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78 Cards in this Set

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What lung alterations take place with restrictive pulmonary disorders?
-lung parenchyma, pleura, chest wall, neuromuscular apparatus
What 4 capacities are decreased with restrictive pulmonary disorders?
1. total lung capacity
2. vital capacity
3. functional residual capacity
4. residual volume
List 4 pulmonary restrictive disorders:
1. diffuse interstitial pulmonary fibrosis
2. Sarcoidosis
3. Hypersensitivity pneumonitis
4. Atelectasis
pulmonary fibrosis:
-not common
-can be autoimmune
-thickening of alveolar interstitum
-may be immune reaction
-survival rate is 4 yrs
What effect does pulmonary fibrosis have on the body?
-rapid, shallow breathing
-exertional dyspnea
-clubbing
Dx of pulmonary fibrosis:
-transbronchial biopsy
-xray (see honeycomb appearance with infiltrates and increased markings)
-decreased PF and O2
Tx for pulmonary fibrosis:
-corticosteroids
-lung transplantation
sarcoidosis:
-abnormal T-cells, similar to TB
-disease of unknown origin marked by formation of granulomatous lesions that appear especially in the liver, lungs, skin, and lymph nodes
-usually affects <40YO but can affect all ages
What effect does sarcoidosis have on the body?
-malaise, fever, dyspnea
-skin rashes, hepatoplenomegaly and lymphadenopathy
-pulmonary infiltration and fibrosis
-lacrimal and parotid involvement can be seen
malaise:
mal-Aze'
A vague feeling of bodily discomfort, as at the beginning of an illness
Dx of sarcoidosis:
-positive Kveim skin test
-trasnbronchial lung biopsy
-xray noting parenchymal involvement and hilar lymphadenopathy
-decreased PF
Tx of sarcoidosis:
-corticosteroids
-treatment of symptoms
hypersensitivity pneumonitis:
-extreme sensitivity to inflammation of lung tissue
-caused by inhalation of organic dusts
What effects does hypersensitivity pneumonitis have on the body?
-symptoms occur 4-6 hrs after exposure
-general and respiratory symptoms
-rales in lung bases
-fibrosis in a chronic form
Dx of hypersensitivity pneumonitis:
-infiltrates and increased markings on xray
-skin testing
Tx of hypersensitivity pneumonitis:
-to prevent further exposure
-possible corticosteroids
atelectasis:
-total or partial collapse of the lung
-congenital condition characterized by the incomplete expansion of the lungs at birth
atelectasis vs. pneumothorax:
atelectasis: internal, blockage in resp tree preventing air, ex: mucus, not manageable, Tx: PEEP

pneumothorax: external, compression to lungs, free air in chest cavity so lung collapses, ex: lung puncture, Tx: intubate
3 Extrapulmonary restrictive disorders:
1. diseases of the pleura
2. diseases of the chest wall
3. neuromuscular disorders
2 Diseases of the pleura:
1. pneumothorax
2. pleural effusion
3 types of pneumothorax:
1. spontaneous (males 20-40)
2. secondary (complication of a disease)
3. tension (from trauma)
Tension pneumothorax:
-emergency situation
-air enters during inspiration but cannot escape during expiration
-shifts lung due to pressure (mediastinal shift)
-decreases venous return and cardiac output
What effect does pneumothorax have on the body?
-decreased to almost absent breath sounds
-hyperresonance
-tension and large spontaneous are emergencies
Dx of pneumothorax:
-xray
-physical findings
Tx of pneumothorax:
< 15% treated with bedrest
> 15% treated with chest tube
-thoracotomy if the lung further collapses and large blebs are formed
pleural effusion:
-an abnormal collection of fluid in the pleural cavity
5 types of pleural effusion:
1. transudates
2. exudates
3. empyema (purulent drainage)
4. hemothorax
5. chylothorax
transudate:
-(thin) fluid substance passed thru a membrane or extruded from the blood
-common in CHF and nephrosis
exudate:
-(thick) fluid, cells, or other substances that have slowly escaped from blood vessels and have been deposited in tissues or on tissue surfaces
-high in protein content
-common in malignancies, infections, embolism, sarcoidosis
What 2 forms are common with pleural effusions caused by trauma?
hemothorax and chylothorax
chylothorax:
-can be caused by trauma or tuberculosis
-An accumulation of chyle in the thoracic cavity
chyle:
-a milky fluid consisting of lymph and emulsified fats
-formed in the small intestine during digestion of ingested fats
What effects does pleural effusion have on the body?
