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respiratory
Stack #175262
| Question | Answer |
|---|---|
| During excercise, which muscles are used for inspiration? | external intercostals, scalene muscles, sternomastoids |
| During excercise, which muscles are used for expiration? | rectus abdominis, internal and external obliques, transversus abdominis, internal intercostals |
| formula for collapse pressure | collapse pressure=2(tension)/radius |
| What does kallikrein do? | activates bradykinin |
| Physiologic dead space (VD). define and give formula | =anatomical dead space of conducting airways plus functional dead space in alveoli. volume of inspired air that does not take part in gas exchange. =VT(PaCO2-PeCO2)/PaCO2 |
| Pulmonary vascular resistance (PVR). give formula | PVR= (P pulm artery - P L atrium)/ cardiac output. |
| oxygen content of blood | =(O2 binding capacity x % saturation)+dissolved O2. |
| cyanosis | Hb<5g/dL |
| oxygen delivery to tissues | =cardiac output x oxygen content of blood |
| alveolar gas equation | PAO2=PIO2-(PACO2/R)=150-PaCO2/.8 |
| causes of increased A-a gradient | shunting, V/Q mismach, fibrosis (diffussion block) |
| V/Q at apex | 3 (wasted ventilation) |
| V/Q at base | 0.6 (wasted perfusion) |
| Relation of PA,Pa,Pv at zone1,2,3 | zone 1= apex= PA>Pa>Pv (wasted ventilation). zone 2=Pa>PA>Pv. zone 3=Pa>Pv>PA (wasted perfusion). |
| List 4 obstructive lung diseases | chronic bronchitis, emphysema, asthma, bronchiectasis |
| chronic bronchitis=blue bloaters. give pathology | hypertrophy of mucus-secreting glands n the bronchioles->Reid index=gland depth/total thickness of bronchial wall>50% |
| emphysema = pink puffer. give pathology | enlarged air spaces, decreased recoil 2/2 destruction of alveolar wall (increased elastase activity). three types (panacinar, centriacinar, paraseptal). |
| findings fo chronic bronchitis | wheezing, crackles, cyanosis |
| findings for emphysemia | dyspnea, decreased breath sounds, tachcardia, decreased I/E ratio |
| cause of panacinar emphysema | alpha1 antitrypsin deficiency, also liver cirrhosis |
| cause of centriacinar emphysema | smoking |
| paraseptal emphysema is associated with? | bullae->cab ryotyre->spontaneous pneumothorax; often in young, otherwise healthy males. |
| asthma findings | cough, wheezing, dyspnea, tachypnea, hyposemia, decreased I/E ratio, pulsus paradoxus, mucus plugging. |
| asthma pathology | bronchial hyperresponsiveness causes reversible bronchoconstriction. smooth muscle hypertrophy and curschmann's spirals. |
| bronchiectasis pathology | chronic necrotizing infection of bronchi->ermanently dilated airways, purulent sputum, recurrent infections, hemoptysis. |
| bronchiectasis is associated with what? | bronchial obstruction, CF, poor ciliary motility, kartageners syndrome. can develop aspergillosis. |
| restrictive lung dz (2 types) | poor breathing mechanics (extrapulmonary, peripheral hypoventilation), interstitial lung diseases (pulmonary, lowered diffusing capacity) |
| restrictive lung diseases associated with poor breathg mechanics | poor muscular effort (polio, MG), poor structural apparatus (scoliosis, morbid obesity) |
| restrictive lung diseases that are interstitial lung dz | ARDS, NRDS (hyaline membrane dz), pneumoconioses (coal miner's silicosis, asbestosis), sarcoidosis, idiopathic pulmonary fibrosis (repeated cycles of lung injury and woud healing with hi collagen), goodpasteures, wegener's granulomatosis, eosinophilic gra |
| causes of ARDS | trauma, sepsis, shock, gastric aspiration, uremia, acut panceatitis, or amniotic fluid embolism |
| development of ARDS | diffuse alveolar damage->increased alveolar capillary permeability->protein-rich leakage into alveoli. Results in formation of intra-alveolar hyaline membrane. Initial damage due to neutrophilic substances toxic to alveolar wall, activation of coagulati |
| asbestosis . define and give findings. | diffuse pulmonary interstitial fibrosis caused by inhaled asbestos fibers. ferruginous bodies in lung (fibers coated with hemosiderin). ivory-white pleural plaques. mainly affect upper lobes. |
| asbestosis. assoc with what hx | shipbuilders, roofers, plumbers. |
| asbestosis. increased risk of what | pleural mesothelioma and bronchogenic carcinoma. |
| bronchial obstruction. describe breath sounds, resonance, fremitus, trachial deviation. | breath sounds absent or decreased over affected area, decreased resonance, decreased fremitus, trachial deviation toward side of lesion. |
| pleural effusion. describe breath sounds, resonance, fremitus, trachial deviation | breath sounds decreased over effusion, resonance dullness, decreased fremitus, no trachial deviation |
| lobar pneumonia. describe breath sounds, resonance, fremitus, trachial deviation | may have bronchial breath sounds over lesion, dull resonance,increased fremitus, no trachial deviation |
| pneumothorax | decreased breath sounds, hyperresonance, absent fremitus, trachial deviation away from side of lesion. |
| complications of lung cancer | SPHERE of complications: superior vena cava syndrome, pancoast's tumor, horner's syndrome, endocrine (paraneoplastic), recurrent laryngeal symptoms (hoarseness), effusions (pleural or pericardial) |
| squamous cell carcinoma | squamous sentral smoking: cavitation; clearl linked to smoking; parathyroid-like activity->PTHrP; keratin pearls and intercellular bridges. |
| adenocarcinoma | develops in site of prior pulmonary inflammation or injury (mc lung cancer in nonsmokers and females). clar cells->type II pneumocytes; multiple densities on x-ray of chest. |
| small cell carcinoma | responsive to chemo. may lead to Lambert-Eaton syndrome (autoantibodies against calcium channels). Kulchitsky cells (small dark blue cells) |
| large cell carcinoma | anaplastic, undifferentiated; poor prognosis; less tendency to metastasize and less responsive to chemo. surgically removed. pleomorphic giant cells with leukocyte fragments in cytoplasm. |
| flushing, diarrhea, wheezing salivation | carcinoid syndrome. seen in carcinoid tumor (secretes serotoin). |
| lung cancer metastasize to ? | brain (epilepsy), bone (frx), liver (jaundice, hepatomegaly). |
| lobar pneumonia | pneumococcus. intraalveolar exudate->consolidation; may involve entire lung. |
| bronchoPNA | s.aureus,h.flu,klebsiella, s. pyogenes. acute inflammatory infiltrates from bronchioles into adjacent alveoli; patchy distribution involving one or more lobes. |
| interstitial (atypical) PNA | viruses (RSV, adoviruses), mycoplasma, legionella, chlamydia. diffuse patchy inflammation localize to INTERSTITIAL areas at ALVEOLAR WALLS; involve one or more lobes. |
| transudative pleural effusions | due to CHF, nephrotic syndrome, or hepatic cirrhosis |
| exudative pleural effusions | due to malignancy, pna, collagen vascular disease, trauma |
| lymphatic pleural effusions | milky fluid; increased triglycerides. |
Created by:
hazelett
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