Pathophysiology: Altered Ventilation and Diffusion

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Chapter 13 Braun; Anderson

acute respiratory distress syndrome ARDS

a condition of severe acute inflammation and pulmonary edema without evidence of fluid overload or impaired cardiac function

adventitious

refers to an alteration in lung sounds, as with wheezing or crackles

air trapping

decreased effective O2 intake and especially CO2 release by retaining air within the alveoli because of loss of elasticity

anoxia

the absolute deprivation of oxygen

aspiration

a problem of inhaling a foreign substance into the lungs

asthma

a chronic inflammatory disorder of the airways resulting in intermittent or persistent airway obstruction caused by bronchial hyperresponsiveness, inflammation, bronchoconstriction, and excess mucous production

atelectasis

a condition of collapse and nonaeration of the alveoli

atopic

describes individuals having a genetic predisposition to developing hypsensitivities

bronchiectasis

the irreversible dilation and destruction of the bronchial tree most often caused by chronic obstruction or infection

caseous necrosis

a distinctive, yellow, pasty, cheese like necrosis of tuberculosis

cavitation

area of necrosis that erode surrounding structures of the lungs, including the bronchioles, bronchi, and surrounding blood vessels

chronic bronchitis

the presence of a persistent, productive cough that lasts for 3 months or longer for 2 or more consecutive years.

chronic obstructive pulmonary diseases (COPD)

a generic term that describes all chronic obstructive lung problems including asthma, emphysema, and chronic bronchitis, separately or in combination

clubbing

a painless enlargement and flattening of the tips of fingers or toes due to chronic hypoxia

compliance

the expected distensibility, or expandibility, of the lung tissue and chest wall

consolidation

a solid mass in the lung tissue

cyanosis

a result of a greater proportion of desaturated hemoglobin in the blood, which gives the blood a bluish hue

auscultation

to listen with a stethoscope

cystic fibrosis (CF)

an autosomal recessive disorder of electrolytes and subsequently water transport that affects certain epithelial cells such as those lining the respiratory, digestive and reproductive tracts

dead space

an area where gas exchange cannot take place

diffusing capacity

a measurement of carbon monoxide (CO2), oxygen, or nitric oxide transfer from inspired gas to pulmonary capillary blood; is reflective of the volume of a gas that diffuses through the alveolar capillary membrane each minute

diffusion

movement of particles from an area of high to lower concentration

dyspnea

the subjective feeling of shortness of breath or the inability to get enough air

emphysema

an irreversible enlargement of the air spaces beyond the terminal bronchioles, most notable in the alveoli resulting in destruction of the alveolar walls and obstruction of airflow

expectorate

to spit out the mucus that is ejected during a cough

expiration

the process of removing carbon dioxide out of the body through the lungs

forced expiratory volume in 1 second (FEV1)

the maximal amount of air expired from the lungs in 1 second

forced vital capacity (FVC)

the maximal amount of air that is exhaled from the lungs during a forced exhalation

fully saturated

a state in which all the available seats for hemoglobin molecules are occupied on the red blood cell

Ghon complex

a combination of of the Ghon focus and additional granulomas that develop through the lymph channels in the lungs

Ghon focus

the formation of a granuloma, or walled off area of bacteria, which is considered the primary lung lesion in tuberculosis

hemoptysis

coughing up blood from the respiratory tract; defined by the presence of red blood cells in the sputum

hypercapnia

a state of increased carbon dioxide in the blood

hypoxemia

decreased oxygen in the arterial blood leading to a decrease in the partial pressure of oxygen (PaO2)

hypoxia

cellular deprivation of oxygen

inspiration

the process of breathing in to acquire oxygen

orthopnea

the physical need to sit in an upright or standing position to reduce respiratory effort

oxygen saturation (SaO2)

the amount of oxyhemoglobin; that is the amount of hemoglobin that is combined, or saturated with oxygn

oxyhemoglobin (HbO2)

the oxygen-hemoglobin combination within the red blood cells

PaCO2

the symbol for the partial pressure of carbon dioxide

PaO2

the symbol for the partial pressure of oxygen

partial pressure

the force exerted by gas molecules within a certain volume

perfusion

the process of forcing blood or other fluid to flow through a vessel and into the vascular bed of tissue for the purposes of providing oxygen and other nutrients

phlegm

large amounts of sputum expectorated from the oropharynx

pneumonia

inflammation of the lungs occurring commonly in the bronchioles,interstitial lung tissue or the alveoli

pneumothorax

the presence of air in the pleural space that causes the lung to collapse

pursed lip breathing

a process of holding the lips puckered tightly together while slowly exhaling to maintain positive airway pressure in the alveoli; this minimizes air trapping and promotes expiration of carbon dioxide

residual volume (RV)

the volume of air that remains in the lungs after maximal expiration

respiration

the process of oxygen use as a source of energy for the production of adenosine triphosphate (ATP) and release of metabolic products from the cell

respiratory failure

a life-threatening condition that can result from any problem that severely affects ventilation, ventilation-perfusion matching, or diffusion

retractions

the pulling in of accessory muscles usually in the intercostal, substernal, and supraclavicular spaces to promote more effective inspiration

sputum

expectorated material

status asthmaticus

a state of bronchospasm that is not reversed by by the patients medications or other measures

surfactant

a lipoprotein that coats the inner portion of the alveolus and promotes ease of expansion and repels fluid accumulation

tidal volume (TV)

the amount of air that is exhaled after passive inspiration; this is the volume of air going in and out of the lungs at rest; in adults this volume is approximately 500ml

total lung capacity (TLC)

the total amount of air in the lungs when they are maximally expanded; is the sum of the vital capacity and residual volume

tuberculosis

an infectious disease caused by an aerobic, rod-shaped bacterium (bacillus) called Mycobacterium tuberculosis

ventilation

the movement of air into and out of the trachea, bronchi and lungs

vital capacity (VC)

the maximal amount of air that can be moved in and out of the lungs with forced inhalation and exhalation

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