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39 Cards in this Set

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Respiration?
Mechanical process of breathing, the exchange of air between the lungs and the external environment.
External respiration? Inhaled air contains ___% oxygen. Exhaled air contains ___% oxygen.
Exchange of air at the lungs. Oxygen is inhaled (inhaled air contains about 21% oxygen) into the air spaces (sacs) of the lungs and immediately passes into tiny capillary blood vessels surrounding the air spaces. At same time, carbon dioxide (gas produced when oxygen and food combine in cells) passes from capillary blood vessels into air spaces of the lungs to be exhaled (exhaled air contains 16% oxygen).
Internal (cellular) respiration?
Exchange of gases at the cells within organs of the body. Oxygen passes out of bloodstream into tissue cells. At same time, carbon dioxide passes from tissue cells into bloodstream to travel to the lungs for exhalation.
Pathway of air from the nose to the capillaries of the lungs?
Nose -- Nasal cavities and paranasal sinuses -- Pharynx -- Larynx -- Trachea -- Bronchi -- Bronchioles -- Alveoli -- Lung capillaries (bloodstream)
Which lung is slightly larger and is divided into three lobes? Which lung is slightly smaller and is divided into two lobes? Each lung is covered by what?
Right; Left; double-folded membrane called the pleura.
Auscultation: What is it? Performed with what? Used chiefly for what?
Listening to sounds within the body. (This procedure, performed with a stethoscope, is used chiefly for diagnosing conditions of the lungs, pleura, heart, and abdomen, as well as to determine the condition of the fetus during pregnancy.)
Percussion: What is it? Performed when?
Tapping on a surface to determine the difference in the density of the underlying structure. (Tapping over a solid organ produces a dull sound without resonance. Percussion over an air-filled structure, such as the lung, produces a resonant hollow note. When the lungs or the pleural space are filled with fluid and become more dense, as in pneumonia, resonance is replaced by dullness.)
Epistaxis: What is it? From the Greek meaning "___". Results from what?
Nosebleed. (From the Greek meaning "a dropping". It commonly results from irritation of nasal mucous membranes, trauma, vitamin K deficiency, clotting abnormalities, or hypertension.
Asthma: What is it? Associated symptoms? Etiology involves what? Triggers? Treatments? Other conditions that impede?
Chronic inflammatory disorder characterized by airway obstruction caused by edema, bronchoconstriction, and increased mucus production. (Associated symptoms of asthma are dyspnea, wheezing, and cough. Etiology can involve allergy or infection. Triggers to asthmatic attacks include exercise, strong odors, cold air, stress, allergens (dust molds, pollens, or foods) and medication (aspirin, beta-blockers). Asthma treatments are inhaled anti-inflammatory agents, bronchodilators, and trigger avoidance by patient education. Other conditions, such as GERD, sinusitis, allergic rhinitis, or medications can impede it.
Bronchiectasis: What is it? Symptoms? Treatment?
Chronic dilation of a bronchus secondary to infection in the lower lobes of the lung. (This condition is caused by chronic infection with loss of elasticity of the bronchi. Secretions puddle and do not drain normally. Symptoms are cough, fever, and expectoration of foul-smelling, purulent (pus-containing) sputum. Treatment is palliative (noncurative) and includes antibiotics, mucolytics, bronchodilators, respiratory therapy, and surgical resection.
Bronchiogenic carcinoma (lung cancer): What is it? Two general categories? Which one comprises 90% of all lung cancers? First is divided into what 2 types? Describe each. What is second category derived from? What are treatments for both categories?
Cancerous tumors arising from a bronchus. This group of malignant tumors, often associated with cigarette smoking, is the most frequent fatal malignancy. Lung cancers are divided into 2 general categories: non-small cell lung cancer and small cell lung cancer. NSCLC = 90% of lung cancers and there are 2 main types (adenocarcinoma -- derived from mucus-secreting cells -- and squamous cell carcinoma -- from lining of a bronchus). Surgery may be curative for localized cancers. When advanced, chemotherapy and radiation are options. SCLC derives from small, round to oval secretory cells in pulmonary epithelium. It grows rapidly early in its course and quickly spreads outside the lung. Treatment = surgery, radiation therapy, and chemotherapy.
