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Pathology Final Exam

Terms in this set (744)

Diseases or conditions that influence the mechanics of breathing:

Asthma: The bronchioles constrict, reducing the size of the airways. This cuts down on the flow of air and makes the respiratory muscles work harder.

Emphysema: The lungs become stiff with fibers and become less elastic, which increases the work of the respiratory muscles.

Bronchitis: The airways become inflamed and narrower, which restricts the flow of air and increases the work of the respiratory muscles

Pneumothorax: Air in the chest cavity equalizes the pressure in the chest cavity with the outside air and causes the lungs to collapse. This is usually caused by trauma or injury.

Apnea: Breathing slows or stops under a variety of conditions. There are many types of apnea, and they are usually caused by problems in the respiratory centers of the brain.

Diseases or conditions that minimize or prevent gas exchange:

Pulmonary edema: Fluid between the alveolus and pulmonary capillary builds up, which increases the distance over which gases must exchange and slows down the exchange.

Smoke inhalation: Smoke particles coat the alveoli and prevent the exchange of gases.

Carbon monoxide poisoning: Carbon monoxide binds to hemoglobin more tightly than either oxygen or carbon dioxide, which minimizes the delivery of oxygen to all the tissues of the body, including the brain, the heart and muscles. Carbon monoxide is a common product of poorly vented heaters (space heaters, furnaces, water heaters) and of automobile exhausts. This condition can be fatal if not caught soon after exposure.
Obstructive:
shortness of breath due to difficulty exhaling all the air from the lungs. Because of damage to the lungs or narrowing of the airways inside the lungs, exhaled air comes out more slowly than normal. At the end of a full exhalation, an abnormally high amount of air may still linger in the lungs.Obstructive lung disease makes it harder to breathe, especially during increased activity or exertion. As the rate of breathing increases, there is less time to breathe all the air out before the next inhalation.

Common causes
Chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis
Asthma
Bronchiectasis
Cystic fibrosis

Treatment
Medicines that relax smooth muscles and improve airflow are called bronchodilators, and are inhaled.


Restrictive:
cannot fully fill their lungs with air.
most often results from a condition causing stiffness in the lungs themselves.

Common causes
Interstitial lung disease, such as idiopathic pulmonary fibrosis
Sarcoidosis, an autoimmune disease
Obesity, including obesity hypoventilation syndrome
Scoliosis
Neuromuscular disease, such as muscular dystrophy or amyotrophic lateral sclerosis (ALS)

Treatment
Few medicines (control inflammation)
supplemental oxygen
Non-invasive positive pressure ventilation (BiPAP) uses a tight-fitting mask and a pressure generator to assist breathing. BiPAP is helpful for people with obesity hypoventilation syndrome and some nerve or muscle conditions causing restrictive lung disease.
Exercise
weight loss
Lung transplant
Chronic Bronchitis (blue bloaters)
Productive cough, with progression over time to intermittent dyspnea
Frequent and recurrent pulmonary infections
Progressive cardiac/respiratory failure over time, with edema and weight gain
Patients may be obese.
Frequent cough and expectoration are typical.
Use of accessory muscles of respiration is common.
Coarse rhonchi and wheezing may be heard on auscultation.
Patients may have signs of right heart failure (ie, cor pulmonale), such as edema and cyanosis.
Because they share many of the same physical signs, COPD may be difficult to distinguish from CHF. One crude bedside test for distinguishing COPD from CHF is peak expiratory flow. If patients blow 150-200 mL or less, they are probably having a COPD exacerbation; higher flows indicate a probable CHF exacerbation.

Emphysema (pink puffers)
A long history of progressive dyspnea with late onset of nonproductive cough
Occasional mucopurulent relapses
Eventual cachexia and respiratory failure
Patients may be very thin with a barrel chest.
They typically have little or no cough or expectoration.
Breathing may be assisted by pursed lips and use of accessory respiratory muscles; they may adopt the tripod sitting position.
The chest may be hyperresonant, and wheezing may be heard; heart sounds are very distant.
Overall appearance is more like classic COPD exacerbation.


