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respiratory pt 4
patho exam 2
| Question | Answer |
|---|---|
| chronic bronchitis | fixed airway obstruction, persistent inflammation-induced narrowing of airways |
| What is fixed airway obstruction in chronic bronchitis caused by? | scarring that thickens basement membranes, increased number and size of mucus glands, loss of support for small airways |
| chronic bronchitis symptoms | copious mucus production, chronic productive cough |
| biggest problem with chronic bronchitis | CO2 accumulates and there are no mechanisms to get rid of it |
| emphysema | damage to lung parenchyma, destruction of gas-exchanging pulmonary surfaces, pulmonary hyperinflation |
| emphysema primary cause | cigarette smoking |
| emphysema classifications | centriacinar emphysema, panacinar emphysema |
| centriacinar emphysema | loss of elastic tissue on the bronchioles |
| panacinar emphysema | loss of elastic tissue on the bronchioles and alveoli |
| pulmonary acini | functional units of lungs where gas exchange occurs |
| what do COPD clinical manifestations depend on | whether symptoms of chronic bronchitis or emphysema are dominant |
| chronic bronchitis clinical manifestations | productive cough for three months consecutively for two consecutive years, progressively worsening dyspnea with SOB and dyspnea on exertion, hemoptysis |
| emphysema clinical manifestations | increased dyspnea on exertion, barrel chest, respiratory muscles reduction of strength, hypoxemia, foot and ankle swelling |
| unique characteristic of COPD | barrel chest |
| advanced COPD clinical manifestations | reduced capacity for gas exchange, deterioration of pulmonary function |
| COPD diagnosis | spirometry, body plethysmography, x-ray |
| COPD treatment | assessment and monitoring, reducing risk factors, managing stable COPD, managing acute exacerbations |
| Cystic Fibrosis | most common lethal genetic disorder, lifelong morbidity |
| What makes cystic fibrosis lethal? | reabsorption of sodium inhibited in skin, reabsorption of sodium enhanced in epithelial exocrine cells |
| What percent of Caucasians carry Cystic fibrosis gene? | 2-5%, uncommon in blacks and asians |
| cystic fibrosis pathophysiology | recessive genetic disorder, affects epithelial transport of fluids |
| What do the gene mutations in CF affect? | capacity of chloride to move to cell membrane |
| What happens when the chloride channels are blocked in CF? | sodium accumulates, fluid gets sticky and affects many processes |
| CF clinical manifestations | thick pulmonary secretions, frequent respiratory infections, chronic cough, abdominal distention, large, fatty, foul smelling stools |
| CF diagnosis | skin sweat test- ppl with CF sweat high in sodium |
| CF treatment | antibiotics for secondary infections, vitamin supplements, pancreatic digestive enzyme replacement |
| What do restrictive lung disorders decrease? | volume of airflow to lungs |
| How do restrictive lung disorders decrease volume of airflow to lungs? | prevent expansion of pulmonary structures, decrease compliance of lungs or chest wall, alter breathing patterns, interfere with oxygenation, increase muscle requirements for adequate ventilation |
| What happens when restrictive lung disorders damage alveolar epithelium and capillaries? | ventilation and perfusion abnormalities, hypoxemia |
| altered breathing patterns in restrictive lung disorders | noncompliant chest wall, stiff lungs, tachypnea |
| tachypnea | rapid shallow breathing: saves energy |
| impaired oxygenation from restrictive lung disorders | oxygen gradient, diffusion distance |
| What is hypoxemia in restrictive lung disorders due to? | low ventilation-perfusion (V-Q) ratios, diffusion defects |
| effects of diffusion defects in restrictive lung disorders | greatly increases diffusion time, results in hypoxemia |
| diffusion defects in restrictive lung disorders measurement | carbon monoxide diffusing capacity (DLco) |
| What does fibrosis between alveoli do? | decreases gas exchange, reducing oxygen transferred to the bloodstream |
| What does restrictive lung disorders of pulmonary expansion include? | disorders of oxygenation and ventilation |
| What do restrictive lung disorders of pulmonary expansion result from? | conditions that limit or prevent expansion of pleura and alveoli |
| conditions that limit or prevent expansion of pleura and alveoli | neurologic injuries, neuromuscular diseases, obesity |
| neuromuscular diseases that limit or prevent expansion of pleura and alveoli | multiple sclerosis, amyotrophic lateral sclerosis, muscular dystrophy |
| aspirations | entry of secretions/foreign material into trachea and lungs |
| who is aspiration more common in? | children under 4, older adults |
| aspiration clinical manifestations | coughing or wheezing, choking |
| aspiration treatment | removal (laryngoscope or rigid bronchoscope) |
| atelectasis | collapsed lung |
| what does atelectasis cause? | relatively low ventilation in comparison to perfusion |
| atelectasis risk factors | immobility, diminished ventilation, restriction of lung volume |
| four types of atelectasis | reabsorption atelectasis, compression atelectasis, contraction atelectasis, microatelectasis |
| reabsorption atelectasis | airway obstruction |
| compression atelectasis | accumulation of air, fluid, or tumor in pleural space |
| contraction atelectasis | fibrotic changes |
| microatelectasis | alveolar collapse |
| atelectasis clinical manifestations | dyspnea, tachypnea, tachycardia, cyanosis, diminished or absent breath sounds over atelectasis |
| atelectasis treatment | focus on cause of atelectasis, vigorous pulmonary toilet |
Created by:
camrynfoster