Chronic bronchitis: What is it? Factors involved? Symptoms? Components of COPD?
Inflamation of the bronchi persisting over a long time. (Infection and cigarette smoking are factors. Symptoms = excessive secretion of mucus, productive cough, and obstruction of respiratory passages. Chronic bronchitis, asthma, and emphysema are all components of Chronic Obstructive Pulmonary Disease.
Atelectasis?
Incomplete expansion of alveoli; collapsed, functionless, airless lung or portion of a lung. Caused by tumor or other obstruction of the bronchus, or porr respiratory effort. (Bronchioles and alveoli resemble a collapsed balloon. Common causes are poor inspiration effort, blockage of a bronchus or smaller tube by secretions, tumor, or chest wound. Acute cases require removal of underlying cause and therapy to open airways.)
Emphysema: What is it? Causes? What is a secondary result?
Hyperinflation of air sacs with destruction of alveolar walls. (Loss f elasticity and breakdown of alveolar walls results in flow limitation. Cigarette smoking causes. As a result of destruction, pulmonary artery pressure rises and the right side of the heart must work harder to pump blood. This leads to ventricular hypertrophy and heart failure.)
Pneumoconiosis: What is it? Various forms are named how? Three examples of forms?
Abnormal condition caused by dust in the lungs, with chronic inflammation, infection, and bronchitis. (Various forms are named by type of dust that causes it: antracosis (coal dust - black lung disease), asbestosis (asbestos particles in shipbuilding and construction trades), silicosis (rocks or glass - grinder's disease)
Pneumonia: What is it? Four different types? Explain each and treatments for each.
Acute inflammation and infection of alveoli, which fill with pus or products of the inflammatory reaction. Etiological agents are pneumococci, staphylococci, and other bacteria, fungi, or viruses. Infection damages alveolar membranes so that fluid, etc. gathers in alveoli. Types: Lobar pneumonia (entire lobe) Bronchopneumonia (common in infants and elderly, patchy consolidation -- treatment is antibiotics and sometimes mechanical ventilation) Community-acquired pneumonia (from contageous respiratory infection -- treated at home with oral antibiotics) Hospital-acquired pneumonia (nosocomial) (from being hospitalized).
Pulmonary edema: What is it? What is it most commonly caused by? Acute cases require what treatment?
Swelling and fluid in the air sacs and bronchioles. (This is most commonly caused by the inability of the heart to pump blood. Blood backs up in the pulmonary blood vessels, and fluid seeps out into the alveoli and bronchioles. Acute cases require immediate attention, including drugs (diuretics, vasodilators), oxygen, and keeping patient in sitting position to decrease venous return to heart.)
Pulmonary embolism (PE): What is it? What happens to cause this? What does it cause? How is it diagnosed?
Clot (thrombus) or other material lodges in vessels of the lung. (The clot travels from distant veins, usually legs. Occlusion can produce an area of dead tissue called pulmonary infarction. PE often causes acute pain with inspiration and is associated with blood in the sputum, fever, and respiratory insufficiency. It is diagnosed by ventilation/perfusion scans that reveal areas of lung that lack perfusion. Other tests are CT scans that reveal obstruction.)
Tuberculosis (TB): What is it caused by? What body part is usually involved? What kind of organism causes it? Early TB? Symptoms of advanced TB? Treatment? What test is given to certain individuals?
Infectious disease caused by Mycobacterium tuberculosis; lungs are usually involved, but an organ in the body can be affected. (Rod-shaped bacteria called bacilli invade the lungs, producing small tubercles (swelling) of infection. Early TB is usually asymptomatic and detected in chest x-ray. Symptoms of advanced cases = cough, weight loss, night sweats, hemoptysis, and pleuritic pain. Antituberculous chemotherapy is effective in most cases. Often necessary to treat with several drugs at same time to prevent drug resistance. PPD skin test is given for most hospital or medical employees b/c it is highly contageous.)
Pleural effusion: What is it? Two types and what are both from?
