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patho exam 2
respiratory disorders part 2
| Question | Answer |
|---|---|
| obstructive lung disorders | asthma, chronic bronchitis, emphysema, CF, bronchiectasis |
| bronchiectasis | permanent widening and thickening of the airways (bronchi) |
| obstructive lung disorders impair | oxygenation and perfusion |
| increased work of breathing associated leads to | increase in metabolic demand |
| anatomic airway structure: role of smooth muscles | bronchoconstriction and bronchodilation |
| worsening airway obstruction during exhalation | inflammation, loss of support for small airways, bronchoconstriction, mucus in airways (affects movement of air) resistance to airflow |
| alterations in pulmonary function | pulmonary function tests (PTFs) |
| PTF uses | assessment of obstructive lung disorders |
| PFT types | spirometry, body plethysmography, nitrogen washout |
| tidal volume | 500 mL, volume of air inhaled and exhaled during one cycle of normal quiet breathing |
| inspiratory reserve volume | 3000 mL, max volume of air that can be inhaled after TV inhalation |
| inspiratory capacity | 3500 mL, max volume of air that can be inhaled after normal exhalation |
| expiratory reserve volume | 1200 mL, max volume of air that can be exhaled after TV exhalation |
| vital capacity | 4700 mL, max amount of air that can be exhaled in nonforced manner after max inhalation |
| asthma is a | chronic inflammatory disorder of airways |
| asthma entails | recurrent episodes of reversible airway obstruction, hyperreactive airways (very sensitive) |
| asthma incidence greatest in | industrialized countries due to pollution which triggers asthma |
| risk factors for asthma | genetics, obesity, exposure to allergens, irritants, tobacco smoke |
| how many people in the US with asthma | over 28 million which means about 1 in 12 people |
| asthma etiology | unknown |
| asthma classification considerations | clinical presentation, precipitating factors or triggers, allergies |
| asthma triggers | allergies, infections, exercise, medications |
| asthma types | allergic, recurrent |
| allergic asthma | most common allergen causes type 1 hypersensitivity response - an allergen being exposed, basophils put antibodies on their surface |
| recurrent asthma | not very common airways remodeled bronchial smooth muscle hypertrophy, increasing capacity for bronchoconstriction |
| asthma CMs | recurrent chest tightness, SOB, wheezing, cough with our without production of thick sputum, severe asthma episodes |
| severe asthma episodes entail | tachypnea and tachycardia |
| severity classifications | mild intermittent asthma mild, moderate or severe persistant asthma |
| diagnosis of asthma | medical history and physical exam, PFTs before and after bronchodilator use, challenge test, exhaled nitrogen oxide |
| treatment of asthma | environmental control, bronchodilator, anti-inflammatory medications |
| COPD is | not reversible |
| COPD entails | progressive airflow limitations that are not fully reversible, includes chronic bronchitis and emphysema |
| COPD is linked to | cigarette smoking |
| cigarette smoking accounts for | 90% of COPD in industrialized countries - MAIN RISK FACTOR |
| COPD has a | gradual onset with slowly progressive symptoms of dyspnea and SOB |
| COPD risk factors | direct and environmental tobacco use, genetics, occupational exposure, indoor air pollution, severe respiratory tract infections |
| COPD etiology | chronic airflow limitation due to abnormal inflammatory response to inhaled particles and gases in lung |
| GOLD 1: mild COPD | Mild airflow limitation Possible chronic cough and sputum production Possible unawareness of individual that lung function is abnormal |
| GOLD 2: moderate COPD | Worsening airflow limitations, SOB on exertion Possible cough and sputum production Chronic respiratory symptoms lead to person seeking care |
| GOLD 3: severe COPD | Further worsening of airflow limitations, greater SOB Reduced exercise capacity, fatigue, and repeated exacerbations Affect on patient's quality of life |
| GOLD 4: very severe COPD | Severe airflow limitations plus chronic respiratory failure |
| pathophysiology of COPD | airway obstruction results from fixed airways that have increased resistance, slowing the rate of airflow hypercapnia - excess CO2 in the blood hyperinflation of the lungs |
