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respiratory

Stack #175262

QuestionAnswer
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