Pulmonary Mod. 4 Disorders

Question 0

Tissue Hypoxia

Answer 0

Decreased O2 in tissue

Question 1

Hypercapnia

Answer 1

Increased PACO2 in atrial blood
Caused by hypoventilation
Suppression of respiration centers (DRG, VRG)
Airways obstruction
Damage to alveoli (emphysema)

Question 2

Hypoxemia

Answer 2

Decreased PAO2 in arterial blood

Question 3

Causes of hypoxemia

Answer 3

Decreased PO2 of inspired air (altitude/suffocation)

Hypoventilation (suppress. DRG/VRG)

Diffusion problem w/alveolocapillary membrane (emphysema, fibrosis, edema)

Altered V/Q perfusion ratio(most common)

Question 4

Hypoxemia-Low V/Q

Inadequate ventilation of well produced areas of lung

Answer 4

Pulmonary r to l shunting (blood travels from r.side of heart to l.side w/out receiving O2.
Ex:
Asthma, pneumonia, bronchitis, ARDS

Question 5

Hight V/Q

Inadequate blood flow in area of well ventilated lungs

Answer 5

PE=high V/Q

LUNG tissue can deliver O2 but blood can’t get there

Question 6

Aspiration

Answer 6

Entry of fluids/solid into trachea/lung

Decreased level of consciousness, neuro probs, meds put at increased risk

Question 7

Pulmonary Edema

Answer 7

Excess fluids in lungs
Main cause-heart disease
Also; tumor, fibrotic tissue, tissue HTN

Question 8

Atelectasis (collapse of lung tissue)

Answer 8

Compressive- external pressure collapses lung (tumor, abd distension,pneumothorax)

ABSORPTIVE- air from blocked/hypoventilated alveoli absorbed into system

SURFACTANT IMPAIRMENT-increased surface tension=collapse

POST-OP ATEL- prevent w/deep breathing, exercise

Question 9

Pneumothorax

Answer 9

Air accumulation within pleural cavity

Question 10

Open pneumothorax

Answer 10

Air enters pleural cavity during inspiration, and leaves during expiration

Question 11

Tension Penumothorax

Answer 11

Trapping if air in pleural cavity, build up of air pressure on pleural space collapses lung. Every breath=more collapsing. Emergency

Question 12

Spontaneous Pneumothorax

Answer 12

Unexpected rupture of pleura, common in young males

Question 13

Pleural Effusion

Answer 13

Fluid in pleural space(transudate, exudate, pus, blood, lymph fluid)

Question 14

ARDS

Answer 14

Respiratory failure due to acute inflammation and alveolar change

Question 15

Phase 1 ARDS

Answer 15

Injury triggers massive inflammatory response, surfactant inactivated, alveoli collapse

Question 16

Phase 2 ARDS

Answer 16

Hyaline membrane become fibrous mass coating alveoli & bronchioles

Question 17

Phase 3 ARDS

Answer 17

Respiratory failure.

Inflammatory mediators can cause secondary response to other parts of body (organs)

Question 18

Obstructive Pulmonary Disease

Answer 18

Airway obstruction worse with expiration (wheezing)
Flow rate diminish

Diseases that cause it:
Chronic bronchitis
Emphysema
Asthma

Question 19

COPD

Answer 19

Usually seen with chronic bronchitis & emphysema

Question 20

Chronic Bronchitis

Answer 20

COPD

condition of excess mucus secretion and productive cough that lasts 3+ months

Question 21

Patho of Chronic Bronchitis

Answer 21

Bronchial tubes narrowed (excess mucus production/increased risk of infec. And inflam.)
Narrow airways=traps air in lungs

Decreased alveolar ventilation
V/Q mismatch (low V/Q)
Hypoxemia
Hypercapnia

Question 22

COPD Emphysema

Answer 22

Accum. Of air in lungs

Centriaacinar- destruction of bronchioles&alveolar ducts but not ALVEOLAR SACS

Panacinar-destruction of entire acinis

Question 23

Patho of Emphysema

Answer 23

Damage to lung tissue (not excess mucus)

Smoking
Inhibits a1-antitrypsin (Which normally protects tissue from inflammatory)

Or genetic deficiencyof a1-antiteypsin

Question 24

Symptoms of emphysema

Answer 24

DOE
Prolonged expiration
Increased WOB
Poor gas exchange
Barrel chest
Change in static lung volume 
hypoxemia, hypercapnia

Question 25

Asthma

Answer 25

Reversible obstructive lung disease

Caused by increased rxn of airways

Question 26

Asthma-Hyper responsiveness of airway

Answer 26

Allergen triggers inflammatory response

3 pathological changes:
Bronchial smooth muscle spasm
Mucus production
Vascular congestion

Question 27

Clinical signs/symptoms of Asthma

Answer 27

Immediate or prolonged
Audible high pitched wheezing
SOB
decreased flow rate (FEV1/FVC<70%)
Tachypnea

Question 28

Restrictive pulmonary conditions

Answer 28

Short shallow breathing
Increased flow rate or stays the same
Static volume decrease (FVC, RV, TLC)
DOE-progress to suspend at rest

Question 29

Restrictive Parenchymal Conditions

Answer 29

Sarcoidosis
Idiopathic pulmonary fibrosis
Pneumoconiosis
Drug induced interstitial lung disease

Question 30

Sarcoidosis

Answer 30

Inflammation that produce tiny lumps of cells in various organs

Question 31

Restrictive-extraparenchymal Conditions

Answer 31

Myasthenia gravis
Guillain barré syndrome
Muscular dystrophies
Cervical spine injury
Kyphoscoliosis
Obesity 
Ankylosing spondylitis

Question 32

Pulmonary Fibrosis

Answer 32

Excessive fibrosis proliferation in lung

Secondary complication from disease, inhalation of environmental hazard, idiopathic pulmonary fibrosis.

Patho:
Altered repair process=fibrosis and poor lung compliance
Chronic inflammation, alveoli shrink and loose elasticity

Question 33

Pneumoconiosis

Answer 33

Pathology due to inaction if environmental hazards.

Silica, asbestos

Question 34

Tuberculosis

Answer 34

Mycobacterium tuberculosis

Highly contagious-transmitted airborne

Question 35

Patho of TB

Answer 35

Inflammatory process form bacteria

Immune response leads to granulomatous lesions (tubercle) which becomes necrotic. Usually remains dormant

Question 36

Pulmonary Embolism

Answer 36

Occlusion of pulmonary vascular/capillary supply

Lung can deliver O2 but blood can’t get there
V/Q mismatch=hight V/Q ratio

Question 37

Patho risk favors of PE

Answer 37

Venous stasis
Hyper coagulation
Damage to endothelium if blood vessels