Exam 3 - Respiratory Flashcards
(56 cards)
Accumulated alveolar macrophages. Cells that are filled with hemosiderin deposits (brown induration)
Hear failure cells
What offers protection against edema in the wall fo the lungs?
Tight junctions of endothelial and epithelial cells
Common causes of pulmonary edema
- Any condition that contributes to pulmonary HTN
- Hypoalbuminemia (reduced oncotic pressure)
- Lymph obstruction
What condition(s) contributes to pulmonary HTN? And what can pulmonary HTN lead to?
Left side heart failure & Mitral stenosis (etc.)
Leads to: Pulmonary edema
What are causes of Hypoalbuminemia (reduced oncotic pressure)? And what can that lead to?
Liver disease, nephrotic syndrome, severe burns
May lead to pulmonary edema
What can cause lymphatic obstruction? And what is the concern?
Tumors, renal disease, congestive heart failure.
The concern is pulmonary edema
What can cause pulmonary emboli and infarcts?
Any factor that leads to systemic thrombosis including: Cardiac disease Immobilization Trauma Surgery Burns Cancer Hypercoagulability states
What is ARDS
Adult respiratory distress syndrome aka Lung Shock
Diffuse alveolar and capillary damage contribute to increased permeability, accumulated fluid and respiratory failure.
On plain film, you would see fluid filled, firm, red, boggy lungs.
ARDS (adult respiratory distress syndrome)
Causes of ARDS?
Most common: sepsis Chemical and thermal injury Oxygen toxicity Severe lung infections Near drowning Narcotic overdose
Atelectasis
Decrease in lung volume for whatever reason
“incomplete expansion of the lungs,”
Greek: ateles “imperfect, incomplete,” literally “without an end,” (from a-, privative prefix, + telos “completion”) + ektosis “extention
Why does atelectasis happen in neonatals?
Stillborn where lungs are airless or secondary deficiencies of surfactant leads to collapsed alveoli
What is acquired atelectasis?
Either obstructive (absorptive) or compressive
Obstructive: airways blocked by foreign bodies, tumors, secretions
Compressive: contributing causes include pneumothorax and hydrothorax
In obstructive atelectasis, what way does the mediastinum shift?
Toward affected side
In compressive atelectasis, what way does the mediastinum shift?
Away from affected side
E.g. pneumothorax and hydrothorax
A group of chronic pulmonary disorders that restrict ventilation (airflow)
COPD (chronic obstructive pulmonary disease)
Characteristics of COPD?
Narrowing of bronchi and bronchioles, chronic or episodic patterns and dyspnea during symptomatic stages
What are major disease characterized by COPD?
Emphysema
Chronic bronchitis
What is common characteristic in emphysema in terms of the alveoli?
Enlargement of alveoli and reduced pulmonary elasticity
E.g. like an office building with a bunch of cubicles — take out some of the cubicle walls and you make the spaces bigger
A serum enzyme produced in the liver protects against action of Proteoglycan enzymes derived from leukocytes activated within lung
Alpha-1-antitrypsin (anti-elastase)
This is associated with the pathogenesis of emphysema
What is the enzymatic hypothesis associated with the imbalanced actions of proteases and protease inhibitors within the lung?
Alpha-1-antitrypsin
Reduced antitrypsin activity includes tobacco smoke and hereditary deficiency of alpha-1-antitrypsin
Whatare the anatomical patterns of emphysema?
Centrilobular — most common
Panlobular — most severe
Other types: paraseptal and irregular (patchy)
What are first signs of emphysema?
- Progressive dyspnea
- Cough but NOT productive
- Weight loss because breathing burns calories
dyspnea
Difficult or labored breathing
