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Patho Week 10 Exam 3: disorders of the pulmonary system

Terms in this set (104)

partial pressure of O2 in arterial blood is called _____
PO2
PO2 measures
O2 gas dissolved in plasma
Norm PO2 ranges = ____ - _____
<_____ means hypoxemia
measured in mmHg or %?
80-100 mmHg
80
mmHg
SO2 measures ______ _______
O2 that is being carried by _________
measured in mmHg or %?
measured by pulse ox
oxygen saturation
hemoglobin
%
4 sites on Hg loaded up with O2 means Hg molecule is ________
saturated
normal ranges of SO2 = _____ -______%
<______% is hypoxemia
97 -100
97
partial pressure of CO2 gas in blood is called _______
normal ranges = _____-_____ mmHg
PCO2
35-45 mmHg
PCO2 abnormal = _________ problem but ______ will be normal
HCO3 abnormal= _________ problem but ______ will be normal
respiratory / HCO3
metabolic / PCO2
level of bicarb in blood is called ______
normal ranges= _____-______
HCO3
22-28
5 steps to ABG's:
1. PH = acidosis or ________
2.PCO2 = CO2 out of norm -> acidosis or alkalosis = _______ origin
3. HCO3= HCO3 out of norm -> acidosis or alkalosis = _______ origin
4. PO2 & SO2 = low = ________
5. underlying etiology= what ______ mechanisms in place
alkalosis
respiratory
metabolic
hypoxemia
compensatory
low Ph caused by hypoventilation is called _____ ______
retention of CO2 -> acid state
kidneys = __________ HCO3 made or _______ its excretion
respiratory acidosis
increase / decrease
high PCO2 is called ________
hypercapnia
high Ph caused by hyperventilation is called _____ ______
blowing off more CO2 -> alkolotic state
kidneys = __________ HCO3 made or _______ its excretion
respiratory alkalosis
decrease / increase
low pH caused by too much acid gang due to renal failure/ diabetic ketoacidosis is called ______ _______
lungs = _______ acid by ______ RR and ______ breaths aka kusmal resps.
metabolic acidosis / decrease / increasing / deep
rapid deep breaths to blow off acid in metabolic acidosis are called ______ ________
kusmal respirations
high pH caused by too much alkali guy due to loss of acid gang or accumulated alkali guy is called ____ ______
lungs = _______ acid by ______ RR and ______ breaths
metabolic alkalosis
increase / decreasing
patient has ______ _______
extreme vomitting
high pH

ABG's
pH= >7.45
PO2= Normal
PCO2= normal
HCO3= >28
metabolic alkalosis
this patient has ______ _______:
patient unconscious
rr decreases to 8 b/m
pH low
CO2 high

ABG's:
pH: <7.35
PO2 = <80
PCO2 = >45
HCO3= normal
respiratory acidosis
this patient has ______ _______:
patient anxious/panic attack
pH high
RR 28
CO2 low


ABG's:
pH: >7.45
PO2 = normal
PCO2 = <35
HCO3= normal
respiratory alkalosis
patient has ______ _______
DKA/ sustained gluconeogenesis
pH low

ABG's
pH= <7.35
PO2= Normal
PCO2= normal
HCO3= <22
metabolic acidosis
2 phases of breathing cycle
inhalation/exhalation
2 parts of inhalation? what is happening in each part?

- diaphragm drops ->thorax gets bigger -> air sucked into bronchi/alveoli -> O2 from alveoli to blood and CO2 from blood to alveoli
ventilation: air passes bronchi -> alveoli tissue

perfusion: blood vessels -> take CO2 to lungs and take away O2 to body
diaphragm and intercostal muscles elastically return to resting state & CO2 expelled is called _______
exhalation
pulmonary disease = increase _______ _____ _________
work of breathing WOB
s/s of work of breathing
_______- not being able to get enough air
_______- dyspnea on extertion
________- dyspnea upon lying down
____ ____ ____- suddenly awakening at night feeling SOB
dyspnea
DOE
orthopnea
paroxymal nocturnal dyspnea
not being able to get enough air is called ________- and called _____ _____ _____ upon exertion
dyspnea / DOE
dyspnea upon lying down is called ______
LHF -> person lays down -> blood return to heart increases -> LV cant pump forward -> back up to lungs
orthopnea
suddenly awakening at night feeling SOB caused by LHF is called _____ ______ _______

