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Pulmonary
Advanced Patho EXAM 2
Question | Answer |
---|---|
What is the first and second process of respiration? | 1st=alveolar respiration 2nd=perfusion |
Describe ventilation. | Air into lungs/exchange of gases |
Why does perfusion have to occur? | has to occur for oxygen to get to tissues and into blood |
What is a pulmonary emboli (PE)? | Undissolved detached material that occludes blood vessels of the pulmonary vasculature |
Most PEs originate from? | DVTs or from the deep veins of the lower extremities |
What are other types of PEs, other than DVTs? | fat, air, amniotic fluid, CA (tumor), foreign material |
What are risk factors for PEs? | sepsis, parasitic, immobility, pregnancy, trauma, heart failure, estrogen use; and virchows triad |
What is virchow's triad? | hyperocaguability venous stasis/sluggish blood flow damage to venous wall |
What is COPD? | chronic and recurrent obstruction of airflow of the pulmonary airways that cause a mismatch of ventilation and perfusion |
What is the major cause of COPD? | cigarette smoking |
COPD consists of what two disease/illness? | emphysema and chronic bronchitis |
What are the s/s of emphysema? | progressive exertional dyspnea, SOB, accessory muscles, pursed lip breathing, cough, may hunch forward to breathe better, prolonged expiration, barrel chest |
What causes chronic bronchitis? | repeated infections, genetic predisposition, inhalation of irritants |
What are the s/s of chronic bronchitis? | usually overweight, SOB with exertion, excess sputum, edema, smoking HX, chills, aches, fatigue, cough, increased sputum production in a.m. |
How does heart disease affect the lungs? | Right or left sided heart failure can lead to pulmonary congestion and impaired gas exchange |
How does lung disease affect the heart? | due to poor gas exchange, lung disease can lead to hypoxia which causes vasoconstriction of pulmonary vessels, which elevates pulm artery pressure & increases workload on R ventricle |
Most common pneumonia is caused by what? | strep pneumoniae |
How does pneumonia enter the system (3 ways/sources)? | (1) aspiration of oropharyngeal secretions, (2) inhalation of contaminants (virus), or (3) contamination from the systemic circulation |
How does pneumonia affect breathing? | There is inflammation of the alveoli and bronchioles which impairs gas exchange |
In the oxyhemoglobin dissociation curve, what causes a shift to the left? | hypothermia, alkalosis, decreased PaCO2 |
In the oxyhemoglobin dissociation curve, what causes a shift to the right? | hyperthermia,anemia, decreased cardiac output |
How do chemoreceptors work to protect the body? | they are defense mechanisms |
Where are the central chemoreceptors located? | in the medullary center |
What do chemoreceptors respond to? | Changes in pH, CO2 and O2 levels |
Describe Obstructive Pulmonary Disorders. | characterized by airway obstruction and limitation in expiratory flow |
List the types of Obstructive Pulmonary Disorders. | Asthma,Acute and Chronic bronchitis, or Emphysema |
Describe Restrictive Pulmonary Disorders. | Result from inflammatory conditions that affect lung structures and produce lung fibrosis and a stiff lung |
List the types of Restrictive Pulmonary Disorders. | ARDS,Infant Acute Respiratory Distress Syndrome, Pneumothorax, Pneumonia |
What is tidal volume (TV)? | the volume of air inspired (or exhaled) with each breath; usually about 500mL in avg adult |
What is FEV1? | the forced expiratory volume that can be exhaled in 1 second |
What is residual volume? | air left after max exhale |
What is ventilation-perfusion? | the matching of adequate volume of air in the alveoli to adequate pulmonary blood flow |
What are two important substances that help the alveoli function correctly? | Surfactant and alpha1 antitrypsin |
What is a nl Va/Q? | 4/5 |
What does a high Va/Q? indicate? | means they are hyperventilated, alveolar ventilation not perfused, ↓ PCO2, NL PaO2 |
What does a low Va/Q indicate? | it means they are underventilated, ↓ PaO2 (hypoxia) |
What is infant respiratory distress syndrome (aka hyaline membrane disease) | a lack of surfactant leading to increased alveolar surface tension and decreased lung compliance |
How can infant respiratory distress syndrome be fatal? | the infant can die from exhaustion |
At what pregnancy week is surfactant produced in greater qualities? | after week 32 |