Exam 2: Ch. 11-15 Flashcards
(282 cards)
1
Q
hemostasis
A
cease of bleeding caused by activation of blood coagulation mechanism
2
Q
factors affecting hemostasis
A
- integrity of small blood vessels
- number of platelets
- normal amt. of coagulation factors/inhibitors
- amt. of calcium ions
3
Q
integrity of small blood vessels
A
constrict upon injury to facilitate closure by clot
-first line of defense
4
Q
platelets
A
fragments of cytoplasm from large precursor cells called megakaryocytes
5
Q
survival period of platelets
A
avg. 10 days
6
Q
3 platelet functions
A
- plug defects in vessel walls
- free vasoconstrictors, causing platelets to aggregate
- release substances that initiate coagulation
7
Q
blood coagulation factors
A
complex chain reaction with 3 phases
8
Q
phase 1 of blood coagulation
A
formation of thromboplastin by interaction of intrinsic or extrinsic factors
9
Q
intrinsic factors
A
in blood, platelets and plasma factors
10
Q
extrinsic factors
A
components outside circulatory system
11
Q
phase 2 of blood coagulation
A
conversion of prothrombin into thrombin
12
Q
phase 3 of blood coagulation
A
conversion of fibrinogen into fibrin by thrombin
- thrombin splits and forms fibrin monomers
- monomers join into long fibrin strands
- strands bond to form a clot
13
Q
blood clot
A
end stage of clotting process
-made of meshwork of fibrin threads with plasma, red and white cells, and platelets
14
Q
coagulation inhibitors
A
“counterbalance” factors-they restrict clotting to a limited area
15
Q
fibrinolysin
A
plasmin that is formed by plasminogen after fibrin is dissolved upon formation
16
Q
what mineral will blood not clot without?
A
calcium
17
Q
4 categories of classification of coagulation disturbances
A
- abnormalities of small blood vessels
- abnormality of platelet formation
- deficiency of 1+ plasma coagulation factors
- liberation of thromboplastin material
18
Q
abnormality of small blood vessels
A
abnormal bleeding resulting from failure of small blood vessels to contract after injury
-due to thrombocytopenia
19
Q
thrombocytopenia
A
deficiency of platelets in blood
20
Q
petechiae
A
pinpoint sized hemorrhages of small capillaries in skin or mucous membranes
-indicative of defective/inadequate platelets
21
Q
hemophilia
A
x-linked hereditary disease affecting males
-episodes of hemorrhage in joints and internal organs after minor injury
22
Q
hemophilia A
A
-classic hemophilia
23
Q
hemophilia B
A
christmas disease
24
Q
von Willebrand disease
A
von Willebrand factor (vWf)
-vWf adheres to damaged vessel wall and helps form a clot and a complex
25
anticoagulant drugs inhibit what?
synthesis of vitamin K dependent factors
26
severe liver disease does what?
