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Respiratory.System.
Pathophysiology
| Question | Answer |
|---|---|
| Spinal fluid et ABG blood draw in r/t CO2 | same level of CO2 seen in both |
| CO2 receptor sites can be found here | chemoreceptors in the medulla |
| The chemoreceptors recognize that there is too much CO2, so it tells the body to respond how? | breathe faster |
| large amts of CO2 stimulate the ___ ___ to increase RR to help blow off the extra CO2 | inspiratory muscles |
| Blow off extra CO2, so the acidity decreases leading to ____ ____ | decreased acidity |
| When there isn't enought CO2 in the body, the chemoreceptors recognizes this et then _____ RR | increases |
| Obstructions/Respiratory disorder affect the chemoreceptors how? | chemoreceptors get overidden by CO2 et shut down et stop working |
| measures volume et air flow | spirometry |
| oxygen saturation measured by this | pulse oximeter |
| ABGs | |
| how quickly a patient can recover from exercise, respiratorily...peak flow test prior to exercise et peak flow after exercise | exercise intolerance test |
| bronchioles will ____ after exercise if somebody has pulmonary disease | constrict |
| Top amount of exhalation you can release; measures amt of air we have | peak flow |
| identify infection/tumor | x-rays |
| performed for people who are at a high risk for cancer of bronchioles/laryngeal | bronchoscopy |
| examines bronchus, bronchiole tree, bronchioles | bronchoscopy |
| pulmonary diagnostic tests | spirometry, pulse ox, exercise intolerance test, ABGs, x-raus |
| sputum culture taken, test what microorganism there is, test antibiotics to see if it goes away, come back for another test in 24-48 hours to see what antibiotic worked the best to treat bacteria/virus | culture sensitivity test |
| yellow-green sputum; evidence that cold has turned from viral to bacterial caused by stasis of mucous | bacterial infection |
| rusty dark sputum; actual damage that is causing bleeding into aveoli | pneumococcal pneumonia |
| large amounts of sputum, purulent sputum with a very foul odor from bronchiectasis; up to 8 oz (1 cup) of purulent sputum possible every 2 hrs | COPD |
| chronically inflammed bronchiole tree; completely damage muscle that leads to no extra push to get extra exhalation out causing a copious amt of sputum | brochiectasis |
| thick, tenacious sputum that is hard to discard | asthma |
| thin, pink-tinged, frothy sputum | pulmonary edema |
| bright red blood, frothy sputum, usually associated c pulmonary edema | hemoptosis |
| non-labored, normal rate RR | eupnea |
| deep, rapid respiration, typical of acidosis (trying to push excess of CO2); type of breathing we have after exercise et happens c people at the end stage of life | Kussmaul's respiration |
| labored respirations, prolonged inspiration or expiration, if having obstruction, wheezing or whistling sounds | chart what you've heard |
| wheezing, whistling sounds that are minor being heard on inspiration or expiration (more often on expiration) | respiration |
| airway constriction during both inspiration et expiration; sounds like a snoring sound in et out; kids have this when having an asthma attack | stridor |
| end of life breathing pattern, breath really fast, gurgling et pause of apnea | Cheynne-Stokes respiration |
| in infants, apnea spells are normal because their medulla is not quite ready to regulate rhythm of breathing; normal amt of time for infant is ___ | 20 seconds |
| crackling sound heard in lungs | rails/crackles |
| deep harsher sounds | bronchi breathing |
| "death rattle"; deep gurggling noises | deep bronchi breathing |
| no aeration; collapsed lung or some obstruction | absence of breath |
| uncomfortable breathing | dyspnea |
| occurs especially with patients with breathing problems, at high risk for undiagnosed pneumonia, when laying down>the excess fluid in lungs make it hard to lay down; COPD use a tripod stance | orthopnea |
| waking up gasping for air at night | proximal nocturnal dyspnea |
| blue color in extermities | peripheral cyanosis |
| lips turn blue, bruising on the face (check the mucous membrane if unsure if it is a bruise or central cyanosis), gums are blue (found around the heart) | central cyanosis |
| obstruction or asthma attack causes this type of cyanosis | central |
| results from some kind of inflammation that has started, because the pleural space around the lungs has inflammation in the parietal lining | pleural pain |
