unit 4 stuff Flashcards
(311 cards)
1
Q
how many layers does the skin have and what are they
A
3
epidermis, dermis, hypodermis
2
Q
what are the 2 parts of the dermis
A
papillary dermis
reticular dermis
3
Q
secondary lesion
A
a lesion becomes secondary when changes occur to primary lesion
(like scale, crust, thickening, ulcer, scar, ect)
4
Q
what does the lab value of prealbumin indicate
A
nutritional status
5
Q
what is the lab value hematocrit used for
A
monitoring wound healing
6
Q
what are the 4 lab values measured with skin lesions/diseases
A
prealbumin
glucose
hemoglobin
hematocrit
7
Q
melasma
A
hyperpigmentation of the cheeks and forehead
8
Q
what happens to blood vessels with aging and what are the implications?
A
reduced numbers and get thinner
this compromises blood flow and impairs the individuals ability to thermoregulate
9
Q
clinical implications of having fewer melanocytes in the skin
A
decreased protection against UV
increased skin cancer risk
10
Q
the epidermis the body’s principal supplier of which vitamin
A
vitamin D
11
Q
how does vitamin D deficiency impact the musculoskeletal system
A
increases osteoporosis because calcium needs vitamin D to maintain bones
12
Q
oxidation damage impacts what 3 parts of the skin
A
lipids
proteins
DNA
13
Q
2 bacterial skin infections
A
impetigo
cellulitis
14
Q
2 viral skin infections
A
herpes zoster (chicken pox)
warts (verrucae)
15
Q
3 fungal skin infections
A
ringworm (tinea corporis)
athletes foot (tinea pedis)
yeast (candidiasis)
16
Q
psoriasis
A
Chronic skin condition with raised, inflamed, red plaques that look scaley
17
Q
lupus erythematosus
A
Autoimmune disease
Impacts kidneys, skin, joints, heart, lungs, etc
Butterfly rash across the face
18
Q
system sclerosis
A
autoimmune disease that causes fibrosis and vascular abnormalities in the skin/joints
19
Q
polymyositis/dermatomyositis
A
autoimmune diseases that cause inflammation of the muscles and weakness
20
Q
what is burn severity determined by
A
the depth and total body surface area
21
Q
what are the percentages and areas of “Wallace rule of nines”
A
9% = arms + head
18% = legs + anterior trunk + posterior trunk
22
Q
lund and browder method
A
a chart that estimates the total body surface area affected by a burn injury
23
Q
____ burns account for 75% of all burn center admissions
A
thermal
24
Q
what special population is most vulnerable to burns
A
children
(then older adults)
25
what 4 body systems are affected by burns
cardiovascular
renal
GI
immune
26
why is heart rate increased with a cutaneous burn
catecholamine release and hypovolemia
27
what happens to cardiac output with a cutaneous burn
decreased in the beginning
returns to normal
then INCREASES around 24 hours after injury
28
2 circulatory system symptoms of extensive burns
- edema in both burned/non-burned tissue
- decrease in circulating intravascular blood volume
29
how do the renal and GI systems respond to a burn
shunting blood from kidneys and intestines
30
oliguria
decreased urine output
31
paralytic ileus
intestinal dysfunction after burns
32
which burn type has a higher chance of being a multisystem injury
electrical burn
33
what are the physical characteristics of an electrical burn
smaller entrance wounds
explosive exit wounds
34
electrical burns impact which type of tissue the most
soft-tissue (muscle/ligament/etc)
35
which is more dangerous and why:
alternating current vs direct current
alternating current
it is associated with cardiopulmonary arrest, ventricular fibrillation, and tetanic muscle contractions
36
what is alternating current
electric current that periodically changes direction
37
why are chemical burns typically deep
they often continue burning until neutralized
38
which burns skin more: acids or alkalines?
