Restrictive and Obstructive Lung Dysfucntion Flashcards
1
Q
A
bronchitis
2
Q
Severe hypoxemia
A
<75% SaO2
<40 mmHg PaO2
3
Q
Tuberculosis S & S
A
if symptomatic,
- usually cough (unproductive)
- and fever,
- night sweats,
- weight loss;
- poss dyspnea;
- crackles w/poss bronchial BS is consolidation
4
Q
Abnormal permanent dilation of bronchi and bronchioles. Destruction of elastic & muscular bronchiole walls:
A
Bronchiectasis
5
Q
Hypocapnia:
A
Low PaCO2 = hyperventilation
6
Q
Blood clot lodges in pulmonary artery
A
Pulmonary Embolism
7
Q
Mild hypoxemia:
A
90 - 94% SaO2
60-79 mmHg PaO2
8
Q
Symptoms of COPD:
A
- Dyspnea on exertion (DOE)
- Chronic cough
- Expectoration of mucus
- Wheezing
9
Q
types of bronchiectasis
A
● Cylindrical (longitudinal)
● Varicose
● Saccular (cystic)
(chronic condition where the walls of the bronchi are thickened from inflammation and infection)
10
Q
In restrictive diseases, what are the most marked lung volumes decreases?
A
IRV and ERV
11
Q
true or false: both restrictive and obstructive pulmonary diseases may present with cor pulmonale.
A
true
12
Q
Hypercapnia S & S:
A
- Increased HR and BP
- Dizziness
- Headache
- Confusion or loss of consciousness
- Muscle twitching and tremor
13
Q
Altered expiratory flow rate, increased RV, increased airflow resistance, loss of elastic recoil, increased work of breathing (WOB):
A
result of the COPD’s inflammatory response
14
Q
Moderate hypoxemia:
A
75 -89% SaO2
40 - 59 mmHg PaO2
15
Q
Signs of hyperinflation can be seen in which three COPD diseases?
A
emphysema, chronic bronchitis and asthma.
16
Q
True or false. V/Q mismatch can be a cause of impaired oxygenation
A
true
17
Q
An increase in CO2 in the body will:
● ____________ pH
● ____________ ventilation
A
- decrease PH (acidosis)
- increases ventilation (to get rid if CO2)
18
Q
Hypocapnia S & S
A
- Lightheadedness
- Fatigue
- Irritability
- Inability to concentrate
- Tingling
- Impaired conciousness
19
Q
Describe the characteristic pathologic changes in emphysema.
A
- Destruction of septal walls of alveoli
- Loss of elastic recoil
- Destruction of vascular bed
- Fusion of adjacent alveoli producing large abnormal airspaces (blebs or bullae)
20
Q
A
emphysema
21
Q
Normal persons use ___VO to support work breathing
A
<5%
22
Q
In tuberculosis, the immune system usually surrounds the TB to form a____
A
granuloma
23
Q
Decrease in the size of the bronchial lumen
causes increased resistance to airflow resulting in hyperinflated lungs – air gets trapped behind
collapsed bronchial walls
A
COPD
24
Q
Nomal hypoxemia range :
A
>95%
80-100 mmHG PaO2
25
emphysema radiograph:
flatten diaphragm
enlarged R side of heart (cor pulmonale)
hyper-lucent lungs (darker)
26
Patient has 80% SaO2 in the blood. This is considered...
**moderate hypoxemia**
27
A look at **obstructive** and **normal** lung volumes:
28
Hypercapnia:
Increased PaCO2 = hypoventilation
29
occurs when **air** leaks into the space between your lung and chest wall (pleural cavity)
pneumothorax
30
Bronchityis S & S:
* Inflammation of the bronchi
* **Blue bloater**
* Barrel chest
* Morning expectoration
* Chronic cough, productive sputum
31
Trasnmition of tuberculosis is by
inhalation of droplets that become airborne, usually with cough or sneeze
32
Hypocapnia is PaCO2 of less than
35 mmHg
33
hypoxemia
low PaO2 in the blood
34
Abnormal, irreversible enlargement of airways distal to terminal bronchioles
**Emphysema**
* Centriacinar/lobar, panacinar, paraseptal →based on location of anatomic disruption
35
Hypercapnia is a PaCO2 of more than\_\_\_\_\_
45 mmHg
36
Inflammatory process of alveolar wall. Scarring leads to stiffness (decreased compliance)
**Pulmonary Fibrosis**
37
Signs of restrictive pulmonary diseases:
* Tachypnea
* Hypoxemia
* Diminished BS
* Adventitious BS
* Decreased lung volumes
* Decreased diffusion capacity
* Cor Pulmonale (Right hearth failure): hearth overloads
38
oxygen toxicity (high concentrations) can cause
* interstitial lung disease
* alveolar edema and hemorrhage with atelectasis
* Need to keep Fraction of Inspired Oxygen (FiO2) \<40%.
