decreased …. and decreased ….

A

changes in arterial blood
PO2
Ph

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17
Q

Hypercapnia is when there is increased ….levels in blood. CO2 easily diffuses into CSF–> which lowers …. which stimulates….–> ….rate and depth of respirations which may lead to hyperventilation. This is a condition of …. and ……depression.

A 
PCO2
pH
respiratory center
increases 
respiratory acidosis 
nervous system
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18
Q

Hypocapnia is decreased … in blood. This may be caused by …. and is a condition of respiratory….

A

PCO2
hyperventilation
alkalosis

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19
Q

Each gas in a mixture moves along its partial pressure gradient, independent of other gases which is which law?

A

Daltons

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20
Q

Factors affecting diffusion of gases?

A

partial pressure gradient
thickness of respiratory membrane
total surface area available
ventilation perfusion ratio

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21
Q

If part of the alveolar wall is destroyed like in …. surface area will be reduced and there will be less …

A

emphysema

exchange

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22
Q

Ventilation and perfusion need to … for maximum gas exchange.

A

match

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23
Q

O2 binding/release to Hb is dependent on …..

A

PO2, PCO2, temperature, plasma pH

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24
Q

Spirometry

What does it test specifically?

A

pulmonary function test

pulmonary volumes and airflow times

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25
Q

Lower respiratory tract infections

A

pneumonia

TB

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26
Q

Pathophysiology of pneumonia

A

infection
inflammation of alveolar sacs
fluid accumulation that may be pus
difficulty breathing and reduced oxygen exchange

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27
Q

Classification of pneumonia is based on..

A

causative agent
anatomic location of infection
pathophysiologic changes
epidemiologic data

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28
Q

Etiology of TB

A

mycobacterium TB transmitted by oral droplets from persons with active infection

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29
Q

Mycobacterium TB characteristics

A 
aerobic, slow growing
can survive in dried sputum for weeks
somewhat resistant to drying and disinfectants
destroyed by UV light, heat, alcohol 
multidrug resistant
normal immune response may not occur
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30
Q

Two stages of TB

A

primary and secondary

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31
Q

Primary or latent infection of TB is where the individual has been …. does not have …. is …. and cannot transmit disease.

A

exposed
active disease
asymptomatic

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32
Q

Secondary infection or reinfection of TB is where the person has …. can ….. and is highly … when there is close personal contact over a period of time.

A

active infection
spread to others
infectious

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33
Q

Process of primary infection of TB:
When microbe first enters lungs it is …. by macrophages which produces local ….
If cell-mediated immunity is adequate, a … will be formed at the site of inflammation. With this, bacteria is …. by connective tissue. ….develops in the center. …. is formed which contains …. and it will be …. on radiogram. This ….may remain viable in a dormant stage for years.
If cell-mediated immunity is inadequate, it will …. and destroy lung tissue which will progress to…

A 
engulfed 
inflammation
granuloma
walled off 
necrosis
tubercle 
live bacilli
calcified
calcified tubercle 
reproduce
TB disease
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34
Q

Process of secondary or reinfection of TB:
Occurs when …. which can be from …, …, …, ….
….microbes invade or new infection occurs. Microbes begin to … and infect lungs. They form large areas of …. which causes ….. and …..
…is common. Cavitation promotes spreading into other parts of lung and infection may spread to …..
Symptoms or signs include:

A 
cell-mediated immunity is impaired 
stress, malnutrition, HIV, age
dormant 
reproduce 
necrosis 
cavitation
erosion 
hemoptysis (blood in sputum)
pleural cavity
cough, low grade fever, night sweat, weight loss, fatigue
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35
Q

Diagnostic tests for TB are for …. and indicated by a positive Mantoux skin test which tests which type of hypersensitivity? Can often see … on X-ray. For active infections of TB to diagnose one has to do …. or …. Treatment involves … and …. with long-term treatment and a combo of drugs.

A

first exposure or primary infection
Type 4
calcification
stain sputum or chest radiography looking for cavitation
sputum culture and sensitivity of microbes to drugs

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36
Q

Positive Mantoux TB test can occur if someone …

A

currently has TB
has been exposed in the past
has received the BCG vaccine which is not administered in the U.S.

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37
Q

Asthma is a …. and occurs in persons with …

A

bronchial obstruction

hypersensitive airways

38
Q

Two types of asthma

A

extrinsic

intrinsic

39
Q

Extrinsic asthma involves acute episodes triggered by ….. reaction to allergen. Intrinsic asthma involves …. tissue in airway which initiates attack.

A

type I hypersensitivity

hyperresponsive

40
Q

Mechanism of Asthma: ….released from mast cells which produces a pathophysiologic change in ….
It causes inflammation of … with …., bronchoconstriction due to contraction of … and increased … which obstructs airways either partially or totally.

