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Terms in this set (62)
Movement of blood
Movement of air into and out of lungs
Movement of gases between the alveoli and the blood
Gases diffuse across the alveolar-capillary membrane
Allow the travel of air in and out of the gas-exchange structures
Nasopharynx, oropharynx, larynx, trachea, bronchi and bronchioles
Gas exchange airways
Allows gas exchange
Terminal end of bronchioles and alveoli
Subjective sensation of uncomfortable breathing
dyspnea on exertion
Difficulty breathing with activity
Paroxysmal nocturnal dyspnea
Standing up at night to relieve gasping for breath
Feel dyspnea when laying flat
Patient feels the need to sit up/stand up in order to breathe
Coughing bloody or blood tinged sputum
Seen in patients with metabolic acidosis
Seen in patients close to death
Alternating patterns of tachypnea and apnea
Crescendo/ Decrescendo pattern
Increased CO2 greater than 45 mm Hg
Results in respiratory acidosis
Decreased CO2 less than 35 mm Hg
Results in respiratory alkalosis
Bluish color of skin and mucous membranes
Bulbous enlargement of the distal segment of a digit
Decreased O2 in arterial blood
Decreased O2 in tissue
Can be caused by hypoxemia, low cardiac output, cyanide poisoning....
V = volume of air that enters the alveoli
Q = amount of blood perfusing the capillaries around the alveoli
Abnormal VQ ratio is the most common cause of hypoxemia
Abnormal distribution of ventilation and perfusion
Inadequate ventilation & good perfusion
Also called "shunting"
Occurs in such conditions as asthma, atelectasis, pulmonary edema...
Good ventilation and poor perfusion
Caused by pulmonary embolus
Acute respiratory failure
Inadequate gas exchange
With respiratory failure....
PaO2 will be less than 50
PaCO2 will be greater than50
pH will be less than 7.25
Caused by direct injury to lungs, chest wall, airway, brain, spinal cord.....
May be related to medication OD, anesthesia, pneumonia, pulmonary embolus, pulmonary edema, atelectasis....
Chest wall disorders
Chest wall restriction
Caused from deformities, obesity, kyphosis, scoliosis, neuromuscular weakness....
Instability of a portion of the chest wall
Caused by fracture of several consecutive ribs in more than one place
Air in the pleural space
Destroys the negative pressure within the thorax causing the lung to collapse.
Also called "spontaneous pneumothorax"
Occurs unexpectedly in healthy individuals
Caused from rupture of blebs (blisters) on the visceral pleura.
Cause of bleb formation is unknown
Can occur during rest, sleep or exercise
Caused by chest trauma, mechanical ventilation...
(can be primary or secondary)
Air pressures in the pleural space equals barometric pressure
Air is being drawn into the thorax with inspiration and forced out during expiration
(can be primary or secondary)
The site of the pleural rupture acts as a one-way valve
Permits air to enter on inspiration, but prevents escape of air on expiration
May require needle aspiration for decompression
Presence of fluid in the pleural space
type of pleural effusion meaning water
type of pleural effusion meaning purulent matter
Presence of microorganmisms
Infected pleural effusion
Consists of blood
Consists of chyle
-A fluid absorbed by the lymphatic capillaries
-Contains interstitial fluid, triglycerides, lymphocytes, fat soluble vitamins...
Restrictive lung diseases
Characterized by a decrease in lung compliance
Requires more effort to expand the lung during inspiration
Common causes of restrictive lung diseases include....
Aspiration, Atelectasis, Bronchiectasis, Bronchiolitis, Pulmonary Fibrosis, Pulmonary edema, Acute Respiratory Distress Syndrome...
Passage of fluid and/or solid particles into the lungs
Can obstruct the airway if a large particle
Can lead to the inflammatory response
Collapse of alveoli
May occur post-anesthesia
Persistent abnormal dilation of the bronchi
Typically present with a chronic productive cough
Clubbing of the fingers is common
Inflammatory obstruction of the bronchioles
Most common in children: RSV
Occurs in adults with chronic bronchitis, viral infection, or with inhalation of toxic gases
Excess water in the lungs
Most common cause is L) sided heart failure
Pink frothy sputum
Acute respiratory distress syndrome (ARDS)
Characterized by acute lung inflammation and diffuse, bilateral alveolocapillary injury
More than 30% of ICU patients have a complication of ARDS
Predisposing factors include...