| can occur from lots of coughing from respiratory infection/virus; coughing makes lungs go in et out really fast causing parietal lining to rub up against each other making inflammation (thousands of nerve endings in parietal lining cause immense pain) | pleurisy (self-limiting) |
| high tendency for tendonitis have a higher risk for getting ____ when having respiratory infection | pleurisy |
| would hear c pleurisy or expanded cancer/tumor in pleural lining; sounds like two rubberbands rubbing together (squeaky) | friction rub |
| normal finding with COPD patients | clubbed digits |
| inadequate oxgyen in the blood | hypoxemia |
| increased carbon dioxide in the blood | hypercapnia/hypercarbia |
| no medications to take away the flu, but these are given to help decrease the affects but rarely do much | anti-viral |
| most normal flu types | A et B |
| rarest flu type | influenza C |
| influenza viruses can change their viral form; | mutation |
| sudden; acute onset, fever, marked fatigue, ACHING of the BODY | influenza viral infection |
| may turn into pneumonia due the damage it is causing on the respiratory system; the pneumonia would then be bacterial et secondary | influenza |
| mild cases can get complicated by secondary bacterial pneumonia; compromised from stress, etc can cause increased complications | influenza |
| viral infection more commonly affects teens et healthy young adults; stress played a major role in vulnerability; high MORTALITY rate because it attacks so harshly to the respiratory tract going into pulmonary edema, pneumonia>leading to ICU/ventilator | H1N1 |
| damage to healthy mucosa>inflammation>swelling>decreases poor airflow from decreased lumen circumference>increased buildup of mucous | cavitation forms |
| every time a child got his ear infection, it would go straight to his lungs; purulent drainage in ear; sinuses can also cause pneumonia from sinus draining into lungs | bacterial pneumonia |
| normal resident flora can cause problems in the respiratory tract et lead to ___ ___ due to sinus drainage/ear infections | bacterial pneumonia |
| in respiratory tract the bacteria invade, necrotic tissue forms, inflammtion occurs leading to ___ ___ | purulent drainage |
| different ways to acquire: viral, bacterial, or fungal; causes cavitation, necrosis, damage, purulent damage, et inflammation no matter the source | pneumonias |
| when naming the pneumonia...dependent on ___ | location of pneumonia |
| with pneumonia, these can fill up with fluid/purulent drainage causing septa to break creating one big blob>decreasing air being pushed out | alveoli |
| deep breathing exercises need to occur to make sure that fluid/sputum is not remaining in stasis otherwise this can occur | nosocomial pneumonia |
| attached to bacterial pneumonia the most, can happen in anyone, no specific reason why acquired, Streptococcus pneumoniae, localizes in lobe | lobar pneumonia |
| vascular congestion that forms excessive amts of exudate; contains fibron et consolidates into mass in lobe>non-functional lung tissue | bacteria in lobar pneumonia |
| purulent drainage gets so excessive, pushes out of lung spaces into pleural space creating infection/inflammation | empyema |
| normal fluid around lungs becomes infected mass; once in parietal area, it become sticky>lungs begin to stick to parietal linging; pain et decreased ability to breathe in et out | empyema |
| sudden onset (very virilant), systemic signs of high fever, fatigue, increased leukocytosis, rails, pleural pain,tachypnea, bradypnea, productive COUGH c dark, rust, bloody sputum, disorientation/confusion | manifestations of bacterial pneumonia |
| see infection come down bronchus, into bronchiole tree, out into bronchioles into alveoli (where infection sets up) | bronchopneumonia |
| definite spots show up on xray of consolidation of aveoli | broncho pneumonia |
| yellow sputum, that is productive | broncho pneumonia |
| legionella/legioneres disease; once it starts its path, it moves quickly; difficult to identify but treated with anti-fungal agent et antibiotic; can be FATAL | fungal pneumonia |
| hot tub harbored fungal growth causing this disease | legionaires disease |
| pneumonia is easy to kill | fungal pneumonia |
| bacteria causes this type of atypical pneumonia>does not stay in aveoli (around)>pushes out into interstitial tissue (caused by viral influenza, RSV in babies) | primary atypical pneumonia |
