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x 6102 Pathophys > resp > Flashcards

resp Flashcards

(56 cards)

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1
Q

dorsal respiratory group

A

set rhythm: resp

send impulses to resp muscles

receive info from carotids + aortic bodies re: PaO2/PaCO2

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2
Q

ventral respiratory group

A

stimulated when extra resp effort needed, otherwise dormant

fight or flight = kick in to give extra resp drive

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3
Q

apneustic + pneumotaxic centers

A

in pons - modifies breathing pattern

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4
Q

normal respiratory quotient

A

aka ventilation-perfusion ratio

0.8

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5
Q

Henry’s Law

A

the amount of O2 dissolved in blood = proportional to partial pressure of O2 in blood

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6
Q

acute respiratory failure: type 1

A

hypoxemic
PaO2 lt 50mmHg

  • hypoventilation
  • diffusion limitation
  • shunt
  • V/Q mismatch
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7
Q

acute respiratory failure: type 2

A

hypercarbic

PCO2 gt/eq 50 mmHg

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8
Q

diffusion limitation

A

relates to Type 1 respiratory failure

PaO2 lt PAO2

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9
Q

right to left shunt

A

passage of blood from pulmonary to systemic circulation without encountering alveolar gases

ex: atelectasis, pneumonia (alveoli not fully ventilated)
ex: congenital heart defect involving venous mix with arterial (PDA, Tetralogy)

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10
Q

VQ mismatch

A

relates to Type 1 respiratory failure

ventilation or perfusion issue

4x

  • normal
  • low V/Q
  • shunt (very low) V/Q
  • high V/Q
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11
Q

low V/Q

A

impaired ventilation

ex: hypoventilation post surgery

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12
Q

shunt V/Q

A

blocked ventilation (collapsed alveolus)

ex: pneumonia, atelectasis

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13
Q

high V/Q

A

low perfusion

ex: PE

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14
Q

transudative pleural effusion

A

thinner viscosity, almost consistency of water
- fluid out of capillaries d/t increased intravascular hydrostatic pressure

ex: heart failure

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15
Q

exudative pleural effusion

A

thicker, more mucoid; contains WBC and plasma
- capillary beds are diseased + increased permeability = leak

indicative of malignancies, infectious et, inflammatory response

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16
Q

empyema

A

pleural effusion that develops an infection that is purulent

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17
Q

1 reason for patient post op to have decreased O2 sats

A

atelectasis

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18
Q

common in post-surgical and trauma due to pain

A

atelectasis

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19
Q

compression atelectasis

A

external pressure on lung

ex: tumor, ascites, profound abdominal distension

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20
Q

absorption atelectasis

A

inhalation of high concentrations of O2

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21
Q

surfactant impairment

A

can lead to atelectasis

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22
Q

atelectasis types x3

A

compression
absorption
surfactant impairment

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23
Q

pulmonary edema

Study These Flashcards
A

excess water in lung
- lost balance between capillary hydrostatic and oncotic pressures

most common cause: L sided heart failure

24
Q

ARDS: exudative (inflammatory)

Study These Flashcards
A

first 72 hours

damage: alveolocapillary membrane

activation: inflammatory response
- neutrophils release proteolytic enzyme/free radicals = exacerbation

25
ARDS: proliferative
4-21 days intraalveolar hemorrhagic exudate = more granular = MORE HYPOXEMIA
26
ARDS: fibrotic
14-21 days remodeling & fibrosis - fibrosis damages alveoli & respiratory bronchioles - gas exchange impaired PERPETUAL SEVERE R-L SHUNT
27
obstructive pulmonary disease x3
asthma chronic bronchitis emphysema
28
asthma
obstructive pulmonary disease affects bronchial mucosa: mucus, edema, rigid muscles - bronchial hyperresponsiveness - airway constriction - airway obstruction (variable, reversible)
29
asthma patho
early: 1. antigen exposure (activates dendritic cells) = cytokines released 2. eosinophils cause direct tissue injury via toxic substances (exacerbate hyperresponse) 3. neutrophils = more inflam 4. outcome: increased cap perm, mucosal edema, bronchospasm, copious mucus ``` late: airway remodeling (permanent damage) ```
30
COPD
obstructive pulmonary disease 1. chronic bronchitis 2. emphysema in central airways, small peripheral airways, and lung parenchyma 3rd cause of death in US PREVENTABLE
31
COPD risk factors x4
smoking (95%) occupational exposures environmental genetic (alpha-1 antitrypsin small)
32
chronic bronchitis
obstructive pulmonary disease; form of COPD airway inflam d/t neuts, macs, lymphocytes ``` 2. inflam results: bronchial edema, increased mucus glands/goblet cells = copious mucus ++ impaired cilia = hard to clear = persistent, productive cough ``` 3. from larger bronchi eventually to affecting airways diffusely
33
emphysema
obstructive lung disease, form of COPD permanently enlarged acini destruction alveolar walls primary: a1 antitrypsin (small %) secondary: inhalation related
34
primary emphysema
less common, a1-antitrypsin
35
acinus (acini)
respiratory bronchioles alveolar duct alveolar sacs (alveoli)
36
secondary emphysema
more common, inhalation related
37
emphysema patho
- alveoli destruction d/t elastase release: *BREAKDOWN/DAMAGE OF ALVEOLAR WALL* - cellular apoptosis = 1. loss of alveoli 2. decreased surface area for gas exchange - bullae/blebs = can rupture, bleed - airtrapping + loss of elastic recoil (OBSTRUCTIVE)
38
most common cause of pneumonia
aspiration
39
pneumonia + patho
infection of lower respiratory tract alveolar macrophages: first responders neutrophils: aid in phago + neutrophil extracellular trap (NET) - catch bact for efficient destruction
40
most common type of pneumonia
community-acquired pneumonia
41
tuberculosis cause & route
mycobacterium tuberculosis airborne droplets
42
tuberculosis patho
survive in macrophages, resist lysosomal killing
43
Virchow's Triad
venous stasis hypercoagulability endothelial damage PULMONARY EMBOLISM RISK FACTORS
44
pulmonary embolism + common findings
partial/full occlusion pulmonary artery ``` pleuritic chest pain (+/-) dyspnea tachypnea tachycardia decreased O2 sat ``` PE usually s/t other probs, detected via other means (ABG, hypoxic, etc)
45
pulmonary artery hypertension
d/t narrowing of arteries carrying blood from heart to lungs if progresses for too long can develop into right heart failure
46
mean pulmonary artery pressure normal vs pulmonary artery hypertension
normal 15 - 18 pulm art htn gt 25
47
most common cause of pulmonary artery hypertension
COPD idiopathic (rare), familial possible too
48
leading cause of cancer deaths in the US (men + women)
lung cancer
49
most common cause of lung cancer
tobacco smoking
50
pulmonary artery vasoconstriction reasons x3
acidemia hypoxic pulmonary vasoconstriction low PAO2
51
Fick's Law
volume gas moving across tissue sheet proportional to - sheet area - diffusion constant - different in partial pressure FICK AIN'T THICK
52
minute ventilation equation | + normal
MV = RR x TV normal: 6-10 L/min
53
lung receptors x3
irritant stretch J-receptors
54
irritant lung receptors where & action & triggers
conducting airway epithelium cough aerosols, gases, particulates
55
stretch lung receptors where & action
airway smooth muscle decrease lung rate/vol to prevent injury
56
J-receptor lung receptors where & triggers & action
near capillaries in alveolar septa respond to increased capillary pressure rapid shallow breathing, laryngeal constriction, mucus secretion, hypotension, bradycardia

x 6102 Pathophys (6 decks)

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