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PAS- PATHOPHYSIOLOGY > Chapter 36 > Flashcards

Chapter 36 Flashcards

Alterations of Pulmonary Function

1
Q

signs and symptoms of pulmonary disease

  • _____ and _____
  • pulmonary disease is associated with many sings and symptoms, and their specific characteristics often help in identifying the underlying disorder. the most common characteristics are _____ and _____
hemoptysis
abnormal sputum
cyanosis
chest pain
clubbing 
altered breathing patterns
hyperventilation
hypoventilation
A

dyspnea
cough
dyspnea
cough

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2
Q 
sings and symptoms of pulmonary disease
dyspnea
-subjective sensation of \_\_\_\_\_
-severe dyspnea
--\_\_\_\_\_ of the nostrils
--use of \_\_\_\_\_ of respiration
--retraction of the \_\_\_\_\_
  • dyspnea on exertion
  • -_____ with activity
  • _____: sitting up in a forward leaning position generally relieves which breathing
  • -orthopnea is generally relieved by _____ in a _____ or supporting the upper body on _____
A 
uncomfortable breathing
flaring
accessory muscles 
intercostal spaces
SOB
orthopnea 
sitting up
forward leaning posture
several pillows
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3
Q

signs and symptoms of pulmonary disease
hypoventilation
-_____ is inadequate in relationship to the _____
-leads to _____ from _____
-is caused by _____, _____, or altered neurologic control of _____

A 
alveolar ventilation
metabolic demands
respiratory acidosis
hypercapnia/high CO2 levels
airway obstruction
chest wall restriction
breathing
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4
Q 
signs and symptoms of pulmonary diseases
hyperventilation
-\_\_\_\_\_ exceeds the \_\_\_\_\_
-leads to \_\_\_\_\_ from \_\_\_\_\_
-is caused by \_\_\_\_\_, \_\_\_\_\_, or severe \_\_\_\_\_
A 
alveolar ventilation
metabolic demands
respiratory alkalosis 
hypocapnia/low CO2 levels
anxiety
head injury
hypoxemia
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5
Q

clubbing

  • clubbing is the selective _____ of the end (_____) of a _____ and is commonly associated with diseases that interfere with _____ such as:
  • -_____, _____, _____, _____, and _____
A 
bulbous enlargement
distal segment
digit
oxygenation
bronchiectasis
cystic fibrosis 
pulmonary fibrosis 
lung abscess
congenital heart disease
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6
Q

conditions caused by pulmonary disease or injury
hypoxemia vs hypoxia
-PaO2: oxygenation of _____
-PAO2: the amount of oxygen in the _____

  • the _____ is a measure of the difference between the alveolar concentration of oxygen and the arterial concentration of oxygen. it is used in diagnosing the source of _____
  • measurement helps isolate the location of the problem as either _____ (within the lungs) or _____ (somewhere else in the body)
A 
arterial blood
alveoli
alveolar-arterial gradient
hypoxemia
intrapulmonary
extrapulmonary
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7
Q

reduced oxygenation of cells in tissues

A

hypoxia

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8
Q

reduced oxygenation of arterial blood (reduced _____), is caused by respiratory alternation

A

hypoxemia

PaO2

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9
Q

conditions caused by pulmonary disease or injury hypoxemia vs hypoxia

  • _____: or reduced oxygenation of arterial blood (reduced PaO2) is caused by _____
  • _____ of _____ through the _____ is impaired if the alveolocapillary membrane is _____ or if the surface area available for _____ is _____
  • _____ and _____ cause hypoxemia by the mechanism of abnormal _____, as occurs with _____ (tissue swelling) and _____ (formation of fibrous lesions), _____ the time required for _____ across the _____ membrane so bottom line point this causes of impairing _____
A 
hypoxemia
respiratory alternation
diffusion
oxygen
alveolocapillary membrane 
thickened 
diffusion
decreased
pulmonary edema
pulmonary fibrosis
thickness
pulmonary edema
pulmonary fibrosis 
increases
diffusion 
alveolocapillary
alveolocapillary membrane diffusion
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10
Q 
pleural abnormalities 
pleural effusion
-presence of \_\_\_\_\_ in the \_\_\_\_\_
-\_\_\_\_\_ effusion
--is \_\_\_\_\_ and diffuses out of the \_\_\_\_\_
  • _____ effusion
  • -is less _____ and contains high concentrations of _____ and _____
A 
fluid
pleural space
transudative 
watery
capillaries
exudate
watery
white blood cells
plasma proteins
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11
Q

exudative effusion

  • exudative effusion contains high concentrations of _____
  • exudative effusion may occur in response to an _____
  • the presence of a _____ can trigger exudative effusion
  • exudative effusion is a result of _____
A

white blood cells
inflammatory process
malignant cancer
increased capillary permeability