alkalines
39
what is the danger of having a circumferential burn
they can make a tourniquet-like effect and lead to compartment syndrome or total loss of circulation
40
what is the clinical implication of having burns on the hands and joints
permanent physical and vocational disability
41
what is the most common and life-threatening complication of burn injuries
infection
42
hypertrophic scarring in burns is associated with
considerable morbidity and potential lifelong disfigurement
43
3 phases of medical management in burns
1. emergent phase
2. acute phase
3. rehabilitative phase
44
what is done in the acute phase of medial management in burns
wound management
infection prevention
debridement and skin grafting
physical therapy
45
what is done in the emergent phase of medial management in burns
fluid resuscitation
ventilatory management
assessment of burn extent
46
xenographts
typically pig skin
47
allografts
typically cadaver skin
48
autografts
own skin
49
biosynthetic grafts
combination of collagen and synthetics
50
what type of graft is most often used in full-thickness burns
autograft
(this permanently closes the injury as well)
51
what are the bony prominences most susceptible to pressure ulcers (6)
heels
sacrum
ischial tuberosities
greater trochanters
elbows
scapula
52
what is used to classify neuropathic ulcers
wagner system
53
stage 1 pressure injury
nonblanchable erythema of intact skin
54
stage 2 pressure injury
partial-thickness skin loss with exposed dermis
55
stage 3 pressure injury
full-thickness skin loss
56
stage 4 pressure injury
full-thickness skin and tissue loss
57
unstageable pressure injury
obscured full-thickness skin and tissue loss
58
deep tissue pressure injury
persistent nonblanchable deep red, maroon, or purple discoloration
59
what causes superficial burns and what does it look like
sunburn (UV exposure) or brief exposure to flame/hot liquids
presents as mild-severe erythema, skin blanches with pressure, dry
60
what causes partial-thickness burns and what does it look like
scalding liquids/semiliquids/solids
targe thick-walled blister, edema, broken epidermis, wet, shiny
61
what causes full-thickness burns and what does it look like
prolonged exposure to chemical, electrical, flame, scalding liquids, steam
red/black/white, dry surface, edema, fat exposed
62
desquamation time for superficial burns
3-7 days
63
healing time for partial-thickness burns (deep and superficial)
deep = 21-28 days
superficial = 14-21 days
64
primordial prevention (and an example)
focused prevention on an entire population
ex: improving access to urban neighborhood to safe sidewalks to promote physical activity
65
how is primordial prevention promoted
through laws and national policy
66
what are ALL 8 symptoms of cardiac disease
1. pain/discomfort in chest/neck/arm
2. angina
3. palpitations
4. dyspnea
5. syncope
6. fatigue
7. cough
8. cyanosis
67
what are the 2 most common symptoms of the vascular component of cardiovascular conditions
edema
leg pain (claudication)
68
claudication
leg pain
69
biomarkers of cardiovascular disease
blood pressure
premature matricular contraction
LDL-C
CRP
70
what is the most common cause of death in the older population in the US
cardiovascular disease
71
cardiovascular disease accounts for over ___% of cardiovascular deaths in 65+
80%
72
what 2 things create stiff arterial walls and narrowed lumen
deterioration of arterial media
atherosclerotic plaque
73
why does BP increase as we age
the arteries are more stiff which means there is less "give" when blood passes through
74
what happens to the aorta with age
it becomes dilated (larger) and elongated
75
in comparison to men, women have higher incidences of (3 things) in their cardiovascular systems
mitral valve prolapse
fatal arrhythmias from cardiac/psychotropic meds (3x more)
bleeding episodes from thrombolytic agents
76
angina pectoris
chest pain/discomfort when the heart does not receive enough o2 rich blood
77
5 components of metabolic syndrome (how many of these components does a person have to get a diagnosis of metabolic syndrome)
1. waist circumference (40in men 35in wom)
2. reduced HDL (>40mg/dl men >50mg/dl wom)
3. blood pressure (130/85)
4. fasting blood glucose (<100)
5. triglyceride (<150)
need 3/5 to be diagnosed
78
optimal cholesterol levels (total, LDL, HDL, triglycerides)
total = 150
LDL = 100
HDL = 40 men; 50 wom
triglycerides = under 150
79
normal BP vs elevated BP
normal BP = 120/80 or less
elevated BPP = 120-129/80