impairs synthesis of adequate amounts of coagulation factors
27
3 causes of thrombocytopenia
1. injury or disease of bone marrow-damages megakaryocytes
2. leukemic or cancer cells infiltrate bone marrow
3. anti platelet antibody destroys platelets
28
disseminated intravascular coagulation syndrome
abnormal bleeding state
- activation of coagulation mechanism
- products of necrosis liberated into circulation
- results in hemorrhaging b/c fibrinolysin is activated to dissolve all clots
29
3 factors that activate coagulation mechanism
1. diseases associated with shock
2. overwhelming bacterial infection
3. estensive tissue necrosis
30
platelet count
examination of blood smear for platelet numbers-evaluates efficiency of coagulation process
31
bleeding time
time it takes for a small skin lesion to stop bleeding; used to evaluate the function of capillaries in the hemostatic process
32
clotting time
time it takes for blood to clot in a test tube
33
partial thromboplastin time (PTT)
time it takes for blood plasma to clot after lipid substance added to plasma sample; measures time of first phase coagulation
34
prothrombin time (PT)
measures time of combined second and third phases of coagulation
-as this increases, risk for venous thrombosis increases
35
thrombin time
bypasses first two phases of coagulation, primarily measures level of fibrinogen
36
pathogenesis (development) of intravascular clotting
stasis of blood flow
vessel wall damage
increased coagulability of blood
37
thrombus
intravascular clot; can occur in any vessel or in heart
38
embolus
detached clot carried into pulmonary or systemic circulation; plugs small vessel blocking blood flow and causing necrosis
39
infarct
tissue necrosis from interruption in blood flow
40
venous thrombosis
clot formation in leg veins
41
predisposing factors to venous thrombosis
- prolonged bed rest
- cramped position for extended period
- varicose veins, any condition preventing normal emptying
42
outcome of venous thrombosis
leg swelling from partial blockage of venous return
| pulmonary embolism can occur
43
pulmonary embolism
embolus from venous thrombosis carried and lodged in pulmonary artery
- can completely block main artery or major branches, obstructing blood flow to lungs
- causes cyanosis and shortness of breath (inadequate oxygenation of blood)
44
what happens if the pulmonary embolus is large?
right side of the heart fills, pulmonary artery fills with blood, increasing pulmonary pressure, the left ventricle is unable to pump adequate blood to brain and vital organs, and blood pressure falls and shock can occur
45
what happens if the pulmonary embolus is small?
it may pass through the main pulmonary arteries and lodge in a peripheral artery, causing raise in pulmonary pressure and affected lung segment to undergo necrosis
46
if an infarct develops as a result of pulmonary embolism, what symptoms develop?
dyspnea, pleuritic chest pain, cough, and spitting up bloody sputum
47
chest x ray
can detect infarcts but not an embolus
48
radioisotope lung scans
detect abnormal pulmonary blood flow caused by embolus
49
pulmonary angiogram
gold standard
| detects the blocked pulmonary artery
50
computed tomography (CT) scan
detects pulmonary embolus indicted by obstructed flow of injected contrast medium
51
treatment of pulmonary embolism
- anticoagulants
- thrombolytic drugs
- angioplasty (balloon or stent)
- thrombectomy
52
arterial thrombosis
development of clot in artery due to injury to vessel wall from arteriosclerosis that blocks blood flow to:
1. coronary artery, causing Myocardial Infarction
2. major leg artery, causing gangrene
3. cerebral artery, causing stroke
53
in arterial thrombosis, an intracardiac thrombosis can form in 3 places:
1. atrial appendages, causing heart failure
2. surfaces of heart valves, causing valve injury
3. wall of left ventricle, causing myocardial infarction
- or may dislodge into circulation and cause infarction of an organ
54
thrombosis by increased coagulability
rise in coagulation factors following surgery or injury
| -estrogen in oral contraceptives also stimulates clotting factors
55
embolism
blood clot, fat, air, amniotic fluid, and foreign particles
56
fat embolism
caused by severe bone fracture that disrupts fatty bone marrow
-fat globules sucked into veins and obstruct pulmonary capillaries
57
air embolism
large amount of air sucked into circulation from lung injury due to chest wound
-can get into heart chambers and prevent blood returning from body from filling heart
58
amniotic fluid embolism
amniotic fluid enters maternal circulation through tear in fetal membranes
- maternal pulmonary capillaries blocked causing severe respiratory distress
- leads to disseminated intravascular coagulation syndrome
59
foreign particulate matter embolism
various types of material
- injections by substance users that crush tablets, trapped in small pulmonary blood vessels
- causes respiratory distress
60
septic embolism
thrombus forms in pelvic veins after uterine infection, invaded by bacteria, travels to lungs causing infarct and lung abscess from bacteria
61
edema
accumulation of fluid in interstitial tissues, first noted in ankles and legs
-from disturbance of extracellular fluid circulation between capillaries and interstitial tissues
62
pitting edema
indentation formed when edematous tissue is pressed with fingers
63
hydrothorax
fluid accumulates in pleural cavity
64
ascites
fluid accumulates in peritoneal cavity
65
pathogenesis (development) of edema
- increased capillary permeability
- low plasma proteins
- increased hydrostatic pressure
66
capillary hydrostatic pressure
force that pushes fluid from capillaries into extracellular space
67
capillary permeability
determines ease of fluid flow through capillary endothelium
68
osmotic pressure
water attracting property of a solution
69
open lymphatic channels
collect fluid forced out of capillaries by hydrostatic pressure and return fluid to circulation
70
shock
low blood flow/pressure to adequately supply body with blood
- potentially life threatening
- circulating blood volume
71
hypovolemic shock
low blood volume
72
cardiogenic shock
reduced cardiac output
73
septic shock
excessive vasodilation secondary to release of toxins and inflammatory mediators
74
anaphylactic shock
excessive vasodilation from release of inflammatory mediators
75
prognosis of shock depends on....
