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Gould's Pathophysiology Chapter 13: Respiratory System Disorders

Terms in this set (165)

What is oxygen necessary for?
Cellular Metabolism
What is the waste product from cellular metabolism?
carbon dioxide
What are the two anatomical areas of the respiratory system?
upper respiratory tract and lower respiratory tract
Which respiratory tract is considered sterile?
lower respiratory tract
What does the upper respiratory tract have that the lower respiratory tract lacks?
resident flora
What does the nasal cavity do in the Upper Respiratory Tract?
warming and moistening of air; foreign material trapped by mucuous secretions
What does the nasopharynx do in the Upper Respiratory Tract?
UNKNOWN [FILL IN LATER]
What is located in the posterior portion of the oral cavity?
Palatine tonsils (lymphoid tissue)
What does the epiglottis protected?
the larynx
When does the epiglottis close?
during swallowing to prevent aspiration
How many pairs of vocal cords are there?
two
What is the common name for larynx?
voice box
What is the trachea lines with/ type of cells?
pseudostratified ciliated epithelium
Describe the structure of the bronchial tree.
Bronchi-Bronchioles-Alveolar ducts to alveoli
What helps to reduce surface tensiona nd maintain inflation in the alveoli?
surfactant
What is the end point for inspired air?
alveoli
Where does gas exchange happen?
in the alveoli
What is ventilation?
Process of inspiration and expiration
What is it called when their is inspiration and expiration>
ventilation
What does airflow depend on?
Boyle's Law, pressure gradient
Airflow depends on pressure gradient. How does the air move?
Air always moves from high-pressure area to low- pressure area
If atmospheric pressure is higher than pressure in alveoli, that would be described as what?
inspiration
If atmospheric pressure is lower than pressure in alveoli, that would be described as what?
expiration
What does Tidal Volume show?
amount of air exchanged with QUIET inspiration and expiration
What is residual volume?
Volume of air REMAINING in lungs after maximum respiration
What does vital capacity show?
MAXIMAL amount of air that can be moved IN and OUT of the lungs with a SINGLE FORCED inspiration and expiration
What is the meaning of Tidal Volume?
amount of air entering lungs with each NORMAL breath
What is the meaning of residual volume?
amount of air remaining in the lungs after FORCED expiration
What is the meaning of inspiratory reserve?
maximal amount of air that can be inhaled in excess of normal quiet inspiration
What is the meaning of expiratory reserve?
maximal volume of air expired following passive expiration
What is the meaning of vital capacity?
maximal amount of air expired following maximal inspiration
What is the meaning of total lung capacity?
total volume of air in the lungs after maximal inspiration
What part of the brain controls ventilation?
medulla and pons
What detects a change in carbon dioxide level, hydrogen ion, and oxygen levels and causes breathing?
chemoreceptors
Where are central chemoreceptors located?
medulla
Where are peripheral chemorecpeots located?
carotid bodies ( near the fork of the carotid artery)
What is hypercapnia?
CO2 retention, abnormally elevated carbon dioxide (CO2) levels in the blood
What three things can hypercapnia cause in the body?
lower pH level in blood (acidosis), hyperventilation and respiratory acidosis, nervous system depression
What is hypoxemia?
abnormally low level of oxygen in the blood
What can hypoxemia lead to?
hypoxia (low oxygen in the tissues)
What is an important mechanism in individuals with chronic lung disease?
hypoxic drive
What is hypocapnia?
low carbon dioxide concentration in the blood
What can cause hypocapnia?
hyperventilation
What are some acid-base imbalances that can be caused by hypocapnia?
respiratory alkalosis
What is PO2?
partial pressure of oxygen
What is PCO2?
partial pressure of carbon dioxide
What does a radiography evaluate for?
tumors
What is a radiography?
imaging technique that uses electromagnetic radiation other than visible light, especially X-rays, to view the internal structure of a non-uniformly composed and opaque object (i.e. a non-transparent object of varying density and composition)
What would a patient need a bronchoscopy?
to perform biopsy, and check site of lesion or bleeding
Where does a bronchoscopy look?
look directly at the airways in the lungs through a thin, lighted tube (bronchoscope)
What color would the patient's sputum be with a bacterial infection?
Yellowish-green, cloudy, thick mucus
What color would the patient's sputum be with a pneumococcal pneumonia?
Rusty or dark-colored sputum
What would the patient's sputum be with bronchiectasis?
Very large amounts of purulent sputum with foul odor
What would the patient's sputum be with astma, cystic fibrosis, tumor or TB?
Thick, tenacious mucus
What is hemoptysis?
Coughing up blood, the spitting up of blood or bloody mucus
What is Eupnea?
normal breathing rate
What is Kussmaul Respirations?
Deep rapid respirations—typical for acidosis; may follow strenuous exercise
What type of breathing pattern would you see with acidosis?
Kussmaul respiration
What would wheezing or whistling sounds indicated?
obstruction in small airways
What would high-pitched Stridor indicate?
upper airway obstruction
How would you describe rales?
light bubbling or crackling sounds, with serous secretions
How would you describe rhonchi?