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12
Q

pleural abnormalities
empyema
-infected _____
-_____ in the _____: causes pulmonary infections (_____, _____), infected _____

clinical manifestations
-_____, _____, _____ (rapid heart rate), _____, and _____

treatment

  • administration of _____
  • drainage of the _____ with a _____
  • severe cases: _____, instillation of _____, or _____ (_____) injected into the _____
A 
pus
pleural space 
pneumonia 
abcesses
wounds
cyanosis 
fever
tachycardia
cough
pleural pain
antimicrobial medications
pleural space 
chest tube
ultrasound-guided pleural drainage 
fibrinolytic agents
deoxyribonuclease 
DNase
pleural space
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13
Q

restrictive lung diseases

  • restrict the _____
  • the lungs are unable to _____ normally, diminishing the amount of _____ that can be _____

obstructive lung diseases

  • affect _____
  • _____ into and out of the lung is _____. increased resistance to air flow caused by _____
A 
lung volume
expand
gas
inspired
gas flow
airflow
obstructed 
narrowing of airways
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14
Q

CXR abnormalities terms

  • _____ and _____: air trapping in the _____ and _____
  • _____ or _____: _____ of lung tissue
  • _____ or _____: cavities
  • _____: nodules
A 
asthma and emphysema
alveoli 
airways
pneumonia 
pulmonary edema 
consolidation 
accesses or tuberculosis
lung cancer
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15
Q

restrictive lung disorders

  • aspiration
  • _____
  • bronchiectasis, bronchitis
  • _____
  • inhalational disorders
  • pneumoconiosis
  • allergic alveolitis
  • _____
  • _____
A

atelectasis
pulmonary fibrosis
pulmonary edema
acute respiratory distress syndrome

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16
Q

atelectasis
-a loss of _____ caused by _____ of _____ and subsequent collapse of part of the _____

etiology:

  1. obstructive (e.g. _____)
  2. non obstructive- _____
  3. pneumothorax
  4. surfactant deficiency
  5. _____ (_____)
  6. asbestosis
A 
lung volume
deflation
alveoli
lung
tumor
pleural effusion
postoperative 
within 72 hours of surgery
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17
Q

atelectasis

  • _____ of _____
  • compression atelectasis
  • -_____ on the _____
  • absorption atelectasis
  • -gradual absorption of _____ from _____ or _____
  • surfactant impairment
  • -_____ production or inactivation of _____

clinical manifestations
-_____, _____, _____, and _____

  • treatment: _____
  • -_____
A 
collapse
lung tissue
external compression
lung
air
obstructed 
hypoventilated alveoli
decreased
surfactant
dyspnea
cough
fever
leukocytosis
prevention
deep breathing
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18
Q

_____ supine left lung _____ in _____

A

atelectasis
reduced
volume

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19
Q

restrictive lung disorders
pulmonary fibrosis
-excessive amount of _____ or _____ in the _____
-_____: no specific cause
–clinical manifestations: increasing _____ on _____

  • treatment
  • -_____; combined treatment with _____ drugs; _____ drugs such as (_____ and _____), interferon, and _____ agents; _____
A 
fibrous
connective 
lung
idiopathic
dyspnea
exertion
corticosteroids
cytotoxic
antifibrotic
N acetylcysteine 
pirfenidone
anticoagulant 
lung transplantation
20
Q

restrictive lung disorders
pulmonary edema
-excess _____ in the lung from disturbances of _____, _____, or _____
-most common cause of pulmonary edema: _____
-clinical manifestations: _____, _____, _____, and increased work of _____

A 
water
capillary hydrostatic pressure
capillary oncotic pressure
capillary permeability
left-sided heart disease
dyspnea
orthopnea
hypoxemia
breathing
21
Q

pulmonary edema
-perihilar, _____ shadow of _____ or _____ appearance. the hatched lines are the _____ (_____ which represent prominent _____ vessels)