80
hypertension stage 1 + 2 levels
stage 1 = 130-139/80-89
stage 2 = 140/90 or higher
81
atherosclerosis
plaque buildup in the inner layer (intima) of the arteries
82
monckeberg arteriosclerosis
destruction of muscle and elastic fibers + formation of calcium deposits
83
what layer of the arteries is monckeberg arteriosclerosis involved with
the middle layer
(it deals with muscle + elastic fibers)
84
arteriolosclerosis
thickening of the walls of small arteries (arterioles)
85
percutaneous coronary intervention (PCI)
balloon is left in the coronary artery to keep it open
86
coronary artery bypass graft is taken from what structure in the body
the great saphenous vein
87
coronary stent is similar to which other coronary intervention
percutaneous coronary intervention
88
β-Adrenergic Receptor Antagonists (β Blockers) helps with
Angina, cardiac arrhythmias, hypertension, heart
failure, ventricular dysfunction post-MI
89
Angiotensin-Converting Enzyme (ACE) Inhibitors helps with
Heart failure, hypertension, ventricular
dysfunction post-MI
90
Antiarrhythmics help with
Cardiac arrhythmias, heart failure
91
Calcium Channel Blockers help with
Angina, hypertension, cardiac arrhythmias
92
Anticoagulants help with
Treatment and prevention of clot formation and emboli in the
deep veins, heart, lungs, and extremities
93
Antiplatelet medications help with
Prevention of clot formation and emboli in the deep veins, heart,
and brain
94
Hemostatics help with
Excessive bleeding, hemorrhage
95
Antidiuretics help with
Central diabetes insipidus
96
Diuretics help with
Heart failure, hypertension, edema
97
Vasodilators help with
Angina; hydralazine and minoxidil are used for hypertension
98
primary hypertension is also known as _____ and accounts for ___% to ___% of all hypertension cases
idiopathic hypertension
90-95%
99
secondary hypertension accounts for ___% to ___% of all hypertension cases
5-10%
100
malignant hypertension
diastolic blood pressure over 125mm Hg with target organ damage
101
which type of hypertension (primary or secondary) is due to an identifiable cause
secondary hypertension
102
ischemia
area of body is not getting enough blood, oxygen, and nutrients
103
MI type I
plaque rupture with thrombus
104
3 qualifications of MI type 2
1. vasospasm/endothelial dysfunction
2. fixed atherosclerosis with supply/demand imbalance
3. supply/demand imbalance ALONE
105
MI type 2 develops due to
lack of oxygen supply vs the demand the heart is requiring
106
MI type 1 develops due to
Coronary artery disease (CAD)
triggered by plaque disruption (like a rupture)
107
heart failure
the heart is unable to pump sufficient blood to the body
108
orthostatic hypotension (give numbers too)
decrease in BP when standing from a seated or laying position
20mm SBP drop
10mm S + D BP drop
15 bpm increase
109
what is the main 2 dangers of older adults getting orthostatic hypotension
syncope (fainting)
falls
110
on an ECG, what is the indication of ischemia
t wave inversion
(line dips down instead of normal bump)
111
on an ECG, what is the indication of hypoxic injury
ST elevation
112
on an ECG, what is the indication of infarction/necrosis
abnormal Q
113
ventricular fibrillation
chaotic rhythm and rate of the heart
114
what is arrhythmia caused by (functionally)
abnormal rate of electrical impulse generation by the sinoatrial node (SA Node)
115
infective endocarditis (+ name 2 structures impacted)
infection of the endocardium
- lining inside heart
- heart valves
116
what disease of the heart is caused by streptococcal group A bacteria
infective endocarditis
117
what are the 2 pericardium layers
inner visceral layer
outer patietal layer
118
what is the pericardium's job
stabilizes the heart in its anatomic position
119
aneurysm
abnormal stretching in the wall of an artery/vein/heart
120
what diameter of dilation of an artery/vein/heart is considered to be an aneurysm
50% dilation
121
what is the most common aneurysm in the body
abdominal aortic
122
thrombophlebitis
swelling of a vein from a thrombus (blood clot)
123
what are the 2 types of thrombophlebitis
deep vein thrombosis
superficial thrombophlebitis
124
4 risk factors of deep vein thrombosis and pulmonary embolism
immobility
trauma
lifestyle
hypercoagulation
125
pulmonary embolism
thrombus breaks loose (usually from the large deep veins of the pelvis and legs) and gets stuck in the lungs
126
what is the most common reason for hospital readmission and death after total hip and knee arthroplasties?
