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Flashcards in 2) Cardiopulm Pathologies Deck (60):
1

Restrictive Diseases

Restricted inspiratory capacity bc lungs can't fully expand

2

Obstructive Diseases

Decr airflow during expiration

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Characteristics of Obstructive Diseases

*Decr elastic recoil
*Incr compliance
*Decr alveolar ventilation
*VQ mismatch
*DOE
*Hyperinflated Lungs
*Flattened diaphragm
*Enlarged R ventricle

4

Main diseases of COPD

*Emphysema
*Chronic bronchitis
*Asthma
*Bronchiectasis

5

Chronic Bronchitis

Cough producing sputum for at least 3 months of 2 consecutive yrs

6

Explain the patho of chronic bronchitis

*Goblet cell & mucus gland hyperplasia
*Decr # of cilia
*Ciliary dysfxn

7

What are the causes of chronic bronchitis?

*Long-term irritation of tracheobronchial tree (smoking)
*Pollution
*Infection

8

Why does smoking cause chronic bronchitis?

Smoking stims goblet cells & mucus glands to secrete mucus & inhibits ciliary action, which causes constriction in the tracheobronchial tree

9

Characteristics of pt's w/chronic bronchitis

*Blue bloaters
*Stocky build
*Incr PaCO2
*Polycythemia
*Incr PAP
*R ventricular hypertrophy

10

Exacerbations of chronic bronchitis

*Incr purulent sputum
*VQ abn's
*Hypoxemia
*Incr RR, work of breathing, & VO2 w/CO2 production
*Incr PAP
*R heart failure (look for edema in ankles & feet)

11

Emphysema

Hyperinflated alveoli so air can't flow out during exhalation

*Leads to alveolar destruction w/enlarged air space in lungs

12

Sx's of Emphysema

*Pink puffers bc of incr respiratory work
*Thin build
*I AP diameter of chest
*Accessory muscle use
*Seen leaning forwards w/hands on thighs
*Decr breath sounds
*Slight PaO2 abns
*Overinflatted lungs & flattened diaphragm
*SOB w/heart failure in the end

13

What causes emphysema?

Not sure but it tends to incr w/age, in smokers, & could be hereditary

14

What is used to consider the prognosis of chronic bronchitis & emphysema?

Pt's age & inital FEV1

15

What are the most common causes of death for pt's w/chronic bronchitis or emphysema?

*CHF
*Pneumonia
*PE
*Respiratory Failure

16

Asthma

Incr responsiveness of the trachea & bronchi to various stimuli so it narrows

17

What happens during an asthma attack?

*Bronchial smooth muscle spasm
*Lumen of AW becomes narrowed/occluded
*Mucosal inflammation
*Overproduction of mucus

18

Allergic/Extrinsic Asthma

Begins in pt's <35y/o bc of allergies

19

Non-Allergic/Intrinsic Asthma

Begins in pt's >35y/o bc of chronic AW obstruction w/bronchospasm & not from a specific trigger

20

Sx's of asthma

*Incr RR w/accessory muscle use
*Prolonged expiration w/wheezing & ronchi
*Underproductive cough w/chest tightness
*Hyperinflated lungs w/small areas of atelectasis
*Decr PaO2 & incr PaCO2
*Nocturnal awakenings

21

Status Asthmaticus

Asthma attack that persists for hours so pt becomes exhausted from breathing

22

For a pt w/a restrictive disorder, what would you expect their PFT to look like?

Decr VC, IC, & TLC

23

Sx's of restrictive disorders

*SOB
*Non-productive cough
*Emaciated appearance

24

Causes of restrictive disorders

*Maturational
*Pregnancy
*Pulmonary
*Cardiac
*Neuromuscular
*MSK
*Immunologic
*CT issues
*Nutritional/metabolic issues
*Traumatic
*Radiologic
*Pharmacologic

25

ARDS

Clinical syndrome characterized by severe hypoxemia & incr alveolar capillary membrane permeability

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What is ARDS associated w/?

Multi-organ failure

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Causes of ARDS

Acute Lung Trauma
*Fat emboli
*Heart-lung transplant
*Massive blood transfusion
*Aspiration
*Drugs
*Inhaled toxins
*Primary pneumonia
*Shock

28

Pulmonary Fibrosis

Chronic inflammation that causes fibrosis, destruction, & distortion of lung parenchyma

29

Sx's of pulmonary fibrosis

*Rapid, shallow breathing
*Decr breath sounds
*Rales
*DOE progressing to DOR
*Cyanosis
*Hypoxemia
*Nonproductive cough
*Fatigue
*Digital clubbing
*Loss of appetite
*Weight loss

30

Atelectasis

Collapsed lung bc of collapsed alveoli

31

What is atelectasis associated w/?

Pathological & mechanical pulmonary abn's caused by obstruction, insufficient surfactant production, & inadequate inspiratory volume

32

Atelectasis can only occur when?

When there's blood flow to the affected alveoli that are trying to absorb gas

33

True or False: Atelectasis will decr lung compliance & incr work of breathing.

True

34

What are the effects of acute atelectasis?

*Profound dyspnea
*Hypoxemia
*Reduce/absent breath sounds
*Crackles
*Tracheal & mediastinal shift towards the affected side

35

Pneumonia

Inflammatory process of the lungs caused by respiratory infections leading to consolidation of alveoli as they fill w/exudate & cellular debris

36

Angina Pectoris

Chest pain bc of ischemia of the myocardium

37

What is the referred pain pattern of angina pectoris?

*Shoulders
*Between scaps
*UE's
*Jaw
*Ear
*Teeth
*Neck

38

Describe the pain of angina pectoris

*Squeezing
*Pressure
*Tightness
*Crushing
*Burning

39

What are the 3 types of angina?

*Stable
*Unstable
*Prinz-Metal

40

Stable Angina

Occurs during physical activity

41

Describe the pain of stable angina

Substernal, non-radiating, lasting 5-15min

42

Tx for stable angina

Nitroglycerin

43

Unstable Angina

Occurs during low-level exercise & stress

44

What is unstable angina indicative of?

CAD progression

45

Prinz-Metal Angina

Occurs at rest, usually during waking

46

MI

Necrosis of a portion of the myocardium

47

Describe the pain of MI

Similar to angina, but it radiates, waxes, & wanes, & NTG doesn't do anything

48

Transmural MI

Full wall thickness

49

Subendocardia (Non Q-wave) MI

Portion of the wall is involved & can extend to transmural

50

Uncomplicated MI

Small infarction w/no complications during recovery

51

Complicated MI

Pt's may have one or a combo of dysrhythmia, heart failure, thrombosis, & damage to heart structures

52

What happens if an MI involves >40% of the L ventricle?

Cardiogenic shock & death

53

Sx's of MI in women

*Nausea
*Fatigue
*Dizziness
*Pain from the waist up
*Pain when sleeping

54

True or False: Menopause & estrogen levels are risk factors for MI in women?

True

55

CHF

Syndrome where the heart is unable to sufficiently pump blood to supply the body's needs

56

LV failure=

CHF

57

RV failure=

Cor pulmonale

58

Explain the patho of CHF

LV doesn't pump effectively so blood backs up into the lungs

59

Explain the patho of cor pulmonale

RV fails to pump effectively so blood backs up into the R atrium & then the periphery

60

Can NSAID's exacerbate heart failure?

Yes