Pulmonary Pathophysiology (Exam 3) Flashcards Preview

Pathophysiology > Pulmonary Pathophysiology (Exam 3) > Flashcards

Flashcards in Pulmonary Pathophysiology (Exam 3) Deck (56)
Loading flashcards...
1
Q

What characterizes asthema?

A

Airway inflammation
airway hyper-responsiveness
Increased secretions

2
Q

How does asthma manifest?

A

cough, dyspnea, wheezing and inability to expel air

3
Q

What are some different aggravating factors for asthma?

A

Exercise (exercise > 90% HRmax, 6-8 mins after starting activity)
Viral respiratory tract infections
Occupations: cotton, bakers, metal salts, wood and vegetable dusts, pharmaceutic agents, industrial chemicals, plastics, biologic enzymes, animal/bird/fish/insect proteins
Weather changes: cold or dampness
High levels of air pollution
Pharmacologic agents: aspirin, drug additives (tartrazine  yellow dye #5) and food preservatives (sulfites)
Emotional or psychological factors

4
Q

What is atelectasis?

A

Incomplete expansion or collapse of all or part of lung

The alveoli never fully expand

5
Q

What is atelectasis caused by?

A
Diseases with decreased chest wall compliance
respiratory muscle weakness
los of surfactant
bedrest
secretions
tumor
6
Q

What is COPD?

A

Chronic Obstructive Pulmonary Disease, a disease of the respiratory tract that obstructs air flow

7
Q

What happens to the lungs and diaphragm during COPD

A

Hyperinflation of the lungs and flattening out of the diaphragm

8
Q

What are the two types of COPD?

A

Chronic bronchitis or emphysema?

9
Q

What happens during chronic bronchitis?

A

inflammation of bronchial lining causing hypersecretion of mucus causing productive cough most days for 3 months x 2 years

10
Q

What size airways does chronic bronchitis start in?

A

Starts in large airways w/o obstruction and progresses to smaller. With more small airway involvement-more disability

11
Q

What gender is chronic bronchitis more common in?

A

Men

12
Q

What are the cellular changes with chronic bronchitis?

A

bronchial lumen and ciliated cells decrease
smooth muscles in bronchial wall, mucus production, and goblet cells increase
atrophy of the cartilage in the bronchial wall

13
Q

What are some causes of chronic bronchitis?

A
Chronic iritation-SMOKING!!!
pollutants
2nd hand smoke
occupational exposure to dusts
exposure to vegetable dusts
14
Q

What is emphysema?

A

an abnormal/permanent enlargement of air spaces distal to terminal non-respiratory bronchioles with concomitant destruction of alveolar walls

15
Q

How is emphysema manifested?

A

Loss of elastic recoil
excessive collapse of airways on exhalation
chronic airflow obstruction
pathological accumulation of air in tissues
pulmonary hypertension develops from capillary loss and vessel intimal thickening

16
Q

What are some clinical features of emphysema?

A

SOB
Scant sputum
decreased subcostal angle (horizontal ribs)
Shortening of pecs
pink puffer (thin, rosy skin tones)
Increased retrosternal air, flattened diaphragm

17
Q

What is cystic fibrosis?

A

defect in the CFTR gene causing decreased water secretion making mucus thick and sticky.
Collects in small distal airways then moves proximal causing areas of chronic bronchitis and bronchiectasis

18
Q

What type of people mostly get CF?

A

Caucasians of European descent

19
Q

Which ribs are most commonly fractured?

A

Ribs 5-9 (not as protected as ribs 1-4

20
Q

What can a rib fracture be associated with?

A

hemothorax–>effusion–>empyema

21
Q

What is a flail rib?

A

A free floating segment of ribs due to an anterior and posterior rib fracture.

22
Q

What is the breathing pattern of those with a flail chest?

A

A paradoxical breathing pattern, inward during inspiration and outward during expiration

23
Q

What other pathology is a flail chest associated with?

A

Lung contusion

24
Q

What is kyphoscoliosis?

A

anteroposterior and lateral curve of thoracic spine

25
Q

What is the ratio of females:males with kyphoscoliosis?

A

4:! females to males

26
Q

What is a pleural effusion?

A

Fluid that abnormally accumulates in the pleural space.