venous thromboembolism
127
2 types of venous thromboembolism
deep vein thrombosis
pulmonary embolism
128
what could emboli be formed by (6 total)
blood clots
air bubbles
fat droplets
amniotic fluid
parasite clumps
tumor cells
129
what happens when veinous valves become incompetent
dilation occurs from back flow creating VARICOSE VEINS
130
the hematologic system is integrated with which 2 body systems
lymphatic
immune
131
main functions of the hematologic system (3)
cellular metabolism
defense against injury/infection
balances body pH
132
difference between thrombus vs embolus
thrombus = solid mass of clotted blood ONLY within a blood vessel or the heart
embolus = solid, liquid, or gas mass that lodges distally from place of origin
133
infarction leads to
tissue necrosis
134
when does shock occur
when the circulatory system is unable to maintain adequate pressure to supply the organs
135
3 main causes of anemia
excessive blood loss (hemorrhage)
destruction of erythrocytes (hemolytic)
decreased production of erythrocytes
136
2 ways to classify anemia
through shapes/sizes
through hemoglobin concentration levels
137
how can NSAIDs cause anemia
GI blood loss from peptic/duodenal ulcers
138
anisocytosis
various sizes of blood cells
139
poikilocytosis
various shapes of blood cells
140
erythropoietin
(what is it, where is it made and what is its function)
a hormone produced by the kidney that stimulates production and maturation of RBC
141
what 3 nutrient deficiencies could cause a decrease production of erythrocytes
iron
vitamin B12
folate
142
what 3 organs are most impacted by anemia
heart
liver
kidney
143
anemia in the presence of coronary obstruction can lead to
cardiac ischemia (risk for heart attack)
144
the 4 biomarkers checked in a complete blood count (CBC) lab
% of erythrocytes in total blood volume
concentration of hemoglobin
erythrocyte count
RBC size/shape
145
reticulocyte count
amount of new RBCs
146
primary hemostasis requires normal # and function of what 2 things
platelets
von willebrand factor
147
what is the most important blood clotting factor in primary hemostasis
blood clotting factor 8 (VIII)
148
what does von willebrand factor do
plasma protein that mediates the initial adhesion of platelets at sites of bleeding
149
thrombocytopenia and what causes it
decrease in the number of platelets
caused by inadequate platelet production from bone marrow, destruction out of bone marrow, or splenic sequestration
150
what is secondary hemostasis
Coagulation
151
persons with abnormalities in secondary hemostasis tend to have deficiencies in _____.
list a disease example of this
clotting factors
hemophilia A or B
152
what is hemophilia and how does a person get it
a bleeding disorder inherited as an X-linked autosomal recessive trait
153
hemophilia A lacks which clotting factor? how about hemophilia B?