early recognition and rapid appropriate treatment
76
treatment for shock
drugs that promote vasoconstriction
IV fluids or blood to restore blood volume
treat underlying cause
77
function of heart
muscular pump, propels blood through the lungs and to tissues
78
heart disease
disturbance of heart function
79
location of heart
within mediastinum, 2/3 of heart lies left of midsternal line, and apex points towards left hip
80
pericardium
double walled sac that surrounds the heart
81
3 layers of pericardium
epicardium, myocardium, endocardium
82
epicardium
outer layer of pericardium, connective tissue, contains coronary arteries
83
myocardium
middle layer of pericardium, muscular layer, thickest, this layer actually pumps the heart
84
endocardium
innermost layer, visceral, smooth membrane, contains heart valves
85
right half of the heart
right atrium on top, right ventricle on bottom
-receives deoxygenated blood into RA from tissues from superior and inferior vena cava, goes through tricuspid valve to RV, RV pumps the blood to lungs to become oxygenated
86
left half of the heart
left atrium on top, left ventricle on bottom
-receives oxygenated blood into LA from lungs via pulmonary veins, goes through mitral valve (bicuspid) to LV, LV pumps blood to tissues and organs
87
semilunar valves
cup shaped valves at entrances of aorta and pulmonary arteries that prevent back flow of blood into ventricles during diastole (relaxation)
88
pulmonary valve
between right ventricle and pulmonary trunk to prevent back flow into right ventricle during diastole
89
aortic valve
between left ventricle and aorta to prevent back flow of blood into left ventricle during diastole
90
pulmonary circulation
oxygen poor blood enters the RA, goes through tricuspid valve to RV, enters pulmonary artery and goes to lungs
91
systemic circulation
oxygenated blood leaves lungs through pulmonary veins, enters LA, goes through mitral valve to LV, goes through aorta to rest of body
92
coronary circulation
supplies blood to the heart
- aorta branches to coronary arteries, carries blood to the heart through capillary beds of myocardium
- collected by cardiac veins, cardiac veins join to form coronary sinus that empties blood into RA
93
right coronary artery
supplies posterior wall and posterior part of interventricular septum
94
left coronary artery and branches
supplies anterior wall and anterior part of interventricular septum
95
what happens in cardiac necrosis?
cardiac muscle dies and it cannot proliferate to replace itself, so it is repaired with non-contractile scar tissue (doesn't stretch)
96
angina pectoris
chest pain from temporary reduction in blood flow to cardiac muscles despite increased oxygen demand
97
causes of angina pectoris
narrowed coronary arteries-arteriosclerosis
| stress induced spasm of coronary arteries
98
prolonged coronary artery blockage can lead to what?