Abnormal accumulation of fluid in the pleural cavity. (2 types are exudates (fluid from tumors, infections, trauma, etc.) and transudates (fluid from congestive heart failure, pulmonary embolism, or cirrhosis).)
Pleurisy (pleuritis): What is it? What does it cause?
Inflammation of the pleura (Causes pleurodynia and dyspnea and in chronic cases pleural effusion).
Pneumothorax: What is it? When may it occur? (3 times).
Collection of air in the pleural space (May occur in course of pulmonary disease when rupture of any pulmonary lesions near the pleural surface allows communication between an alveolus or bronchus and the pleural cavity. May also follow trauma and perforation of the chest wall or prolonged high-flow oxygen delivered by respirator in ICU unit.)
Bronchoscopy: What is it? How is it done?
Fiber optic or rigid endoscope inserted into the bronchial tubes for diagnosis, biopsy, or collection of specimens. (Places tube through throat, larynx, and trachea into bronchi. In bronchial alveolar lavage (bronchial washing), fluid is injected and withdrawn. In transbronchial biopsies, forceps grab tissue or brush (bronchial brushing) is inserted through bronchoscope.)
Laryngoscopy: What is it? How is it done?
Visual examination of the voice box. (Lighted, flexible endoscope is passed through the mouth or nose into the larynx.)
Mediastinoscopy: What is it? How is it done?
Endoscopic visual examination of the mediastinum. (Incision is made above the breastbone for inspection and biopsy of lymph nodes.)
Pulmonary function tests (PFTs): What is it? Used for what four reasons? They determine if lung disease is ___ or ___. Explain each and give examples of each.
Tests that measure the ventilation mechanics of the lung (airway function, lung volume, and capacity of the lungs to exchange oxygen and carbon dioxide efficiently.)
Used to: 1. Evaluate patients with shortness of breath (SOB); 2. Follow patients with known respiratory diagnoses; 3. Evaluate disability; 4. Assess lung function before surgery or chemotherapy. A spirometer measures the volume and rate of air passing in and out of lung.
They determine if lung disease is obstructive, restrictive, or both. In obstructive, airways are narrowed, resulting in resistance to decrease expiratory flow rate (FEV1). Ex's = asthma, COPD, CF, etc. In restrictive, expansion of lung is limited by disease that affects the chest wall, pleura, or lung tissue itself. Ex's = pulmonary fibrosis, radiation damage, etc. Other causes are myasthenia gravis, muscular dystrophy, and paralysis.
A patient breathes in small amount of carbon monoxide and length of time it takes the gas to enter the bloodstream is measured by DLco.
Thoracentesis: What is it? What is it for?
Surgical puncture to remove fluid from the pleural space. Fluid is used to diagnose or is taken out to drain a pleural effusion. Chest tube may be inserted for further drainage of fluid.
Thoracotomy: What is it? What is it necessary for?
Major surgical incision of the chest. Incision cuts into bone, muscle, and cartilage. Necessary for lung biopsies and resections.
Thorascopy: What is it? What is Video-assisted thorascopy (VATS)? What is it for?
Visual examination of chest via small incisions and use of an endoscope. VATS allows surgeon to view chest from video monitor. The scope is equipped with a camera that magnifies the image. Can diagnose and treat conditions of the lung, pleura, and mediastinum.
Tracheostomy: What is it? What is it for? What is a tracheotomy?
Creation of an opening into the trachea through the neck. Tube inserted to create an airway. May be permanent or an emergency device. Tracheotomy is the incision necessary to create a stomy.
COPD?
chronic obstructive pulmonary disease (airway obstruction associated with emphysema and chronic bronchitis)
CPR?
cardiopulmonary resuscitation (three basic steps: airway opened by tilting head, breathing restored by mouth-to-mouth breathing, circulation restored by external cardiac compression)
DOE?
dyspnea on exertion
MDI?
metered-dose inhaler; used to deliver aerosolized medications to patients with respiratory disease
PFTs?
pulmonary function tests
PND?
paroxysmal nocturnal dyspnea
PPD?
purified protein derivative (substance used in a tuberculosis test)
SOB?
shortness of breath
URI?
upper respiratory infection