A: CF VIII
B: CF IX
154
what is a normal concentration of coagulation factors
50-150%
155
mild hemophilia symptoms
Random bleeding is rare
156
moderate hemophilia symtoms
Random bleeding is not super common but can happen with minor traumas
157
severe hemophilia symptoms
Random bleeding often occurs, particularly in the joints and deep muscles
158
functions of the lymphatic system (4)
absorb macromolecules
help maintain fluid balance
fight infection
removes cell debris/waste
159
lymphatic organs/tissues of the body (5)
thymus
bone marrow
spleen
tonsils
peyer patches in small intestine
160
the _____ lymphatic drainage system is very symmetric while the ______ lymphatic drainage is very asymmetric
superficial
deep
161
3/4ths of the total flow of the lymphatic system drains into what structure
the left subclavian vein
162
what enhances the lymphatic flow in the trunks and ducts
respiratory effort
163
right upper extremity and thoracic lymphotome drain where
the right lymphatic duct
164
which lymph system vessels rely on muscle contraction and hydrostatic pressures to transport the lymph fluid
superficial vessels
165
what type of muscle are lymph nodes made of
smooth
166
lymphatic capillary functions
Transport/filter lymph from body cells and tissues
167
lymphangion
each segment of collecting lymphatic vessels between valves
168
lymphangion function
prevents backflow
enhances pumping action
169
what nervous system controls the lymph vessel network
(bonus points: how many times do they contract per minute)
autonomic nervous system
5-10x/min
170
lymphatic watersheds
separate territories of lymph flow regions in the body
171
lymphadenitis
inflammation of one or more lymph nodes
172
lymphangitis
inflammation of lymphatic vessel
173
lymphadenopathy
enlargement of the lymph nodes
174
2 types of lymphedema
idiopathic (primary)
acquired (secondary)
175
what stage of lymphedema does lymphedema elephantiasis occur
state III
176
most common cause of secondary lymphedema WORLD-WIDE
filariasis
177
what is filariasis and how to you get it
parasitic worm
mosquito bite
178
most common cause of secondary lymphedema IN THE USA
invasive procedures used to diagnose and treat cancer
179
what is the Braden scale and what 6 components for patients are measured
determines likelihood of patient developing an ulcer
sensory perception
moisture
activity
mobility
nutrition
friction/shear
180
____ tissue predisposes bacterial invasion and infection
necrotic
181
what cell types dissolve necrotic tissues? What type of enzymes are used?
bacteria and macrophages
proteolytic enzymes
182
what 2 patient populations are most susceptible to infections of pressure ulcers
immunosuppressed
diabetic
183
lab values to look for in patients at risk for pressure ulcers
hemoglobin
hematocrit
prealbumin
total protein
lymphocytes
184
how often does a patient need to be moved to avoid pressure ulcer development (independent vs dependent)
independent: every 15 mins
dependent: every 2 hours in bed and 1 hour while sitting
185
the head of the bed should be lifted no more than _____ degrees to prevent pressure and shear forces on the skin
30 degrees
186
5 causes of secondary lymphedema
- any trauma/surgery that impairs the lymphatics
- multiple abdominal surgeries
- bacterial/viral infections
- repeated pregnancies
- crush injuries (including burns)
187
infections elsewhere in the body can lead to ______
lymphadenitis (or lymphadenopathy)
188
chronic vs acute lymphadenitis
chronic develops scarred lymph nodes with fibrous connective tissue
while acute is enlarges, tender, warm, and reddened
189
lymphangitis/cellulitis
acute inflammation of the subcutaneous lymphatic channels
190
The most common cause of secondary lymphedema in the US is…
Invasive procedures done for cancer diagnosis/treatment
191
The most common cause of secondary lymphedema in the US is…
Invasive procedures done for cancer diagnosis/treatment
192
renal neoplasms
tumor growth in the kidneys that can be benign or malignant
193
renal calculi
