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patho exam 2
respiratory disorders part 1
| Question | Answer |
|---|---|
| ways to split up respiratory tract | upper/lower conducting zone/respiratory zone |
| upper respiratory tract | from nose to trachea |
| lower respiratory tract | from trachea to alveoli |
| conducting zone | nose to terminal bronchioles |
| respiratory zone | respiratory bronchioles to alveoli |
| what is the beginning of the lower respiratory tract | trachea |
| what does the trachea break into | two primary bronchi |
| what is the middle of the trachea called | lumen |
| respiratory mucosa lines | the conducting portion of the respiratory system |
| respiratory mucosa consists of | an epithelial layer and an areolar layer called the lamina propria |
| lamina propria supports | the respiratory epithelium |
| lamina propria in the upper respiratory system | contains mucous glands that secrete mucous onto epithelial surface |
| lamina propria in the conducting portion of the lower respiratory system | contains smooth muscle cells that encircle lumen on bronchioles |
| paranasal sinuses all | connect to the nasal cavity |
| what happens when the sinuses are inflammed | fills with exudates which leak through the cavities of respiratory systems fluids with plasma leak to sinus |
| what are sinuses lined with | mucosa |
| what are the two openings of the respiratory system | nasal and oral cavity |
| 3 layers of the nasal cavity | nasal conchae - superior, middle, inferior |
| 3 portions of the pharynx | nasopharynx, oropharynx, laryngopharynx |
| bronchi divide for | about 20 generations after entering the lungs |
| what allows gas exchange | only the respiratory bronchioles and alveoli |
| terminal bronchioles rely on | smooth muscle |
| contraction of inspiratory muscles causes | intrapulmonary pressure to decrease |
| when the volume of chest increases then | the pressure inside decreases |
| sequence of events in inspiration | inspiratory muscles contract, thoracic cavity volume increases, pressure drops, air flows in |
| sequence of events in expiration | inspiratory muscles relax, thoracic cavity volume decreases, pressure rises, air flows out |
| during inspiration | ribs are elevated and sternum flares and diaphragm moves inferiorly |
| during expiration | ribs and sternum are depressed and diaphragm moves superiorly |
| inspiratory reserve volume is | the air you can get in, 3100 mL |
| tidal volume is | the air you can get in/out, 500 mL |
| expiratory reserve volume is | the air you can release, 1200 mL |
| residual volume is | the air that remains in your lungs, 1200 mL |
| vital capacity is | the air you can inhale and exhale, 4800 mL |
| total lung capacity is | the maximum amount of air in your lungs, 6000 mL |
| alveolar ventilation calculation | dead space volume is subtracted from tidal volume |
| lung disorders | infections, obstructive lung diseases, restrictive lung diseases, vascular disorders, intrapulmonary disorders |
| infections | most common respiratory disorder treated in the hospital occurs either in the upper or lower respiratory tract |
| obstructive lung diseases | block the flow of air into or out of the lungs |
| restrictive lung diseases | the normal expansion of lungs is limited, problem with expansion of lungs and what allows pressure to impact I and E |
| vascular disorders | more localized at the alveoli |
| primary viral infection | influenza or common cold virus, induced by a virus |
| virus attached to respiratory mucosa... | invades tissues causing necrosis or epithelial cells, inflammation and swelling - leads to congestion and obstructive airways |
| virus penetrates cells and causes | necrosis which activates inflammatory responses and makes environment more muscularized |
| virus spreads along continuous mucosa invading | ears - otitis media (ear inflammation) sinuses - sinusitis (sinus inflammation) bronchi and lungs - severe pnuemonia (in the terminal of lower respiratory tract) |
| bacteria sometimes penetrate the damaged mucous membranes causing | secondary bacterial infection |
| loss of boundary means | perfect conditions for virus to penetrate bacteria |
| upper respiratory tract infections are | acute infection of nose, paranasal sinuses, pharynx, larynx, trachea and bronchi |
| URIs range from | mild to life threatening |
| high prevalence of URIs | large numbers of viruses, ease of transmission, incomplete immunity developed after viral infection, ability of some viruses to mutate |
| people at increases risk for URIs | very young, very old, immunosuppressed individuals, those with chronic diseases |
| transmission of URIs | social contact |
| pathogenesis of URIs | usually viral, primary or secondary bacterial infections |
| CMs of URIs | vary depending on location and severity of the infection and age of patient cough and change in mucus are common rhinorrhea fever, sore throat, myalgia, malaise |
| rhinorrhea | a profuse, watery discharge from nose |
| treatment of URIs | comfort measures and medications |
| croup aka | larynhotracheobronchitis |
| what is croup | a parainfluenza virus |
| croup is spread among | children younger than 5 years of age |
| croup transmission | direct contact with respiratory secretions or large aerosol droplets |
| symptoms of croup | airway obstruction, fever, dyspnea, restlessness |
| croup is characterized by | a wet cough |
| airway changes with croup | epligottis swells occluding airway trachea swells against cricoid cartilage, resulting in restriction |
| infectious disease of the lower respiratory tract are caused by | viruses, bacteria, fungi |
| ID of lower respiratory tract: factors affecting incidence, morbidity and mortality | season, age, health status |
| ID of lower respiratory tract: risk factors | altered LOC, impairment of normal ventilation, chronic disease, inhalation of smoke of irritant gases |
| ID of lower respiratory tract: CMs | cough, malaise, fever, sore and inflamed throat, enlarged lymph nodes, mucoid or purulent sputum, wheezing, fine crackles on auscultation |
