Exam 4: Respiratory

Question 1

Upper Respiratory Tract:

Answer 1

conducts air to the lower airways; protects lungs from foreign particles or liquid; filters and humidifies air as it enters lungs

nose, pharynx, larynx

Question 2

Lower respiratory tract:

Answer 2

area of gas exchange, oxygenating blood and excretes carbon dioxide at alveoli

bronchiole, alveolar duct, alveoli, trachea, bronchus, bronchioles

Question 3

Aspiration:

Answer 3

particles or fluid from oropharynx enters the lower respiratory tract

Patho: failure to remove excess particles from the cilia so that it can be swallowed
Neurological decreased control
Decrease saliva productive

Question 4

Mucocilary apparatus:

Answer 4

ciliated epithelial cells and goblet cells; provide airway protection

Question 5

Oxyhemoglobin:

Answer 5

Oxygen combines loosely with the heme portion of hemoglobin to form oxyhemoglobin; important function of hemoglobin is to combine with oxygen in the lungs and then release oxygen to the peripheral tissues. It then collects carbon dioxide from the tissues and carries it back to the lungs to be excreted oxygen combined with hemoglobin

Question 6

Perfusion:

Answer 6

is the movement of blood through the pulmonary circulation, eventually providing oxygen to every part of the body

Question 7

Ventilation:

Answer 7

is the process of inspiration and expiration of air through the pulmonary airways

Question 8

Ventilation-perfusion ratio (V-Q ratio):

Answer 8

ratio of the amount of air reaching the alveoli to the amount of blood reaching the alveoli

Question 9

Atelectasis:

Answer 9

collapse of a small number of alveoli resulting in poor gas exchange

Question 10

Anoxia:

Answer 10

zero oxygen in the blood

Question 11

Tactile fremitus:

Answer 11

is palpable vibration transmitted through the patient’s bronchi to the chest wall

Question 12

Compliance:

Answer 12

elasticity or flexibility of lungs

Question 13

Kussmaul Respirations:

Answer 13

Deep labored breathing pattern; increased rate, large volumes often seen in Diabetic Ketoacidosis

Question 14

Cheynes Stokes Respirations:

Answer 14

Breathing pattern alternating periods of deep and shallow respirations. Crescendo and decrescendo pattern. Result decreased blood flow to brain

Question 15

Agonal respirations:

Answer 15

labored gasping breathing pattern; associated with extreme conditions of hypoxia

Question 16

Hypercapnia:

Answer 16

Increased carbon dioxide concentration in arterial blood. Increased PCO2 in ABG Stimulus to breath: When partial pressure of carbon dioxide (Pco2) exceeds the upper limit of normal in the bloodstream (greater than 45 mm Hg)

Question 17

Cyanosis:

Answer 17

a bluish discoloration of the skin and mucous membranes, occurs with hypoxia because of the excessive concentration of deoxygenated hemoglobin in the small blood vessels

Question 18

Central cyanosis:

Answer 18

decreased arterial oxygenation best detected in oral mucosa, lips, and skin

Question 19

Minute ventilation:

Answer 19

tidal volume X Respiratory Rate

The amount of air that enters the lungs in a minute

Question 20

Hypoventilation:

Answer 20

decreased minute ventilation

Question 21

Hyperventilation:

Answer 21

increased Respiratory rate or tidal volume; alveolar ventilation exceeds demand; results in rapid removal of C)2 and possibly hypocapnia

Question 22

Empyema:

Answer 22

infected pleural effusion; complication of pneumonia, surgery, trauma, bronchial Obstruction (tumor)

Question 23

Pulmonary edema:

Answer 23

high hydrostatic pressure within the pulmonary capillaries causes fluid from the blood to diffuse into the interstitial tissues –> excess fluid in lungs

Question 24

Erythropoietin:

Answer 24

stimulated by hypoxia; responsible for the stimulation of RBC production, is secreted by the kidneys in response to low oxygen levels in the bloodstream

Question 25

Phrenic nerve:

Answer 25

Originates as the fourth cervical spinal nerve (C4), innervates the diaphragm.

Question 26

Bronchoscopy:

Answer 26

direct visualization of larynx, trachea, bronchi- scope device with camera and suction

Question 27

Thoracentesis:

Answer 27

large bore needle inserted into chest wall into pleural space; pleural fluid can be removed and or sent for “culture”

Question 28

Pulmonary Function Tests (PFTs):

Answer 28

measures of forced expiratory volume at 1 second (FEV1) and forced vital capacity (FVC)

Question 29

Obstructive disease:

Answer 29

is characterized by an increase in resistance to airflow from the trachea and larger bronchi to the terminal and respiratory bronchioles

Question 30

Restrictive disease:

Answer 30

Is characterized by reduced expansion of lung tissue, with decreased total lung capacity. Lungs are stiff and noncompliant in restrictive disease

Question 31

MVV

Answer 31

Maximal voluntary ventilation spirometry test that measures the largest volume that can be moved into and out of the lungs during a 10-15 second interval with voluntary effort

Question 32

FVC

Answer 32

Forced vital capacity the amount of air exhaled forcefully and quickly after inhaling as much as you can

Question 33

FEV 1.0

Answer 33

Forced expiratory volume in 1 sec amount of air you can force from your lungs in one second

Question 34

FEV1.0/FVC%

Answer 34

The normal value for this ratio is above 0.75-85, though this is age dependent. values less than 0.70 are suggestive of airflow limitation with an obstructive pattern used to diagnose COPD and other diseases

Question 35

Typical pneumonia

Answer 35

Etiology: bacterial Epi: older adults Clinical manifestations: cough, fever, leukocytosis

Question 36

Atypical pneumonia

Answer 36

Etiology: common Mycoplasma pneumonia or viruses like influenza, RSV Epi: common children and young adults Clinical manifestations: minimal, fever, HA, dry hacking nonproductive cough Patho: patchy lung involvement Atypical less striking symptoms and physical findings no leukocytosis, no purulent sputum, lack of lobar consolidation on chest imaging

Question 37

Community-acquired Pneumonia (CAP)

Answer 37

Etiology: bacteria or viral. most common is Streptococcus Pneumoniae, Haemophilus influenzae Epi: Children and older adults most susceptible, under normal conditions, healthy host has mechanisms to prevent clinical infection Prognosis: use of vaccine every 5-10 years is helpful

Question 38

Hospital-acquired Pneumonia (HAP)

Answer 38

Etiology: infection w/in 48 hours after admission or while in the hospital Epi: immunocompromised, chronic lung disease, intubation, predisposing condition Prognosis: 20-50% mortality

Question 39

Chronic bronchitis-

Answer 39

cough for 3 months out of the year for 2 consecutive years

Question 40

Emphysema-

Answer 40

overdistension of alveoli with trapped air, creating an obstruction to expiratory airflow, loss of elastic recoil of alveoli and high residual volume of CO2 in lung.