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zFoundations of Pathophysiology > Topic 7 - Acute and Chronic Pulmonary Disease > Flashcards

Topic 7 - Acute and Chronic Pulmonary Disease Flashcards

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1
Q

What are some symptoms of COPD?

A

hunched over, thin, pursed lips, overdeveloped SCM

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2
Q

Why is performing overhead tasks a problem for people with COPD?

A

weakened muscles

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3
Q

What are the three diseases which make up COPD?

A

asthma, bronchitis, emphysema

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4
Q

What does FEV1 mean?

A

forced expiratory volume after 1 sec

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5
Q

What does FVC mean?

A

forced vital capacty

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6
Q

What is TLC?

A

total lung capacity

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7
Q

What is RV?

A

residual volume, amount of air left in lungs after a breath out

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8
Q

Why would people with COPD have acidic blood?

A

increased levels of CO2

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9
Q

Why would people with COPD have high amounts of carbon dioxide?

A

inability to remove CO2 from lungs during expiration

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10
Q

Why would people with COPD have low amounts of oxygen?

A

inability to get oxygen in

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11
Q

Why would people with COPD have high amounts of bicarbonate?

A

acts as a buffer to the abnormally acidic blood

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12
Q

What are some medications to achieve and maintain lung function?

A

reliever, preventer, symptom controller, combination (symptom controller and preventer)

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13
Q

What is the pleura?

A

encases each lung, consists of a pleural cavity filled with pleural fluid

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14
Q

What is the role of pleural fluid?

A

lubrication

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15
Q

Is the pressure inside the lungs lower than outside?

A

the intrapleural pressure is lower than atmospheric presure

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16
Q

How many lobes does the right lung have?

A

3: upper, middle, lower

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17
Q

How many lobes does the left lung have?

A

2: upper, lower

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18
Q

What are the fissures of the right lung?

A

oblique, horizontal

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19
Q

What is the fissure of the left lung?

A

oblique

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20
Q

What are the two unique features of the left lung?

A

cardiac impression, aortic arch impression

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21
Q

What are the divisions of the upper, middle and lower lobes of the the right bronchopulmonary segment?

A

Upper: apical, anterior, posterior
Middle: lateral, medial
Lower: apical, medial basal, anterior basal, lateral basal, posterior basal

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22
Q

What are are divisions of the upper, and lower lobes of the left bronchopulmonary segment?

A

Upper: apical, anterior, posterior, lingular (superior, inferior)
Lower: apical, anterior basal, lateral basal, posterior basal

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23
Q

What is an obstructive pulmonary disease?

A

characterised by an increase in resistance to airflow owing to complete or partial obstruction at any level

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24
Q

What is restrictive pulmonary disease?

A

characterised by reduced expansion of lung paranchyma with decreased lung capacity