A 
interstitial opacities
butterfly
bat wings
septal lines
kerley lines
interlobular lymphatic
22
Q

kerley b lines

  • these are _____ lines at the lung _____. these lines represent _____ which are usually less than 1 cm in length and parallel to one another at _____ to the _____
  • they are located peripherally in contact with the _____, but are generally absent along _____
  • they may be seen in any zone but are most frequently observed at the _____ at the _____ on the PA radiograph
A 
short parallel
periphery 
interlobular septa
right angles
pleura
pleura
fissural surfaces
lung bases
costophrenic angles
23
Q 
restrictive lung disorders
ARDS
-\_\_\_\_\_ (ALI) or \_\_\_\_\_ (ARDS)
--is a \_\_\_\_\_ form of \_\_\_\_\_ characterized by \_\_\_\_\_ and \_\_\_\_\_
--injury to the \_\_\_\_\_
--increased \_\_\_\_\_
--inflammation
--\_\_\_\_\_
--edema and atelectasis
A 
acute lung injury
acute respiratory distress syndrome
fulminant 
respiratory failure
acute lung inflammation
diffuse alveolocapillary injury
pulmonary capillary endothelium
capillary permeability
surfactant inactivation
24
Q

ARDS pathophysiology

  • in acute respiratory distress syndrome (ARDS), _____ and _____ fill with _____ as a result of inactivation of _____ and the impairment of _____
  • _____ release inflammatory mediators such as _____, _____, _____, and _____
A 
alveoli
respiratory bronchioles
fluid
surfactant 
type II alveolar cells
neutrophils
proteolytic enzymes
oxygen-free radicals
prostaglandins
leukotrienes
platelet activating factor
25
Q

obstructive pulmonary diseases

name the 4

A

asthma
chronic bronchitis
emphysema
chronic bronchitis plus emphysema equals chronic obstructive pulmonary disease (COPD)

26
Q

obstructive pulmonary disease

  • airway obstruction is worse with expiraton
  • disease requires _____ to _____ a _____
A

more force
expire
volume of air

27
Q

asthma

  • pathophysiology
  • -episodic attacks of bronchospasm, bronchial inflammation, mucosal edema, and increased mucous production
  • early asthmatic response
  • -_____ (_____), may contribute to the pathophysiologic characteristics of asthma
  • -_____ that are produced by asthma:
  • -_____
  • -_____
  • -_____
  • -_____
  • late asthmatic response
  • begins 4-8 hours after the early response
  • chemotactic recruitment of lymphocytes, eosinophils, and neutrophils occurs
  • -the release of _____ contributes to _____
  • clinical manifestations
  • -_____ and _____, _____, _____, and _____
A 
immunoglobulin E IgE
inflammatory mediators
histamine
bradykinin
leukotrienes
prostaglandins 
toxic neuropeptides
increased bronchial hyper responsiveness 
inspiratory
expiratory wheezing
dyspnea
nonproductive cough
tachypnea
28
Q

chronic bronchitis
_____- _____ is more severe
-hypersecretion of mucus and chronic productive cough that lasts at least 3 months of the year and for at least 2 consecutive years

pathophysiology:
-the production of _____ associated with chronic bronchitis is due to _____ in _____

clinical manifestations:

  • _____
  • _____ and _____
  • _____ (_____) becomes _____
  • polycythemia
  • decreased FEV1

treatment
-_____: disease _____ can be _____

A 
blue bloaters
hypoxia
mucus 
increased
goblet cell size
decreased exercise tolerance
wheezing
shortness of breath
productive cough
smokers cough
copious
smoking cessation 
progression
halted
29
Q

emphysema
_____, _____ breathing, _____
-abnormal permanent _____ of the _____ accompanied by the _____ of the _____ without _____
-loss of _____
-primary emphysema: inherited deficiency of the enzyme _____
-secondary emphysema: _____: main cause
–air pollution, occupational exposures, and childhood respiratory infections: possible contributors

clinical manifestations:
-include _____, _____ on _____, use of _____, and _____ with _____

treatment:
-the initial step in the management of emphysema: _____

A 
pink puffer
pursed lip
barrel chest
enlargement
gas-exchange airways 
destruction 
alveolar walls
obvious fibrosis 
elastic recoil
a1-antitrypsin
cigarette smoke
unexplained weight loss
dyspnea
exertion
accessory muscles
tachypnea
prolonged expiration
smoking cessation
30
Q

emphysema
_____ means that it is filled with more air than usual. this is a common finding in someone with _____. the hyperinflation also causes the _____

lateral chest xray: the _____ of the _____ are significantly _____. the thorax can be described as a _____