| bronchiolitis | inflammation of bronchioles most often caused by respiratory syncytial virus (RSV) |
| bronchiolitis frequently preceded by | upper respiratory infection |
| recurrent cases of bronchiolitis may be due to | CF |
| who does bronchiolitis occur in | high-risk adults such as smokers or infants |
| pathogenesis of bronchiolitis | injury to bronchiolar epithelium from infection will induce inflammation, RSV (infants) |
| bronchial tube during bronchiolitis | lumen is narrow, air trapped in or out of alveoli which results in wheezing sounds and overinflated or collapsed alveoli |
| CMs of bronchiolitis | necrosis or respiratory epithelium, excess mucus production and submucosal swelling, bronchiolitis obliterans (more thickness and swelling), infants: fever and tachypnea, older children: cough and nasal discharge, fine crackles and E wheezing with db |
| treatment for bronchiolitis | supportive management of respiratory symptoms - if too congested, give anti-inflammatory, humidifiers |
| pertussis aka | whooping cough |
| pertussis is induced by | bacteria |
| pertussis is transmitted by | air droplets, contact with contaminated respiratory secretions |
| pathogenesis of pertussis | bordatella pertussis, |
| CMs of pertussis | uncontrollable, spasmodic cough that ends in loud, crowing, inspiratory whoop |
| treatment of pertussis | pertussis vaccination |
| influenza is a | highly infectious, highly contagious, very common viral infection that is typically seasonal |
| influenza has | a short incubation period that facilitates rapid spread |
| influenza is transmitted by | inhalation of aerosolized particles |
| people at risk for influenza | children under 5 years of age, pregnant women, people over 50, people with chronic medical conditions, people who live with or care for people at high risk, anyone with a poor immunological system |
| pathogenesis of influenza | viruses - antigenicity, can develop antigens (memory) against virus necrosis and desquamation of respiratory tract epithelial cells but can regenerate quicker so reversible condition diffuse watery nasal discharge response: release of inflam mediators |
| CMs of influenza | fever and headache, myalgias, sever malaise, photophobia, cough and sore throat, rhinorrhea |
| treatment for influenza | supportive to alleviate symptoms, antiviral therapy, influenza vaccine |
| classifications of pneumonia | location where patient was exposed to pathogen, causative pathogen, location of pathogen within lung |
| pathogenesis of pneumonia | microaspiration of pathogens from upper airway |
| pathogenesis of pneumonia: community acquired (CAP) | bacteria or virus typical (bacterial, induced by coccus) vs atypical (virus or related to virus or noncircular bacteria) |
| pathogenesis of pneumonia: hospital acquired (HAP) | more fatal, severe preexisting chronic diseases, immunosuppressed |
| pathogenesis of pneumonia: opportunistic | main COD for HIV pts, do not cause illness in healthy person |
| pathogenesis of pneumonia: zoonotic infections | transmitted from usual animal reservoirs to humans, not very common |
| pathogenesis of pneumonia: bacterial | pulmonary tissue consolidated by bacterial exudates primarily within the alveoli, very little interstitial involvement |
| pathogenesis of pneumonia: viral | interstitial involvement - in interstitial space, between bronchis patchy inflammatory changes in alveolar walls and septa - damage to walls of alveoli make them less capable to do gas exchange between lungs and blood stream |
| pneumonia in alveolus | bacteria penetrate bloodstream, cause damage to epithelial cells and then exudate spreads in the area |
| bronchopneumonia | diffuse - bacterial spreads one to another |
| lobar pneumonia with pleurisy | consolidation - bacterial lower lobe consolidated good Tx is abx |
| primary atypical pneumonia | interstitial - viral mycoplasmal walking pneumonia, not as severe |
| treatment for pneumonia | all treated with Abx even if the cause is viral because of secondary infections |
| CMs of typical pneumonia | abrupt onset of high fever, chills, productive cough with mucopurulent sputum (secretion) |
| CMs of atypical pneumonia | milder symptoms but last longer |
| diagnosis of pneumonia | X ray = best way to identify sputum analysis to check if its viral or bacterial |
| treatment for pneumonia | supportive measures - rest and hydrate supplemental oxygen - if lungs are too congested for fluid antibiotics and antivirals |
| tuberculosis caused by and affects | rod-shaped aerobic M. tuberculosis bacillus primarily affects the lungs but lymphatic TB affects lymph nodes |
| TB infection | M. tuberculosis have seeded in lung but no significant tissue damage - can survive inside immuno cells which is why its so hard to treat and diagnose since its not it the bloodstream |
| TB disease | significant tissue damage in the lungs, contagious when disease is active and pt has cough, not contagious when bacteria is incubated in the system |
| risk factors for TB | HIV/AIDS, foreign immigration (green card requires TB test), low income/homelessness/malnourishment, crowded urban conditions |
| pathogenesis of TB | can be dormant for years (latent TB) |
| pathogenesis of active TB | symptomatic and communicable, distinguishing characteristic is formation of granuloma |
| TB has cavitation | the formation of vapor-filled bubbles in a liquid when its pressure drops below its vapor pressure |
| CMs of active TB | cough, weight loss and anorexia, low grade fever, night sweats, dull aching chest pain, hemoptysis |
| CMs of latent TB | individual is asymptomatic, TB activated when immune defenses are weak |
| diagnosis of TB | history - travel, family member with active TB physical exam x-ray mantoux test - blood test where you inject a piece of antigen (TB) and see if there is any inflammation where you inject |
| treatment of TB | medications - from health dpt, need to be monitored TB vaccine - spreads very easily |
Created by:
leh195