Deeper or harsher sounds from thicker mucus
What is dysnea?
Sudden shortness of breath, or breathing difficulty
What are some signs of severe dyspnea?
flaring nostrils, use of accessory respiratory muscles, retraction of muscles between or above ribs
What is a common cause of orthopnea?
pulmonary congestion
What are clubbed digits?
painless, firm, fibrotic enlargement at the end of the digit
What causes clubbed digits?
chronic hypoxia
What would painless, firm, fibrotic enlargement at the end of the digit indicate?
chronic hypoxia
What is a thoracentesis?
Removal of excessive fluid from pleural cavity, prevent atelectasis
What is a tracheotomy?
Incision into the trachea below the larynx to permit air intake
How is the common cold spread?
respiratory droplets
What type of infection is the common cold?
viral infection
What is sinusitis?
inflammation of the sinuses
What is the common name for Laryngotracheobronchitis?
croup
What is Laryngotracheobronchitis (croup)?
acute nonspecific inflammation of the mucous membrane of the larynx, trachea and bronchi characterized by abundant secretion of thick mucus
What are common causes of croup?
Parainfluenza viruses and adenoviruses
What are manifestations of influenza?
sudden, acute onset with fever, marked fatigue, aching pain in the body
What is influenza complicated by?
bacterial pneumonia
How do antiviral treat influenza?
may reduce symptoms and duration
What is the typical sign of scarlet fever?
Strawberry tongue
How is bronchiolitis spread?
Oral Droplet
What is the etiology of bronchiolitis?
an infection of the bronchioles, the small air passages in the lungs
What are signes of bronchiolitis?
Wheezing and dyspnea, rapid shallow respirations, cough, rales, chest retractions, fever, malaise
How is the distribution of lobar pneumonia?
ONE LOBE, Upper lobe
How is the distribution of broncho- pneumonia?
Scattered
What part of the lung does pneumonia affect?
Alveoli, inflammation
What is a consolidation?
when neutrophils, RBCs, and fibrin accumulate in the alveolar exudate, forming a solid mass
What causes the rusty sputum associated with lobar pneumonia?
RBCs in the exudate
How is tuberculosis transmitted?
droplet
What is empyema?
collection of pus in the pleural cavity caused by microorganisms, usually bacteria
What type of environment does legionnaire's disease like?
warm, moist environments
What is the patho of primary infection of tuberculosis?
Macrophages engulf TB and local inflammation occurs, some bacilli migrate to lymph nodes and are walled off and calcifyied
What is a sign of nontypical pneumonia?
nonproductive hacking cough
Would a person with primary of latent infection show signs of TB?
No, individual has been exposed and infected, but does not have disease and is asymptomatic
What causes a tubercle?
lymphocytes and macrophages form come together to form granuloma, which contains the bacilli
What is is a caseation necrosis?
a form of cell death in which the tissue maintains a cheese-like appearance. The dead tissue appears as a soft and white proteinaceous dead cell mass.
What are the lesions in the lung and lymph nodes referred to as?
Ghon complexes
When Ghon complexes calcify they may be visible on what test?
chest X-Ray (radiograph)
What vaccine can give a false positive for a TB test?
Calmette-Guerin (BCG) vaccine
Can someone with primary or latent TP transmit disease?
no
What causes TB to become secondary or re-infected?
an impaired cell mediated immunity
What is the ghon complex?
lesion seen in the lung that is caused by tuberculosis. The lesions consist of a calcified focus of infection
What are granulomas?
form when the immune system attempts to wall off substances it perceives as foreign but is unable to eliminate
What is the pathophysiology of cystic fibrous?
Genetic disorders causes exocrine glands causes abnormally thick secretions
What is a key symptom of cystic fibrous?
Tenacious mucus
What is the main concern with cystic fibrous?
Mucus obstructs airflow in bronchioles and small bronchi
What are the most common sequale's to cystic fibrosis?
infections, Commonly caused by Pseudomonas aeruginosa and Staphylococcus aureus
What is meconium ileus?
Meconium ileus is a bowel obstruction that occurs when the meconium in a child's intestine is even thicker and stickier than normal meconium, creating a blockage
What is a common first sign of cystic fibrous in new born?
salty taste, Sweat has high sodium chloride content.
What is the first indication of cystic fibrous in a new born?
meconium ileum, small intestine blocked by mucus
What is Bronchogenic carcinoma?
Most common type of primary malignant lung tumor
Where does bronchogenic carcinoma arise from? (pathophysiology)
bronchial epithlium
What are some effects of lung tumors?
abnormal breath sounds and dyspnea (caused by obstruction of airflow)
cough, hemoptysis and secondary infections cased by inflammation and bleeding)
pleural effusion, hemothorax, pneumothorax
paraneoplastic syndrome (occurs when tumor secretes hormone)
What are early signs of lung cancer?
