HLTH 2501: chronic obstructive pulmonary disease, restrictive disorders and vascular disorders

Question 1

chronic obstructive pulmonary disease

Answer 1

is a group of common chronic respiratory disorders that are characterized by progressive tissue degeneration and obstruction in the airways of lungs

Question 2

types of COPD

Answer 2

emphysema, chronic bronchitis, and acute asthma

Question 3

restrictive lung diseases

Answer 3

silicosis, asbestosis, and farmer’s lung; these are restrictive because the irritant causes interstitial inflammation and fibrosis, resulting in loss of compliance or ‘stiff lung’

Question 4

results of COPD

Answer 4

irreversible and progressive damage to the lungs and respiratory failure may result due to severe hypoxia or hypercapnia; can also lead to right-sided CHF

Question 5

another name for right-sided CHF

Answer 5

cor pulmonale

Question 6

emphysema

Answer 6

is destruction of the alveolar walls and septae, leading to large, permanently inflated alveolar air spaces

Question 7

why do alveoli destruct in emphysema?

Answer 7

a deficiency of alpha 1 -antitrypsin, genetic factors, cigarette smoking, and air pollution

Question 8

alpha 1-antitrypsin

Answer 8

is a protein that inhibits the activity of proteases which are destructive enzymes released by neutrophils during an inflammatory response; ex. elastase

Question 9

what occurs in emphysema

Answer 9

alveolar wall breakdown, fibrosis and thickening of the bronchial walls, difficulty with expiration, and loss of tissue

Question 10

what occurs when the alveolar walls breakdown in emphysema?

Answer 10

loss of SA for gas exchange, loss of pulmonary capillaries, loss of elastic fibres, altered ventilation-perfusion ratio, and decreased support for other structures like the small bronchi

Question 11

how do the bronchial walls thicken and fibrosis in emphysema?

Answer 11

due to chronic irritation and the frequent infections associated with smoking and increased mucus production

Question 12

result of fibrosis and thickened bronchial walls in emphysema?

Answer 12

narrowed airways, weakened walls. and interface with passive expiratory airflow

Question 13

what is the result of progressing difficulty with expiration in emphysema?

Answer 13

air trapping, increased residual volume, overinflation of the lungs, fixation of the ribs in an inspiratory position, and the diaphragm will appear flattened on x-rays

Question 14

what does loss of tissue in emphysema result in?

Answer 14

adjacent alveoli fuse, forming large air spaces; there may be holes in the lungs; tissue or pleural membrane may rupture, resulting in pneumothorax; hypercapnia occurs; infections develop often; and cor pulmonale may develop

Question 15

blebs

Answer 15

air filled-spaces in the lungs cause by damaged alveoli fusing, forming air spaces

Question 16

cor pulmonale in emphysema

Answer 16

this may develop as a result of loss of tissue because the pulmonary blood vessels are destroyed and hypoxia causes pulmonary vasoconstriction; the increased pressure increases resistance to the right ventricle, causing it to eventually fail

Question 17

signs of emphysema

Answer 17

dyspnea, hyperventilation with a prolonged expiration, barrel chest position, anorexia, fatigue, clubbed finger, and secondary polycythemia

Question 18

barrel chest

Answer 18

occurs with hyperventilation in emphysema and is a position of sitting and leaning forward to facilitate breathing

Question 19

testing for emphysema

Answer 19

chest X-rays and pulmonary function tests (these looks at residual volume and total lung capacity)

Question 20

treatment for emphysema

Answer 20

avoidance of respiratory irritants, immunization against influenza and pneumonia, appropriate exercise to facilitate breathing, learning breathing techniques (pursed lip breathing), adequate nutrition and hydration, bronchodilators, and lung reduction surgery

Question 21

chronic bronchitis

Answer 21

is characterized by significant changes in bronchi resulting from chronic irritation from smoking or exposure to industrial pollution; this results in inflammation, obstruction, repeated infections, and chronic coughing

Question 22

how does chronic bronchitis develop?

Answer 22

exposure to irritants causes the mucosa to be inflamed and swollen, causing hypertrophy and hyperplasia of the mucus glands and increased mucus secretion; fibrosis and thickening of the bronchial walls also occurs, causing obstruction

Question 23

complications of chronic bronchitis

Answer 23

low O2 leads to cyanosis; dyspnea and fatigue interfere with nutrition and communication; and cor pulmonale may develop

Question 24

causes of chronic bronchitis

Answer 24

cigarette smoking, urban area (air pollution), and sometimes asthma

Question 25

signs of chronic bronchitis

Answer 25

constant cough (worse in the am), tachypnea with and shortness of breath, purulent and thick secretions, hypoxia leading to cyanosis, hypercapnia, secondary polycythemia, weight loss, and signs of cor pulmonale

Question 26

treatment for chronic bronchitis

Answer 26

reducing exposure to irritants, influenza and pneumonia vaccines, antimicrobials, bronchodilators, chest therapy, and low-flow oxygen and nutritional supplements

Question 27

bronchiectasis

Answer 27

is usually a secondary problem and is a irreversible dilation of the medium-sized bronchi

Question 28

what may cause bronchiectasis?

Answer 28

CF, COPD, childhood. infection, aspiration of foreign bodies, of a congenital weakness in the bronchial wall

Question 29

two types of dilations in bronchiectasis

Answer 29

saccular or elongated (fusiform)

Question 30

how does bronchiectasis develop?