A 
histamine
bronchi and bronchioles
mucosa with edema
smooth muscle cells
secretion of thick mucus
41
Q

Partial obstruction of airways produces ….

Total obstruction of airways leads to …

A

air trapping and hyperinflation of lungs

atelectasis or non-aeration of tissue

42
Q

Atelectasis

A

section collapses in the lung

43
Q

Asthma manifestations

A 
hypoxia
respiratory alkalosis
respiratory acidosis
metabolic acidosis 
respiratory failure
44
Q

When does respiratory alkalosis, acidosis, metabolic acidosis and respiratory failure occur in asthma?

A

initially due to hyperventilation
due to decreased ventilation
decrease in aerobic metabolism
fatigue in respiratory muscles

45
Q

COPDs

A

emphysema
chronic bronchitis
bronchiectasis

46
Q

COPD is the …in airways. This is ….tissue degeneration and is …. damage. Respiratory failure may occur due to … and ….
It may lead to development of cor pulmonale which is …

A 
obstruction 
progressive 
irreversible 
hypoxia and hypercapnia 
right sided HF due to lung disease
47
Q

Emphysema is the destruction of … due to the breakdown of … This leads to ….air spaces in alveoli. Contributing factor is a deficiency in …

A

alveolar walls
elastin
large, permanently inflated alveolar air spaces
alpha1 antitrypsin

48
Q

Alpha1 antitrypsin is a … inhibitor. It inhibits ….

When there is a deficiency what happens?

A

protease
elastase
genetic mutation
damage of it

49
Q

Elastase is …, …., …

A

enzyme that destroys elastin
released by neutrophils during inflammation
released by some pathogenic bacteria

50
Q

Emphysema changes the lungs by

A

loss of pulmonary capillaries
surface area of gas exchange
small bronchi collapsing
fibrosis and thickening of bronchial walls (narrowed airways)

51
Q

A loss of elastic fibers in the lungs affects….
Loss of surface area for gas exchange and pulmonary capillaries alter…
Narrowed airways interferes with…

A

lung recoil during expiration
ventilation-perfusion ratio
expiratory airflow

52
Q

In emphysema there will be a progressive difficulty with …. which means there will be air …., increase in ….volume, … of lungs, …. of ribs in an inspiratory position, increased …. of thorax, and …diaphragm on radiograms.

A 
expiration
trapping
residual
overinflation
fixation
anterior-posterior (barrel chest)
flattened
53
Q

Signs and symptoms of emphysema

A

dyspnea even at rest
hyperventilation with prolonged expiratory phase
pink puffers (hyperventilation and pink face color)
Clubbed fingers
secondary polycythemia
fatigue, weight loss

54
Q

Chronic bronchitis is a disease from …. The damage is .. and …

A

smoking, air pollutions

irreversible and progressive

55
Q

Changes in bronchi with chronic bronchitis?

A

mucosa is inflamed and swollen
hypertrophy and hyperplasia of mucous glands (increased production of mucous secretions)
fibrosis and thickening of bronchial wall
low blood O2 levels

56
Q

Signs and symptoms of chronic bronchitis

A 
dyspnea 
frequent thick and purulent secretions 
constant productive cough 
hypoxia 
hypercapnia
fatigue
weight loss
57
Q

Emphysema is known as ….. and chronic bronchitis is known as …

A

pink puffers

blue bloaters

58
Q

Bronchiectasis is …
Usually secondary to ….
Arises from ….
Leads to …. of muscle and elastic fibers in bronchial walls which …. them. ….is accumulated and areas become ….

A

permanent dilation of medium-sized bronchi
cystic fibrosis or COPD, childhood infection or congenital weakness of bronchial wall
recurrent inflammation and infection
weakening
dilates
fluid
infected

59
Q

Bronchiectasis signs and symptoms

A

chronic cough

production of large amounts of purulent foul-smelling sputum

60
Q

Restrictive lung disorders are a group of disorders with …. and reduced …
Two groups: First group has …. of chest wall which …. examples:
Second group is caused by …. affecting the supporting framework of lungs not alveoli or airways. Example:

A 
impaired lung expansion 
total lung capacity 
abnormality 
limits or impairs lung expansion 
kyphosis or scoliosis, polio, ALS, botulism, muscular dystrophy
diseases
idiopathic pulmonary fibrosis
61
Q

Pneumonconioses is a …. lung disorder.
It is … and results from …. to irritating particles like …, … ,….
Inflammation leads to development of … and loss of …. of lungs.
Onset is … where … develops first.