myocardial infarction (MI)-heart attack
99
conduction system
specialized muscle cells that initiate electrical impulses in the heart, initiated in the sinoatrial node in the right atrium
100
systole
contraction period
101
diastole
relaxation period
102
cardiac cycle
all events associated with blood flow through heart during one heart beat
-atrial systole, atrial diastole, ventricular systole, ventricular diastole
103
cardiac output
5 liters/minute from each ventricle
104
blood pressure
blood flow in arteries results from force of ventricular contraction
- systolic pressure is highest
- diastolic pressure is lowest
105
electrocardiogram
ECG, EKG
| measures electrical activity of the heart and detects disturbances in rate, rhythm, conduction, extent of muscle damage
106
cardiac arrhythmias
disturbances in heart rate or rhythm
107
atrial fibrillation
AF
| the atria quiver instead of contracting, causing ventricles to beat irregularly
108
ventricular fibrillation
VF
| ventricles don't contract normally, incompatible with life
109
heart block
- complete or incomplete
| - delay or interruption of impulse transmission from atria to ventricles, from arteriosclerosis
110
congenital heart disease
birth defect
- bypass channels don't close normally
- septal defects
- obstruction of flow
- abnormal formation of aorta and pulmonary artery
111
how to prevent congenital heart disease?
protect the developing fetus from intrauterine injury
112
rheumatic fever
common in children
- immune reaction weeks after initial strep infection
- fever and connective tissue inflammation, especially heart and joints
113
outcomes of rheumatic fever
- scarring of cardiac tissues/valves
- death from severe inflammation and acute heart failure
- recurs if strep infection reactivates hypersensitivity and tissue damage
114
rheumatic heart disease
complication of rheumatic fever where heart valves are scarred
-causes valve regurgitation or stenosis (narrowing)
115
non rheumatic aortic stenosis
```
aortic stenosis (narrowing), where aortic valve has 2 cusps instead of 3
-valve thickens, calcifies from increased strain leading to heart failure
```
116
mitral valve prolapse
one or both leaflets enlarge, stretch, and prolapse into left atrium and don't fit together tightly
-click sound on systole followed by a murmur
117
serotonin-related heart valve damage
```
increased serotonin in blood, released from:
-platelets and histamine
-nerve endings
-neuroendocrine tumors in GI tract
-drugs that suppress appetite
develops thickening of heart valves
```
118
infective endocarditis
affects abnormal or damaged mitral and aortic valves
- complication of any valvular heart disease
- platelets and fibrin deposit on damaged valves, sites for bacteria to implant and thrombi to form
119
acute infective endocarditis
highly pathogenic organisms, commonly staph
-affects normal heart valves, those at risk include IV drug users and if unsterile materials enter the right side of the heart forming bacteria sites for thrombi to form
120
coronary heart disease
caused by arteriosclerosis
- cholesterol and lipids accumulate, form crystals, causing necrosis
- arterial walls calcify
- atheroma forms (rough, ulcerated surface predisposed to clots)
121
atheroma/atheromatous plaque
irregular mass of yellow, mushy debris extending into muscular and elastic tissues of arterial wall
122
stable plaque
buildup in arteries surrounded by fibrous tissue, causing permanent narrowing of vessel
123
most important coronary heart disease risk factors
```
elevated blood lipids
high blood pressure
cigarette smoking
diabetes
-1 risk factor= 2x risk
-2 risk factors=4x risk
-3 risk factors=7x risk
```
124
manifestations of coronary heart disease
asymptomatic, angina pectoris, oppressive chest pain that radiates into neck/arms
125
what is ischemic heart disease?
coronary heart disease
| -decreased blood supply to heart muscle from stenosis or obstruction of coronary arteries
126
myocardial ischemia
stenosis or obstruction of coronary arteries
127
stable angina
midsternal pressure or discomfort on exertion
128
unstable angina
pain lasts longer, occurs more often, and is less completely relieved
129
prinzmetal's angina
pain at rest rather than exertion
130
severe and prolonged myocardial ischemia may lead to an acute episode manifested as:
```
myocardial infarction (necrosis of heart muscle)
cardiac arrest (cessation of cardiac contractions
```
131
myocardial infarction
necrosis of heart muscle due to insufficient blood flow through coronary arteries
132
transmural infarct
full thickness infarct from endocardium to epicardium, usually from major coronary artery clot
133
subendocardial infarct
part of wall undergoes necrosis
134
myocardial infarction often involves which part of the heart's muscles?