urinary stone disease that causes urinary obstruction and severe pain
194
eGFR lab numbers for normal kidney function, kidney disease, and kidney failure
normal: 60-120 (best to be over 90)
disease: 15-60
failure: 0-15
195
prostatitis
inflammation of the prostate gland that can be acute/chronic and bacterial/nonbacterial
196
benign prostatic hyperplasia
nonmalignant enlargement of the prostate gland
197
organs in the upper urinary tract
kidney
ureter
198
organs in the lower urinary tract
bladder
urethra
199
3 functions of the kidneys
filter waste
control mineral/water balance
endocrine secretion
200
why do females have higher incidence of UTI (2 reasons)
shorter urethra
urethra is closer to rectum
201
UTI symptoms (just name a few)
urinary frequency, urgency, incontinence
nocturia
fever/chills
hematuria
202
UTI pain referrals
shoulder
back
flank
pelvis
lower abdomen
203
responses to vasoconstriction stimuli in the renal system are __(enhanced/impaired)___ while vasodilatory responses are ____(enhanced/impaired)____
enhanced
impaired
204
what is the most common bacterial infection in the hospital and community
UTI
205
what 2 structures are also involved in UTIs
bladder (cystitis)
urethra (urethritis)
206
uncomplicated vs complicated UTI
complicated = UTI caused by medical condition (kidney stones, weak immune system, etc)
uncomplicated = typical bacterial infection of the bladder
207
what type of bacteria makes up 80% of UTIs
E. coli
208
main clinical manifestations of UTI
fever, nausea, vomiting
cloudy, bloody, smelly urine
burning/pain peeing
209
3 reasons people can develop acute pyelonephritis
1. ascending UTIs caused by E. coli
2. bloodborne pathogens infecting other parts of the body
3. being immunocompromised
210
most common cause of chronic pyelonephritis
vesicoureteral reflex
211
pyelo means
renal pelvis
212
pyeloephritis
a type of urinary tract infection where one or both of the kidneys become infected
213
vesicoureteral reflux
urine flows backward from the bladder into the ureters and kidneys
214
murphy sign + what is this used to diagnose
tenderness over the costovertebral angle
ACUTE pyelonephritis
215
what is the most common renal neoplasm diagnosis
renal cell carcinoma (90-95% of tumors)
216
Male:Female ratio of renal cell carcinoma diagnosis
2:1
male:fem
217
what are the 2 most common subtypes of renal cell carcinoma
1. conventional/clear cell (75%)
2. papillary (15-20%)
218
long term use of diuretics and analgesic pain medications (aspirin, acetaminophen, ibuprofen) can increase risk of developing....
renal cell carcinoma
219
what race is most susceptible to renal cell carcinoma
african americans
220
what is the most common metastatic tumor to the sternum
renal cell carcinoma
221
4 types of kidney stones and which is the most common
calcium (most common)
uric acid
stuvite
cysteine
222
does an acidic or basic urine pH increase the risk of kidney stones
acidic
223
kidney stone formation steps (5)
1. supersaturation
2. nucleation
3. crystal growth
4. aggregation
5. stone formation
224
size a stone must be to be considered renal calculi
>20 um
225
pain areas of renal calculi
- severe “colicky” flank pain radiating to the groin/perineal areas
- pain on the back where the kidney is
226
renal calculi shares similar symptoms to _____
UTI
227
HOW MANY MONTHS must go by with an eGFR over 60 and/or having the presence of kidney damage biomarkers to be diagnosed as chronic kidney disease (CKD)
3 months
(no matter what the underlying cause is)
228
what are the 2 main conditions that increase risk for developing CKD
diabetes (30-50% of all CKD cases)
hypertension (>25% of all CKD cases)
229
excessive nonprescription analgesic drug use can cause ______ which leads to CKD
analgesic nephropathy
230
what are the 2 pathogenic signs of CKD
hyperglycemia
release of angiotensin II
231
what is angiotensin II and what does it do
a hormone that constricts vessels to increase blood pressure (for filtration purposes) inside the kidneys
232
BUN
blood urea nitrogen
233
3 lab reports for assessing kidney disfunction
