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Flashcards in Final Deck (29):
1

What is asthma?

-an obstructive pulmonary disease characterized by airway inflammation, bronchospasm and excessive mucus production in response to various stimuli
-a key feature of asthma is that the airway obstruction is reversible

2

What are the pathological changes of asthma?

-airway edema
-smooth muscle constriction of bronchial airways (bronchospasm)
-excessive production of thick white bronchial secretions
-mucus plugging
-hyperinflation of alveoli (air trapping)

3

What is extrinsic asthma?

predisposition, IgE antibody production, allergens such as dust mites, pollen, grass, house dust, cockroaches and food preservatives

4

What is the immunologic response to asthma?

-Exposure to antigen (antibody formation)
-Re-exposure (mast cell degranulation and release of chemical mediators)
-Chemical Response: inflammation, bronchospasm, mucus hypersecretion

5

Early response begins ____ and lasts about an hour. Late response begins ____ after exposure and lasts for a while.

in minutes; hours

6

What is intrinsic asthma?

occurs after age 40, not linked to a specific antigen, common stimuli include infections, exercise, cold air, industrial and occupation exposure (isocyanate, trimellitic anhydride), drug and food preservatives, GERD, nocturnal asthma, stress, and premenstrual asthma

7

What are the physical findings of asthma?

-Increased: Resp Rate, Heart Rate and Blood Pressure
-Accessory muscle use during inspiration and expiration
-Pursed Lip Breathing
-Increased Airway Resistence
-Retractions
-Cyanosis
-Cough, Sputum production, Hemoptysis (thick, white, tenacious sputum with eosinophils and other white blood cells)
-Pulsus Paradoxus
-Decreased blood pressure during inspiration and -increased during expiration

8

What are the chest assessment findings of asthma?

Prolonged expiratory phase
Decreased tactile fremitus
Hyperresonant percussion
Diminished Heart Sounds
Wheezing and Rhonchi

9

What are the radiologic findings of asthma?

Dark Lung fields (translucence)
depressed or flattened diaphragm

10

What are the PFT results of asthma?

VC- Decreased
FRC- Increased
FVC- Decreased
FEV1- Decreased
PEFR- Decreased

11

What is COPD?

-is a preventable and treatable disease state characterized by airflow limitation that is not fully reversible.
-the airflow limitation is usually progressive and is associated with an abnormal inflammatory response of the lungs to noxious particles or gases, primarily caused by cigarette smoking.

12

What tests confirm COPD?

Three main spirometry tests are FEV1, FVC, FEV1/FVC, when FEV1 and ratio are decreased

13

What are the stages of COPD?

Stage 1: FEV1 >= 80%
Stage 2: FEV1 50- <30% or 50% predicted, with chronic ventilatory failure

14

What is emphysema?

-Is defined pathologically as the presence of permanent enlargement of the airspaces distal to the terminal bronchioles, accompanied by destruction of their walls and without obvious fibrosis
-Emphysema is based on the pathology, or the "anatomic alterations of the lung," associated with the disorder.

15

What are the anatomic alterations of emphysema?

˜Permanent enlargement and deterioration of the air spaces distal to the terminal bronchioles
˜Destruction of pulmonary capillaries
˜Weakening of the distal airways, primarily the respiratory bronchioles
˜Air trapping and hyperinflation of alveoli (air-trapping)

16

What is chronic bronchitis?

I-s defined clinically as chronic productive cough for 3 months in each of 2 successive years in a patient in whom other causes of productive chronic cough have been excluded Caused by: smoking, pollutants, more common among males
˜Chronic bronchitis is based on the major "clinical manifestations" associated with the disease.

17

What are the anatomical alterations of chronic bronchitis?

˜Chronic inflammation and swelling of the peripheral airways
˜Excessive mucus production and accumulation
˜Partial or total mucus plugging of the airways
˜Smooth muscle constriction of bronchial airways (bronchospasm)
˜Air trapping and hyperinflation of alveoli-occasionally in the late stages

18

What are the PFT findings of chronic bronchitis?

VT, FRC, TLC, RV/TLC- N or inc
RV- inc
IRV, ERV, IC- N or dec
VC- dec

19

What is bronchiectasis?

Comes in three forms, Varicose, Cylindrical and saccular

20

What are the anatomic alterations of bronchiectasis?

Chronic dilation and distortion of bronchial airways
Excessive production of foul smelling sputum
Bronchospasm
Hyperinflation of alveoli
Atelectasis, consolidation and parenchymal fibrosis
Hemorrhage secondary to bronchial arterial erosion

21

What are the findings of the physical exam of bronchiectasis?

Increased respiratory rate, heart rate and blood pressure
Use of accessory muscles during inspiration and expiration
Cyanosis, Pursed Lip Breathing, Digital Clubbing, Peripheral Edema and Venous Distention, Cough, Sputum Production and Hemoptysis

22

What are the chest assessment findings of bronchiectasis?

Decreased tactile and vocal fremitus
Hyperresonant percussion
Diminished breath sounds
Wheezing and Rhonchi

23

What are the PFT findings for bronchiectasis?

-VT, TLC, RV/TLC- N or inc
-RV, FRC- inc
-IRV, ERV, IC- N or dec
-VC- dec

24

What are the radiologic findings for bronchiectasis?

Depressed or Flattened Diaphragm, Long/Narrow heart or Enlarged heart, areas of consolidation and atelectasis

25

What are the anatomic alterations of pneumonia?

˜Inflammation of the alveoli
˜Alveolar consolidation
˜Atelectasis

26

What are the clinical signs of pneumonia?

Increased respiratory rate, heart rate, cardiac output, and blood pressure
Chest pain, cyanosis, cough, sputum production, hemoptysis

27

What are the chest assessment findings for pneumonia?

Increased tactile and vocal fremitus
Dull percussion
Bronchial breath sounds
Crackles and Rhonchi
Pleural friction rub and whispering pectoriloquy

28

What are the PFT findings of pneumonia?

-VT, IRV- N or dec
-RV, IC, ERV, FRC, VC, TLC- dec
-RV/TLC- N

29

What are the radiologic findings of pneumonia?

Increased density, air bronchograms, pleural effusions