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Patho > Respiratory (exam 3) > Flashcards

Respiratory (exam 3) Flashcards

1
Q

Why are bronchioles important?

A

Wrapped in smooth muscle
Expand and contract
Control airflow into and out of alveoli

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2
Q

What is the primary reactive airway?

A

Bronchioles

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3
Q

Where does gas exchange take place?

A

Alveolus

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4
Q

What makes up the upper respiratory tract?

A

Larynx and above

Nasal cavity, pharynx, larynx

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5
Q

What makes up the lower respiratory tract?

A

Trachea and below

Trachea, primary bronchi, lungs

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6
Q

Where does the division between the upper and lower respiratory tracts start?

A

Trachea

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7
Q

What is the respiratory mucosa?

A

Mucous membrane lines respiratory tract
Traps pathogens, dust, etc
Immune support (T & B cells, macros)
Lubricant

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8
Q

What are the mucous membranes?

A

Epithelial membranes that line body surfaces opening directly to the exterior

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9
Q

What are the functions of mucosa?

A

Protection (underlying tissue)
Immune Support (capture debris, mucins presence)
Lubricant (allow food to move to digestive tract)

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10
Q

What is the purpose of the pleura?

A

Sac around the lungs

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11
Q

What is the purpose of the nasal cavity? Turbinates?

A

Turbinates are formed by the conchi

Warm, filter, humidify air

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12
Q

What is the purpose of the pharynx?

A

Shared by respiratory and digestive tracts

3 regions: nasopharynx, oropharynx, laryngopharynx

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13
Q

What is the purpose of the larynx?

A

Tighter the strings= higher pitch
Looser the strings= lower pitch
Thyroid cartilage makes the adams apple

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14
Q

What is the purpose of the trachea?

A

Windpipe
Wrapped with cartilage to keep it open
C rings because esophagus is behind= allows food passage

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15
Q

What is the purpose of the bronchi?

A

2: right and left

Right is wider and straighter= aspirations typically caught here

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16
Q

What is the purpose of the alveoli?

A

Gas exchange
Functional unit of the respiratory system
Clustered to give more surface area
kept open by surfactant= decrease surface tension, keep alveoli from sticking together

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17
Q

What part of the respiratory system does emphysema destroy?

A

Destroys the alveoli

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18
Q

How many lobes does the right lung have? Left lung?

A 
Right= 3
Left= 2, no middle due to heart
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19
Q

What is the serous membrane? Where in the body are they?

A

2 layers with serious fluid in between (parietal layer- hug cavity, visceral layer- hug organ)
Pericardium: around heart
Pleura: around lungs
Peritoneum: around viscera

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20
Q

How do we represent the pressure in the alveoli?

A

Pa

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21
Q

How do we represent the pressure outside the body? Does the pressure change?

A

Barometric pressure
Pb
Pressure doesn’t change

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22
Q

How do we represent the intrapleura pressure?

A

Pip

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23
Q

Which pressure involved in the respiratory tract never changes in a healthy individual?

A

Pip

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24
Q

What is pressure gradient in reference to the lungs?

A

Air moves from high to low pressures

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25
Q

What are the pressure gradients during inspiration (inhalation)?

A

Pb > Pa

Pip < Pa

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26
Q

What are the pressure gradients during expiration (exhalation)

A

Pa > Pb

Pip < Pa

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27
Q

What does it mean when Pa = Pip? Pb = Pip?

A

Collapsed lung

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28
Q

What is the primary muscle of inspiration? Secondary muscle?

A 
Primary= diaphragm
Secondary= External intercostals
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29
Q

Are muscles involved in normal expiration?

A

No

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30
Q

What are the primary and secondary muscles of forced expiration?

A 
Primary= rectus abdominus
Secondary= internal intercostals
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31
Q

What are the mechanics of breathing?

A
  1. Alveolar Surface Tension (surfactant)
  2. Elastic properties of the lung and chest wall (elastic recoil, compliance)
  3. Airway resistance
  4. Work of breathing
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32
Q

What kind of alveolar surface tension do we want? Do we want to increase or decrease it?

