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Pathophysiology

Exam 3

QuestionAnswer
Mucociliary Blanket Pulmonary defense system. Protects the resp sys by entrapping dust, bacteria, and other foreign particles that enter the airways. Cigarette smoking slows down or paralyzes the motility of the cilia.
Larynx Associated with speed and lung protection. Located between the upper airways and the luings and sometimes referred to as the "watchdog of the lungs".
Glottis "Vocal Cords" Opens and closes for speech.
Epiglottis During swallowing the freeedges of the epiglottis move downward to cover the larynx, thus routing liquids and foods into the esophagus..helps prevent aspiration pneumonia.
Trachea windpipe. connects the larynx with the major bronchi of the lungs.
Carina Between the main bronchi is a keel-like ridge, the mucosa is highly sensitive; violent coughing is intiated when a foreign object (suction catheter) makes contact with it.
Lungs (3) Has 3 lobes on the right and 2 on the left. There is only 2 lobes on the left because of the heart. Site of gas exchange. Makes heparin that thins blood.
Surfactant Type II Alveolar cells produce this. Provides surface tension of alveoli. Birth control helps with this because of stress that the baby is under produces cortisol.
Bronchial Circulation Distributes blood to the conducting airways and supporting structures of the lung.
Pulmonary Circulation Arises from the pulmonary artery and provides for the gas exchange and function of the lungs. This is the only part of the circulation where arteries carry unoxygenated blood and veins carry oxygenated blood.
Pleura a thin, transparent, double-layered serous membrane that lines the thoacic cavity and encases the lungs.
Pleural Effusion Describes an abnormal collection of fluid or exudate in the pleural cavity.
Tidal Volume The amount of breath that moves into and out of the lungs during a normal breath.
How can you measure lung volumes Incentive Spirometer
Respiratory Center of the Brain PONS and MEDULLA
Cough Primary defense mechanism
COPD Chronic increase of CO2 levels comes with hyperventilation, respiratory alkalosis and is stimulated by hypoxia...that's why it's not good to up O2 on COPD Patient.
Viruses Most frequent cause of respirtory tract infections and lead to bacterial infections. Treat the symptoms
The Common Cold A viral infection of the upper respiratory tract. S&S sore throat, hoarseness, headache and generalized malaise. Lasts approx 7 days. Fingers are the greatest source of spread, thru nasal mucosa and conjunctiva of eyes.
Viral Influenza Abrupt onset with profound malaise. Prevention with flu shot (70-90% effective with good match) and antiviral drugs.
Typical Pneumonia Bacterial Pneumonia-caused by staph aureus (community and hospital) high cause of morbidity and mortality in elderly
Two types of Bacterial Pneumonia Streptococcus Pneumonia and Legionnaires
Atypical Pneumonia Walking Pneumonia or micoplasma (bacterial)
Legionnaires Air vents and standing water
TB Airborne, common cause of HIV death. T-cell delayed hypersensitivity response (Pathogenesity)
Ghon Focus TB.....cheeselike necrosis, granulomas
Lung Cancer Leading cause of cancer death in men and women. Usually advanced when discovered therefore prognosis is poor. Lung is usually the site of frequent metastases from cancers from other parts of the body.
Bronchogenic Cancer Arises from epithelial lining of the major bronchi
Small cell lung cancer greatest associated with tobacco smoking, tends to metastasize to brain. Highly malignant. Most commong sites of matastese are brain, bone and liver. Without treatment 1/2 people die with in 12-15 weeks. Approx. 70% have detectable metastases at time
Upper airway restriction and decreased airflow in babies Can result in nasal congestion. Small nares.
Retractions Abnormal inward movements of the chest wall during inspiration; they may occur intercostally (between the ribs) in the substernal or epigastric area, and in the supraclavicular spaces.
Grunting An audible noise emitted during experiation
Stridor Audible crowing sound during inspriation.
Nasal Flaring a method that infants use to take in more air
Croup characterized by inspriatory stridor, hoarseness, and a barking cough. Usually follow Upper respiratory tract infections.
Epiglottitis Poses greatest threat of hypoxia because of inflammatory edema, comes on suddenly bringing danger or airway obstruction and asphyxia.