- needs to sleep propped up on recliner chair
paroxymal nocturnal dyspnea
2 breathing abnormalities caused by age?
bradypnea
tachyapnea
3 breathing abnormalities caused by depth?
hypopnea
hyperpnea
apnea
2 breathing abnormalities caused by abnormal usage of muscles to breath?
using accessory muscles like diaphragm or intercostal muscles means abnormal breathing
nasal flaring in children
3 breathing abnormalities caused by pulmonary disease?
cough
hemoptysis
purulent sputum
hypoventilation aka ___________ is RR < 12
- caused by _______ prob caused by brain bleed/inflammation
bradypnea
CNS
CNS problems = _______ RR
decreased
hyperventilation aka ___________ is RR >20
fright/anxiety cause this
____ _____- need for O2 in person w/ pulmonary prob.
tachypnea
air hunger
shallow breathing is called ________
increased depth of resp. is called ________
no resp. AT ALL is called ________
hypopnea
hyperpnea
apnea
coughing up blood is called ________
-inflammation of bronchi
-pulmonary edema
hemoptysis
green, yellow, brown sputum caused by infection is called ______ ______
purulent sputum
ceratin combos of s/s that indicate malfunction in some form of breathing is called _____ ________
respiratory distress
person can no longer breathe on their own is called _____ _______
SO2,PO2,pH low
PCO2 high
respiratory failure
________ lung diseases:

low V/Q disorders = chest, airway, lung, pleural
high V/Q disorders = perfusion, structural
restrictive
________ lung diseases:
asthma
emphysema
chronic bronchitis
obstructive
restrictive lung diseases have to do with difficulty __________ causing __________
inhaling
hypoxemia
V normal ventilation = _____L per min
Q normal perfusion= _____ L per min
normal V/Q ratio = _______ (____/____)
4
5
0.8 4/5
nuclear imaging test that measures V/Q is called ____ _____
V/Q scan
chest, airway, lung tissue, and pleural restrictions are all part of ______ V/Q disorders

pulmunoary embolus and strucutral prob are part of ______ V/Q disorders
Low
high
low V/Q = decreased ____________
ex: V/Q aka air/blood -> 3/5 -> V/Q 0.6

________ remains normal
ventilation
perfusion
high V/Q = decreased ____________
- not enough blood to alveoli for gas exchange

