Diseases Of The Lungs Flashcards
(10 cards)
Anatomy of the lungs
h 3 lobes and 10 segments in the right lung,
and 2 lobes and 9 segments – in the left lung. Each
segmental bronchus has a corresponding branch of the
pulmonar
Functions of the lungs
The main function
of the lungs is gas
exchange between
the inhaled air and
blood of the
capillaries envelo-
ping alveoli. For
normal gas ex-
change the oxygen
pressure in the
alveoli must reach
110 m m Hg, and
the pressure of
carbon dioxide –
40 mm Hg.
Additional functions of the lungs are the barrier function due to macrophages and regulation of
water metabolism and acido-basic status.
Mechanics of Breathing
air moves by differences in air pressure
• Inspiration
• active process; get contraction of diaphragm & external intercostal muscles
• results in increase in size of chest cavity
• Expiration
• passive process with normal expiration
• active process with forced expiration; get contraction of abdominal & internal
intercostal muscles
• results in decrease in size of chest cavity which increases pressure & forces air ou
Manifestations of Pulmonary Disease
Manifestations of Pulmonary Disease
• Sneezing = reflex response to irritation of upper respiratory tract
• Coughing = reflex response to irritation of lower respiratory tract
• Sputum production
• If yellowish- green —— infection
• If rusty ——- blood + pus = pneumococcal pneumonia
• If bloody , called “hemoptysis” —- usually frothy — seen in pulm. Edema
• Also seen in pulm. TB & cancer
• Large amounts & foul = bronchiectasis
• Thick & sticky = asthma, cystic fibrosis
• Breathing patterns
• Eupnia, labored (dyspnea) , wheezing, stridor
• Breath sounds
• Normal, rales, rhonchi, decreased breath sounds
• Dyspnea — discomfort feeling when can’t get enough air
• Orthopnea = dyspnea lying down
• Cyanosis — not a reliable early indicator of hypox
Respiratory System Diseases
Infectious diseases
A. Upper infectious disease
• URI
• Croup
• Epiglottitis
• Flu (Influenza)
B.Lower infections disease
• Bronchiolitis (RSV)
• Pneumonia
• SARS
• TB
• Fungal diseases
- Obstructive lung diseases
• Cystic fibrosis
• Cancer
• Aspiration pneumonia
• Asthma
3.COPD (chronic obstr. pulm. dis)
• Emphysema
• Chronic bronchitis
3.Restrictive lung diseases
• Chest wall abnormalities
• Connective tissue abnormalities
•Pneumoconiosis
4.Vascular disorders
• Pulmonary edema
• Pulmonary embolism
•
5.Expansion disorders
• Atelectasis
• Pleural effusion
• Pneumothorax
• Resp. distress syndrome2
Acute infectious destructions of the lungs definition etiology complains diagnosis treatment
manifest themselves basically by primary purulent-
necrotic foci in the form of an acute abscess or lung
gangrene.
Acute abscess
is an acute purulent-destructive inflammatory
process characterized by the presence of separated
purulent lung cavity surrounded by an infiltrate.
Lung gangrene
is a non-separated (without demarcation) purulent-
necrotic process of the lung tissue portion with the
tendency to spread onto the lobe or the whole lung
Etiology -Bacteria
Fungi:
Viruses:
Complaints: pronounced weakness, headache, local pain in the chest.
Fever and chills with excessive perspiration. Dry cough or cough with
discharge of small amount of sputum. Hemoptysis is possible
Shortening of percussion sound and dullness above the damaged area
of the lung, reduced harsh, sometimes bronchial breathing. Moist
crepitant rales, sounds of pleural friction are usually heard.
Delay at respiration by the damaged side of the chest, local
intensification of the vocal
fremitus and bronchophony
Elevation of the body temperature up to 39-40°C with sharp
intermittent falls. Leucocytosis up to 20-30 ×109/l, ESR –up to 60-70
mm/h. Anemia. Hypoproteinemia, moderate disturbance of the water-
electrolytic balance and acido-basic status.
Instrumental diagnostics
Roentgenography
Ct scan
Usi
Fistulography.
Complications of acute infectious
Hemmorhhage
Sepsis
Phlegm oof the thiraic walk
Bronchial fistulas
Empyema- collection of pus in the space between the lung and the inner surface of the chest wall
Treatment
Lobectomy
Pulmonectomy
Thoracostomy
Resection of the lung
Lung abscess definition etiology complains diagnosis treatment
Microbial infection causes suppurative necrosis of the
lung parenchyma producing a cavity.