left ventricle and septum
135
mechanisms that trigger heart attack
- sudden blockage of artery from thrombus
- hemorrhage into atheromatous plaque
- arterial spasm
- sudden greatly increased myocardial oxygen requirements, such as from vigorous physical activities
136
cardiac arrest may result from
- arrhythmia from prolonged myocardial ischemia that disrupts ventricular contraction
- asystole (cessation of cardiac contractions)
137
pericarditis
inflammation and fluid accumulation in pericardial sac
| -complication of MI where infarct extends to epicardial surface
138
cardiac rupture
blood leaks into pericardial sac from perforation in necrotic muscle
139
papillary muscle dysfunction
infarcted papillary muscle can't control mitral valve resulting in mitral valve prolapse
140
ventricular aneurysm
outward bulging of healing infarct during ventricular systole and blood fills aneurysm sac
141
MI mortality rates
6% for small infarct w/o heart failure to >50% for large infarct w/ heart failure
142
enzyme test
diagnoses MI, because enzymes leak out from necrotic cells after an infarct, and the larger an infarct, the longer for elevated levels to return to normal
143
thrombolytic therapy
most effective if used within one hour of first MI symptoms b/c it may not dissolve clot completely
144
streptokinase
enzyme from strep, reduces blood coagulability and dissolves clots
145
tissue plasminogen activator
TPA
| converts plasminogen to plasmin and dissolves clots
146
aspirin
reduces tendency of platelets to aggregate and clot within one hour of ingestion, but increases risk of brain hemorrhage with stroke
147
heparin
reduces coagulability of blood and clot formation
148
bypass surgery
uses segment of saphenous (leg vein) vein to bypass the obstructed artery
149
coronary angioplasty
a balloon or stent is inserted via catheter and expanded to push plaques to the side and dilate the vein
150
cocaine-induced arrhythmias and infarcts
intensifies effects of sympathetic nervous system
- heart rate, muscle irritability, and peripheral vein vasoconstriction
- leads to increased O2 demand and blood pressure
151
neutral fat
triglyceride from ingested fat, sugar, and carbs
152
c-reactive protein
CRP
| produced in liver and released in response to tissue injury or inflammation--high level predicts high CVD risk
153
metabolic syndrome
abdominal obesity, hypertension, abnormal lipids, insulin resistance, impaired glucose tolerance
-leads to heart disease and type 2 diabetes
154
homocysteine
sulfur-containing amino acid that when present in high levels is a risk factor for CVD
155
hypertension
vasoconstriction of small arterioles
- increased force of ventricular contraction
- increase in systolic pressure
156
cardiac effects of hypertension
higher workload, cardiomegaly, heart failure
157
vascular effects of hypertension
increased pressure, accelerated atherosclerosis, rupture and hemorrhage
158
renal effects of hypertension
decreased blood supply to kidneys, renal failure
159
primary/essential hypertension
hypertension from an unknown etiology
160
secondary hypertension
hypertension from a known disease
161
isolated systolic hypertension
mild/moderate rise in systolic pressure, low or normal diastolic pressure
162
two types of primary myocardial disease
myocarditis, cardiomyopathy
163
myocarditis
inflammation, injury, and necrosis of individual muscle fibers caused by viruses, parasites, fungi, or hypersensitivity
164
cardiomyopathy
no evidence of inflammation, dilated cardiomyopathy and hypertrophic cardiomyopathy
165
dilated cardiomyopathy
enlargement of heart and dilation of chambers, unknown cause and no treatment, leads to heart failure
166
hypertrophic cardiomyopathy
hereditary, transmitted as dominant trait, marked hypertrophy of heart muscle, reduces size of ventricles
167
idiopathic hypertrophic sub aortic stenosis
IHSS
| stenosis below aortic valve, causing excessive fatigue and lightheadedness on exertion