Function of lungs Oxygenate and remove Carbon Dioxide (CO2)
Pneumothorax Complete or partial collapse of entire lung. Air enters pleural cavity causing lung to collapse. Two Types Puncture (hole into lung) or Tension (air enters but doesn't leave, shift in mediastinum and trachea to opposite side of chest and unaffected lung
Atelectasis Incomplete expansion of a lung or portion of a lung. Most often caused by airway obstruction such as a mucus plug.
Pleura Serous membrane that encases the lungs
Pleural Cavity Space between two layers contains a thin layer of serous fluid, which lubricates the pleural surfaces and allows the pleurae to slide smoothly over each other during breathing movements.
Hypercapnia PCO2 greater than 50 (increase in Carbon Dioxide (CO2) in blood)
Pleural Effusion Abnormal collection of fluid in the pleural cavity
Bronchial Asthma Inflammation. Chronic disorder of airways, causes airway obstruction, bronchial hyper responsiveness, airway inflammation, usually reversible.
S&S of Bronchial Asthma Wheezing, breathlessness, cough worse at night and early morning.
Extrinsic (Atopic) Asthma Type I hypersensitivity. Onset in childhood. usually have hay fever and hives.
Emphysema Alveoli (airsacs) collapse. Characterized by hyper inflation of lungs, Increase in total lung capacity, with bronchi episodes?, persistent airway obstruction, chronic infection, loss of lung elastic fibers, barrel chest.
Cystic Fibrosis (CF) Recessive disorder, increase in secretion of fluid in respiratory, GI (gastrointestinal) and reproductive tract. Increase in lung infection due to an increase in mucus in bronchi. Lack of pancreatic enzymes (abnormal pancreas function). Salt depletion
Pulmonary Embolism Blood-borne substance lodges in a branch of the pulmonary artery and obstructs the flow. Almost all arise from DVT (Deep Vein Thrombosis) in the lower extremity. Adverse effect is vasoconstriction. Diagnose with D-Dimer, lung scan and CT scan. S&S ches
Cor Pulmonale Hypertrophy R Ventricle. Right heart failure secondary to respiratory disease. Decreased lung ventilation and oxygenation. Pulmonary vasoconstriction. Incrased workload on right heart and workload on rest of heart. Kidney releases erythropoietin with
Adult Respiratory Distress Syndrome (ARDS) 50-60% die, cell injury, increased permeability of alveolar capsule membrane allows fluid or protein to enter the alveoli. Damages and stiffens lungs. Can't inflate, causes major trauma and sepsis.
Respiratory Failure Condition where the respiratory system fails in one or both of its gas exchange functions (oxygenation of or elimination of CO2 from blood) Common result is hypoxemia (low oxygen) and hypercapnia (high CO2 in blood)
Appetite Stimulated by? Hypothalamus
Hiatal Hernia Development of an abnormal gap around the wall of the esophagus can lead to herniation of stomach into the thoracic cage. S&S acid reflux and heartburn.
Dysphagia diffculty in swallowing
Reflux backward or return movement..acid into esophagus.
GERD (Gastroesophageal Reflux Disease) thought to be associated with weak or incompetent lower esophageal sphincter that allows reflux to occur, exposing the esophagus to the irritan effects of the refluxate and decreasing clearance of the reflux acide from the esophagus after it has occured.
Cancer of Esophagus Dysphagia is most frequent complaint. Mostly caused by alcohol and tobacco use.
Acute Gastritis refers to transient inflammation of the gastric mucosa. Most commonly associated with local irritants such as bacterial endotoxins, alcohol, and aspirin.
Peptic Ulcer Caused by H. Pylori (causes gram negative rods) infection and aspirin or NSAIDS
H. Pylori Characterized by gram negative rods, it releases toxins, treat with antibiotics and prilosec.
IBS (Irritable Bowel Syndrome) characterized by persistent or recurrent symptoms of abdominal pain, altered bowel function, and varying complaints of flatulence, bloating, nausea and anorexia, constipation or diarrhea, and anxiety or depression. Hallmark sigh is abdominal pain relieve
Two types of Inflammatory Bowel Disease Chron's Disease and Ulcerative Colitis. Both produce inflammation of the bowel, both lack confirming evidence of a proven causative agent, both have a pattern of familial occurrence, and both can be accompanies by systemic manifestations.