ex: pulmonary embolus
V/Q aka air/blood -> 4/4 -> V/Q 1.0
perfusion
Low V/Q: chest wall restriction
deformity - ______
obesity
___________ weakness - Polio/myasthenia gravis
kyphosis
neuromuscular
Low V/Q: airway restriction
foreign body
tumors of _______/________
__________- high pitched raspy sound caused by turbulent flow in airway
_______ - inflammation of laryn x& bronchi
trachea/bronchi
stridor
croup
s/s of _________ aka _________
low V/Q
children less than 1
increased RR
fever
barking cough
stridor
croup aka laryngotracheobronchitis
tx for stridor?
tx for croup?
cold air
humidifier, or steroids
Low V/Q: airway restriction
pleural _________- extra fluid in pleural space (viscera/parietal) causing inflammation
_____________- air in pleural space
effusion
pneumothorax
cancer cells in lungs and heavy coughing from bronchitis/ pneumonia can cause irritation to pleura aka _______ _________
pleural effusion
s/s of _______ _______
chills
low V/Q
fever - if infection present
pleurisy
shallow resp.
pain
fluid buildup
pleural effusion
pleuritic pain upon deep breath, cough, or movement of chest is called ___________
pleurisy
air in pleural space caused by rupture of visceral/parietal pleura or chest wall is called __________
- neg pressure disrupted -> lung collapses -> _______ accumulates in thorax -> chest pain and ________
pneumothorax
air
SOB
2 types of pneumothorax? trauma from where?
BOTH ARE DEADLY
open pneumothorax - outside aka broken rib punctures pleura
closed pneumothorax - inside (tension) aka air builds up adds pressure to other lung
trauma from the inside is called _______
tension
closed pneumothorax aka ________ pneumothorax
seen in patients? 2
spontaneous
tall thin smokers
underlying disease
Tx for open/closed pneumothorax?
chest tube in water seal drainage system
Low V/Q: airway restriction
pneumonia - __________,__________,____________
pulmonary edema
lung cancer - ____________ carcinoma
CAP - community acquired
Nosocomial
aspiration
bronchogenic
infection of lower resp tract caused by microbe is called ______________
pneumonia
immunocompromised
mostly elderly but all ppl
alcoholism
smoking
intubation
malnutrition
immobilization
are risk factors for a lung tissue restriction that causes low V/Q is called _______________
pneumonia
_________ pneumonia:
- gram positive
- "walking pneumonia"
-no hospitalization except for susceptible ppl to OI
-least bad
CAP
community acquired pneumonia
_________ pneumonia:
- virulent gram negative pseudomonas
-worse than CAP
- very strong antibiotics needed
- hospital acquired
nosocomial
_________ pneumonia:
- inhale something into lungs -> inflammation of lung tissue
-CAP or nosocomial
-gag, cough, swallowing reflexes suppressed
-alert person will never get this
aspiration
alert person will never get _______ pneumonia
aspiration
3 ex. of aspiration pneumonia?
elderly w/ dysphasia
passed out alcoholic
brain injured/ post CPR or seizure
aspiration pneumonia:
microbe in alveoli -> attacked by _________ -> attack ineffective/ activate body def mechanism ->infectious debris (_________) accumulate in alveoli/tissue ->infiltrates collapse of portion of lung tissue (________) and alveoli cave in due to _______ blockage -> air cant get into alveoli -> collapsed ________ -> infiltrates + atelectasis = _______________ -> lung w/ stiff and diminished function in local area (_______ pneumonia) or more diffuse (_________)
macrophages
infiltrates
atelectasis
mucus
alveoli
consolidation
lobar pneumonia
bronchopneumonia
s/s of __________
fever, chills, cough, malaise
pleural pain
dyspnea
crackles
diminished breath sounds
abnormal x-ray
pneumonia
diminished breath sounds in pneumonia are caused by ____ _______ no air going through it so no sound

crackles sounds in pneumonia are caused by ______ _______ in alveoli
consolidated tissue
inflammatory fluid
pneumonia can be ________ or end result of atelectasis can be ____________
atelectasis
pneumonia
collapse of alveoli is called ___________
atelectasis
excess water in alveoli is called _______ ________ caused by _________ or noncardiogenic
pulmonary edema
LHF
disruption of _________ production in alveoli -> fluid from capillary to _______ -> pulmonary edema
surfactant
alveoli
__________ keeps alveoli from sticking together
decreased ___________ = alveoli collapse
surfactant
surfactant
s/s of ________ ________
dyspnea
cough
inspiratory crackles
pink frothy sputum- caused by ______ leakage
hypoxemia
pulmonary edema
plasma
lung cancer aka _______ _________
- carcinogens from smoking
-small cell or non-small cell lung cancer
bronchogenic carcinoma
s/s of _____ _____
pleural effusion
cough, sputum, sob
chest pain
anorexia, cachexia
weight loss
lung cancer
high V/Q disorder
structural - _____ in vessels, malformations, birth defects
________ ____________ - occlusion of pulmonary vessel by blood clot, tissue frag, air bubble
strictures
pulmonary embolus
pulmonary embolus risk factors in patients with _______ ________
what happens?
virchows triad
endothelial injury, hypercoagulability, venous stasis -> DVT -> dislodges and travels to lung
embolus in pulmonary: 3 artery -> arterioles -> gets stuck -> no deoxgen blood gets to alveoli to get O2 -> ______ and _____ _____
artery intima irritated -> inflammation -> blood in lung tissue -> ________
lung inflamed -> inflammatory mediators -> sys. vasodilation -> ______
SOB and chest pain
hemoptysis
shock
obstructive pulmonary dz is caused by difficulty w/ _________
force needed
obstruction of airway
s/s retractions an prolonged expiratory phase aka exhalation time takes longer
exhalation
test used to measure how well they can force out air ______ _______ test
- how much air blown out in 1st sec of exhale
peak flow
decreased PF = _______ __________ disease
increased pulmonary
3 ex of obstructive pulmonary dz?
asthma
bronchitis + emphysema = COPD
cystic fibrosis
COPD stands for
_________ + __________= COPD
chronic obstructive pulmonary disease
bronchitis + emphysema = COPD
chronic inflammatory disorder due to bronchial hyper responsiveness to allergens is called __________