39
Global Initiative for Obstructive Lung Disease
(GOLD)
to increase awareness of COPD
40
an inflammatory disease that affects multiple organs in the body, but mostly the lungs and lymph glands
sarcoidosis
41
in Cystic Fibrosis what is the key to its treatment?
**Bronchial hygiene** is key!!!!
42
In COPD, obstruction affects **mechanical function** or does it affect **gas exchange**?
both
43
Cor pulmonale
* abnormal enlargement of the **right side of the heart** as a result of disease of the lungs or the pulmonary blood vessels.
* Sign of both **COPD** and **restrictive**
44
\_\_\_\_\_\_\_\_\_\_\_\_\_\_of the lung is simply a “solidification” of the lung tissue due to accumulation of solid and liquid material in the air spaces that would have normally been filled by gas. The most common cause of \_\_\_\_\_\_\_\_\_\_\_is pneumonia – inflammation of the lung – as cellular debris, blood cells and exudate collects in the alveoli (air sacs) of the lung.
**Consolidation**
45
**Pulmonary artery vasoconstriction** is a S & S of what?
i**mpaired oxygenation** from:
* *Respiratory: reduced inspired O
hypoventilation, impairment of diffusion, V/Q
mismatch*
* *Other systems: decreased blood volume,
anemia, carbon monoxide poisoning,
hypothermia*
46
Some people with **emphysema** develop empty spaces in the lungs called \_\_\_\_
**bullae.** Giant bullae can be as large as half the lung. In addition to reducing the amount of space available for the lung to expand, giant bullae can increase your risk of pneumothorax.
47
Patient has 98% SaO2 in the blood. This is considered...
**normal hypoxemia**
48
Inflammation of the airway is associated with alveolar
wall destruction & rupture of attachments b/t outer airways & alveoli ➔ loss of elastic recoil in the lung tissue (leads to airway obstruction and hyperinflation of lungs)
bronchitis
49
Patient has 68% SaO2 in the blood. This is considered...
severe hypoxemia
50
Incomplete expansion (or collapse) of lung that can result from secretion retention or compression of the lung
Atelectasis
51
Signs of COPD:
* **Hypoxemia**
* **Hypercapnia**
* Increased production of mucous/impaired mucous clearance
* Pulmonary hypertension
* Polycythemia
* **Cor pulmonale**
* Often see productive cough
* Decreased expiratory flow rates (FEV1)
* **Increased residual volume**
52
**Bronchiectasis** auscultation:
crackles, wheezes, pleural rub, decreased BS
53
May be idiopathic (IPF), immune response, genetic, occupational hazards (coal dust, asbestosis → inflammatory process of alveolar wall. Scarring leads to **stiffness** (decreased compliance)
**Pulmonary Fibrosis**
**(Restrictive disease)**
54
Another look at lung volumes
55
inflammation of the bronchi, obstruction of the airway:
bronchitis
56
In children, is caused by RSV (respiratory syncytial virus)
**Bronchiolitis Obliterans (BO)**
Adults: by toxic fumes, or other infections
57
Abnormal reduction in pulmonary ventilation
often due to **diminished lung expansion** resulting in a decreased volume of gas moving in and out
restrictive disease
58
Drop in CO2 will:
● ____________ pH
● ____________ ventilation
* increase PH
* decrease ventilation (to keep CO2)
* Alkalosis
59
in genereal, with COPD, how does mucus pluggins affect breath sounds?
decreased breath sounds
60
Symptoms of restrictive pulmonary diseases:
* Dyspnea
* Cough
* Emaciation
61
reduced inspired O2, hypoventilation, impairment of diffusion, V/Q mismatch, decreased blood volume, anemia, carbon monoxide poisoning, hypothermia **will cause**
**hypoxemia**
62
Sudden respiratory failure due to fluid leaking from smallest blood vessels in lungs into the alveoli. Often seen in critically ill patients. Develop severe SOB w/in hours → days of initial injury/disease
**Acute Respiratory Distress Syndrome (ARDS)**
63
Chronic inflammatory disease of the airways characterized by reversible obstruction to airflow with increased mucosal edema
Asthma
64
Inflammatory process of the lung. Often begins from a lower respiratory tract infection
**Pneumonia**
65
What is the difference between a pleural effusion and a pneumothorax?
* Pleural effusion: **fluid** in the pleural space
* Pneumothorax: **air** the pleural cavity
66
Hypersecretion of mucus in response to a chronic
irritation (smoking)
bronchitis
67
Cystic Fibrosis X-ray
68
Patient has 92% SaO2 in the blood. This is considered...