A 
restrictive 
chronic 
long-term exposure
asbestos, coal dust, silica, fungal spores
fibrosis 
functional areas 
insidious 
dyspnea
62
Q

Vascular disorders include

A

pulmonary edema

pulmonary embolism

63
Q

Pulmonary edema, fluid accumulates in … it can result from many primary conditions like…, …, …, …
It reduces …of oxygen in blood and interferes with …. as a result of reduced surfactant.

A 
alveoli and interstitial area 
left sided HF leading to pulmonary HBP
hypoproteinemia (due to liver or kidney disease)
inflammation of lungs
blockage in lymphatic drainage 
diffusion
lung expansion
64
Q

Why does left sided HF and pulmonary hypertension lead to pulmonary edema?

A

increases in hydrostatic capillary pressure.

65
Q

Why does hypoproteinemia lead to pulmonary edema?

A

decreases in osmotic pressure of plasma

66
Q

Why does inflammation in lungs result in pulmonary edema?

A

increases in permeability of capillaries

67
Q

Signs and symptoms of pulmonary edema

A 
cough
orthopnea 
rales
hemoptysis
frothy, blood-tinged sputum
68
Q

Expansion disorders

A 
atelectasis
pleural effusion
pneumothorax
ARDS
acute respiratory failure
69
Q

Atelactasis is …..
Alveoli become …. and collapse caused by … or …
It leads to … in gas exchange and …
It interferes with …. through the lung.
Both … and … are altered.

A 
nonaeration or collapse of lung or part of lung 
airless 
inflammation or atrophy 
decreased 
hypoxia
blood flow 
ventilation and perfusion
70
Q

Mechanisms of atelactasis

A 
obstructive or resorption
compression
due to increased surface tension
contraction
postoperative
71
Q

Compression atelectasis

A

mass/tumor exerts pressure on part of the lung

72
Q

Increased surface tension of alveoli

A

prevents expansion of lung

73
Q

Contraction atelectasis

A

fibrotic tissue in lungs or pleura may restrict expansion and lead to collapse

74
Q

Pleural effusion is the presence of … which causes increased …. , … of pleural membranes and … cohesion during inspiration.

A

excessive fluid in pleural cavity
pressure
separation
decreased

75
Q

Transudative effusions are … effusions or ….

They result from … in hydrostatic pressure and …. in osmotic pressure.

A

watery
hydrothorax
increase
decrease

76
Q

Exudative effusions contain … and … and respond to ….

A

proteins
WBCs
inflammation

77
Q

Pneumothorax is ….in pleural cavity and leads to…

It can be a …. pneumothorax or a ….or a…

A 
air 
atelectasis 
closed 
simple or spontaneous
open
78
Q

Closed pneumothorax air can…

Simple or spontaneous…

A

enter pleural cavity from internal airways–no opening in chest wall.
tear on surface of the lung

79
Q

Open pneumothorax is ….

A

atmospheric air enters pleural cavity through and opening. “sucking wound”

80
Q

Secondary pneumothorax is associated with ….
it can be a rupture of …. on lung surface
…by a tumor
….cavitation

A

underlying respiratory disease
emphysematous bleb
erosion
tubercular

81
Q

Tension pneumothorax is the …. form. It results from … or …. pneumothorax. With each respiration, air … in pleural cavity. Increase in pleural pressure =

A

most serious
closed or open
accumulates
atelectasis

82
Q

ARDS or Adult (acute) respiratory distress syndrome

A

shock lung or wet lung or stiff lung

results from injury to alveolar wall and capillary wall

83
Q

ARDS’ injury to alveolar wall leads to … which increases permeability of capillary wall, increases … and … in interstitial area and alveoli and damages ….producing cells.

A

release of chemical mediators
fluid and protein
surfactant-producing

84
Q

Most common presdisposing condition for ARDS

A

sepsis

85
Q

ARDS signs and symptoms

A 
dyspnea
restlessness
rapid, shallow respiration
increased HR
decreased PO2
combo of respiratory and metabolic acidosis
86
Q

Acute respiratory failure is the … of many pulmonary conditions. May be from what disorders?
Blood gases are …. PaO2 and …PaCO2. Respiratory arrest may follow.

A 
end-result
emphysema
acute respiratory disorders
many NM diseases
Combo of chronic and acute disorders
decreased
increased
87
Q

Two types of broad lung cancers

A

small cell

non-small cell

88
Q

Small cell lung cancer comes from..

A

oat cells

89
Q

Non-small cell includes

A

squamous cell

adenocarcinomas

90
Q

Large cell carcinoma is regarded as

A

everything else

91
Q

Squamous cell carcinoma =

from … cells that fill-in cells after epithelium is damaged.

A

epithelial cells

reserve

92
Q

Adenocarcinomas=

…cell carcinomas

A

mucus producing cells

bronchoalveolar

Pathophysiology (20 decks)

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