Causes:
In general, the vast majority of COPD cases are the direct result of tobacco abuse. While other causes are known, such as alpha-1 antitrypsin deficiency, cystic fibrosis, air pollution, occupational exposure (eg, firefighters), and bronchiectasis, this is a disease process that is somewhat unique in its direct correlation to a human activity.
Antibiotics to treat and prevent lung infections
Mucus-thinning drugs to help you cough up the mucus, which improves lung function
Bronchodilators to help keep your airways open by relaxing the muscles around your bronchial tubes
Oral pancreatic enzymes to help your digestive tract absorb nutrients
Chest physical therapy-loosen thick mucus in lungs
Chest clapper, a hand-held device that mimics the effect of cupped hands clapping over the ribs
Inflatable vest, a device worn around the chest that vibrates at high frequency
Breathing devices, usually a tube or mask through which you exhale while performing breathing exercises
Pulmonary rehabilitation
Your doctor may recommend a long-term program to improve your lung function and overall well-being. Pulmonary rehabilitation is usually done on an outpatient basis and may include:

Exercise training
Nutritional counseling
Energy-conserving techniques
Breathing strategies
Psychological counseling or group support or both
Surgical and other procedures

Nasal polyp removal. Your doctor may recommend surgery to remove nasal polyps that obstruct breathing.
Oxygen therapy. If your blood-oxygen level declines, your doctor may recommend you sometimes breathe pure oxygen to prevent high blood pressure in the lungs (pulmonary hypertension).
Endoscopy and lavage. Mucus may be suctioned from obstructed airways through an endoscope.
Lung transplant. If you have severe breathing problems, life-threatening lung complications or increasing resistance to antibiotics used to treat lung infections, lung transplantation may be an option. Because both lungs are affected by cystic fibrosis, both need to be replaced. Lung transplants for people with cystic fibrosis are controversial because studies indicate the procedure is associated with many complications, and may not prolong life or enhance quality of life.
Feeding tube. Cystic fibrosis interferes with digestion, so you can't absorb nutrients from food very well. Your doctor may suggest using a feeding tube to deliver extra nutrition while you sleep. This tube may be threaded through your nose to your stomach or surgically implanted into the abdomen.
Bowel surgery. If a blockage develops in your bowel, you may need surgery to remove it. Intussusception, where a section of bowel has folded in on itself, also may require surgical repair.
Lung function tests, also called pulmonary function tests, measure how well your lungs work. These tests are used to look for the cause of breathing problems, such as shortness of breath.

Lung function tests measure:

How much air you can take into your lungs. This amount is compared with that of other people your age, height, and sex. This allows your doctor to see whether you're in the normal range.
How much air you can blow out of your lungs and how fast you can do it.
How well your lungs deliver oxygen to your blood.
The strength of your breathing muscles.
Doctors use lung function tests to help diagnose conditions such as asthma, pulmonary fibrosis (scarring of the lung tissue), and COPD (chronic obstructive pulmonary disease).

Lung function tests also are used to check the extent of damage caused by conditions such as pulmonary fibrosis and sarcoidosis (sar-koy-DOE-sis). Also, these tests might be used to check how well treatments, such as asthma medicines, are working.

Overview

Lung function tests include breathing tests and tests that measure the oxygen level in your blood. The breathing tests most often used are:

Spirometry- This test measures how much air you can breathe in and out. It also measures how fast you can blow air out.
Body plethysmography-This test measures how much air is present in your lungs when you take a deep breath. It also measures how much air remains in your lungs after you breathe out fully.
Lung diffusion capacity-This test measures how well oxygen passes from your lungs to your bloodstream.
These tests may not show what's causing breathing problems. So, you may have other tests as well, such as an exercise stress test. This test measures how well your lungs and heart work while you exercise on a treadmill or bicycle.

Two tests that measure the oxygen level in your blood are pulse oximetry and arterial blood gas tests. These tests also are called blood oxygen tests.

Pulse oximetry measures your blood oxygen level using a special light. For an arterial blood gas test, your doctor takes a sample of your blood, usually from an artery in your wrist. The sample is sent to a laboratory, where its oxygen level is measured.
How
Placing a pacemaker requires minor surgery. The surgery usually is done in a hospital or special heart treatment laboratory.

Before the surgery, an intravenous (IV) line will be inserted into one of your veins. You will receive medicine through the IV line to help you relax. The medicine also might make you sleepy.

Your doctor will numb the area where he or she will put the pacemaker so you don't feel any pain. Your doctor also may give you antibiotics to prevent infection.

First, your doctor will insert a needle into a large vein, usually near the shoulder opposite your dominant hand. Your doctor will then use the needle to thread the pacemaker wires into the vein and to correctly place them in your heart.

An x-ray "movie" of the wires as they pass through your vein and into your heart will help your doctor place them. Once the wires are in place, your doctor will make a small cut into the skin of your chest or abdomen.

He or she will slip the pacemaker's small metal box through the cut, place it just under your skin, and connect it to the wires that lead to your heart. The box contains the pacemaker's battery and generator.

Once the pacemaker is in place, your doctor will test it to make sure it works properly. He or she will then sew up the cut. The entire surgery takes a few hours.

