Chapter 12: The Lungs (Part 1)

Question 1

What is the normal amount of breaths we take per minute?

Answer 1

12-20 breaths

Question 2

If we take in less than 12 breaths per minute, this condition is known as?

Answer 2

bradypnea

Question 3

If we take in more than 20 breaths per minute, this condition is known as?

Answer 3

tachypnea

Question 4

How many lobes are in the right lung? left lung?

Answer 4

Right= 3
Left= 2

Question 5

What two respiratory structures are found in the acinus?

Answer 5

alveolar duct and alveoli

Question 6

Respiratory pathologies involve what three structures?

Answer 6

Airways, Vasculature, Interstitium

Question 7

Which type of pneumocyte makes up 95% of the surface of the lungs ?

Answer 7

Type I Pneumocyte

Question 8

What is the role of type II pneumocytes?

Answer 8

surfactant and repair

Question 9

What is the medical term for a collapsed lung?

Answer 9

Atelectasis

Question 10

What causes atelectasis?

Answer 10

collapse of multiple alveoli which causes a decrease in lung volume.

Question 11

Atelectasis is involved with deoxygenated blood which can create ____ ______.

Answer 11

tissue hypoxia

Question 12

What are the three types of atelectasis?

Answer 12

Resorption, Compression, Contraction

Question 13

Resorption Atelectasis is caused by:

a) Airway obstruction
b) Mechanically collapsed Lung
c) scarring of the lungs

Answer 13

a) airway obstruction

Question 14

What are the two main causes of resorption atelectasis (airway obstruction)?

Answer 14

Mucopurulent plug
or
Tumor, foreing body, surgical fibrosis

Question 15

What are some examples of mucopurulent plugs that can lead to resorption atelectasis

Answer 15

asthma, CF, chronic bronchitis, bronchiectasis

Question 16

How is area of collapse determined in resorption atelectasis?

Answer 16

location of obstruction ( can either be single lobe or entire lung)

Question 17

Compression Atelectasis is caused by:

a) Airway obstruction
b) Mechanically collapsed Lung
c) scarring of the lungs

Answer 17

b) mechanically collapse lung

Question 18

What leads to the mechanically collapsed lung in compression atelectasis?

Answer 18

something filling the pleural cavity; either blood, tumor or air

Question 19

What is the most common cause of pleural effusion?

Answer 19

Congestive Heart Failure (CHF)

Question 20

What is pleural effusion?

Answer 20

fluid around the lungs

Question 21

Besides CHF, what else can cause pleural effusion?

Answer 21

edmea and blood

Question 22

Name the condition: Air enters the pleural cavity

Answer 22

Pneumothorax

Question 23

Contraction Atelectasis is caused by:

a) Airway obstruction
b) Mechanically collapsed Lung
c) scarring of the lung

Answer 23

c) scarring of the lungs

Question 24

What two types of scarring can cause contraction atelectasis?

Answer 24

1) Interstitial fibrosis

2) Pleural Fibrosis

Question 25

What is the mechanism by which contraction atelectasis occurs?

Answer 25

Scarring causes decreased expansion of lungs, which limits alveolar opening which causes collapse

Question 26

Which type of Atelectasis has the most limited recovery: 1) Compression Atelectasis 2) Contraction Atelectasis 3) Resorption Atelectasis

Answer 26

2) Contraction Atelectasis

Question 27

Which vascular damage is associated with Acute Respiratory Distress Syndrome?

Answer 27

Diffuse Alveolar Damage (D.A.D.)

Question 28

Which type of epithelial damage is associated with acute respiratory distress Syndrome?

Answer 28

hyaline membrane is pink

Question 29

What causes hypoxia to occur when you have Acute Respiratory Distress Syndrome?

Answer 29

Trauma prevents gas exchange which causes hypoxemia which leads to hypoxia.

Question 30

Which tissues are most likely to be impacted by hypoxia?

Answer 30

CNS, heart, kidneys

Question 31

What is the prognosis for Acute Respiratory Distress Syndrome?

Answer 31

rapid onset, life-threatening; if they survive, prolonged recovery (6-12 months)

Question 32

What respiratory sign is characteristic of obstructive lung diseases?

Answer 32

wheezing (aka airflow resistance)

Question 33

What are the four main obstructive lung diseases studied in class?

Answer 33

Emphysema, chornic bronchitis, bronchiectasis, and asthma

Question 34

What two obstructive lung diseases make up COPD?

Answer 34

Emphysema and chronic bronchitis

Question 35

A decrease in lung expansion will lead to what lung disease?

Answer 35

Restrictive Diseases

Question 36

What are the two types of restrictive lung diseases mentioned in class?

Answer 36

1) Interstitial lung diseases (fibrosis) | 2) Chest Wall Disorders

Question 37

What obstructive lung disease is associated with the destruction of the alveolar septa?

Answer 37

Emphysema

Question 38

What happens to the acini in emphysema?

Answer 38

they enlarge

Question 39

What causes dyspnea in patients with emphysema?

Answer 39

There is decreased surface area= decreased gas exchange= dyspnea

Question 40

Can the acini heal in patients with emphysema?

Answer 40

no

Question 41

What are the two major causes of inflammation in emphysema?

Answer 41

1) Increase in proteases and decrease in anti-proteases | 2) Increase in ROS

Question 42

How is emphysema diagnosed?

Answer 42

Based on the destructive morphology of the alveolar septa

Question 43

What causes the damage of the alveolar septa in emphysema patients?

Answer 43

Incoming WBC's (neutrophils, macrophages and lymphocytes)

Question 44

What is a major risk for emphysema?