Main cause is obstruction of bronchi
acute < 1month,
chronic > 1 month
Primary lung abscess or Secondary lung abscess;
Primary lung abscess:
used when abscess develops in
individuals prone to aspiration or in
general good health
80% of lung abscess is primary
(50% of these associated with putrid
sputum)
Secondary lung abscess:
obstructive airway neoplasm as a
complication of intrathoracic surgery or
systemic condition/treatment that
compromises host immune defense
mechanisms
Putrid lung abscess (foul odor of expectorated um
Causes bacteria fungi mycobacteria neoplasm(abnormal growth) septic embolism pulmonary infarction
Vasculitis bronchiectasis,
Risk factors -stroke, drugs, general anesthesia, dysphasia, respiratory muscle
dysfunction, tooth extraction,
Symptoms:
•Pronounced weakness
•Headache
•Local pain in chest
•Dry cough or cough with sputum
discharge
•Hemoptysis
Physical examination
Shortening of percussion sound and
dullness above damaged area of the lung
•Reduced harsh , sometimes bronchial(auscultation)
breathing
•Moist crepitant rales
•Sounds of pleural friction is heard(palpation)
•Local intensification of the vocal
fremitus and bronchophony
Diagnosis-Ctscan
Chest X-ray
grain stain culture ultrasonography elevation of BP leukocyttosis
Shift
Bronchscopy
Treatment if abscess less than 8/5 antibiotic therapy clindamycin Flaggl or penicillin plus flagyl
Surgery lobectomy pmeumoectomy
Complication of sbsecesx
Lung cancer trapped lung emphysema pleural fibrosis respiratory failure
Bronchopleural fistula
Pleural cutaneous fistula
tervention
Surgery is rarely required for patients with uncomplicated lung
abscess The usual indications for surgery are
– failure to respond to medical management,
– suspected neoplasm, or
– congenital lung malformation
Bronchiectases definition etiology complains diagnosis treatment
Abnormal widening of the main bronchus dilation of destruction of the large bronchus
Can be congenital and acquired
Take years to develop
Risk factors- air pollution tobacco a chronic bronchitis
Complains -elevated body temp
Streaks of blood in sputum violent cough pain in chest dyspnea
drumstick” fingers, “clock hand” nails.
At percussion the pulmonary sound in this area is usually shortened or
dullness is detected. At auscultation – multiple macrovesiculous and
mediovesiculous moist rales
Diagnosis bronchscopy blood and urine analysis a
Treatment lobectomy pulmonectomy
segmentectomy
Pulmonary bleeding definition etiology complains diagnosis treatment
Pulmonary hemorrhage is the release through the respiratory tract of a
significant amount of blood flowing from the vessels of the lung tissue
and bronchial tree.
Wounds of the lungs and bronchi
Causes of LB/Причины ЛК:
• Acute destructive processes in the lungs and bronchi.
• Chr. nonspecific and tuberculous processes in the lungs
• Foreign bodies of the lungs and bronchi
Classification
Hemoptysis - sputum production with a higher or lower blood content (from
50 to 100 ml per day). Bleeding:
• I degree (light) - up to 100 ml per day. It is divided into: single and
multiple; explicit and hidden.
• Shortness of breath - up to 22-24 breaths per 1 minute; P - 80-86 in 1 min;
arterial pressure is stable; Hb is stable.
• II degree (average) - from 100 to 500 ml per day. It is divided into: a form with a
decrease in blood pressure and Hb and without a decrease in blood pressure and
Hb. Dyspnea up to 24-26 breaths per 1 minute; P - 90-96 in 1 min; art. Pr. - up to
100mm-Hg.; Hb - reduced by 10-15%.
• Grade III (severe) - more than 500 ml per day. It is divided into: abundant with a
sharp drop in blood pressure and Hb and fulminant, deadly. Dyspnea up to 28-30
breaths per 1min .; P -110-115 in 1 min .; BP - below 90 mm Hg. v .; Hb - reduced by
20-25%.w
SIGN AND SYMPTOMS
Pulmonary hemorrhage begins with tickling, gurgling in the throat,
followed by discharge of scarlet frothy blood (with a strong jet) when
coughing. Subsequently, the blood darkens (the appearance of red blood
during this period indicates a renewed bleeding). Dyspnea appears. feeling of pain, burning, heat or expansion of the half of the
chest, where there is a source of bleeding
• X-ray - allows you to determine the lesion.
• Bronchoscopic - accurate localization of the bronchus - the source of
bleeding. The most
moment for bronchoscopy is immediately
after the actie bleeding has stopped
Angiography
Laboratory methods. They include the whole complex of studies of blood
coagulation and hemodynamics. Currently, the most objective test for
determining blood loss is the determination of BCC and GV (globular
volume).
TREATMENT
CONSERVATIVE/
• 1st aid: sitting position, with lowered legs and bundles laid on them, hot-water bottles to
the legs, drinking salted water. 1st medical aid:
• Hemostatic therapy
• . In order to redistribute blood in the body and reduce hypertension in the pulmonary
circulation, a camphor solution is injected, and atropine is used to expand the vessels of
the abdominal cavity.
Surgical treatment
Surgical interventions are divided into:
• 1. Resection-amputation
• 2. Organ-preserving (ligation of the bronchial artery, pulmonary artery,
bronchus).
• 3. Combined - endovascular occlusion and resection methods.
Bronchotomy
Lung cancer definition etiology complains diagnosis treatment
