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Patho.4Book
| Question | Answer |
|---|---|
| The pulmonary system consists of what 4 parts | Lungs, airways, chest wall, pulmonary circulation |
| The pulmonary primary function | The exchange of gases between the environmental air and the blood |
| The movement of air into and out of the lungs | ventilation |
| the movement of gases between air spaces in the lungs and the bloodstream | diffusion |
| the movement of blood into and out of the capillary beds of the lungs to body organs and tissues | perfusion |
| ventilation and diffusion are carried out by what system | Pulmonary |
| perfusion is carried out by what system | cardiovascular system |
| Name the lobes of the right lung | upper, middle, and lower |
| Name the lobes of the left lung | upper, lower |
| The space between the lungs which contains the heart, great vessels, and esophagus is called what? | mediastinum |
| What are the conducting airways that deliver air to to each section of the lungs | bronchi |
| The upper airway consists of what? | nosopharynx, oropharynx |
| what about mouth breathing is less efficient? | Filtering and humidifying the air |
| What connects the upper and lower airways and consists of the of the endolarynx and its surrounding triangular-shaped bony and cartilaginous structures? | larynx |
| What encompasses the false vocal cords and the true vocal cords | endolarynx |
| What is the space above the false vocal cords called? | vestibule |
| What 3 large cartilages form the laryngeal box | Epiglottis, thyroid, cricoid |
| What 3 small cartilages form the the laryngeal box | arytenoid, coniculate, cuneiform |
| What function do the cartilages of the larynx serve | prevent collapse of the larynx during inspiration and swallowing |
| The internal laryngeal muscles serve what purpose | control vocal cord length and tension |
| The external laryngeal muscles serve what purpose | move the larynx as a whole |
| What do both sets of laryngeal muscles take part in? | swallowing, ventilation, vocalization |
| The trachea connects what two structures | larynx to the bronchi |
| Irritant receptors in the trachea and large airways trigger what response | cough |
| Irritant receptors in the nares or nostrils trigger what response | sneeze |
| single-celled exocrine glands in the epithelial lining of the bronchi contain what mucus-secreting cells | goblet cells |
| The 3 parts that participate in gas exchange and make up the terminal end of the conducting airways | respiratory bronchioles, alveolar ducts, and alveoli |
| The primary gas exchange units of the lung | alveoli |
| Type I alveoli cells serve what purpose? | structure |
| Type II alveoli cells serve what purpose? | secrete surfactant |
| surfactant serves what purpose | lowers alveolar surface tension preventing lung collapse |
| What are the names of the cells specific to the lungs that ingest foreign material that reach the alveolus. They also prepare it for removal through the lymphatics | Alveolar macrophages |
| Plmonary circulation facilitates what? | gas exchange, delivers nutrients to lung tissues, acts as a reservoir for the left |
| The shared alveolar and capillary walls compose what? | alveolocapillary membrane |
| Gas exchange happens where? | alveolocapillary membrane |
| true or false - pulmonary veins have no valves | true |
| This circulation is a part of systemic circulation and supplies nutrients to the conduction airways, large pulmonary vessels, and membranes (pleurae) that surround the lungs. | bronchial circulation |
| true or false - bronchial circulation participates in gas exchange | false |
| What circulation helps warm and moisten the air in the bronchiols | bronchial circulation |
| The chest wall consists of what 3 structures | skin, ribs, intercostal muscles |
| pleura are what kind of membrane | serous |
| The membrane covering the lungs is called what | visceral pleura |
| The membrane lining the chest cavity is called what | parietal pleura |
| The area between the parietal and visceral pleura is called what | pleural space or pleural cavity |
| pressure in the pleural space is usually what? | negative (-4 to -10 Hg). |
| Disease that limit ventilation result in ______ retention | CO2 |
| The part of the brain stem that controls respiration by transmitting impulses to the respiratory muscles | respiratory center |
