Flashcards in Atelectasis Deck (24):
What is atelectasis
it is the collapse of the lung tissue. it may part or in all of the lung. the alveoli are deflated down to little or no volume. It is can be described as a collapsed of the lung tissue.
What are the causes for atelectasis
it can occur as a post operative complication or a result of surfactant deficiency
What are the different types of atelectasis
Resorption, compression and surfactant deficiency
What is Resorption Atelectasis
occurs when an obstruction prevents air from reaching the distal airways. the air gradually becomes absorbed and the alveolar collapse. it depends on the level of airway obstruction. Common cause is the obstruction of a bronchioles by mucous and muco-purulent Plug. Usually a postoperative complication with 24 hrs. clinical finding are fever and shortness of breath, absent breath sounds and treated with incentive spirometry
What is compression Atelectasis ?
Associated with accumulation of fluid, blood, or air with the pleural cavity. Pleural effusion cause by congestive failure (CHF). Pneumothorax is league of air into the pleural cavity
What are the signs or symptoms of atelectasis
SOB(dyspnea), Chest Pain, Cough, Hemoptysis
What are signs of a respiratory diseases
Palpation, Tachypnea and lung sounds
Where is the exchange of the gases in the lungs
What is the structure of the respiratory unit
there is the capillary endothelium, Basement membrane, pulmonary interstitial: (fine elastic fibers, small bundles of collagen, a few fibroblast like cells, smooth muscle cells, mast cells, rate mononuclear cells) and the alveolar Epithelium
What does the alveolar epithelia made of
Type 1 and type 2 pneumocytes
What is the function of type 1 pneumocytes
it functions in the actual gas exchange between the alveoli and blood . the cells are flattened, platelike and cover 95% of the alveolar surface
What is the function of type 2 pneumocytes
it functions in the secretion of the pulmonary surfactant that decreases the surface tension within the alveoli along with the repair of alveolar epithelia after damage to the type 1 and they tend to have a round shape.
What are the different lung alveolar structures and their lung disease
airway disease = ventilation defects
Interstitum diseases = diffusion defects
Pulmonary disease = vasculature
What happen when there is a lose of surfactant in a newborn
it is hyaline membrane disease or IRDS where there is a general loss of lung expansion and its duel to the loss of surfactant in the lamellar bodies.
What does IRDS lead to
Decrease of surfactant in the fetal lungs, maternal diabetes that leads to metal hyperglycemia, increase in insulin release, counter reacts with corticosteroids and decrease surfactnace synsthesis.
C- section : no stress on the baby, no release of cortisol.
What is Acute lung injury
is an inflammation of the lungs that can be life-threatening and Progress to ARDS
What are the causes of ARDS?
Left Heat Failure, Nephrotic syndrome and liver cirrhosis.
There is also:
What is the progression of ARDS
acute one of shortness of breath
decreased arterial oxygen pressure/ PaO2 (hypoxemia)
Development of bilateral pulmonary infiltrates on the chest radiograph
no clinical evidence of primary left sided heart failure
may process to ARDS
What are the MCC of Acute lung Injury
Gram Negative sepsis
What is the mechanism for actor lung injury
Under the Influence of Pro-inflammatory Cytokines such as Interleukins IL-8, IL-1 and Tumor Necrosis Factor (TNF), Released by Macrophages, Neutrophils Initially Undergo Sequestration in the Pulmonary Microvasculature, followed by Margination and Egress into the Alveolar Space, Where they Undergo Activation.
• Activated Neutrophils Release Chemical Mediators which Contribute to Local Tissue Damage, Accumulation of Edema Fluid in the Air Spaces, Surfactant Inactivation, and Hyaline Membrane Formation.
Subsequently, the Release of Macrophage-derived Fibrogenic Cytokines such as Transforming Growth Factor-β (Tgf-β) And Platelet-derived Growth Factor (PGDF) Stimulate Fibroblast Growth and Collagen Deposition Associated with Healing.
What is ARDS
It is a clinical syndrome causes by diffused alveolar capillary and epithelial Damage. Rapid onset of life threatening respiration insufficiency, cyanosis, and severe arterial hypoxemia. the hypoxemia (low concentration) is refractory to oxygen therapy and may progress to mulitsystem organ failure.
What is the pathogenesis of ARDS
There is endothelia and epithelial injury where the vascular permeability increases and causes alveolar flood. the macrophages release cytokines and cause neutrophils to migrate.there is production of hyaline membrane and decrease in surfactant
How does ARDS look on an x- ray
Bilateral, intestinal and infiltrates