inhaled irritants -> inflammatory mediators ____ ->

vasodilation, increased perm, neutrophils/________ ->swelling of _____ line
&
bronchial smooth muscle -> _____ and constrict bronchi
asthma
HLP
bronchial
spasm
s/s of _______
remission & exacerbations
wheezing on exhale
accessory muscle use
hyperventilate -> normal resp alkalosis

cant get air out -> air cant get in -> hypoxemia ->hyperventilate
asthma
asthma is treated w/ bronchodilators like _______ via nebulizer
or steroids
ventolin
COPD _______:
main cause smoking
chronic hyperventilation
norm resp alkalosis
if this person goes into resp acidosis -> going into resp failure
emphysema
COPD emphysema:
cant expel irritants due to altered cilia -> inflammation & increased proteolytic enzymes (__________) -> destroyed patches of alveoli membrane/walls -> large, stiff __________ alveoli -> no elastic recoil so ____ traps -> inhaled air trapped so hard to exhale -> hypoxemia -> increased ____-> chronic _______
elastase
hyperinflated
air
RR
hyperventilation
s/s ______ ________
tachypnea always present
pink puffer
thin & no appetite
barrel chest
tripod position
pursed lips
wheezing/ diminished lung sounds
COPD emphysema
ABG's of this patient indicate they have _____ _________:
pH= >7.45
PCO2 = <35
HCO3 = normal
PO2 / SO2 = 93%
COPD emphysema
COPD _____ _______:
hypersecretion of mucus
chronic cough
blue bloater
norm respiratory acidosis
chronic bronchitis
COPD chronic bronchitis:
smoking- > cant expel altered cilia -> irritate bronchi walls-> inflamed/neutrophils/ macros -> bronchi ________ -> thick _______ & bronchospasm -> obstruction and ____ traps -> cant expel air
edema
mucus
air
s/s _____ ______ _____:
mucus plugs -> hypoxemia
NO hyperventilation
overweight
cyanosis -> blue bloater
clubbing fingers
brown sock syndrome
resp acidosis
COPD chronic bronchitis
RHF due to lung disease like COPD chronic bronchitis is called _____ ______
cor pulmonale
COPD Chronic bronchitis
cor pulmonale -> _______ ________

no air exchange -> chronic __________ -> resp acidosis
in a chronic hypoxic state always
peripheral edema
hypercapnia
ABG's of this patient indicate they have _____ _____ _________:
pH= <7.35
PCO2 = >45
HCO3 = normal
PO2 = <80
SO2 = <97
COPD Chronic bronchitis
emphysema = norm __________ _____________
Chronic bronchitis= norm _______ ____________
resp alkalosis
respiratory acidosis
high V/Q restrictive disorder = prob w/ ___________ and ___________
inhalation and hypoxemia
Q= decreases so V/Q is not .8 now is 1 aka high V/Q
buildup of carbon dioxide is called _____________
hypercapnia
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