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25
What are the characteristics of an obstructive lung disease?
low FEV1/FVC ratio, low FEV1
26
What are the characteristics of a restrictive lung disease?
normal FEV1/FVC ratio, decreased FEV1, decreased FVC
27
What is the definition of COPD?
presence of airflow obstruction that is not fully reversible
28
What is the definition of asthma?
episodes of widespread but variable airflow obstruction that is reversible either spontaneously or with treatment
29
What is type 1 resp failure?
low oxygen
30
What is type 2 resp failure?
low oxygen, high carbon dioxide
31
What is the pathological definition of emphysema?
permanent enlargement of airspaces distal to terminal bronchioles and destruction of alveolar tissue
32
What are the causes of emphysema?
smoking or a1 antitrypsin deficiency
33
What is progressive chronic dyspnoea?
breathlessness out of proportion to the level of activity
34
What are the signs and symptoms of emphysema?
hunched posture, weight loss, dyspnoea, cough, pursed lip breathing
35
Why is there a characteristic hunched posture?
recruitment of accessory inspiratory muscles, abdominal contents push on diaphragm, giving it a mechanical advantage - allows dome to contract and descend
36
Why is weight loss a symptom of emphysema?
increased energy consumption, breathlessness affects eating
37
When does emphysema show itself?
after 1/3 of lung paranchyma is damaged
38
How does death occur if a person has emphysema?
type 2 resp failure, right sided heart failure, pneumothorax
39
What is bullae?
overstretched alveoli causing burst or rupturing --> pneumothorax, buildup of positive pressure
40
What is the clinical definition of chronic bronchitis?
persistent cough with sputum production for at least three months in at least 2 consecutive years in the absence of any other identifiable cause; chronic inflammation by inhaled subatance
41
How does smoking affect chronic bronchitis?
interferes with ciliary action, damage to airway epithelium, inhibits bronchial and alveolar leukocytes
42
How does death occur by chronic bronchitis?
right sided heart failure, cardiac failure, respiratory failure
43
What are the effects of chronic bronchitis on lungs?
swollen and boggy, excessive mucous, heavy casts, pus-filled bronchi
44
What is the definition of asthma?
chronic inflammation of the airways involving mast cells, eosinphils, T-cells, macrophages, neutrophils and epithelial cells; inflammation causes recurrent episodes of wheezing, breathlessness, chest tightness and coughing esp at night and morning; variable airflow obstruction that is often reversible; hyperresponsive bronchioles
45
What is meant by hyper responsive bronchioles?
requires less stimulus to trigger a response as the person ages or as the condition worsens
46
What are the symptoms of asthma?
constriction, congestion, cough/sputum, distress, asymptomatic between attacks
47
What are the classifications of asthma?
atopic, non atopic, persistent, intermittent
48
What is the pathway of atopic asthma?
antigen --> mast cell --> chemical mediators --> histamine (bronchoconstriction, increased secretions), leukotrienes (prolonged bronchoconstriction, increased secretion, increased vascular permeability), open mucosal intercellular junction (ncreased antigen access)
49
What is the pathology of airflow obstruction
- smooth muscle hypertrophy and hyperplasia = thickening - inflammatory cells infiltrate = narrowing - oedema - goblet cells and mucus glands hyperplasia - mucous hypersecretion - protein deposition including collagen = remodelling = stiffer - epithelial desquamation = shedding
50
What is COPD?
- presence of airflow obstruction that is not fully reversible --> inflammation, fibrosis, remodelling - poor exercise tolerance/deconditioning
51
What is bronchiectasis?
permanent dilation of bronchi + bronchioles = destruction of muscle and elastic tissue leading to necrotising infection - normal clearing methods impaired --> stagnating secretions, pooling of secretions, lungs don't clear - foul-smelling sputum (bacteria), exacerbations precipitated by UTRI's
52
What is the management of bronchiectasis?
antibiotics, physio
53
What is resorption?
airway obstruction, excessive secretion, occurs with asthma, chronic bronchitis, bronchiectasis, post operatively
54
What is compression?
compression of lung tissue, pneumothorax/effusion, surgery, seen in patients with heart failure, abnormal elevation of diaphragm
55
What are pulmonary infections?
inflammation --> bacteria, viruses, other organisms | secretion accumulation
56
What is pneumoitis?
inflammation of lung paranchyma due to chemical or physical agents
57
What is pneumonia?
pulmonary defence mechanisms impaired or decreased host resistance compromised clearing mechanisms
58
What are the classifications of pneumonia according to origin?
- community acquired | - hospital acquired
59
What are the primary, secondary and atypical classification?
- primary - intact immune system, sudden onset, usually community acquired - secondary - impaired immune system, ill/elderly - atypical - often viral (Legionella, mycoplasma), problem with immune system
60
What are the classifications based upon anatomical location?
- lobar - entire anatomic lobe, classic progression | - broncho - entire lobe isn't filled
61
What is a complication of pneumonia?
lung abscesses
62
What is a lung abscess?
fluid filled cysts, no oxygenation
63
What occurs during red hepitisation?
neutrophils and fibrin fill alveoli, exudation of RBC, rusty sputum, red airless lungs
64
What occurs during grey hepitisation?
increase fibrin, degeneration of WBC/RBC, fibrin, exudate
65
What are the pleural conditions?
pleural effusion, emphysema, pneumothorax | affect the lining of the lungs
66
What is a pleural effusion?
serous fluid collection in pleural space
67
What is a pneumothorax?
air in pleural space, can be spontaneous/traumatic
68
What are the vascular conditions?
thrombosis, embolism, pulmonary oedema, right suded heart failure
69
Thombosis
coagulation of blood, intravascular, formed by interaction of blood vessel walls (endothelium), blood (platelets), plasma coagulants (clotting system)
70
Embolism
'clot on holidays' | travels in bloodstream from origin
71
How is an embolism prevented?
early ambulation and anti-coagulant medication
72
What is pulmonary oedema?
- accumulation of fluid --> interstitial fluid - heavy, wet lungs - cardiac failure = cause
73
What is left-sided heart failure?
left ventricle not working therefore lungs cannot empty blood into heart
74
What is right-sided heart failure?
- occurs due to lung disease - decreased blood oxygen (hypoxaemia) due to chronic lung disease --> pulmonary constriction (blood diverted from diseased areas --> narrowing of pulmonary capillaries --> hypertension --> right side of heart must work harder --> right-sided heart failure

zFoundations of Pathophysiology (10 decks)

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