| types of airway obstructions for COPD | chronic inflammation structural remodeling of lung tissue alterations in vascular structure destruction of pulmonary structures |
| main causes of COPD are | cigarette smoking and air pollution |
| cigarette smoking and air pollution cause | continual bronchial irritation and inflammation and breakdown of elastin in CT of lungs |
| continual bronchial irritation and inflammation leads to | chronic bronchitis |
| chronic bronchitis causes | bronchial edema, hypersecretion of mucus, chronic cough, broncospasm |
| breakdown of elastin in CT of lungs leads to | emphysema |
| emphysema causes | destruction of alveolar septa, airway instability (disruption of alveolar walls) |
| emphysema and chronic bronchitis lead to | airway obstruction, air trapping, dyspnea, frequent infections |
| airway obstruction, air trapping, dyspnea, frequent infections leads to | abnormal ventilation-perfusion ratio (high CO2, low O2) hypoxemia, hypoventilation, cor pulmonale |
| chronic bronchitis originated by | inflammation in bronchiole |
| chronic bronchitis is fixed airway obstruction caused by | scarring that thickens basement membrane, increase number and size of mucus glands, loss of support for small airways |
| chronic bronchitis is the | persistent, inflammation induced narrowing of airways |
| symptoms of chronic bronchitis | copious mucus production, chronic productive cough |
| chronic bronchitis blocks air from | going in and out of alveoli, so CO2 is increasing |
| emphysema | damage to lung parenchyma (walls of alveoli), destruction of gas-exchanging pulmonary-surfaces (alveoli), pulmonary hyperinflation (decreased areas where gas can be exchanged) |
| causes of emphysema | cigarette smoking, dont know why but air pollution is also a cause |
| classifications of emphysema | centriacinar and panacinar |
| centriacinar emphysema | loss of elastic tissue on the bronchioles, bronchioles remain in normal structure but lost function to expand so can't inhale and exhale |
| panacinar emphysema | more severe, loss of elastic tissue on the bronchioles and alveoli |
| pulmonary acini | functional units where gas exchange occurs |
| CMs of COPD | depends on whether symptoms of chronic bronchitis or emphysema are dominant |
| CMs of chronic bronchitis | productive cough for three months in 2 consecutive years, progressively worsening dyspnea with SOB and dyspnea on exertion (DOE), hemoptysis (lack of blood O2) |
| CMs of emphysema | increased DOE, barrel chest, respiratory muscles reduction of strength, hypoxemia, foot and ankle swelling |
| CMs of advanced COPD | reduced capacity for gas exchange, deterioration of pulmonary function |
| physical changes with hyperinflation | destruction of alveoli so the capacity of E is decreased significantly |
| diagnosis of COPD | spirometry, body plethysmography, x-ray |
| treatment of COPD | assessment and monitoring, reducing risk factors, managing stable COPD, managing acute exacerbations |
| real treatment of COPD | no real treatment, just monitoring symptoms and manage factors like not smoking, etc. |
| what does cystic fibrosis affect | respiratory system and other organs |
| CF is the most common | lethal genetic disorder |
| CF is the reabsorption of | sodium inhibited in skin, sodium enhanced in epithelial exocrine cells |
| lifelong morbidity of CF | 2-5% of caucasians carry the gene uncommon in blacks and asians |
| pathophysiology of CF | recessive genetic disorder, affects epithelial transport of fluids |
| gene mutations in CF leads to | production of unusually thick and sticky mucus that can clog ducts and airways |
| reproductive system with CF | makes pt sterile |
| liver/pancreas with CF | digestive problems that can be treated with meds |
| CMs of CF | thick pulmonary secretions, frequent respiratory infections (more prone), chronic cough, abdominal distention, large/fatty/foul smelling stool since there are problems with digestive system |
| diagnosis of CF | skin sweat test - sweat is very high in sodium! |
| treatment of CF | abx for secondary infections, vitamin supplements to overcome lack of digestive enzymes due to pancreas problems, pancreatic digestive enzyme replacement |
Created by:
leh195