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Gould's Pathophysiology chapter 13 respiratory system disorders

Terms in this set (60)

The production of yellow green and thick sputum indicates
Bacterial infection
Most common cause of viral pneumonia
Influenza viral
Higher rates of TB are associated with
Immune compromised people (HIV) and living in close quarters (homelessness)
Epinephrine causes what reaction in the respiratory system
Bronchiodilation
Lobular pneumonia is identified by...
Sudden onset of fever and chills, with rales and rusty sputum
Central chemoreceptors in the medulla are sensitive too?
Elevated CO2 levels
infectious rhinitis
Common cold. Serous nasal discharge, congestion and sneezing
Blood in the pulmonary artery is
PO2 low 40mm Hg and PCO2 high 45 mm Hg
Blood in the pulmonary vein
PO2 high 105mm Hg and PCO2 low 40mm Hg
Inspired air is
PO2 high 160mm Hg and Pco2 low 0.3mm Hg
Expired air is
PO2 is 120mm Hg
PCO2 is 27mm Hg
eupnea
Rhythm smooth with expiration longer than inspiration
Usually a bacteria infection secondary to a cold or allergies
*facial pain or tooth ache, nasal sinus congestion
Sinusitis
Laryngotracheobronchitis (croup)
Common childhood (age 1-2) viral infection caused by influenza and adenovirus
*barking cough and hoarse voice
Epiglottitis
acute infection caused by bacterial organism H. influenzae type B.
common in children aged 3-7
swelling of the larynx, supraglottic area and epiglottis, which appears as a red ball blocking the airway
*fever, sore throat, refusal to swallow causing drooling
assumes a sitting (tripod) position with mouth open
Influenza (flu)
, can cause viral pneumonia 3 versions
Differs from common cold in that it has a sudden onset with fever, marked fatigue, aching pains
Secondary infections such as pneumonia can develop
Scarlet fever
Upper respiratory infection caused by group A beta-hemolytic Strep. pyrogens. Symptoms include fever, sore throat, cills, vomiting, abdominal pain and strawberry tongue. A fine rash can develop on chest, neck, groin and thighs.
Bronchiolitis (Respiratory Syncytial Virus Infection)
Caused by respiratory syncytial virus (RSV)
Transmissible by droplets necrosis and inflammation of small bronchi and bronchioles, increased secretions and reflex bronchospasm leading to obstruction of the small airways.
*wheezing, dyspnea, cough, rales, chst retractions, fever, malaise, areas of hyperinflation or areas of atelectasis due to obstruction
Pneumonia
Risk if anything is aspirated into the lungs

Bacterial caused by, staphylococcus aureus or Legionella
Lobular or pneumococcal pneumonia
Caused by streptococcus pneumoniae, sudden and acute onset.
congestion stage - inflammation and exudate of the alveoli
neutrophils, RBCs and fibrin accumulate in the alveolar exudate, forming a solid mass called a consolidation

High fever and chills, productive cough, rales
Rusty sputum
empyema (accumulation of pus inside pleural cavity)
Bronchopneumonia
Caused by many bacteria
Infection is usually in both lungs, often in lower lobes
In many cases, pooled secretions in the lungs become infected by organisms draining from the upper passages, which can occur with immobilized patients
Mild fever, productive cough, Dyspnea
Yellow green sputum
Legionnaires' Disease
Pneumonia caused by Legionella pneumophila, lives in air conditioning systems and spas, can be nosocomial. Can be difficult to identify because it lives inside pulmonary macrophages
Primary Atypical Pneumonia (PAP)
Caused by influenza virus or mycoplasma

Necrosis of bronchial

Variable fever, headache, aching muscles and non productive hacking cough
Caused by microbes, close exposure to droplets. Lymphopenia and thrombocytopenia and increased C Proteins
SARS, Severe Acute Respiratory Syndrome
Tuberculosis
Caused by bacteria mycobacterium tuberculosis.

Microbe can survive in dried sputum for weeks

2 stages primary and secondary infections
Anthrax
Bacterial infection of skin, respiratory tract or GI Tract.

Flu like symptoms then acute respiratory distress
Cystic fibrosis
Congenital obstructive lung disease

Mucus obstructs airways affects lungs, digestive tract, reproductive tracts and sweat glands

Excessive Cl, salty sweat, chronic cough
Bronchogenic carcinoma

Lung cancer
Arising from the bronchial. Most common type

Obstruction causes abnormal breath, cough
Squamous cell carcinoma

Lung cancer
Epithelial lining of bronchus

Early signs of cancer, persistent cough, and wheezing, hemoptysis, pleural, chest pain, hoarseness
Adenocarcinoma

Lung cancer
Periphery of the lung

Systemic: weight loss, anemia, and fatigue

Paraneoplastic syndrome: hormones released by tumor
Passage of food or liquid into the right lower lung.

Coughing, choking, stridor, hoarseness, wheezing (liquids), tachycardia and tachypnea
Aspiration
Occurs most often in males. Pharyngeal tissues collapse during sleep

Worse with obesity, need assisted breathing
Obstructive sleep apnea
Asthma
Hypersensitive I reaction

Chronic or acute, avoid stimuli.

Signs cough, tight chest, *thick sticky mucus coughed up. Hypoxia, respiratory Acidosis second to Alkalosis
Emphysema

Chronic obstructive pulmonary disease
Smoking caused it, found in alveoli, destruction of alveoli wall. Barrel chest

Some coughing little sputum
Chronic Bronchitis

Chronic obstructive pulmonary disease
Caused by smoking or air pollution found in bronchi. Frequent infections constant cough

Mucosa inflamed and swollen, O2 low
Bronchiectasis
Secondary to something else, such as Chronic obstructive pulmonary disease or cystic fibrosis, or childhood infection or congenital weakness. Decreasing in US due to antibiotics.