**mild hypoxemia**
69
In restrictive lung disease → **work of breathing increases or decreases?**
**increases**
70
COPD disease that used to be deadly characterized by thick, excessive secretions and poor ciliary function
**Cystic fibrosis**
71
Cystic Fibrosis X-ray
72
One of the most common chronic lung diseases in
**children** (along with asthma and CF)
**Bronchpulmonary dysplasia (BPD)**
more common in pre-term children
73
PaO2 bet 40- 60?
moderate hypoxemic
74
Inflammatory immune response in the lungs
usually in response to noxious stimuli (ex: cigarette smoke)
COPD pathogenesis
75
So, with increased CO2 production, chemoreceptors will _______ ventilation to express the CO2 and
\_\_\_\_\_\_\_ the H+ concentration
increase ventilation
decrease the H+ concentration
76
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ sends i**nhibitory impulses** to the inspiratory area→shortening inhalation
pneumotaxic area in the pons
77
how would percussion be in emphysema?
**hyper-resonant,** because is so air filled
78
**Blood Gas** looks at what aspect of impaired oxygenation disease?
PaO2
**Amount of O2 in the blood: HYPOXEMIA**
Blood for an ABG test is taken from an artery.
79
**Emphysema Signs and Sx**
* pink puffer
* Often thin
* Increased accessory mm use
* lung hyperinflated (decreased BS)
80
leading cause of cancer deaths:
**carcinoma**
81
This COPD disease is characterized by exocrine gland dysfunction:
* GI: pancreatic enzyme deficiency
* Integumentary: increased sweat production
**Cystic Fibrosis**
82
Hemothorax
blood in the pleural cavity
83
PaO2 bet 80 and 100
normal oxygen level
84
Increased fluid in the lung (alveoli), often due to
left ventricular failure (CHF). Can be a medical emergency
**Pulmonary Edema**
85
True or false.
In bronchitis, the **cilia** in airways remain intact
false
86
Incubation time of tuberculosis
2-12 weeks (PPD + ~6-8 wks)
87
in Bronchiectasis think of...
disgusting horrible muscus that you have to help pt clear
88
asthma
89
Air trapping in the lungs due to premature closure of the airways
COPD
90
Anoxia
absence of oxygen
91
Types of COPD:
| (COPD diseases)
* **Bronchitis** (blue boater)
* **Asthma**
* **Emphysema** (pink puffer)
* **Bronchiectasis:** chronic condition where the walls of the bronchi are thickened from inflammation and infection
* **Cystic Fibrosis**
92
PaO2 of less than 40
severely hypoxemic
93
increased CO2 would cause \_\_\_\_\_\_\_\_in H+ (\_\_\_ in pH)
increase H+
decreases PH (Acidosis)
94
hypoxia
low oxygen in the tissues
95
Oxygentation status values:
96
Disease of respiratory tract which produces an obstruction to airflow
obstructive disease (COPD)
97
Manifestations of respiratoty diseases:
* **Impaired Oxygenation**
* **Impaired CO2 removal**
98
PaO2 bet 60 and 80
mild hypoxemic
99
Causes of impaired oxygenation:
* **Respiratory:**
* reduced inspired O2
* alveolar hypoventilation
* impairment of diffusion
* V/Q mismatch
* **Other systems:**
* decreased blood volume
* anemia (not enough RBC)
* carbon monoxide poisoning
* hypothermia
100
asthma
101
Lung diseases that result in **air trapping** in the lungs
COPD
* Increased lung compliance with larger lung volumes
102
Signs and symptoms of impaired oxygenation:
* Cyanosis
* Tachycardia, tachypnea
* Cerebral hypoxia (disoriented)
* Cardiac arrhythmia
* Pulmonary artery vasoconstriction
103
Patients with COPD usually present with:
1. hyperinflation,
2. barrel chest, and
3. increased accessory respiratory muscle use
104
Types of asthma:
* **Exercise induced asthma**
* **Asthma attack**
* **Status asthmaticus:** attack that persists for hours and is unresponsive to medical management → medical emergency
105
Diagnosis of COPD is made by
* pulmonary function test,
* symptoms
* history
106
This disease can be **extrinsic** – begins in childhood, triggered by allergens (allergic) or **Intrinsic** – begins as adult (usu after age 35), more severe (non-allergic)
Asthma
107
Pleural Effusion
* Fluid in the pleural space (from an infection like pneumonia)
108
Occurs in infants by RSV (respiratory syncytial virus)or dults by toxic fumes, or other infections. Fibrotic lung dx of smaller airways with **necrosis** of the respiratory epithelium from inflammatory injury that causes destruction of bronchioles
**Bronchiolitis Obliterans** (BO) / with Organizing Pneumonia (BOOP)
109
Productive cough on MOST days for 3 months during 2 consecutive years
**Bronchitis**
110
With restrictive lung disease, % of O2 expediture utilized in the work of breathing can go up to \_\_\_\_
25%
Can develop respiratory mm fatigue, overuse, and failure
111
What are the universal precaustions in tuberculosis?
* mask
* respiratory isolation