Chron's Disease A recurrent, granulomatous type of inflammatory response that can affect any area of the GI tract from the mouth to the anus. Most common in the prosimal protion of the colon and less often the ileum. Cobblestone appearance. Pain in the LOWER RIGHT QUAD
Ulcerative Colitis Characterized by psudopolyps (tonguelike projections that resemble polyps) 30-40 diarrhea bowel movements per day. Stools typically contain blood and mucus.
Clostridium Difficile Colitis (C Diff Colitis) Patient is typically on antibiotic. Caused by normal gram positive C Diff Bacteria.
Diverticulosis Condition in which mucosal layer of colon herniates through the muscularis layer. Intestine and colon effected.
Diverticulitis complication of diverticulosis in which there is inflammation and gross or microscopic perforation of the diverticulum. Pain in LEFT LOWER QUADRANT.
Mechanical Obstruction caused by? Adhesions
Appendicitis Pain in LOWER RIGHT QUADRANT. Reboudn tenderness, which is pain that occurs when pressure is applied to the area and then released. 5-30yo
Liver Produces bile, m
Bilirubin Gives bile its color
Jaundice Abnormally high accumulation of bilirubin in the blood, as a result of which there is a yellowish discoloration to the skin and deep tissues.
Hepatitis Inflammation of the liver.
Hepatitis A Onset of symptoms is usually abrupt and includes fever, malaise, nausea, anorexia, abdominal discomfort, dark urine and jaundice. Transmitted by the fecal-oral route. Can get from contaminated milk or water and eating shellfish from infected waters and
Hepatitis B Transmitted through inoculation with infected blood or serum. Common among injecting drug users, persons with multiple sex partners, and men who have sex with men and health care workers are at risk owing to blood exposure and accidental needle injuries.
Hepatitis C Most common cause of chronic hepatitis, cirrhosis, and hepatocellular cancer in the world, spread through contaminated blod transfusions or blood products. Can induce chronic hepatitis and cirrhosis. Asymptomatic.
Cirrhosis End stage of chronic liver disease in which much of the functional liver tissue has been replaced by fibrous tissue. splenomegaly and ascites and encephalopathy (neural toxin accumulation).
Gall Bladder distensible, pear-shaped, muscular sac located on the ventral surface of the liver. Function to store and concentrate bile.
Cholecystitis Inflammation of the gallbladder
Cholelithiasis Gallstones (fat, forty, female, fair, fertile) Pain RIGHT UPPER QUADRANT.
Function of Pancreas produce secretions that breakdown dietary proteins, starch and fats.
Cancer of the Pancreas Considered to be one of the most deadly malignancies. Smoking is risk factor. Don't pick up on it until it is advanced because of large reserve and it's location.
Testing Body Fluid Daily weight. Perform at same time each day with same amount of clothing provides a useful index of water gain (1L=2.2lbs.)
Syndrome of Inappropriate secretion of ADH (SIADH) Manifests with dilutional hyponatremia.
Hyponatremia Normal serum sodium 135-145. Hyponatremia is below 135.
Hypernatremia Normal serum sodium 135-145. Hypernatremia is above 145.
Hypokalemia Normal potassium is 3.5-5. Hypokalemia is below 3.5.
Hyperkalemia Normal potassium is 3.5-5. Hyperkalemia is above 5. Happens with renal failure.
Parathyroid gland Produces parathyroid hormone (PTH) which helps maintain calcium levels.
Magnesium is essential to all reactions that require energy for every step related to replication and transcription of DNA and for the translation of messenger RNA.
Normal pH 7.35-7.45
ROME Respiratory Opposite...Metabolism Equal
Kidney Functional unit is nephron. Filters blood. Secrete calcium ,erythropoietin, and Vit. D.
Loop of Henle Plays important role in controlling the concentration of urine.
Kidneys and BP Produce renin when blood pressure is low.
Serum Creatinine Real function that tells you how kidneys are doing in comparison to GFR (Glomerular Filtration Rate.)
Created by: mamarnold