| bronchopneumonia; bacterial, diffused so attacking lots of aveoli areas of lungs | broncho pneumonia |
| this side of the lungs has more issues with infection/pneumonia | right side |
| fills whole lobe (centralized lobe, middle lobe, or base) | lobar pneumonia |
| in active form it is easy to acquire, droplet spreading, mycobacteria (asian country at high incidence | TB |
| resistant to drying, stays active for long time, resistant to disinfectant, can live in dried sputum for several weeks, UV light will kill it et some chemicals | TB |
| we don't seem to amt a normal immune response to the bacteria, in active form it can become bloodborne, it can travel to any organ in body leading to damage | TB |
| when infection first attacks body c localized inflammation with it (positive tb test can occur with this) | primary tb infection |
| destroy lining et tissue in lungs means that TB is ____; disease is contagious in this form | active |
| if we have a cell-mediated immunity response, the bacteria will go straight to the lymph nodes around the bronchial tree...forming a granuloma that encapsulates the bacteria | tubercle |
| positive TB titer test would cause an individual to have an ___; in search of walled of tubercles/granuloma | xray |
| individual resistant to immune response, will have walled off areas making the infection of TB; they can contain active bacteria within the granuloma | latent |
| stress, malnutrition, age, HIV can let granulomas break open making it active et contagious | TB |
| highly contagious in TB | cavitation |
| inhalation of bacteria into lungs>inflammatory response>no resistance TB goes straight to cavitation et damaging lung tissue>if high resistance pt will have tubercle>positive TB test=xrays to be taken looking for tubercles also called ___ ___ | Ghom complexes |
| tb titer test, chest xray, acid fast sputum test (to see if it is right kind of bacteria) sputum culture to i.d. right antibiotic needed | diagnostic tests for primary exposure TB et then active TB |
| it is becoming more et more resistant than before increasing death rates | TB is becoming resistant |
| breakdown of metabolism rate, spilling off by products which spills fluid off into lungs, usually die from excess static fluid which will lead to bacterial infection pneumonia | lung cancer |
| 90% of lung cancer can be traced back to ___ ___ | lung cancer |
| most common type of cancer that we have | bronchogenic carcinoma |
| a cancer that can also cause obstruction by blocking off throat; hoarseness is number one sympton | laryngeal cancer |
| disorientation, COUGHING, dyspnea, SOB, fatigue | symptoms of lung cancer |
| productive cough with bright red or rusty colored sputum, | lung cancers |
| lung cancer metast. to ___ et ___ | bone, brain |
| most painful cancer | bone cancer |
| constictive airway disease causes obstruction by type I sensitivity response (allergic response) | asthma |
| usually if you have asthma, et your not a smoker you almost always have a __ __; or exposure to a chemical that causes a ___ ___ | family heredity, hypersensivity reaction |
| chemicals can cause throat to constric (cleaning products, candle scents, cigarette smoke) | reactive airway reaction (form of asthma) |
| triggered by type I response, extrinsic asthma | acute reaction |
| asthma has never been around until later on in adulthood, near 30; more hereditary; hyperresponse of tissue that responds to attack; exposure to COLD, exercise induced asthma; | intrinsic asthma |
| hereditary reaction to allergens | intrinsic asthma |
| reaction outside issues/chemicals/etc | extrinsic asthma |
| pathological changes in bronchi et bronchioles; causes inflammation in mucosa leading to bronchoconstriction | total obstruction or partial obstruction |
| people with asthma can inhale well but can exhale due to bronchoconstriction; CPR will not help asthmatic; get on prednisone or high levels of anti-inflammatory | asthma |
| barking cough trying to get excess air out, wheeze on expiration, rapid et labored breathing, tachycardia, hypoxia | symptoms of asthma attack |
| alkalosis at first>retaining of air turns into acidotic response | asthma attack |
| edema of mucosa, tenacious mucous forms, lumen is closed off by mucous formed et become more constricted | asthma |
