Advanced Patho EXAM 2
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What is the first and second process of respiration? | 1st=alveolar respiration
2nd=perfusion
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Describe ventilation. | Air into lungs/exchange of gases
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Why does perfusion have to occur? | has to occur for oxygen to get to tissues and into blood
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What is a pulmonary emboli (PE)? | Undissolved detached material that occludes blood vessels of the pulmonary vasculature
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Most PEs originate from? | DVTs or from the deep veins of the lower extremities
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What are other types of PEs, other than DVTs? | fat, air, amniotic fluid, CA (tumor), foreign material
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What are risk factors for PEs? | sepsis, parasitic, immobility, pregnancy, trauma, heart failure, estrogen use; and virchows triad
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What is virchow's triad? | hyperocaguability
venous stasis/sluggish blood flow
damage to venous wall
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What is COPD? | chronic and recurrent obstruction of airflow of the pulmonary airways that cause a mismatch of ventilation and perfusion
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What is the major cause of COPD? | cigarette smoking
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COPD consists of what two disease/illness? | emphysema and chronic bronchitis
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What are the s/s of emphysema? | progressive exertional dyspnea, SOB, accessory muscles, pursed lip breathing, cough, may hunch forward to breathe better, prolonged expiration, barrel chest
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What causes chronic bronchitis? | repeated infections, genetic predisposition, inhalation of irritants
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What are the s/s of chronic bronchitis? | usually overweight, SOB with exertion, excess sputum, edema, smoking HX, chills, aches, fatigue, cough, increased sputum production in a.m.
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How does heart disease affect the lungs? | Right or left sided heart failure can lead to pulmonary congestion and impaired gas exchange
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How does lung disease affect the heart? | due to poor gas exchange, lung disease can lead to hypoxia which causes vasoconstriction of pulmonary vessels, which elevates pulm artery pressure & increases workload on R ventricle
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Most common pneumonia is caused by what? | strep pneumoniae
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How does pneumonia enter the system (3 ways/sources)? | (1) aspiration of oropharyngeal secretions, (2) inhalation of contaminants (virus), or (3) contamination from the systemic circulation
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How does pneumonia affect breathing? | There is inflammation of the alveoli and bronchioles which impairs gas exchange
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In the oxyhemoglobin dissociation curve, what causes a shift to the left? | hypothermia, alkalosis, decreased PaCO2
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In the oxyhemoglobin dissociation curve, what causes a shift to the right? | hyperthermia,anemia, decreased cardiac output
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How do chemoreceptors work to protect the body? | they are defense mechanisms
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Where are the central chemoreceptors located? | in the medullary center
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What do chemoreceptors respond to? | Changes in pH, CO2 and O2 levels
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Describe Obstructive Pulmonary Disorders. | characterized by airway obstruction and limitation in expiratory flow
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List the types of Obstructive Pulmonary Disorders. | Asthma,Acute and Chronic bronchitis, or Emphysema
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Describe Restrictive Pulmonary Disorders. | Result from inflammatory conditions that affect lung structures and produce lung fibrosis and a stiff lung
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List the types of Restrictive Pulmonary Disorders. | ARDS,Infant Acute Respiratory Distress Syndrome, Pneumothorax, Pneumonia
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What is tidal volume (TV)? | the volume of air inspired (or exhaled) with each breath; usually about 500mL in avg adult
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What is FEV1? | the forced expiratory volume that can be exhaled in 1 second
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What is residual volume? | air left after max exhale
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What is ventilation-perfusion? | the matching of adequate volume of air in the alveoli to adequate pulmonary blood flow
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What are two important substances that help the alveoli function correctly? | Surfactant and alpha1 antitrypsin
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What is a nl Va/Q? | 4/5
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What does a high Va/Q? indicate? | means they are hyperventilated, alveolar ventilation not perfused, ↓ PCO2, NL PaO2
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What does a low Va/Q indicate? | it means they are underventilated, ↓ PaO2 (hypoxia)
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What is infant respiratory distress syndrome (aka hyaline membrane disease) | a lack of surfactant leading to increased alveolar surface tension and decreased lung compliance
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How can infant respiratory distress syndrome be fatal? | the infant can die from exhaustion
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At what pregnancy week is surfactant produced in greater qualities? | after week 32
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