BUN
creatinine
protein in urine
234
stage G1 kidney disease
Reversible for some people
may remain in stage 1 indefinitely
235
stage G2 kidney disease
Damaged capillaries allow small amounts of albumin to be excreted in the urine
236
stage G3 kidney disease
albumin levels increase in the urine and decrease in the blood
results in noticeable edema
237
stage G4 kidney disease
Proteinuria (the kidneys are no longer able to excrete toxins)
hypertension due to increased production of renin
238
stage G5 kidney disease
uremia (a cluster of symptoms)
239
2 types of dialysis
hemodialysis (blood filtration, done in hospital or dialysis center)
peritoneal dialysis (cleansing fluid, can be done at home)
240
2 treatment options for renal replacement
dialysis
kidney transplantation
241
micturition
voiding or bladder emptying
242
what is the smooth muscle of the bladder called
detrusor
243
obstructive voiding or defecation, dyspareuia, and pelvic pain are all symptoms of
overactive pelvic floor
244
urinary or fecal incontinence and pelvic organ prolapse are all symptoms of
underactive pelvic floor
245
what is a significant contributory factor related to falls in older adults, pressure sores, skin breakdown, UTIs, institutionalization, depression, and isolation?
urinary incontinence
246
2 most common types of urinary incontinence
Stress Urinary Incontinence (SUI)
Urgency Urinary Incontinence (UUI)
247
Stress Urinary Incontinence (SUI)
Complaint of involuntary loss of urine on effort or physical exertion, or on sneezing or coughing
248
Urgency Urinary Incontinence (UUI)
A sudden compelling desire to urinate that is difficult to defer resulting in a loss of urine
249
what muscle can be blamed for Urgency Urinary Incontinence
detrusor
250
prostatitis category I
bacterial infection of prostate from infection by bacteria or virus (STIs)
251
prostatitis category II
chronic bacterial prostatitis that leads to sexual dysfunction like ED + ejaculatory pain
252
prostatitis category IIIA vs IIIB
IIIA: pain and urinary dysfunction WITH inflammation
IIIB: pain and urinary dysfunction WITHOUT inflammation
BOTH DO NOT INVOLVE INFECTION
253
prostatitis category IV
asymptomatic inflammatory prostatitis
254
how do doctors know if someone has asymptomatic inflammatory prostatitis
WBCs and inflammatory markers are found in semen and/or prostate tissue
255
prostate volume of ____mL defines having benign prostatic hyperplasia
30mL
256
what direction/pattern do the prostate cells grow toward in BPH? what is the consequence?
inward which causes obstruction of the urethra
257
what is PSA and what is the lab norm #
4 ng/mL
258
what are the top 2 deadly cancers in men (in order)
1. lung cancer
2. prostate cancer
259
1 in ___ men in america will develop prostate cancer
1 in 6!!!
260
________ accounts for 98% of primary prostatic tumors
adenocarcinoma
261
how do prostate cancer cells grow vs BPH cells
cancer: STARTS in the OUTER portion of the prostate then grows inwardly
BPH: new cells grow inward
262
what causes the growth of prostate cancer cells vs BPH cells
cancer: decreased level of testosterone
BPH: new cells develop faster than old ones die
263
where is prostate cancer likely to metastasize to (think bones, not organs)
axial skeleton
264
upper airway structures
nasal cavities
sinuses
pharynx
tonsils
larynx
265
lower airway structures
conducting airways (trachea, bronchi, bronchioles)
266
ventilation
the ability to move the air in and out of the lungs via a pressure gradient
267
respiration
the gas exchange that supplies O2 to the body and removes CO2
268
symptoms of hypoxemia (7)
headache
shortness of breath
fast heartbeat
coughing
wheezing
confusion
blush of skin, fingernails, lips
269
hypoxemia
deficient oxygenation of arterial blood
270
what is the most common condition caused by pulmonary disease/injury
hypoxemia
271
hypoxia
a broad term meaning diminished availability of oxygen to the body tissues
272
-emia
blood or referring to the presence of a substance in the blood
273
SaO2 levels are determined by...