A

Decreased tension, keep open

Accomplished by surfactant

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33
Q

What part of breathing does elastic recoil affect?

A

Expiration

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34
Q

What part of breathing does compliance affect?

A

Inspiration

Stretch and expand

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35
Q

Do we want to increase or decrease airway resistance?

A

Decrease airway resistance

Airway resistance is bad, blockage, inhibits airflow

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36
Q

Discuss how the mechanics of breathing affect the work of breathing?

A

Decrease surface tension and increase elastic properties and decrease the work of breathing
Increase surface tension and decrease elastic properties and increase the work of breathing

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37
Q

What are the 4 steps of breathing?

A

Ventilation of lungs
Diffusion of oxygen from alveoli into capillary blood
Perfusion of systematic capillaries with oxygenated blood
Diffusion of oxygen from systematic capillaries into the cells

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38
Q

How does diffusion of CO2 occur?

A

Diffusion of CO2 from cells into systemic capillaries
Perfusion of systemic capillaries with CO2 blood
Diffusion of CO2 from capillaries into lungs
Exhalation of CO2

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39
Q

What role does the medulla play in respiration?

A

Normal rhythmicity center

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40
Q

What role does the apneustic center of the pons play in respiration?

A

Stimulates neurons to promote inspiration via external intercostals and the diaphragm
No air so says to inhale

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41
Q

What role does the pneumotaxic center of the pons play in respiration?

A

Stimulated neurons to promote expiration via the internal intercostals and the rectus abdominus
Need to move air out, causes expiration

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42
Q

What role does the pons play in respiration?

A

Adjustment of breathing

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43
Q

What role do chemoreceptors play in respiration?

A

Measure chemical (CO2 and O2) levels

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44
Q

Where are the central chemoreceptors located? What do they do?

A

Medulla

Detect increased levels in CO2 and then stimulate increase in respiration rate

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45
Q

Where are the peripheral chemoreceptors located? What do they do?

A

Aorta and Carotid bodies

Detect increased levels in CO2 and then stimulate increase in respiration rate

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46
Q

What are the functions of the pulmonary system?

A

Ventilate the alveoli
Diffuse gases into and out of the blood
Perfuse the lungs so the body receives oxygen

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47
Q

What is the minute volume?

A

Volume of air being moved in a minute

Ventilatory rate multiplied by the volume of air per breath

48
Q

What is Alveolar ventilation?

A

How much air is actually getting to the alveoli for gas exchange

49
Q

What are the Type 1 Alveolar cells (type 1 numocytes)? What do they do?

A

Epithelial cells of the alveoli

Where diffusion of respiratory gases occurs

50
Q

What are the Type 2 Alveolar cells (type 2 numocytes)? What do they do?

A

Epithelial cells of the alveoli

Surfactant production

51
Q

What are dust cells?

A

Macrophages in the alveoli

52
Q

Does pulmonary circulation have a higher or lower pressure than the systemic circulation?

A

Lower pressure

53
Q

How many pulmonary vessels are filled with blood at any given time?

A

One third of pulmonary vessels

54
Q

Where does the pulmonary artery divide and enter the lungs?

A

At the Hilus

55
Q

Do bronchus and bronchioles have accompanying arteries?

A

Yes each bronchus and bronchiole has an accompanying artery or arteriole

56
Q

What is the alveocapillary membrane?

A

Formed by the shared alveolar and capillary walls
Gas exchange occurs across the membrane
Formed by type 1 numocytes

57
Q

What direction does gas move in reference to concentration gradient?

A

Moves down the concentration gradient

58
Q

What is the Ventilation- Perfusion Ratio?

A

V-Q Ratio
Airflow to blood flow
Match airflow to blood flow to alveoli

59
Q

How is oxygen transported?

A

Dissolved in plasma

Oxyhemoglobin- 1 hemoglobin has 4 hemes each with an iron, oxygen binds to the iron, gives off red glow

60
Q

How is carbon dioxide transported?