| medical emergency, in children, hypoxic very quickly, similar to antiphalactic response | status asthmaticus |
| emphysema et chronic bronchitis, asthma can fall under this as well | COPD |
| irreversible damage has taken place when diagnosed with this, lung capacity lost is lost completely | COPD |
| COPD leads to ___ ___ | pulmonary hypertension |
| lots of pressure that builds up within blood vessels/capillaries of the lungs>causing restriction of the heart to be able to pump the blood into the lungs properly | PH |
| PH then leads to ___ __ | heart failure |
| right sided heart failure caused by high pressure in lungs | cor pulmonale |
| CO2 increases>lungs are overinflated>no increase in respirations because medulla no longer responds>the only thing that drives pt to breathe is lack of O2 (inner brain stem responds to decreased oxygenation) | COPD |
| respirations slow way down/88-92 SaO2/low levels of O2/oxygenation deprivation | COPD |
| alveolar problem; become overinflated et septae break away et form a bleb | emphysema |
| only way to get acquire emphysema if no genetic insufficiency, is through ___ | smoking |
| Alpha 1 anti-tripsin | genetic emphysema |
| cigarette smoking et pathogenic bacteria | if not genetic, emphysema |
| fibrotic, rigid alveolar | increased susceptibility to infection |
| able to intake oxygen fine, but unable to exhale>diaphragm flattens out | barrel chest |
| loss of tissue, become hypercapnic, hypoxia driving force for breathing, PH, retain fluids into lungs, leading to right sided heart failure | advanced emphysema |
| diagnostic tool used to check for lesions emphysema | xray |
| work their way to outside tissues of lungs, can break open et cause leakage | blebs |
| coughing irritation throughout a year; have chronic cough lasting over three month period over a two year period (has to occur twice); inflammation in bronchioles, thick sputum, low oxygen levels; caused by smoking or environmental factor, secondhandsmoke | chronic bronchitis |
| same symptoms as emphysema but located in a different area of lungs | chronic bronchitis |
| fluid collect in alveoli et interstitial space; decreased oxygenation in alevoli | pulmonary edema |
| inflammation in the lungs et people that have low protein levels can cause this to occur | pulmonary edema |
| low albumin level, makes patient at high risk for acquiring this because protein pulls water into bloodstream | pulmonary edema |
| cough, orthopnea, crackling sounds in lungs (rails), pink frothy blood tinged fluids, excessive runny nose because fluids are being pushed out of respiratory tract | symptoms of pulmonary edema |
| life-ending event, depending on the size of obstruction et where it is deposited | pulmonary embolus |
| if occlusion occurs in main bronchiole trees | is more severe for life-ending |
| large emboli cause sudden __ | death |
| small emboli cause ___, do not usually cause death | cough |
| what percent of PE come from DVT? | 90% |
| transient pain, cough, dyspnea, bloody sputum | symptoms of PE |
| crushing tightness in chest, different than heart attack, et then sends patient into shock | PE |
| deep, gasping respirations normally associated c DKA | Kussmaul respirations |
| hypoventilation does not cause hypocapnia | true |
| What is it called when air enters pleural space and cannot escape, causing incr. intrathoracic pressure? | tension pneumothorax |
| A person has developed collapsed alveoli after surgery because of unwillingness to deep breathe. What is this called? | atelectasis |
| Marks: 1/1 What are the characteristics of TB infection if cell-mediated immunity is adequate? | postive skin test by no S |
| hallmark sign of pulmonary edema | frothy, pink sputum |
| What pulmonary disease is caused by inflammation and scar tissue forming in lungs? | pulmonary fibrosis |
| What is the best description of patho of COPD? | hyperinflation of alveoli et increased secreion of mucous |
| What is it called when consecutive ribs are fractured causing an unstable chest wall? | flail chest |
| The pathophysiologic problem with a pneumothorax is increased negative pressure. | false |
| Which of the following best describes the patho of ARDS? | fluid in the pleural space causes compression atelectasis |
| increase cap. permeability, blocked lymph vessels, increased fluid volume in lungs | cause pulmonary edema |
| What is it called when a person wakes up at night gasping for air? | PND |
Created by:
melissaaclark