27
Q

How much fluid is normally in the pleural space? How much liquid can be drained out?

A

5cc’s. ~1 litres can be removed with pleural effusion

28
Q

What are some clinical signs of a pleural effusion?

A

Pain
short inspiratory phase of breathing
Decreased breath sounds
Pleural friction rub present on auscultation

29
Q

What is aspiration? What can it lead to?

A

Inflammation of lungs and bronchial tubes due to inhalation of foreign material
can lead to inflammatory reaction, pneumonia or lung abscess

30
Q

In which lung are aspirations more common in?

A

Right upper lung due to R mainstem anatomy

31
Q

What is the pathophysiology of bacterial pneumonia?

A

Bacteria enters lower respiratory tract
edema fluid + leukocytes phagocytoze bacteria
Fibrin deposited in inflamed areas
antibodies fight infection ~ day 5

32
Q

What is the onset of bacterial pneumonia?

A

Abrupt onset

33
Q

What are some symptoms of bacterial pneumonia?

A
lobar consolidation
high fever
chills
dyspnea
tachypnea
productive cough pleuritic pain
leukoctyosis
34
Q

What is the etiology of viral Pneumonia?

A

Virus localizes in respiratory epithelial cells–>destruction of cilia and mucosal surface–>loss of mucociliary function

35
Q

What happens if the viral pneumonia reaches the alveoli?

A

you may have edema, hemorrhage, hyaline membrane formation and development of ARDS (acute respiratory distress syndrome)

36
Q

What is the onset of viral pneumonia?

A

insidious onset

37
Q

What are the symptoms of viral pneumonia?

A

patchy, diffuse bronchopulmonary infiltrates, moderate fever, dyspnea, tachypnea, nonproductive cough, myalgia,
NORMAL WBC count

38
Q

What is pulmonary edema?

A

increase in the amy of fluid in the lung

39
Q

What is affected first with pulmonary edema? then?

A

interstitial affected first, THEN alveolar spaces

40
Q

What are the two causes of pulmonary edema?

A

Increase in pulmonary capillary hydrostatic pressure due to left ventricle failure
Increase alveolar capillary membrane permeability (loss of integrity of plum. capillary endothelial cells)

41
Q

What are some causes of pulmonary edema?

A
toxic levels of O2, sulfur dioxide
aspirated water
viruses
medications
shock or trauma
42
Q

Pulmonary edema may also lead to ?

A

Pleural effusions

43
Q

What is the protein concentration of pulmonary edema?

A

Has an increased protein content

44
Q

What is a pulmonary embolism?

A

When a clot breaks off and travels to the RA–>RV–> pulmonary arteries

45
Q

Where are the venous thrombi from (in the body)?

A

95% fron LE

5% from thorax

46
Q

look at pathophysiology of a pulmonary embolism

A

read it

47
Q

What is interstitial pulmonary fibrosis?

A

Inflammatory process involving all parts of the alveolar wall allowing fibrin to enter alveolar spaces and causing scarring

48
Q

How do you get interstitial pulmonary fibrosis?

A

present with occupational dust diseases, post radiation changes

49
Q

What is life expectancy with interstitial pulmonary fibrosis?

A

< 6years from diagnosis

50
Q

What happens with breathing and interstitial pulmonary fibrosis?

A

The overall work of breathing increases.

51
Q

What are the three issues with smoking

A

besides not looking any cooler…

  1. Thermal injury to upper airways
  2. Chemical injury to tracheobronchial tree
  3. systemic poisoning due to carbon monoxide or cyanide
52
Q

What happens to your cough with a spinal cord injury? LEading to what?

A

ineffective cough–>increased pulmonary infections

53
Q

What happens to your inspiratory muscles with a spinal cord injury? Leads to what?

A

weakness of inspiratory muscles–> increased atelectasis

54
Q

What happens to the sigh reflex with a spinal cord injury? Leads to what?

A

Loss of sigh reflex. Leads to increased atelectasis and alveolar collapse

55
Q

What happens to the breathing pattern with a SC injury?

A

paradoxical breathing

56
Q

What happens to pulmonary and chest wall compliance w/ SC injury?

A

pulmonary and chest wall compliance decrease over time