A

Dissolved in plasma
Bicarbonate (HCO3)- most carried here
Carbaminohemoglobin- CO2 bound to hemoglobin

61
Q

What is hypoxic pulmonary vasoconstriction?

A

Caused by low alveolar PO2

Blood is shunted to other, well ventilated portions of the lungs

62
Q

What is acidemia?

A

Acidic blood
Causes pulmonary artery constriction
High CO2 in blood

63
Q

What is dyspnea?

A

Shortness of breath (SOB)

64
Q

What is orthopnea?

A

Dyspnea (SOB) when laying down

65
Q

What is Paroxysmal nocturnal dyspnea (PND)?

A

Causes orthopnea
People with CHF
Generally with Liver failure

66
Q

What is tachypnea?

A

Hyperpnea

Fast breathing rates

67
Q

What is bradypnea?

A

Slow respiratory rate

68
Q

What is apnea?

A

No breath

69
Q

What is Kussmaul respirations?

A

Hyperpnea

Fast breathing when we have acidic blood (high CO2 in blood)

70
Q

What is Cheyne- Stokes respirations?

A

End of life respirations

Periods of apnea then hyperpnea

71
Q

What does Hypoventilation cause?

A

Hypercapnia (high CO2 levels)

72
Q

What does Hyperventilation cause?

A

Hypocapnia (low CO2 levels)

73
Q

What is Hemoptysis?

A

Blood in sputum

74
Q

What is cyanosis?

A 
Bluing
Short term (acute) hypoxia
75
Q

What is clubbing?

A

Chronic, longer term hypoxia

Shortening of nails/ nails beds

76
Q

What is hypoxemia?

A

Low oxygen in the blood

77
Q

What is the difference between hypoxemia and hypoxia?

A

Hypoxemia is low oxygen in blood

Hypoxia is low oxygen in general tissues

78
Q

What are the acute and late chronic symptoms of hypoxia?

A

Early RAT is late to BED
Restlessness, Anxiety, Tachycardia/ Tachypnea & cyanosis
Bradycardia, Extreme restlessness, dyspnea (severe), clubbing

79
Q

What are the symptomes of hypoxia in pediatrics?

A 
F- Feeding difficulty
I- Inspiratory stridor
N- Nares flare
E- Expiratory grunting
S- Sternal retractions
80
Q

What is pulmonary edema?

A

Excess water in the lungs

81
Q

What leads to pulmonary edema?

A

Valvular dysfunction, coronary artery disease, left ventricular dysfunction
Injury to capillary endothelium
Blockage of lymphatic vessels

82
Q

What is aspiration?

A

Passage of fluid and solid particles into the lungs

Most often on the right side

83
Q

What is atelectasis? What types are there?

A

Partial lung collapse
Compression atelectasis
Absorption atelectasis

84
Q

What is compression atelectasis?

A 
Something growing (tumor or fungal growth), stop airflow, cause collapse
Does not break pleura
85
Q

What is absorption atelectasis?

A

Mucous plug or something in an alveoli, decrease flow, cause collapse, bad ventilation, shunting to better ventilated alveoli
Does not break pleura

86
Q

What is bronchiolitis? Who is it most common in? When do adults get it?

A

Inflammatory obstruction of the bronchioles (small airways)
Most common in children
Occurs in adults with chronic bronchitis, in association with a viral infection or with inhalation of toxic gases

87
Q

What is bronchiolitis obliterans?

A

Exaggerated bronchiolitis, persists for long time, obliterates bronchiole tissue

88
Q

What is a pneumothorax?

A

True collapsed lung

89
Q

What is an open pneumothorax?

A

Open to external environment

Pip = Pb

90
Q

What is a tension pneumothorax?

A

Microscopic tear of pleura (Pa & Pip) causes a one-way valve
Every inhalation collapses the lung more adding air to intrapleural space
Pip = Pa
See tracheal deviation moving toward the good lung

91
Q

What is a spontaneous pneumothorax?

A

Spontaneous

Tall, white, young, men that like to drink and smoke

92
Q

What is a secondary pneumothorax?