Purpose
uses electrical pulses to prompt the heart to beat at a normal rate

can relieve some arrhythmia symptoms, such as fatigue and fainting. A pacemaker also can help a person who has abnormal heart rhythms resume a more active lifestyle.
The human body does not handle excessive blood loss well. Therefore, the body has ways of protecting itself. When, for some unexpected reason, sudden blood loss occurs, the blood platelets kick into action.
Platelets are irregularly-shaped, colorless bodies that are present in blood. Their sticky surface lets them, along with other substances, form clots to stop bleeding.
When bleeding from a wound suddenly occurs, the platelets gather at the wound and attempt to block the blood flow. The mineral calcium, vitamin K, and a protein called fibrinogen help the platelets form a clot.

A clot begins to form when the blood is exposed to air. The platelets sense the presence of air and begin to break apart. They react with the fibrinogen to begin forming fibrin, which resembles tiny threads. The fibrin threads then begin to form a web-like mesh that traps the blood cells within it. This mesh of blood cells hardens as it dries, forming a clot, or "scab."
Calcium and vitamin K must be present in blood to support the formation of clots. If your blood is lacking these nutrients, it will take longer than normal for your blood to clot. If these nutrients are missing, you could bleed to death. A healthy diet provides most people with enough vitamins and minerals, but vitamin supplements are sometimes needed.
A scab is an external blood clot that we can easily see, but there are also internal blood clots. A bruise, or black-and-blue mark, is the result of a blood clot. Both scabs and bruises are clots that lead to healing. Some clots can be extremely dangerous. A blood clot that forms inside of a blood vessel can be deadly because it blocks the flow of blood, cutting off the supply of oxygen. A stroke is the result of a clot in an artery of the brain. Without a steady supply of oxygen, the brain cannot function normally. If the oxygen flow is broken, paralysis, brain damage, loss of sensory perceptions, or even death may occur.
Peptic ulcers. Helicobacter pylori (H. pylori) infections and long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen, are common causes of peptic ulcers.
Esophageal varices. Varices, or enlarged veins, located at the lower end of the esophagus may rupture and bleed massively. Cirrhosis is the most common cause of esophageal varices.
Mallory-Weiss tears. These tears in the lining of the esophagus usually result from vomiting. Increased pressure in the abdomen from coughing, hiatal hernia, or childbirth can also cause tears.
Gastritis. NSAIDs and other drugs, infections, Crohn's disease, illnesses, and injuries can cause gastritis—inflammation and ulcers in the lining of the stomach.
Esophagitis. Gastroesophageal reflux disease (GERD) is the most common cause of esophagitis—inflammation and ulcers in the lining of the esophagus. In GERD, the muscle between the esophagus and stomach fails to close properly, allowing food and stomach juices to flow back into the esophagus.
Benign tumors and cancer. A benign tumor is an abnormal tissue growth that is not cancerous. Benign tumors and cancer in the esophagus, stomach, or duodenum may cause bleeding.
Causes of bleeding in the lower digestive tract include the following:
Diverticular disease. This disease is caused by diverticula—pouches in the colon wall.
Colitis. Infections, diseases such as Crohn's disease, lack of blood flow to the colon, and radiation can cause colitis—inflammation of the colon.
Hemorrhoids or fissures. Hemorrhoids are enlarged veins in the anus or rectum that can rupture and bleed. Fissures, or ulcers, are cuts or tears in the anal area.
Angiodysplasia. Aging causes angiodysplasia—abnormalities in the blood vessels of the intestine.
Polyps or cancer. Benign growths or polyps in the colon are common and may lead to cancer. Colorectal cancer is the third most common cancer in the United States and often causes occult bleeding.
Pathogens-microorganisms that cause disease (bacteria, fungi, viruses, protozoa)

Bacteria-common pathogens include cholera bacteria, Salmonella and E.coli (food poisoning), dysentery bacteria, and MRSA

Fungi-Pathogenic fungi tend to be ones that cause infections to the surface of the body. Their fibres grow in the upper layer of the skin which causes inflammation and damage. This can also provide a route into the body for other opportunistic infections. Diseases such as athlete's foot, ringworm, oral and vaginal thrush are examples of fungal infections. Fungi can cause infections inside the body such as in the lungs, brain and heart which can be very serious and even fatal.

Virus-All natural viruses cause disease including the common cold, influenza (flu), measles, mumps and rubella. They are not living cells themselves, and they can only reproduce inside other living cells.

Protozoa- Infection is usually spread by structures called cysts which are cells that have secreted a protective layer around them so that they can survive the journey from one host to the next. Once inside the new host, these cysts develop into the active protozoa which grow, reproduce and cause symptoms of disease in the new host. Malaria, dysentery, and sleep sickness

Parasites-organism that lives in or on another organism (the host). The parasite gets some or all of its food from the host organism. This can cause anything from mild disease to death to the host. Parasites can also spread diseases from one organism to another.