| The respiratory center is composed of what groups of neurons | The Dorsal respiratory group (DRG),ventral respiratory group (VRG), the pneumotaxic center, and the apneustic center |
| Basic automatic rhythm of respiration is set by what part of the repiratory center | DRG |
| The DRG receives afferent input from peripheral chemoreceptors where | aortic and carotid bodies and from several different types of receptors in the lungs |
| This part of the respiratory center remains nearly inactive until increased ventilatory effort is needed | VRG |
| The pneumotaxic and apneustic center do what | act as modifiers of the rhythm of ventilation |
| These receptors are found in the epithelium of all conducting airways. They are sensitive to noxious aerosols, gases, and particulate matter. When stimulated, cough results. | Irritant receptors |
| These receptors are located in the smooth muscles of the airways and are sensitive to increases in the size or volume of the lungs. They decrease ventilatory rate and volume when stimulated. | stretch receptors |
| These receptors are located near the capillaries in the alveolar septa and are sensitive to increased pulmonary capillary pressure, which stimulates them to initiate rapid, shallow breathing , hypotension, and bradycardia | J-receptors |
| The parasympathetic receptors cause smooth muscle to do what? | contract |
| The sympathetic receptors cause smooth muscle to do what? | relax |
| The main controller of airway caliber under normal conditions is what? | The parasympathetic division of the ANS (Autonomic nervous system) |
| These monitor the pH, PaCO2, and PaO2 of arterial blood | Chemoreceptors |
| These monitor arterial blood indirectly by sensing changes in the pH of cerebrospinal fluid | Central chemoreceptors |
| Central chemoreceptors are sensitive to ___________ concentration in the CSF | hydrogen ion |
| The major muscles of inspiration are what muscles | diaphragm and external intercostal muscles |
| Contraction of the diaphragm causes what | inspiration |
| What major muscles are needed for expiration | none - expiration happens primarily by relaxation of muscles needed for inspiration |
| The tendency for liquid molecules that are exposed to air to adhere to one another is called what | surface tension |
| The tendency of the lungs to return to the resting state after inspiration is what? | elastic recoil |
| One half to two thirds of total airway resistance occurs where | nose |
| muscular effort for inspiration has what relationship to compliance | inverse |
| The greatest volume of pulmonary blood flow normally will occur in what part of the lung | gravity-dependent areas |
| Oxygen is transported in the blood in what two forms? | A small mount dissolves in the plasma, and the remainder binds to hemoglobin molecules |
| When hemoglobin molecules bind with oxygen, what forms | oxyhemoglobin |
| An oxyhemoglobin dissociation curve is shifted to the right by what? | low pH and increased PaCO2; Hyperthermia |
| An oxyhemoglobin dissociation curve is shifted to the left by what? | high pH and decreased PaCO2; Hypothermia |
| The shift in the oxyhemoglobin curve by levels of CO2 or O2 is called what? | Bohr Effect |
| The most important cause of pulmonary artery constriction is what | low alveolar PO2 |
| Uncomfortable breathing, or the feeling of being unable to get enough air | Dyspnea |
| difficulty breathing while laying down | orthopnea |
| normal breathing | eupnea |
| normal tidal volume | 400 - 800 ml |
| normal ventilation rate | 8-16/minute |
| increased ventilatory rate | hyperpnea |
| alternating periods of deep and shallow breathing | Cheyne-Stokes respirations |
| inadequate alveolar ventilation | Hypoventilation |
| increased blood CO2 levels | hypercapnia |
| alveolar ventilation exceeding metabolic demands | hyperventilation |
| decreased blood CO2 levels | hypocapnia |
| Central cyanosis (decreased oxygen saturation of hemoglobin in arterial blood) is best seen where | buccal mucous membranes and lips |
| Peripheral cyanosis (slow blood circulation in fingers and toes) is best seen where | nail beds |
| The selective bulbous enlargement of the end of a digit finger or toe | clubbing |
| Chronic cough is defined as what | one that has persisted for more than 3 weeks |
| Coughing up of blood or bloody secretions | hemoptysis |
| Reduced oxygenation of arterial blood | Hypoxemia |
| Reduced oxygenation of cells in tissues | Hypoxia |
| The amount of oxygen in alveoli | PAO2 |
