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4th exam for path > Disorders of Ventilation and Gas Exchange > Flashcards

Disorders of Ventilation and Gas Exchange Flashcards

1
Q

__________– labored breathing, SOB

A

Dyspnea

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2
Q

________ – reduction in blood O2

A

Hypoxemia

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3
Q

________ – too much CO2

A

Hypercapnia

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4
Q

Primary function of respiratory system
Remove _______
Add O2

A

CO2

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5
Q

Insufficient exchange of gases leads to
– Hypoxemia (reduction in blood O2)
– Hypercapnia (too much CO2)

A
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6
Q

Hypercapnia
Increased arterial PCO2
Caused by hypoventilation or
mismatching of ventilation & perfusion

Effects
–Acid-base balance (decreased pH,
respiratory acidosis)
– Kidney function
– Nervous system function
– Cardiovascular function

A
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7
Q

Matching Ventilation & Perfusion
Required for gas exchange between the
alveoli and capillaries
Two factors interfere with the process:
– Dead air space and __________

A

shunt

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8
Q

__________________
Blood moves from venous to arterial side of the
circulation without passing through lungs

A

Anatomic Shunt

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9
Q

___________________
Mismatching of ventilation and perfusion

Insufficient ventilation to provide the oxygen needed to oxygenate the blood flowing through alveolar capillaries

A

Physiologic Shunt

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10
Q

Factors Affecting Alveolar Capillary Gas Exchange
____________available for diffusion
______________ of the alveolar–capillary membrane
Partial pressure of alveolar gases
Solubility and molecular weight of the gas

A

surface area, thickness

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11
Q

Disorders of the Pleura
Abnormal collection of fluid in the
pleural cavity
– Pleural Effusion
– Hemothorax
– Pneumothorax
– Pleuritis

A
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12
Q

Characteristics and Symptoms of Pleural Pain
_________ in onset
Unilateral, localized to lower and lateral
part of the chest
May be referred to the ______________
Usually made worse by chest
movements
Breathing becomes more __________

A

abrupt,shoulder, rapid

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13
Q

___________– blood in pleural cavity
– Small, moderate or large
– Small often resolves in 10-14 days
– Moderate to large require drainage

A

Hemothrorax

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14
Q

Hemothrorax – blood in pleural cavity
– Small, moderate or large
– Small often resolves in 10-14 days
– Moderate to large require ___________

A

drainage

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15
Q

__________________
Air in pleural space

A

Pneumothorax

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16
Q

____________-Occurs when an air-filled blister on the lung surface ruptures

A

Spontaneous pneumothorax

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17
Q

___________________
Caused by penetrating or nonpenetrating injuries

A

Traumatic pneumothorax

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18
Q

__________-Occurs when the intrapleural pressure exceeds
atmospheric pressure

A

Tension pneumothorax

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19
Q

___________:Incomplete expansion of a lung or portion of a lung

A

Atelectasis

20
Q

Atelectasis

  • Causes
    – Airway ________________
    – Lung compression such as occurs in
    pneumothorax or pleural effusion
    – Increased recoil of the lung due to loss of
    ____________________
A

obstruction

pulmonary surfactant

21
Q

Obstructive Airway Disorders
Bronchial Asthma
Chronic Obstructive Pulmonary Disorder
_____________

A

Cystic Fibrosis

22
Q

Asthma
Bronchial Asthma
– Chronic disorder of airways

Causes ______________
Bronchial hyperresponsiveness
Inflammation
– Prevalence has increased
Mortality and hospitalizations have stabilized

A

obstruction

23
Q

Asthma Triggers
Exaggerated ___________ response
2 types
– Extrinsic or atopic
– Intrinsic or nonatopic

Matter for patho, not so much clinically

A

hypersensitivity

24
Q

____________________
Type I hypersensitivity reaction to extrinsic antigen
Usually has child/adolescent onset
2 phases

A

Extrinisic asthma

25
Q

Intrinsic Asthma
Triggers include
_________________
_______________
Drugs and chemicals
Hormonal changes and emotional upsets
Gastroesophageal reflux
Remember, asthma often clinically presents
with both intrinsic and extrinsic parts

A

Respiratory tract infections, exercise

26
Q

Manifestations of Asthma
Wide range of symptoms
Episodic ____________
Chest tightness
Acute immobilizing attack
Often worse at _______

