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Respiratory exam 3 Flashcards

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1
Q

Emphysema

A

gas exchange is abnormal d/t destruction of alveolar walls

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2
Q

Primary emphysema

A

rare inherited deficiency of alpha 1 antitrypsin

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3
Q

Alpha 1 antitrypsin

A

normally inhibits the enzymes that chew up elastin

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4
Q

secondary emphysema

A

inability of the body to inhibit proteolytic enzymes

caused by smoking/toxin exposure

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5
Q

What does airway obstruct do?

A

prolongs expiratory phase of respiration and causes the potential for impaired gas exchange d/t mismatching v/q

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6
Q

FVC

A

forced vital capacity

amount of air that can be expelled forcibly after maximal inspiration

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7
Q

Is FVC increased or decreased with people who have chronic lung disease

A

increased

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8
Q

Is the FEV decreased or increased in people with chronic lung disease?

A

decreased

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9
Q

What are examples of restrictive lung disease?

A

pulmonary fibrosis, pulmonary edema, PNA

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10
Q

What is restrictive lung disease

A

it keeps the lungs from inflating causing decreased compliance; there is a problem with the lung tissue itself

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11
Q

are tidal volumes and vital capacity decreased or increased with restrictive lung disease?

A

decreased

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12
Q

Pulmonary fibrosis is caused by:

A

extra connective tissue/elastin causes increased thickness of respiratory membrane and insufficient gas exchange

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13
Q

pulmonary edema is caused by:

A

water in the lungs that disrupts balance b/t pressure and capillary permeability

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14
Q

What are examples of pulmonary vascular diseases?

A

PE, pulmonary hypertension, cor pulmonale, ARDS, respiratory failure

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15
Q

What causes a PE?

A

clot, thrombus, tissue fragment, lipids, air bubbles

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16
Q

What are the consequences of a PE?

A

blood backflow to the right ventricle which leads to increased pressure and decreased gas perfusion

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17
Q

What is Virchow’s Triad?

A

1) stasis of blood
2) increased blood coagulability
3) vessel wall injury

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18
Q

Pleurial effusion

A

accumulation of fluids in the pleural cavity

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19
Q

what is transudate/hydrothorax and what are some causes?

A

water

caused by CHF, renal failure, liver failure, nephrosis

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20
Q

What is exudate/empyema and what are some causes?

A

pus

caused by infection, lupus, RA, malignancies

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21
Q

What is a hemothorax and what are some causes?

A

blood

chest injury, surgery, vessel rupture, malignancies

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22
Q

What is chyle and what are some causes?

A

milky fluid from lymph from GI tract

trauma, infection, malignant infiltration

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23
Q

What is secondary atelectasis? what are some causes?

A

a lung that is collapsed that was previously inflated
causes: airway obstruction(mucous plug), lung compression (pneumothorax, effusion), increased lung recoil (decreased surfactant)

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24
Q

what is primary atelectasis?

A

insufficient surfactant at birth

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25
what are examples of restrictive lung disease?
Asthma, COPD, Cystic Fibrosis
26
what is restrictive lung disease?
increased airway resistance and a decreased FEV1 | a change in radius causes change in resistance
27
Asthma
a chronic inflammatory disorder resulting in airflow obstruction with recurrent episodes of wheezing, SOB, chest tightness FEV1/FVC is decreased>>air cannot be expelled quickly enough
28
What is the pathophysiology of asthma?
IgE and mast cells degranulate causing inflammatory mediators to be released, leading to smooth muscle contraction and increased secretions
29
FEV1
the maximal amount of air you can forcefully expel in one second
30
What FEV1 percentage qualifies for obstructive lung disease?
less than 80%
31
what is epinephrine's use with asthma and what are some side effects?
it will act as an alpha agonist which may help decrease airway edema as well as providing additional beta-2 agonism S/E: it has secondary effects on alpha/beta adrenergic receptors elsewhere in the body (tachycardia)
32
Beta-2 receptors use with asthma
beta 2 receptors are located in the lungs so this would focus on dilating the bronchial smooth muscle with less side effects
33
Anticholinergics use with asthma
works on inflammation to help open airways
34
Glucocorticoids use with asthma
works to decrease inflmmation and help open up the constricted airway
35
What is hypoxemia caused by?
low oxygen in the blood, mismatched ventilation and perfusion
36
Shunt
venous blood directly joining arterial circulation; poor ventilation with perfusion
37
what are the causes of a shunt?
obstruction, pulmonary edema, bronchoconstriction
38
what is hypercapnia?
increased Co2 with hypoventilation
39
what are some causes of hypercapnia?
depression of respiratory center from medications or anesthesia, disease of the medulla, spinal cord disruption, large airway obstruction
40
what is the normal range for ventilation-perfusion matching?
0.6-3.0
41
Ventilation (V)
refers to the air in the lungs available for exchange
42
Perfusion (Q)
refers to the blood supply in the aveoli
43
V/Q mismatching
no gas exchange occurs in the alveoli | no ventilation d/t obstruction because of decreased oxygen and paO2
44
Compliance
measure of the lung and chest wall dispensability | influenced by elastin and collagen
45
What is compliance determined by?
elastic recoil and surface tension | if there's high surface tension lungs collapse?
46
What diseases cause decreased compliance?
pulmonary edema, pulmonary fibrosis
47
What diseases cause increased compliance?
Emphysema because the tissues are too stretched out
48
Surface tension
the tendency of molecules exposed to air to adhere to one another; occurs at gas-liquid interference
49
Surfactant
decreases surface tension to help keep alveoli open against surface tension, produced by type II epithelial cells
50
Tension pneumothorax
air enters but does not leave most dangerous because it can lead to obstructive shock d/t compression of vena cava Pleuric cavity pressure is greater than atmospheric
51
Open pneumothorax
air enters chest wall d/t trauma | pleuric cavity and atmospheric pressure are about the same
52
Spontaneous pneumothorax
closed, air blebs/blisters form on surface and cause rupture; smokers pleural cavity is less than atmospheric pressure
53
What are the main functions of the respiratory system?
1) Regulates pH by eliminating Co2 2) makes ACE (angiotensin converting enzyme) 3) surfactant 4) inactivation of prostaglandins 5) defense mechanisms ( cough, mucociliary escalator, macrophages, IgA)
54
What are the conducting airways?
Upper airways, anatomical dead space nose, pharynx, larynx, trachea, bronchi, and bronchioles
55
What is the respiratory zone?
respiratory bronchioles, alveolar ducts, alveoli (lung parenchyma) gas exchange occurs here
56
Dead space
ventilation without perfusion
57
what is the respiratory center of the brain?
brain stem and medulla
58
How does gas exchange occur?
by diffusion | and is dependent upon adequate alveolar ventilation and pulmonary blood perfusion
59
what is ventilation/perfusion?
V/Q ratio across respiratory membrane
60
the medulla controls what?
the basic rhythm
61
the pons does what?
modifies the rhythm
62
What do central chemoreceptors do?
measure Co2 and pH | they increase RR when Co2 increases or pH decreases
63
what is the primary respiratory signal?
carbon monoxide (Co2)
64
what is the secondary respiratory signal?
oxygen
65
what do peripheral chemoreceptors do?
measures oxygen in arterial blood | they increase RR when o2 is less than 60
66
Fick's law of diffusion
occurs in response to a concentration gradient expressed as the change in concentration due to a change in position

advanced patho (4 decks)

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