| As acidity increases, what happens to the pH | decreases |
| The more basic the solution the _______ the pH | higher |
| The threshold between basic and acidic in the body is what value? | 7.4 |
| Body acids that are eliminated as a gas through breathing are called _________ | volatile |
| Body acids that are eliminated through the kidneys and ultimately urine are called __________ | nonvolatile |
| A substance that makes an acid more basic or a base more acidic is known as what? | buffer |
| The most important plasma buffer systems are what? | carbonic acid-bicarbonate and the protein hemoglobin |
| The most important intracellular buffers are what? | Phosphate and protein |
| The carbonic acid-bicarbonate buffer pair operates in what major organs | lungs and the kidneys. (also a major extracellular buffer) |
| Normal bicarbonate level is what? | 24 mEq/L |
| Normal carbonic acid level is what | about 1.2 mEq/L |
| The respiratory system compensates for changes in pH by doing what? | changing ventilation |
| The renal system compensates for changes in pH by doing what? | Producing more acidic or more alkaline urine |
| When a buffer neutralizes an acid or base, this is called what? | correction |
| Proteins are primarily what kind of buffer? | Intracellular |
| In acidemia, the pH of arterial blood is less than what value? | 7.4 |
| A systemic increase in hydrogen ion concentration is what? | acidosis |
| What term is used when the pH of arterial blood is greater than 7.4? | alkalemia |
| A systemic decrease in hydrogen ion concentration is termed ________ | alkalosis |
| When noncarbonic acids increase or bicarbonate is lost from extracellular fluid | metabolic acidosis |
| bicarbonate is a buffer for acids or bases | acids |
| Renal and respiratory adjustments to changes in pH are known as ________ | compensation |
| Early symptoms of metabolic acidosis include what? | lethargy, headache (which will progress to coma when severe) |
| The respiratory system will attempt to "blow off" carbon dioxide to compensate in metabolic acidosis. What is this kind of breathing called? | Kussmaul respirations |
| What is characteristic of Kussmaul respirations? | Slightly increased ventilatory rate, very large tidal volumes, and no expiratory pause |
| This happens when excessive loss of metabolic acids occurs and bicarbonate increases | metabolic alkalosis |
| CO2 makes the fluids more _________ | acidic |
| Common signs of alkalosis | weakness, muscle cramps, hyperactive reflexes, tetany, shallow and slow respirations, confusion, convulsions, and atrial tachycardia |
| increased CO2 in the blood does what | makes more acidic |
| Excessive loss of metabolic acids, bicarbonate increases | metabolic alkalosis |
| bicarbonate abbreviation | HCO3 |
| bicarbonate increases does what to the blood/body tissues | less acidic/more alakaline |
| A decrease in alveolar ventilation in relation to the metabolic production of carbon dioxide produces what affect | respiratory acidosis |
| Renal compensation for acidosis in general | elimination of H+ and retention of bicarbonate |
| Renal compensation for alkaline blood/tissues | retain H+ and no reabsorbing of bicarbonate |
| Disruption by disorders that occlude the vessels, increase pulmonary vascular resistance, or destroy the vascular bed are called what | Pulmonary vascular diseases |
| Occlusion of a portion of the pulmonary vascular bed by an embolus, which can be a thrombus, tissue fragment, lipids, foreign body, or an air bubble is called what | pulmonary embolism |
| 90% of pulmonary emboli result from what? | clots formed in the veins of the legs and pelvis |
| Most susceptible to pulmonary emboli | elderly and hospitalized |
| An embolus that occludes a major portion of the pulmonary circulation | Massive occlusion |
| An embolus that is large enough to cause infarction (death of a portion of lung tissue | Embolus with infarction |
| an embolus that is not severe enough to cause permanent lung injury | Embolus without infarction |
| Emboli that may be chronic or recurrent | Multiple pulmonary emboli |
| S/S of pulmonary embolism | sudden sharp chest pain, dyspnea, tachypnea, tachycardia, and unexplained anxiety |
| Symptoms of massive pulmonary occlusion | hypertension and shock |
| Pulmonary hypertension is defined as what? | mean pulmonary artery pressure 5-10 mm Hg above normal (20 mm Hg) |
| idiopathic form of hypertension and is characterized by pathologic changes in precapillary pulmonary arteries | Primary Pulmonary Hypertension (PPH) |