arterial blood gas analysis
274
Normal PaO2
80-100 mm Hg
275
Normal SaO2 & SpO2
95-100%
276
SpO2 determines (and what is it taken with)
% of hemoglobin molecules in the peripheral blood saturated with oxygen
taken with pulse oximeter
277
2 ways of measuring arterial oxygenation levels
(name the direct measure then the indirect measure)
direct: saturation of arterial O2 (SaO2)
indirect: saturation of peripheral oxygen (SpO2)
278
what is the clubbing sign
symptom of pulmonary disease that causes the tips of fingers to swell and nails to curve
279
what is the normal angle of the finger/fingernail when measuring for clubbing
160*
280
diminished gas exchange is primarily due to...
increased physiologic dead space
281
what is the job of cilia
sweeps away mucus and debris
282
3 ways pneumonia can occur
1. infection
2. inhalation of toxins
3. aspiration of food/fluids
283
lobar pneumonia
can involve one or both lungs at the level of the lobe
284
bronchopneumonia
affecting the bronchioles and alveoli
285
what are the most common infections in hospitalized patients
hospital-acquired pneumonia
ventilatory associated pneumonia
286
what type of infectious agent (bacteria/virus) causes the most pneumonia
viral
287
what 2 bacteria cause pneumonia and which is the most common?
streptococcus pneumoniae (most common)
mycoplasma
288
dysphagia
difficulty swallowing
289
what is the most common virus for pneumonia
respiratory syncytial virus (RSV)
290
aspiration pneumonia
fluids or other materials are inhaled into the lower respiratory tract
291
most cases of pneumonia preceded by an __(upper/lower)___ respiratory infection
UPPER
292
airway clearance techniques and early mobility may aid in clearing WHAT
purulent sputum
293
acute bronchitis is typically caused by
viral infection
294
acute bronchitis
an inflammation of the trachea and bronchi that is of short duration (1 to 3 weeks)
295
COPD
(what does it stand for and what is it)
Chronic Obstructive Pulmonary Disease
obstruction of the lungs that causes persistent respiratory symptoms and airflow limitation
296
the 2 main diseases that cause COPD
chronic bronchitis
emphysema
297
5 major COPD risk factors
smoking
low socioeconomic status
age (40+)
long-term exposure to lung irritants
rare genetic conditions (AAT deficiency)
298
signs and symptoms of COPD (5)
constant cough
shortness of breath
can't breathe deep
excess sputum
wheezing
299
the spirometer measures (2 things)...
1. how much air the lungs can hold
2. how well the respiratory system can move air in/out
300
chronic bronchitis clinical definition
productive cough lasting for at least 3 months per year for 2 consecutive years
301
chronic bronchitis increased the production of _____
mucus
302
hypersecretion of mucus, thick sputum, + impaired ciliary function are all signs of....
chronic bronchitis
303
emphysema
enlargement of the alveolar ducts and alveoli that causes them loss of elasticity
304
what is the biggest factor that contributes to emphysema development
cigarette smoking
305
asthma
- reversible
- obstructive lung disease
- inflammation and reactivity of smooth muscles causing bronchoconstriction/airflow restriction
306
2 types of asthma
1. extrinsic (allergic)
2. intrinsic (nonallergic)
307
4 main triggers of extrinsic asthma
foods
pollutants
pollen/dust/mold
animal dander/feathers
308
which immunoglobulin is the main one present in asthma and what cell accompanies it
IgE is present on mast cells
309
what is the leading cause of sleep apnea (70% of cases)
obesity
310
what is the most common type of sleep apnea
obstructive
311
overlap syndrome
co-occurrence of obstructive sleep apnea and COPD