Irreversible abnormal dilation of the medium bronchi from recurrent inflammation and infection. Loss of cilia and obstructions interfere with removal of fluids. Cough and copious purulent sputnum, rales, bad breath, dyspnea and hemoptysis, weight loss, anemia and fatigue. Treat with antibiotics, bronchodilators and treating primary condition.
Pneumoconiosis
Restrictive lung disorders. Inflammation in fibrosis tissues with gradual destruction of connective tissue. As fibrosis extends, the functional areas of the lungs, including alveoli are lost. Coal workers disease "anthracosis"; Silicosi; Asbestosis - also causes pleural fibrosis and greater risk of lung cancer, especially in cigarette smoking.
Symptoms: dyspnea, extra effort for inspiration, cough
Pulmonary Edema
Vascular disorder
Excessive amount of fluid in interstitial area and alveoli causing severe hypoxemia
Plasma protein levels are low, decreasing plasma osmotic pressure
Pulmonary hypertension develops

Can development with left sided congestive heart failure.

Signs: cough, orthopnea, and rales. Blood-tinged and frothy sputum; cyanosis; paroxysmal nocturnal dyspnea
Rx: treat causative factors, supportive care such as O2
Pulmonary embolus
Blood clot or mass in pulmonary artery

Small, is silent, moderate cause respiratory impairment. Large cause right sided heart failure and decreased cardiac output.

Originates from deep veins in legs

Risk factors immobility, trauma to legs, childbirth, CHF, dehydration and cancer

S/S: chest pain, cough or dyspnea with small emboli
Chest pain that increases with coughing or deep breathing, tachypnea and sypnea develop suddenly. Hemoptysis and fever present later
Hypoxia triggers SNS response - anxiety, restlessness, pallor and tachycardia
Massive emboli causes severe, crushing chest pain, low BP, weak pulse, loss of consciousness.
Fat emboli - acute respiratory distress, petechial rash on trunk and confusion and disorientation.
Treat with blood thinners, surgery
Atelectasis
collapse of a lung or part of a lung leading to decreased gas exchange and hypoxia. From complication of many primary conditions
Obstructive atelectasis
total obstruction of airway due to mucus or tumor leads to diffusion into the tissue of air distal to the obstruction; this air is not replaced
compression atelectasis
A mass (tumor) exerts pressure on a part of the lung and prevents air from entering that section; or when pressure in the pleural cavity is increased (increased fluid or air) adhesion between pleural membranes is destroyed and the lung cannot expand
Increased surface tension in alveoli
Causes atelectasis by preventing expansion of the lung due to pulmonary edema or respiratory distress syndrom
Contraction atelectasis
Fibrotic tissue in the lungs or pleura may restrict expansion and lead to collapse
Postoperative atelectasis
24-72 hours after surgery, esp abdominal surgery. Factors include restricted ventilation due to pain or abdominal distention, slow respirations due to anesthetics and analgesics, increased secretions due to supine position and decreased cough effort
Pleural Effusion
Presence of excessive fluid in the pleural cavity, causing separation of the pleural membranes, preventing their cohesion during respiration. Prevents expansion of the lung, leading to atelectasis. Mediastinal shift is indicated by tracheal deviation.
S/S: dyspnea, chest pain, inc. respiratory and heart rates, absence of breath sounds
Rx: draining fluid via thoracocentesis
Pleurisy
May preced or follow pleural effusion or occur independently. A condition where pleural membranes are inflamed, swollen and rough, often in association with pneumonia. Also called pleuritis.
Exudative pleural effusion
Fluid in lungs caused by inflammation, in response to a tumor, in which increased capillary permeability allows fluid containing protein and WBCs to leak into pleural cavity.
Transudate pleural effusion
Pleural effusion fluid is watery, sometimes called hydrothorax, that result from increased hydrostatic pressure or decreased osmotic pressure int he blood vessels, leading to as shift of fluid out of the blood vessels into the pleural cavity. May occur secondary to liver or kidney disease
Hemothorax
Pleural effusion fluid is blood resulting from trauma, cancer or surgery.
Empyema
Pleural effusion liquid is purulent as a result from infection, often related to pneumonia
Pneumothorax
Presence of air in pleural cavity, leading to separation of pleural membranes and atelectasis.
Closed pneumothorax
when air can enter pleural cavity through an opening directly from the internal airways (no opening in the chest wall). Can be spontaneous or secondary to another disease.
Simple or spontaneous pneumothorax
associated with underlying respiratory disease; results from rupture of an emphysematous bleb on the surface of the lung, or erosion by a tumor or tubercular cavitation through the visceral pleura.
Open pneumothorax
air enters pleural cavity through an opening in the chest wall, from trauma or surgery
Sucking sound
indicates a large opening in the chest wall, in which the sound of air moving in and out makes a typical sucking sound.
tension pneumothorax
most serious form results from an opening through the chest wall and parietal pleura (open pneumothorax), or from a tear in the lung tissue and visceral pleura (closed pneumothorax) that causes atelectasis. Creates a one-way valve effect - air is allowed to go into cavity but not come out, increasing pressure and causing mediastinal shift and compressing other side of lungs. Severe hypoxia and respiratory distress develop quickly
Dyspnea
Subjective feeling of discomfort when a person feels they are unable to inhale enough air
orthopnea
difficulty breathing when lying down
Paroxysmal nocturnal dyspnea
sudden awakening from sleeping, gasping for air, common in patients with left-sided CHF.
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