| This form of pulmonary hypertension results from diseases of the respiratory system that cause hypoxemia and are characterized by pulmonary arteriolar vasoconstriction and arterial remodeling | Secondary Pulmonary Hypertension |
| Right heart failure | cor pulmonale |
| What solid signs are there of pulmonary hypertension | none - signs are usually not present until problem becomes quite severe |
| right ventricular enlargement and failure | cor pulmonale |
| Restrictive lung diseases are characterized by what? | Decreased Compliance, Increased Work. Increased respiratory rate, decreased tidal volume |
| Excessive amount of fibrous or connective tissue in the lung | pulmonary fibrosis |
| Most common form of pulmonary fibrosis is caused by what | Idiopathic - no known cause |
| Prolonged exposure to high concentrations of oxygen can result in this | oxygen toxicity |
| Any change in the lung caused by inhalation of inorganic dust particles | Pneumoconiosis |
| Prolonged pneumoconiosis causes what affect? | Pulmonary fibrosis |
| Inhalation of organic dusts resulting in an allergic inflammatory response | extrinsic allergic alveolitis or hypersensitivity pneumonitis |
| This condition is characterized by acute lung inflammation and diffuse alveolocapillary injury | Acute respiratory distress syndrome |
| Obstructive lung disease is characterized by what | airway obstruction that is worse with expiration |
| Examples of obstructive lung disease | Asthma, chronic bronchitis, and emphysema |
| Chronic bronchitis and emphysema combined form what disease | chronic obstructive pulmonary disease |
| Unifying symptom of obstructive lung disease | dyspnea |
| Unifying sign of obstructive lung disease | wheezing |
| Asthma is most prominent at what times | night or in the early morning |
| true or false - Asthma is a familial disorder | true - over 20 genes have been identified that may play a major role |
| What is PaCO2 | Partial pressure of Carbon dioxide: This is the partial pressure of carbon dioxide in arterial blood measured in millimetres of mercury (mmHg) or kilopascals (kPa). |
| This syndrom includes the pathologic lung changes consistent with emphysema or chronic bronchitis | Chronic obstructive pulmonary disease (COPD) |
| Hypersecretion of mucous and chronic productive cough for at lease 3 months of the year for at least 2 consecutive years | Chronic Bronchitis |
| This disease is an abnormal permanent enlargement of gas-exchange airways accompanied by destruction of alveolar walls without obvious fibrosis | Emphysema |
| Emphysema that is commonly linked to an inherited deficiency of enzymes is called what | Primary emphysema |
| Emphysema begins with the destruction of what | alveolar septa |
| This kind of emphysema ends in septal destruction which occurs in the respiratory bronchiles and alveolar ducts, causing inflammation in bronchioles. Alveolar sac is intact. This tends to happen in people that smoke and poeple with chronic bronchitis | Centriacinar emphysema |
| This kind of emphysema involves the entire acinus, with damage more randomly distributed and involving lower lobes of the lung. Happens with the elderly and those lacking essential enzymes | Panacinar emphysema |
| The most common cause of short-term disability in the US | respiratory tract infections |
| Infection of the lower respiratory tract and caused by bacteria, viruses, fungi, etc | Pneumonia |
| The most common viral community-acquired pneumonia in adults | influenza |
| This kind of pneumonia is caused by S. pneumonia which initiates the inflammatory response, and inflammatory exudate causes alveolar edema | Pneumococcal pneumonia |
| infection or inflammation of the airways or bronchi and usually self-limiting. Majority caused by viruses | Acute Bronchitis |
| Chest radiographs show what in a person with Acute Bronchitis | no infiltrates (unlike pneumonia) |
| A circumscribed area of suppuration and destruction of lung parenchyma | abscess |
| Reduced oxygenation of arterial blood | Hypoxemia |
| Increased CO2 in the arterial blood | Hypercapnia |
| Hypercapnia is caused by what? | Hypoventilation |
| An area where alveoli are ventilated but not perfused is called what? | alveolar dead space |
| Excess water in the lungs | Pulmonary Edema |
| Most common cause of pulmonary edema | heart disease |