168
heart failure
heart is no longer able to pump adequate amount of blood and can result from any type of heart disease
169
chronic heart failure
develops slowly and insidiously
170
acute heart failure
rapid onset
171
forward failure
reduced blood flow to tissues, reduced renal blood flow, salt and water retention, edema
172
backward failure
blood backs up in veins draining to heart, leading to increased venous pressure, congestion, and edema
173
diuretic drugs
promote excretion of excess salt and water by kidneys to lower blood pressure
174
digitalis
drug that increases efficiency of ventricular contraction
175
ACE inhibitors
blocks angiotensin converting enzyme (ACE) that promotes retention of salt and water, increasing blood pressure
176
acute pulmonary edema
manifestation of acute heart failure from temporary disproportion in ventricle output
- right heart pumps blood into lungs faster than left heart delivers blood to tissues
- lungs fill with blood
177
aneurysms
dilation or out pouching of portion of arterial wall
| -caused by arteriosclerosis and congenital causes
178
arteriosclerotic aneurysm
narrowing, thrombosis, and weakening of vessel wall
| -can occur in aorta, can rupture and lead to fatal hemorrhaging
179
venous thrombosis
blockage of vein by clots
180
phlebitis
inflammation of veins
181
varices/varicosities
excessive dilation of veins
182
stem cells
precursor cells in bone marrow that form red cells, white cells, and platelets
183
red cells
transport oxygen, most numerous cells, can survive 4 months
184
erythroblast
precursor red cell in bone marrow
185
hemoglobin
oxygen-carrying protein formed by developing red call
186
leukocytes
less numerous, survival rate is several hours to several days
187
lymphocytes
can last several years, 2nd most common leukocyte
- mostly located in lymph nodes, spleen
- cell mediated defense reactions
188
types of leukocytes
neutrophils, monocytes, eosinophils, and lymphocytes
189
neutrophils
most numerous in adults, 70% of total circulating white cells
-predominant in inflammatory reactions
190
monocytes
phagocytic, increased in certain chronic infections
191
eosinophils
increased in allergic reactions or presence of animal-parasite infections
192
platelets
essential for blood coagulation, smaller than leukocytes, survive for 10 days
193
megakaryocytes
largest precursor cells in bone marrow that produce platelets
194
hematopoiesis
formation and development of blood cells, bone marrow replenishes blood cells
195
4 substances necessary for hematopoiesis
protein, vitamin B12, folic acid, iron
196
reticulocyte
young red cell w/o nucleus but retains some organelles
197
anemia
reduction in RBC or subnormal level of hemoglobin and deficiency of iron, vitamin B12, folic acid
198
normocytic anemia
RBC have normal size and appearance
199
macrocytic anemia
RBC larger than normal, show folic acid and vitamin B12 deficiency
200
microcytic anemia
RBC smaller than normal
201
hypochromic anemia
reduced hemoglobin content
202
hypochromic microcytic anemia
smaller than normal RBC and reduced hemoglobin
203
iron deficiency anemia
- most common type
- hypochromic microcytic
- inadequate iron intake, menstruation, infants during rapid growth all susceptible
204
characteristic lab profile of iron deficiency anemia
- low serum ferritin and serum iron
- high serum iron binding protein
- low percent iron saturation
205
treatment of iron deficiency anemia
primary focus is to learn the cause and direct treatment towards the cause, and administer iron supplement
206
vitamin B12 deficiency anemia
leads to neurologic disturbance b/c it is required for structural and functional integrity of nervous system
207
pernicious anemia
lack of intrinsic factor results in macrocytic anemia (intrinsic factor is in vitamin B12)
208
folic acid deficiency anemia
relatively common, body has very limited stores which much be replenished continually