Most common is sepsis and multiple trauma
obstructive lung diseases
Characterized by airway obstruction that is worse with expiration
More force is required to expire a given amount of air
May require use of accessory muscles
Common signs and symptoms
Dyspnea , wheezing, increased work of breathing
Common obstructive disorders include...
Chronic inflammatory disorder of the airways
Inflammation occurs in response to a trigger
Hyperresponsiveness of the airways
Asthma in children...
Most prevalent chronic disease in childhood
Manifestations are similar to adult asthma:
Nasal flaring and use of accessory muscles are more commonly seen in children
Chronic Obstructive Pulmonary Disease (COPD)
Characterized by progressive airflow limitations, not fully reversible
Genetic and environmental components
Text states "preventable"
Risk Factors include...
Tobacco smoke, occupational dust and chemical exposure, air pollution...
Includes Emphysema and Chronic Bronchitis
Enlargement of the alveoli
Loss of elastic recoil of alveoli
Results in air being trapped in the alveoli
Air that is trapped is not oxygenated
Does not allow oxygenated air in
Hyper-secretion of mucous
Chronic productive cough
Eventually leads to VQ mismatch
Acute infection or inflammation of the bronchi
Commonly follows a viral illness
Acute bronchitis causes similar symptoms to pneumonia but does not demonstrate pulmonary consolidation and chest infiltrates
Inflammation/Infection in the lung fields (alveoli)
Can be bacterial, viral, fungi, protozoa, parasites...
Can be classified as "VAP"
Ventilator acquired pneumonia
A "nosocomial" infection
Can be classified as "CAP"
Community acquired pneumonia
Pneumonia can also be caused by aspiration
For example: Meconium aspiration in newborns
Caused by the Mycobacterium tuberculosis
Transmitted by airborne droplets through the airways to the alveoli
Inflammatory response is inititated
Leukocytes approach and surround the bacilli
A characteristic tissue "granuloma" forms
Clumps of live and dead bacilli surrounded by macrophages forming a protective wall
The person will now have a positive PPD skin test
Granulomas turn into a fibrous tissue mass
The bacteria becomes dormant
Latent TB infection (LTBI)
Occurs when there is an effective immune response and the bacteria become dormant
Reactivation of LTBI can occur if the host's defense mechanisms become impaired.
If the bacilli are not contained, multiply and spread
Clinical symptoms appear
Most commonly caused from compromised immune system
Occlusion of a portion of the pulmonary vasculature by a thrombus, tissue fragment, lipids, air bubble...
Pulmonary emboli commonly arise from the deep veins in the leg
Pulmonary circulation is normally a low-pressure system
The main pulmonary artery & major branches are relatively thin
Pulmonary hypertension occurs with an elevated pressure in the pulmonary circulation
Most cases develop secondary to other conditions
Categories of Pulmonary Hypertension
Secondary to left sided heart failure
Secondary to chronic lung disease
Secondary to chronic thromboembolic disease
Right sided heart hypertrophy secondary to pulmonary hypertension
Pulmonary hypertension creates chronic pressure overload in the right ventricle
The right ventricle remodels and becomes larger and inefficient.
Most common cause is cigarette smoking
Heavy smokers have a 20 times' greater chance of developing lung cancer than nonsmokers
Smoking is related to cancers of the larynx, oral cavity, esophagus, and urinary bladder
Environmental or occupational risk factors are also associated
non-small cell cancer
Squamous cell carcinoma (slow growth rate)
Adenocarcinoma (Moderate growth rate)
Large cell carcinoma (Rapid growth rate)
neuroendocrine tumor of the lung
Small cell carcinoma (Very rapid growth rate)
-From neuroendocrine tissue
Aspiration of foreign bodies
Foreign body aspiration in children occurs frequently between the ages of 1 and 3
Symptoms depend on size of foreign body and location of the blockage
Aspirated foreign bodies can usually be removed by bronchoscopy
Autosomal recessive multisystem disease
Exocrine or mucus-producing glands secrete abnormally thick mucus because of defective epithelial ion transport
Results in alterations in:
Thick pulmonary secretions...
Obstruct the bronchioles
Predispose the lungs to chronic infections
Lead to chronic inflammation
Respiratory failure is almost always the cause of death
Sudden Infant Death Syndrome (SIDS)
Defined as "sudden death of an infant under one year of age which remains unexplained"
Lower during first month of life, increases in the second month, and peaks at 3 to 4 months
More common in male infants
Higher frequencies during the winter months
Almost always occurs during sleep
"back to bed" campaign
Overheated sleeping environment
Low birth weight
Siblings of prior SIDS baby
Smoking during PG
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