| Capillary injury that increases capillary permeablility in the lungs can result in what? | pulmonary edema |
| Obstruction of they lymphatic system can result in what? | pulmonary edema |
| The passage of fluid and solid particles into the lung | Aspiration |
| The presence of air or gas in the pleural space caused by a rupture in the visceral pleura or the parietal pleura and chest wall | Pneumothorax |
| Spontaneous pneumothorax is caused by what | spontaneous rupture of blebs on the visceral pleura |
| the presence of fluid in the pleural space | Pleural Effusion |
| mathmatical equation for minute volume | RR X tidal volume |
| FIO2 of air at sea level | 21% |
| What is going to be needed for anybody with pulmonary edema | oxygen supplementation |
| The collapse of lung tissue | Atelectasis |
| This type of atelectasis is caused by external pressure exerted by tumor, fluid, or air in the pleural space | Compression atelectasis |
| This kind of atelectasis results from removal of air from obstructed or hypoventilated alveoli or from inhalation of concentrated oxygen or anesthetic agents | Absorption atelectasis |
| Persistent abnormal dilation of the bronchi | Bronchiectasis |
| Bronchiectasis is often caused by what? | Bronchial infection |
| Inflammatory obsrtruction of the small airways or bronchioles, occuring most commonly in children, is called what | Bronchiolitis |
| Bronchiolitis that leads fibrotic processes that occlude airways and causes permanent scarring of the lungs is called what | Bronchiolitis obliterans |
| watery fluid from intact blood vessels | transudative fluid |
| fluid with high concentrations of white blood cells and plasma proteins | exudative fluid |
| infected pleural effusion where the presence of pus can be found in the pleural space | Empyema |
| An autosomal recessive inherited disease that results from defective epithelial chloride ion transport. Multiorgan disease, but its most important effects are on the lungs and respiratory failure | Cystic Fibrosis |
| typical features of CF lung disease are what | mucus plugging, chronic inflammation, and chronic infection |
| These two bacterias tend to colonize in airways of more than 75% of children with CF | Pseudomonas Aeruginosa, and Staphylococcus Aureus |
| The majority of cases of CF are diagnosed before what age | 1 year old |
| What is the cause of sudden infant death syndrom (SIDS) | no known cause |
| SIDS is most common in what gender | male (60%) |
| What sleeping position is most associated with SIDS | prone |
| The most common site of lip cancer | lower lip |
| Most common cell type associated with lip cancer | squamous cell carcinoma |
| Lung cancers arise from where | the epithelium of the respiratory tract (therefore, lung cancer excludes all other pulmonary tumors, etc). |
| The most common cause of lung cancer | smoking |
| The two major categories of lung cancer | non-small cell carcinoma and small cell carcinoma |
| The three forms of non-small cell carcinoma are what? | Squamous cell carcinoma, Adenocarcinoma, Large cell carcinoma |
| This cancer has the strongest correlation with cigarette smoking | small cell lung cancer |
| The current accepted system for the staging of non-small cell cancer is what? | TNM classification |
| Which side of the lung is more susceptible to aspiration | right side - because of the branching angle of the right main stem bronchus is straighter than the left side |
| Carbon dioxide is transported in the blood primarily how | bicarbonate ions |
| These conditions contribute to gasping respirations that consist of irregular, quick inspirations with an expiratory pause | shock and severe cerebral hypoxia |
| Small tidal volumes, rapid ventilatory rate (tachypnea), and rapid expiration are characteristic of what? | Restricted breathing - disorders like pulmonary fibrosis |
| A rapid ventilatory rate, small tidal volumes, increased effor, and prolonged expiration are indicative of what? | labored breathing - asthma, chronic obstructive pulmonary disease |
| Normal pCO2 (partial pressure of carbon dioxide) levels | 35-45mmHg |
| Normal pH levels | 7.35 - 7.45 |
| Normal HCO3 (Carbonic acid) levels | 22-26 mEq/L |
| Normal PO2 (partial pressure of oxygen) levels | 80 - 100 mmHg |
| The cause of intrinsic asthma is what | unknown - Characterized by absence of clearly defined precipitating factors (may be common cold, exercise, or emotional) |
Created by:
mwillis
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