A 
hyper inflated lungs
chronic obstructive pulmonary disease (COPD)
flattened diaphragms
domes
diaphragm 
flattened 
barrel chest
31
Q 
lung infections
pneumonia 
-infection of the \_\_\_\_\_
-responsible for more disease and death than any other infection
-community-acquired pneumonia: \_\_\_\_\_
-health-care associated pneumonia
-hospital-acquired (\_\_\_\_\_) pneumonia
-ventilator-associated pneumonia
A

lower respiratory tract
streptococcus pneumoniae
nosocomial

32
Q 
pneumonia
community acquired (CAP)
-\_\_\_\_\_
-\_\_\_\_\_
-\_\_\_\_\_
A

streptococcus pneumoniae
H. influenza
moraxella catarrhalis

33
Q 
pneumonia
ventilator-associated (VAP)
-\_\_\_\_\_
-\_\_\_\_\_
-\_\_\_\_\_
A 
pseudomonas
staphylococcus aureus (MRSA)
klebsiella
34
Q 
pneumonia
health care associated (HCAP)
\_\_\_\_\_
\_\_\_\_\_
\_\_\_\_\_
A 
pseudomonas 
staphylococcus aureus (MRSA)
klebsiella
35
Q 
pneumonia
hospital acquired (HAP)
-has the greatest \_\_\_\_\_
-\_\_\_\_\_
-\_\_\_\_\_
-\_\_\_\_\_
A

mortality
pseudomonas
staphylococcus aureus (MRSA)
klebsiella

36
Q

pneumonia
routes of infection
-_____
-most common route of _____ is via _____ of _____

A

aspiration
lower respiratory tract infection
aspiration
oropharyngeal secretions

37
Q

streptococcus pnemoniae

  • streptococcus pneumonia
  • -ALI, resulting in _____ and _____, causes _____
  • -_____ creates a medium for the multiplication of _____ and aids in spreading infection into adjacent portions of the lung
  • -involved lobe undergoes _____
  • -four phases:
    1. _____
    2. _____
    3. _____
    4. _____
A 
inflammatory cytokines
cells
alveolar edema
edema
bacteria
consolidation
consolidation
red hepatization
gray hepatization
resolution
38
Q

pneumonia
_____ pneumonia
-is seasonal; usually mild and self limiting
-can set the stage for a secondary bacterial infection
-most common form: _____

A

viral

influenza

39
Q

pneumonia

  • clinical manifestations:
  • for streptococcus pneumonia look for _____ of _____ preceded by an _____, followed by _____, _____ (_____ or _____)

treatment:

  • bacterial pneumonia: _____
  • viral pneumonia: _____ alone, unless _____ is present
A 
rapid onset
shaking chills
upper respiratory infection
fever pleuritic chest pain
productive cough
yellow-ish green 
rust
antibiotics 
supportive therapy 
secondary bacterial infection
40
Q

tuberculosis
pathophysiology:
-isolation of _____ by enclosing them in _____ and surrounding the _____ with _____

A

bacilli
tubercles
tubercles
scar tissue

41
Q

tuberculosis
how the body walls off the bacilli
-in tuberculosis, the body walls off the bacilli in a tubercle by stimulating _____ that activate _____
-in defense, _____ and _____ release _____, which inhibits the replication of the _____ and stimulates more _____ to attack the _____. _____ can also activate _____

A 
apoptotic infected macrophages 
cytotoxic t cells
macrophages
lymphocytes
interferon
microorganism
macrophages
bacterium
apoptotic infected macrophages 
cytotoxic t cells
42
Q

tuberculosis

a patchy dense _____ can be seen in the _____

A

infiltrate

left upper lobe

43
Q

acute bronchitis

  • is an acute infection or inflammation of airways or bronchi; commonly follows a _____
  • causes symptoms similar to _____ but does not demonstrate _____ and _____
  • clinical manifestations:
  • -_____ occurs in paroxysms and is aggravated by _____, _____, or _____
  • treatment:
  • -rest, _____, humidity, and _____ (codeine)
A 
viral illness
pneumonia
pulmonary consolidation
chest infiltrates
nonproductive cough
cold
dry
dusty air
aspirin
cough suppressant
44
Q

pulmonary embolus causes alveolar dead space
-a pulmonary embolus that impairs _____ to a segment of the _____ results in an area where _____ are _____ but not _____, which causes _____

A 
blood flow
lungs
alveoli
ventilated 
perfused
alveolar dead space
45
Q

aging and the pulmonary system

  • loss of _____
  • _____ of the _____
A

elastic recoil
stiffening
chest wall

PAS- PATHOPHYSIOLOGY (17 decks)

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