-inadequate diet, poor absorption from intestinal disease, and pregnancy all cause it
209
complete blood count
assesses degree of anemia, leukopenia (reduced WBC), and thrombocytopenia (low platelets)
210
blood smear
determine if blood cell size ir normal, macro, micro
211
reticulocyte count
assesses rate of production of new red cells
212
lab tests
determine iron, vitamin B12, and folic acid levels
213
bone marrow study
studies abnormalities in bone marrow cells
214
hemolytic anemia
hereditary, spherical, hemoglobin S and C, defective hemoglobin synthesis, and enzyme defects (G6PD)
215
polycythemia
primary and secondary polycythemia
216
secondary polycythemia
reduced oxygen saturation leads to increase in RBC
217
primary polycythemia
overproduction of red cells, white cells, and platelets
218
complications of polycythemia
clot formation due to increased blood viscosity and platelet count
219
hemochromatosis
common genetic disease, transmitted as recessive trait
- iron overload but hard to excrete
- iron buildup leads to organ damage, scarring and derangement of organ function
220
manifestations of hemochromatosis
take years to develop
- tan to brown skin
- diabetes
- cirrhosis
- heart failure
221
treatment of hemochromatosis
periodic removal of blood (phlebotomy) until iron stores depleted
222
thrombocytopenia
primary and secondary thrombocytopenia, where there is allow platelet count
223
secondary thrombocytopenia
damage to bone marrow from drugs or chemicals, where bone marrow is infiltrated by leukemic cells
224
primary thrombocytopenia
bone marrow produces platelets but are rapidly destroyed
225
lymphatic system
provides immunologic defenses against foreign material via cell mediated defense mechanisms, made of lymph nodes and lymph veins
226
lymph nodes
bean shaped structure consisting of mass of lymphocytes supported by meshwork of reticular fibers and phagocytic cells-phagocytic cells destroy microorganisms
227
spleen
mass of lymphocytes that filters blood and forms antibodies
228
lymphoid tissue
in thymus, tonsils, and adenoids. lymphoid aggregates in intestinal mucosa, respiratory tract, and bone marrow
229
thymus
overlies base of heart--large during infancy and childhood, but atrophies during adolescence
230
lymphadenitis
inflamed and enlarged lymph nodes
231
infectious mononucleosis
caused by Epstein-Barr virus (EBV)
| -infection of B lymphocytes, enlargement of spleen, lymph nodes, and lymphoid tissues
232
neoplasms
metastatic tumors in breasts, lung, colon, and other sites
| -spreads to more distant lymph nodes through lymph channels
233
malignant lymphoma
hodgkin's and non hodgkin's
234
lymphocytic leukemia
from lymphoid precursor cells
| -can be acute or chronic
235
effects of speed removal
- less efficient elimination of bacteria
- impaired antibody production
- predisposed to systemic infections
236
oxygen delivery
respiratory system oxygenates blood, removes CO2
| -circulatory system transports gases in bloodstream
237
how many lobes in each lung?
2-left
| 3-right
238
bronchi
largest conducting tube for lungs
239
bronchioles
less than 1mm, connected to bronchi
240
terminal bronchioles
smallest tubes conducting air in and out of lungs
241
respiratory bronchioles
distal to terminal bronchioles with alveoli, participate in gas exchange
242
two functions of respiration
ventilation and gas exchange between alveolar air and pulmonary capillaries
243
atmospheric pressure
760 mmHg
244
requirements for efficient gas exchange
- large capillary surface in contact with alveoli
- uninterrupted diffusion across alveolar membrane
- normal pulmonary blood flow
- normal alveoli
245
pulmonary function tests
evaluate efficiency of pulmonary ventilation and pulmonary gas exchange-measure volume of air moved in and out under normal conditions
246
vital capacity
max volume of air expelled after max inspiration
247
one-second forced expiratory volume (FEV)
max volume of air expelled in 1 sec.
