Respiratory

Question 1

Disease states that alter the elastic properites of lung tissue, resulting in changes to it

Answer 1

Compliance

Question 2

Normal, quiet breathing

Answer 2

Eupnea

Question 3

• Decreased oxygen in the blood
• Results from inadequate gas exchange
• PaO2 < 85%, give oxygen

Answer 3

Hypoxemia

Question 4

_____ : inflammation, mucus secretion, obstruction of airway

_____: abnormal enlargement of gas exchange airways accompanied by destruction of alveolar walls

_____: hypersensitivity, mucus production, bronchoconstriction, obstruction of air flow

Answer 4

Chronic Bronchitis

Emphysema

Asthma

Question 5

_____ is characterized by lungs that are difficult to inflate

• Will see incrased or normal ratio of FEV/FVC
• Decreased compliance is best indicator
• Residual volume and total lung capacity are generally decreased

Answer 5

Restrictive Lung Disease

Question 6

Blood pooling into the pleural cavity

Seen in chest injury, surgery, malignancies, vessel rupture

Answer 6

Hemothorax

Question 7

The site of gas exchange

Answer 7

Alveoli

Question 8

Causes of ARDS

Answer 8

• often unknown but associated increased risks include
  
  • pneumonia
  • near drowning
  • toxins
  • IDC
  • infection
  • trauma
  • septic shock

Question 9

_____ is an increase in blood pressure in the blood vessels of the lung that can lead to shortness of breath, dizziness, fainitng and edema

• secondary to increased volume pressure of blood or narrowing/obstruction of vessels
• can lead to pulm edema/ pleural effusion
• may result in cor pulmonale

Answer 9

Pulmonary Hypertension

Question 10

The process of moving air into the lungs, available for gas exchange

Answer 10

Ventilation

Question 11

Lymph fluid coming into pleural cavity

Occurs in trauma, infection, malignant infiltration

Answer 11

Chylothorax

Question 12

• Increased CO2 in the blood
• Results from inadequate alveolar ventilation
• Hypoventilation is the most common cause

Answer 12

Hypercapnia

(Normal is 38-42 mmHg)

Question 13

Leads to a decreased surface area for gas exchange (decreased A)

Answer 13

Emphysema

Atelectasis

Pneumothorax

Question 14

_____ is characterized by an increased airway resistance

The small the radius of airway, the larger the resistance

_____ (ratio) is decreased in this disorder

Answer 14

Obstructive Lung Disorders

FEV₁/FVC

Question 15

Air enters but does not leave pleural space

trachea deviation can be seen on injured side

Answer 15

Tension pneumothorax

Question 16

Air-filled blebs/blisters on lung surface form and rupture, allowing air to enter the pleural space

Can occur in smokers

Answer 16

Spontaneous pneumothorax

Question 17

Primary or secondary emphysema?

• Caused by inability of body to inhibit proteolytic enzymes in lung (from exposure to toxins or cigarette smoke)
• Results from inherited deficiency of a1-antitrypsin that inhibits the action of proteolytic enzymes

Answer 17

1. Secondary
2. Primary

Question 18

Lung tissue remains uninflated at birth

• Often due to insufficient surfactant
• often seen in premature births
• Treated w/ exogenous surfactant to help open airways and allow for good gas exchange

Answer 18

Primary Atelectasis

Question 19

Movement of respiratory gases occurs by _____

Answer 19

Diffusion

Question 20

Blood supply to the alveoli

Answer 20

Perfusion

Question 21

Exudate that comes from inflammatory processes or immune responses

Occurs from infections, malignancies, RA, lupus

Answer 21

Empyema

Question 22

• Some alveoli have no ventilation due to an obstructed airway, therefore no gas excahnge occurs in that alveoli
• Pulmonary venous blood has gas partial pressures due to mixed venous return blood
• leads to hypoxema
• Ex. airway obstruction, bronchoconstriction, pulmonary edema

Answer 22

“Shunt”

Question 23

• Transudate (fluid from different cells)
• Occurs in people with
  
  • CHF, renal failure, nephrosis, liver failure
• possibly caused by loss of albumin that changes osmotic pressure and leads to a collection of fluids

Answer 23

Hydrothorax

Question 24

Obstructive airway disorders include _____, _____, _____

Answer 24

Chronic bronchitis

Asthma

Emphysema

Question 25

**Restrictive Lung Disorders include \_\_\_\_\_, \_\_\_\_\_, and \_\_\_\_\_** \*generally there is a problem with the lung tissue itself rather than the airways

Answer 25

**Pulmonary Fibrosis** **Pulmonary Edema** **Pneumonia**

Question 26

* **Characterized by** * **acute lung inflammation** * **diffuse alveolocapillary injury (increased permeability)** * **causes severe pulmonary edema** * **Injury initiates a massive inflammatory response, futher damaging lung tissue** * **Decreased lung compliance increases work of breathing** * **Leaded to decreased surfactant, increased surface tension**, **and atelectasis**

Answer 26

**Acute Respiratory Distress Syndrome**

Question 27

Leads to an increased thickness of the partition between air and blood (increased X)

Answer 27

Pulmonary fibrosis

Question 28

**Air enters pleural space as a result of chest wall injury (trauma) or punctures (stab, gunshot wounds)**

Answer 28

**Secondary pneumothorax**

Question 29

**Ventilation but no matching blood supply (perfusion) to participate in gas exchange** **Occurs because of occlusion of blood supply to that alveoli** **Ex. PE, emphysema**

Answer 29

**"Dead Space"**

Question 30

* Right ventricular enlargement (right sided HF) * Secondary to pulmonary hypertension caused by disorders of lungs or chest wall

Answer 30

Cor Pulmonale

Question 31

\_\_\_\_\_ may be restrictive as well as obstructive \_\_\_\_\_ causes incrased fluid secretions \_\_\_\_\_ and _____ form a COPD

Answer 31

* Emphysema * Chronic bronchitis * chronic bronchitis and emphysema

Question 32

Decreased concentrations of oxygen in inspired air compromising the concentration gradient (decreased DC)/ difference in partial pressure

Answer 32

Altitude CO2 poisoning Anesthesia

Question 33

**What is...** * **Tachypnea** * **Dyspnea** * **Apnea** * **Cheyne-Stokes** * **Kussmaal respirations**

Answer 33

* **Tachypnea- increased respiratory rate** * **Dyspnea- sensation of breathlessness/difficulty breathing** * **Apnea- cessation of respiration** * **Cheyne-Stokes - a waxing and waning tidal volume with periodic apnea** * **Kussmaal respiration- rapid and deep ventilation (metabolic acidosis, seen in DKA)**

Question 34

**Adult lungs that have previously been inflated -\> collapse** * **Airway obstruction (tumors, mucous plug, exudate)** * **Lung compression (pneumothorax or pleural effusion)** * **Increased lung recoil (decreased surfactant)**

Answer 34

**Secondary Atelectasis** **Ineffective cough reflex results in poor alveolar expansion and obstruction. Increased viscosity of sputum leads to obstruction**

Question 35

**\_\_\_\_\_ reduces surface tension and needs to constantly be replenished by normal ventilation** **Surface tension tends to collapse alveoli, the ideal is to avoid having the wet sides of alveoli stick together and to keep the lungs and alveoli open**

Answer 35

**Surfactant**