A

wheezing, night

27
Q

Classifications of Asthma Severity
Mild intermittent
Mild persistent
Moderate persistent
Severe persistent

A
28
Q

__________________
* The 4th leading cause of death in US
* 80-85% of causes were linked to smoking
– Symptoms usually absent in early stages

A

COPD

29
Q

Etiology & Pathogenesis of COPD
Includes
___________ & __________ of the bronchial wall
Hypertrophy of the submucosal glands
Hypersecretion of mucus
Loss of elastic lung fibers
Impairs the expiratory flow rate, increases air
trapping, & predisposes to airway collapse
– Alveolar tissue
Decreases the _____________ for gas exchange

A

inflammation and fibrosis

surface area

30
Q

Types of COPD
2 major types
Emphysema
Enlarged airspaces and destruction of lung tissue

________________________
Increased mucus production
Chronic cough
Obstruction of small airways

COPD is overlapping features of both!

A

Chronic Obstructive Bronchitis

31
Q

Pulmonary __________ Char.
Smoking history
Age of onset: 40–50 years
Often dramatic barrel chest
Weight loss
Decreased breath sounds
Normal blood gases until late in disease
process
Cor pulmonale only in advanced cases
Slowly debilitating disease

A

Emphysema

32
Q

Chronic Bronchitis
Smoking history
Age of onset 30–40 years
Barrel chest may be present
Shortness of breath predominant early symptom
Often dramatic cyanosis
Hypercapnia and hypoxemia may be present
Frequent cor pulmonale and polycythemia
Numerous life-threatening episodes due to
acute exacerbations

A
33
Q

__________________
Autosomal Recessive Disorder
Fluid secretion in epithelial lining of the
respiratory, GI, and reproductive tracts

Cause
Mutations in cystic fibrosis transmembrane regulator (CFTR), which functions as a chloride (Cl-) channel in epithelial cells

A

Cystic Fibrosis

34
Q

Cystic Fibrosis
Major cause of severe respiratory disease
– Children have it worst, improve as airways
expand

causes
Pancreatic exocrine deficiency
Pancreatitis
Excessive loss of sodium in the sweat

A
35
Q

______________________
–Arises from the pulmonary artery
– Provides for the gas exchange function of the lungs

A

Pulmonary Circulation

36
Q

__________________
Arises from the thoracic aorta
Supplies the lungs and other lung structures with
oxygen
Distributes blood to the conducting airways
Warms and humidifies incoming air

A

Bronchial Circulation

37
Q

___________________
A blood-borne substance lodges in a branch of
the pulmonary artery and obstructs the flow

A

Pulmonary Embolism

38
Q

Pulmonary Embolism
3 major types
Thrombus, Fat, and Amniotic Fluid

A
39
Q

______________: arising from deep vein thrombosis

A

Thrombus

40
Q

__________: mobilized from the bone marrow after a
fracture or from a traumatized fat depot

A

Fat

41
Q

____________: enters the maternal circulation after
rupture of the membranes at the time of delivery

A

Amniotic fluid

42
Q

Pulmonary Hypertension

Pulmonary circulation
Low-pressure system, facilitate gas exchange
Hypertension most often occurs 2ndary.

Results from chronic hypoxemia
COPD
Heart disorders (mitral or aortic valves)
Thromboembolic disease

A
43
Q

Secondary pulmonary hypertension is
– Dyspnea and fatigue
– Peripheral edema
– Ascites
– Signs of right heart failure (cor pulmonale)

A
44
Q

____________________
Right heart failure resulting from
Primary lung disease &
Long-standing primary or 2nd pulmonary
hypertension
Involves hypertrophyand the eventual
failure of the right ventricle
Manifestations include the signs and
symptoms of primary lung disease and
the signs of right-sided heart failure.

A

Cor Pulmonale

45
Q

Causes of Respiratory Failure
Impaired ventilation
Upper airway obstruction
Weakness of paralysis of respiratory
muscles
Chest wall injury
Impaired matching of ventilation and
perfusion
Impaired diffusion
Pulmonary edema
Respiratory distress syndrome

A
46
Q

Types of COPD
2 major types
___________________
Enlarged airspaces and destruction of lung tissue

Chronic Obstructive Bronchitis
Increased mucus production
Chronic cough
Obstruction of small airways

COPD is overlapping features of both!

A

Emphysema

4th exam for path (13 decks)

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