Answer 30

recurrent inflammation and infection in the airways leads to the weakening of the muscle and elastic fibres in the bronchial wall, in which fibrous adhesions may pull the wall outward, dilating it

Question 31

infections and bronchiectasis

Answer 31

in dilated and ballooning areas, large amounts of fluid collect and become infected; the infections can cause a loss of cilia and metaplasia in the epithelium, causing additional fibrosis

Question 32

what organisms often cause infection in bronchiectasis?

Answer 32

streptococci, staphylococci, pneumococci, and H influenzae

Question 33

signs of bronchiectasis

Answer 33

chronic cough, copious production of purulent sputum, rales and rhonchi, foul breath, dyspnea, hemoptysis, weight loss, anemia, and fatigue

Question 34

treatment for bronchiectasis

Answer 34

antibiotics, bronchodilators, and chest PT

Question 35

restrictive lung disorders

Answer 35

a group of diseases in which lung expansion is impaired and total lung capacity is reduced

Question 36

restrictive lung disorders two groups

Answer 36

those in which an abnormality of the chest wall limits lung expansion and those in which lung disease impairs expansion

Question 37

restrictive disorders in which an abnormality of the chest wall limits expansion

Answer 37

includes conditions like kyphosis, scoliosis, poliomyelitis, ALS, muscle dystrophy, or botulism

Question 38

botulism

Answer 38

respiratory muscle paralysis

Question 39

restrictive disorders in which lung disease impairs expansion

Answer 39

is when the tissues providing the supportive framework are effected; includes idiopathic pulmonary fibrosis, pulmonary edema, and occupational disease from inhaled irritants

Question 40

pneumoconioses

Answer 40

are chronic restrictive diseases resulting from long-term inhalation of irritating particles like asbestos

Question 41

how does pneumoconiosis develop?

Answer 41

the normal defence in the upper tract cannot handle the overload of foreign material with long-term exposure; inflammation and fibrous tissue then develop, causes loss of function and frequent infections

Question 42

types of pneumoconiosis

Answer 42

coal workers disease, silicosis, asbestosis, and farmer's lung

Question 43

coal workers disease

Answer 43

is caused by coal dust in mines

Question 44

silicosis

Answer 44

is caused by silica in stone-cutting, sand-blasting and mines

Question 45

farmers lung

Answer 45

is caused by fungal spores from hay

Question 46

effects of asbestos fibres

Answer 46

frequent cause pleural fibrosis and increase the risk of lung cancer

Question 47

signs of pneumoconiosis

Answer 47

dyspnea, effort for inspiration, and cough

Question 48

pulmonary edema

Answer 48

refers to fluid collecting in the alveoli and instersital area; this reduces gas exchange

Question 49

why does excess fluid develop in pulmonary edema?

Answer 49

inflammation in the lungs (increases capillary permeability), low plasma proteins (decreases plasma osmotic pressure), and pulmonary hypertension

Question 50

results of pulmonary edema

Answer 50

inference of gas exchange, hypoxemia, decreased action of surfactant, difficulty expanding lungs, capillary rupture, and blood sputum

Question 51

causes of pulmonary edema

Answer 51

left sided CHF, hypoproteinemia (caused by kidney or liver disease), inflammation from inhalation of toxic gases or tumors, or blocked lymphatic drainage from fibrosis

Question 52

signs of mild pulmonary edema

Answer 52

cough, orthopnea, and rales

Question 53

signs of severe pulmonary edema

Answer 53

hemoptysis, frothy and bloody sputum, labored breathing, hypoxemia, cyanosis, and paroxysmal nocturnal dyspnea

Question 54

treatment for pulmonary edema

Answer 54

treating causative factors, positive pressure mechanical ventilation, and upper position elevated position

Question 55

pulmonary embolus

Answer 55

is a blood clot or mass of other material that obstructs the pulmonary artery or a branch of it, blocking the flow of blood through the lung tissue

Question 56

what are most pulmonary embolus a result of?

Answer 56

are thrombi or blood clots originating from the deep leg veins; this may be caused by phlebothrombosis or thrombophlebitis

Question 57

effects of a small pulmonary emboli

Answer 57

are often silent or asymptomatic but multiple small ones can be dangerous

Question 58

signs of a small pulmonary emboli

Answer 58

chest pain, cough, and dynspea

Question 59

effects of a medium sized pulmonary emboli

Answer 59

can cause respiratory impairment and pulmonary infarction; reflex vasoconstriction also occurs, obstructing the vessel further

Question 60

signs of a medium sized emboli

Answer 60

chest pain, tachypnea, dyspnea, hemoptysis, fever, and hypoxia

Question 61

effects of a large sized pulmonary emboli

Answer 61

can cause right sided CHF, decreased CO (shock), and sudden death

Question 62

signs of a large size emboli

Answer 62

severe crushing chest pain, low BP, rapid weak pulse, and loss of consciousness

Question 63

risk factors for thrombi forming in the legs

Answer 63

immobility, trauma or surgery to the legs, childbirth, CHF, dehydration, and cancer

Question 64

fat emboli

Answer 64

occur from loss of bone marrow resulting from a fracture of a large bone (ex. femur)

Question 65

types of emboli

Answer 65

thrombi from the leg veins, fat emboli, vegetations resulting from endocarditis in the right side of the heart, amniotic fluid, tumor cells, or air

Question 66

signs of a fat emboli

Answer 66

show separate signs like acute respiratory distress, a rash on the trunk, and neurologic signs like confusion

Question 67

diagnosis for pulmonary edema

Answer 67

X-ray, lung scan, MRI, and pulmonary angiography; the source can be identified using doppler ultrasound or venography

Question 68

treatment of pulmonary edema

Answer 68

includes assessing risk factors, compression stockings, filter surgically inserted in the inferior vena cava, heparin to remove clots, or mechanical ventilation