248
pleura
thin membrane covering lungs (visceral) and internal surface of chest wall (parietal)
249
pleural cavity
potential space between lungs and chest wall
250
intrapleural pressure
pressure within pleural cavity
251
intrapleural (pleural cavity) pressure is lower or higher than intrapulmonary (within lungs) pressure?
less. aka negative pressure b/c it is less than atmospheric pressure
252
pneumothorax
escape of air into pleural space due to lung injury or disease
253
spontaneous pneumothorax
no apparent cause, rupture of a small air filled sac at lung apex
254
manifestations of pneumothorax
chest pain, shortness of breath, reduced breath sounds
255
tension pneumothorax
positive pressure develops in pleural cavity (higher than pressure within lungs), cured with chest tube
256
atelectasis
lung collapse, can be caused by a bronchial obstruction
257
compression atelectasis
caused by external compression of lung by fluid, air, or blood in pleural cavity
258
pneumonia
inflammation of the lung
| -exudate spread through lungs and alveoli, reaching pleural surface causing irritation and inflammation
259
lobar
infection of entire lung by pathogenic bacteria
260
bronchopneumonia
infection of parts of lobes or lobules adjacent to bronchi
261
clinical features of pneumonia
fever, cough, purulent sputum (pus in sputum), pain on respiration, shortness of breath
262
COPD
emphysema and chronic bronchitis
263
pulmonary emphysema
destruction of alveolar structure, destruction begins in upper lobes, begins with dyspnea on exertion
264
chronic bronchitis
chronic inflammation of terminal bronchioles; cough and purulent sputum
265
3 main anatomic derangements in COPD
1. inflammation and narrowing of terminal bronchioles
2. dilation of pulmonary air spaces
3. loss of lung elasticity, lungs no longer recoil normally following inspiration
266
bronchial asthma
spasmodic contraction of smooth muscle walls of bronchi and bronchioles; dyspnea and wheezing on expiration
267
neonatal respiratory distress syndrome
progressive respiratory distress soon after birth-alveoli don't expand normally
-premature, c section, and diabetic mothers
268
adult respiratory distress syndrome
shock is major manifestation, blood pressure falls and blood flow to lungs reduced
269
traumatic shock
results from severe injury
270
septic shock
results from systemic infection
271
pulmonary fibrosis
fibrous thickening of alveoli from irritant gases, organic and inorganic particles
-makes lungs rigid, gas exchange hampered, progressive respiratory disability
272
pneumoconiosis
lung injury from inhalation of injurious dust
273
lung carcinoma
usually smoking related neoplasm, common malignant tumor in both genders
-aka bronchogenic carcinoma, cancer usually arises from bronchial mucosa
274
squamous cell carcinoma
lung carcinoma that is very common
275
adenocarcinoma
lung carcinoma that is very common
276
large cell carcinoma
lung carcinoma with large, bizarre epithelial cells
277
small cell carcinoma
lung carcinoma with small, irregular dark cells with scanty cytoplasm resembling lymphocytes, very poor prognosis
278
prognosis of lung carcinoma
generally poor due to early spread
279
MTB
multiple drug resistant tuberculosis-resistant to at least two drugs
280
XDR-TB
extremely drug resistant tuberculosis-no longer controlled by many TB drugs
281
arterial blood gases
pH=7.35-7.45 (acidic-below, basic-above)
oxygen= >80-100, hypoxemia if below
carbon dioxide= 35-45, respiratory cause if below
bicarbonate (HCO3)= 22-26, metabolic cause if high
282
```
ex) 7.48 pH
78 O2
32 CO2
24 HCO3
identify imbalance?
```
```
basic/alkaline
hypoxemia
respiratory cause
normal value
respiratory alkalosis with hypoxemia
```