Answer 44

Smoking

Question 45

Why is smoking a major risk for emphysema?

Answer 45

Smoke increases ROS and causes a oxidant-antioxidant imbalance

Question 46

Long- term emphysema can lead to:

Answer 46

progressive dyspnea, wheezing, and coughing; forced expiration, hyperventilation, and weight loss

Question 47

What is the name of the appearance given to patiens with long-term emphysema?

Answer 47

Pink Puffer

Question 48

What are the two types of Emphysema?

Answer 48

Centriacinar and Panacinar

Question 49

Which type of Emphysema is most common: Centriacinar or Panacinar?

Answer 49

Centriacinar

Question 50

Which type of Emphysema destroys the central acinus?

Answer 50

Centriacinar

Question 51

What is the most common location of centriacinar emphysema?

Answer 51

Apices of lungs

Question 52

What is a major risk factor of centriacinar emphysema?

Answer 52

smoking

Question 53

What type of emphysema has the acinus uniformly destroyed?

Answer 53

Panacinar

Question 54

What is the most common location of panacinar emphysema?

Answer 54

lower lung fields

Question 55

Patients with Panacinar emphysema are deficient in what enzyme?

Answer 55

Alpha1-antitrypsin

Question 56

What affect does smoking have on panacinar emphysema?

Answer 56

accelerates destruction

Question 57

Hypersecretion of mucus is seen in what respiratory condition?

Answer 57

Chronic bronchitis

Question 58

What causes the hypersecretion of mucus in chronic bronchitis?

Answer 58

increased sputum production due to the hypertrophy and hyperplasia of mucous glands

Question 59

What are the risk factors for chronic bronchitis?

Answer 59

smoking, air pollutants, Males aged 40-65

Question 60

What conditions must be met to be diagnosed with Chronic bronchitis?

Answer 60

persistent productive cough lasting more than 3 consecutive months in more than 2 consecutive years

Question 61

What signs and symptoms are present in patients with Chronic Bronchitis?

Answer 61

Dyspnea, wheezing, cyanosis, weight gain; possible cor pulmonale

Question 62

What is the name of the appearance given to Chronic bronchitis patients?

Answer 62

blue bloater

Question 63

Are recurrent infections common in chronic bronchitis cases?

Answer 63

yes

Question 64

IF chronic bronchitis coincides with emphysema, this condition is known as:

Answer 64

``` Chronic Obstructive Pulmonary Disease COPD ```

Question 65

What is unique about the airflow obstruction in COPD?

Answer 65

Irreversible Airflow

Question 66

What can happen as a result of irreversible airflow obstruction?

Answer 66

prominent wheezing | possible pulmonary HTN

Question 67

What is asthma?

Answer 67

bronchoconstriction which leads to obstruction of the airway

Question 68

What are the various stimuli for asthma?

Answer 68

smooth muscle hypertrophy and hyperreactivity Inflammation and increased mucous

Question 69

Does asthma have reversible or irreversible airway obstruction?

Answer 69

reversible

Question 70

What are the signs and symptoms of asthma?

Answer 70

wheezing, dyspnea, cough, or chest tightness; difficulty inhaling or exhaling

Question 71

What time is asthma most pronounced?

Answer 71

morning and evenings

Question 72

What histological features are characteristic of asthma?

Answer 72

Curschmann spirals and charcot-leyden crystals

Question 73

Which type of asthma is a type I hypersensitivity and caused by allergens?

Answer 73

Atopic Asthma

Question 74

Which type of asthma is bronchial hyper-responsiveness and causes by various (non-allergic) exposures?

Answer 74

Non-Atopic Asthma

Question 75

What is the most common form of asthma cases?

Answer 75

Atopic Asthma (70%)

Question 76

Which type of asthma has a childhood onset with family history and happens with exposure to environmental antigens?

Answer 76

Atopic Asthma

Question 77

What are examples of Atopy?

Answer 77

eczema/urticaria, allergic rhinitis

Question 78

How common is non-atopic asthma?

Answer 78

Less common, only 30%

Question 79

Which type of asthma is characterized by bronchial inflammation and hyper-responsiveness, idiopathic and has no allergen or family history?

Answer 79

Non-Atopic Asthma

Question 80

What are the various stimuli for non-atopic asthma?

Answer 80

Viral URTI, pneumonia, exercise, cold air, aspirin, inhaled irritants, psychological stress

Question 81

What is chronic asthma?

Answer 81

prolonged severe wheezing/dyspnea

Question 82

What causes bronchial narrowing in chronic asthma?

Answer 82

1) hypertrophy of bronchial smooth muscles 2) Fibrosis 3) Increased submucosal glands (mucous plugs) 4) Increased submucosal vascularity

Question 83

What happens to the acini in chronic bronchitis?

Answer 83

It becomes hyperinflated

Question 84

What is status asthmaticus?

Answer 84

asthma that does not respond to bronchodilators or steriods

Question 85

Is status asthmaticus lethal?

Answer 85

Yes, can cause hypoxemia

Question 86

What is bronchiectasis?

Answer 86

permanent dilation of bronchi due to the destruction of connective tissue and musculature

Question 87

What diseases can cause obstruction leading to necrotizing infection in bronchiectasis?

Answer 87

Lung Ca, TB, chronic bronchitis, foreign bodies or Mucus: asthma, CF

Question 88

Where is bronchiectasis located in the lungs?

Answer 88

lower lob, could be localized or bilateral

Question 89

Patients with bronchiectasis can have episodes of severe coughing that can produce what ?

Answer 89

hemoptysis | purulent foul-smelling sputum