A

Due to injury, trauma or disease

More pathologic

93
Q

What is pleural effusion?

A

Collection of stuff or junk in intrapleural space

94
Q

What is transudative effusion?

A

Clear fluid in the intrapleural space

95
Q

What is exudative effusion?

A

Thick, junky, non clear fluid in intrapleural space

96
Q

What is hemothorax?

A

Blood in intrapleural space

Usually from trauma

97
Q

What is empyema?

A

Gross, pussy, fluid in intrapleural space

Infection

98
Q

What is chylothorax?

A

Lymph fluid in intrapleural space

Trauma or post surgery

99
Q

What is flail chest?

A

Instability of a portion of the chest wall
Inhale draws lung into thoracic cavity (decrease thoracic pressure)
Exhale drives lung outward (increasing thoracic pressure)
Trauma, congenital defect

100
Q

What is pneumoconiosis?

A

Inhalation of toxic substances (silica, asbestos, coal, exposure to toxic gases)

101
Q

What is allergic alveolitis?

A

Hypersensitivity pneumonitis

102
Q

What is Acute Respiratory Distress Syndrome (ARDS)?

A

Respiratory failure characterized by acute lung inflammation
Not carrying out adequate gas exchange
Cause= chronic lung inflammation
Injury to the pulmonary capillary endothelium (inflammation and platelet activation)
Surfactant inactivation
Atelectasis
Treat with ventilator of oxygen

103
Q

What is obstructive pulmonary disease? Symptoms? Common obstructive disorders?

A

Airway obstruction that is worse with expiration
Dyspnea (SOB), wheezing
Asthma, Emphysema, Chronic bronchitis

104
Q

What is status asthmaticus?

A

Asthma attack

105
Q

What is chronic bronchitis?

A

Hypersecretion of mucus and chronic productive cough that lasts at least 3 months of the year for at least 2 consecutive years
Persistent inflammation after infection is gone
Harder to get air out

106
Q

What are chronic bronchitis symptoms?

A

“Blue Bloater”
Hypoxia- cyanosis (blue)
Hypercapnia (Increase CO2)

107
Q

What is emphysema?

A

Loss of elastic recoil
Harder time pushing extra air out
Destroy alveoli bubbles
Lose surface area

108
Q

What are emphysema symptoms?

A

“Pink Puffer”
Increase CO2 retention (pink)- can’t breathe it out
Purse lip breathing
Barrel chest

109
Q

What is pneumonia? What types are there?

A 
Infection lead to inflammation causing fluid build up
Inflammation of lung (alveoli)
Community acquired pneumonia
Hospital acquired pneumonia
Pneumococcal pneumonia
Viral pneumonia
110
Q

What are chest infiltrates? What are they a clinical indicator of?

A

Increase inflammation and fluid, get a bright white patch on the x-ray
Indicatory of pneumococcal pneumonia

111
Q

What is Tuberculosis?

A 
Mycobacterium tuberculosis
Airborne transmission
Lives in macros (dust cells) and evades immune system
Induces phagocytosis 
Necrosis- destroy lung tissue
112
Q

What is acute bronchitis?

A

Acute infection or inflammation of the upper airways (bronci)
Commonly follow a viral illness

113
Q

What is a pulmonary embolism?

A

Blockage of blood flow due to occlusion to the lungs

Commonly arise from thrombi of deep veins in the thigh

114
Q

What is pulmonary hypertension?

A

High blood pressure in pulmonary artery

Pulmonary artery carries deoxygenated blood

115
Q

What are the classifications of pulmonary hypertension?

A

Pulmonary arterial hypertension
Pulmonary venous hypertension (CHF)
Pulmonary hypertension due to respiratory disease or hypoxemia (COPD)
Pulmonary hypertension due to thrombotic or embolic disease (PE)
Pulmonary hypertension due to disease of the pulmonary vasculature

116
Q

What is cor pulmonale?

A

Right heart failure

Primarily due to right ventricular enlargement (failure)

117
Q

What is the most common cause of lung cancer?

A

Cigarette smoking

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