Persistent productive cough
hemoptysis
chest pain
hoarseness, facial or arm edema
headache, dysphagia or atelectasis
What is the first change in the lungs associated with smoking or chronic irritation?
metaplasia, a change in the epithelial tissue
What are systemic signs of lung cancer?
weight loss, anemia, fatigue
What are signs of metastases of lung cancer?
bone pain
cognitive deficits, motor deficits
Which lung is more often affected by aspirated material?
right
What is the patho of asthma?
Bronchial obstruction occurs with persons with hypersensitivity or hyper-responsive airways
A person who has their asthma triggered by type 1 hypersensitivity has which type of asthma?
extrinsic asthma
A person who has their asthma triggered by hyperreponsive tissue in due to stimuli has which type of asthma?
instrinsic
What three pathophysiological changes occur during an asthma attack?
inflammation of the mucosa with edema, bronchoconstriction (Caused by contraction of smooth muscle) and increased secretion of the thick mucus
Which type muscles are affected in an asthma attack?
smooth muscle
What pulse sign would you see with an asthma attach?
pulsus paradoxus , Pulse differs on inspiration and expiration
What is pulsus paradoxus?
Pulse differs on inspiration and expiration
What ABG would you expect initially with an asthma attack?
Respiratory aLKalosis
What ABGs would you expect as a late sign of asthma attack?
Respiratory acidosis
What is persisten severe attack of asthma?
Status asthmaticus
What is the patho of Emphysema?
Destruction of alveolar walls and septae. Leads to large, permanently inflated alveolar air spaces
What does the breakdown of the alveolar walls result in?
loss of surface for gas exchange, loss of pulmonary capillaries, loss of elastic fibers, altered ventilation-perfusion ratio
Which part of ventilation does someone with Emphysema have trouble with?
expiration, air gets trapped
What are some physical changes you see with someone with emphysema?
barrel chest
What becomes the driving force for respiration in Emphysema?
Hypoxia (deprived of adequate oxygen)
What is pulmonary hypertension?
a type of high blood pressure that affects the arteries in your lungs and the right side of your heart.
What are signs and symptoms of emphysema?
hyperventilation with prolonged expiratory phase, fatigue, clubbed fingers
How do you define chronic bronchitis?
inflammation, obstruction, repeated infection, chronic coughing twice for 3 months or longer in 2 years
What would you see in chronic bronchitis in the mucous glands?
hypertrophy and hyperplasia
What type of oxygen therapy would you place a chronic bronchitis patient on?
low-flow oxygen
What is bronchiectasis?
Irreversible abnormal dilation of the medium-sized bronchi
What is the patho of bronchiectasis?
recurrent inflammation causing weakening of muscle and elastic fibers in the bronchial walls or both
What is a sign of bronchiectasis?
Copious amounts of Purulent, Foul-smelling sputum
What are causes of pulmonary edema?
increased permeability of capillaries (inflammation), decrease osmotic pressure of plasma (low levels of protein plasma)
What are signs and symptoms of pulmonary edema?
frothy, blood-tinged sputum
Where do the majority of pulmonary emboli originate?
deep vein thrombosis in legs
What is atelectasis?
collapse of lung or part of a lung
What is a pneumothorax?
Air in pleural cavity
What is a closed pneumothorax?
Air can enter pleural cavity from internal airways—no opening in chest wall
What is a open pneumothorax?
Atmospheric air enters the pleural cavity though an opening in the chest wall.
Where is basic rhythm of breathing control center in the brain?
medulla and pons
What is the physiology of how the medulla control the basic rhythm?
stimulates the phrenic nerves (C3-C5) to the control the diagram and intercostal nerves to the external intercostal muscles
What part of the brain sets the rate and depth of respirations?
medullary center
What blood gas causes automatic breathing?
carbon dioxide (PaCo2)
What do central chemoreceptors respond to?
slight elevations in PC02 our decrease in pH
Where are the central chemoreceptors located?
medulla
Where are the peripheral chemoreceptors located? carotid bodies in the bifurcation of the common carotid arteries and the aortic body
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What do the peripheral chemoreceptors respond to?
decrease oxygen level and low pH
Which patients patients breath because of hypoxic drive?
COPD
What is the pathophysiology of the common cold?
viral infection of the upper respiratory tract, respiratory droplet
What is the pathophysiology of sinusitis?
bacterial infection secondary to a cold or allergy that obstructed the drainage of the sinus cavity
What is the pathophysiology of laryngotracheobronchitis?
common viral infection, inflammation of mucisa of larynx and trachea obstructs airway
What are signs of laryngotracheobronchitis? hoarse, barking cough, inspiratory stridor
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What is the pathophysiology of epiglottis?
supraglottic inflammation and swelling of epiglottis obstructs airway
What is a sign of epiglottis?
drooling, dysphagia
What is the pathophysiology of bronchiolitis?
inflammation of mucosa of bronchioles obstructs small passages
What is a sign of bronchiolotis?
increasing dyspnea, wheezing and rapid slow respirations
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