-pt are asymptomatic if condition is small
-symptoms formed from irritation or air occupying space
What pressures are affected with a pleural effusion?
hydrostatic
colloid
intrapleural
Dx of pleural effusion:
-fluid analysis
-cytology
Tx of pleural effusion:
-treat the underlying cause
-thoracentesis
thoracentesis:
-puncturing the chest wall so as to let out liquids contained in the cavity of the chest
3 diseases of the chest wall:
1. Kyphoscoliosis
2. Ankylosing spondylitis
3. Obesity
Kyphoscoliosis:
-backward and lateral curvature of the spine
-reduces chest capacity
-symptoms and treatment related to degree of severity
Dx of pleural effusion:
-fluid analysis
-cytology
Ankylosing spondylitis:
-progressive inflammation leading to immobility of vertebral joints and rib fixation
-fibrotic response resulting in joint calcification and ligament ossification
-can cause restrictive lung dysfunction
Tx of pleural effusion:
-treat the underlying cause
-thoracentesis
Obesity as a disease of the chest wall:
-increases abdominal size
-causes hypoventilation
thoracentesis:
-puncturing the chest wall so as to let out liquids contained in the cavity of the chest
Tx for ankylosing spondylitis:
-breathing and mobility exercise
-non-steroidal medication
3 diseases of the chest wall:
1. Kyphoscoliosis
2. Ankylosing spondylitis
3. Obesity
5 neuromuscular disorders:
1. Poliomyelitis
2. Amyotrophic lateral sclerosis
3. Muscular dystrophies
4. Myasthenia gravis
5. Guillain-Barre syndrome
Kyphoscoliosis:
-backward and lateral curvature of the spine
-reduces chest capacity
-symptoms and treatment related to degree of severity
poliomyelitis:
-aka infantile paralysis
-highly infectious viral disease that affects children & causes inflammation of motor neurons of the spinal cord and brainstem, leading to paralysis, muscular atrophy, and often deformity
-preventable through vaccination
Ankylosing spondylitis:
-progressive inflammation leading to immobility of vertebral joints and rib fixation
-fibrotic response resulting in joint calcification and ligament ossification
-can cause restrictive lung dysfunction
amyotrophic lateral sclerosis:
-aka Lou Gehrig's disease
-progressive weakness
-chronic, progressive disease marked by gradual degeneration of the nerve cells in the central nervous system that control voluntary muscle movement.
-causes muscle weakness and atrophy and usually results in death.
Obesity as a disease of the chest wall:
-increases abdominal size
-causes hypoventilation
Tx for ankylosing spondylitis:
-breathing and mobility exercise
-non-steroidal medication
5 neuromuscular disorders:
1. Poliomyelitis
2. Amyotrophic lateral sclerosis
3. Muscular dystrophies
4. Myasthenia gravis
5. Guillain-Barre syndrome
chylothorax:
-can be caused by trauma or tuberculosis
-An accumulation of chyle in the thoracic cavity
chyle:
-a milky fluid consisting of lymph and emulsified fats
-formed in the small intestine during digestion of ingested fats
What effects does pleural effusion have on the body?
-pt are asymptomatic if condition is small
-symptoms formed from irritation or air occupying space
What pressures are affected with a pleural effusion?
hydrostatic
colloid
intrapleural
Dx of pleural effusion:
-fluid analysis
-cytology
Tx of pleural effusion:
-treat the underlying cause
-thoracentesis
thoracentesis:
-puncturing the chest wall so as to let out liquids contained in the cavity of the chest
3 diseases of the chest wall:
1. Kyphoscoliosis
2. Ankylosing spondylitis
3. Obesity
Kyphoscoliosis:
-backward and lateral curvature of the spine
-reduces chest capacity
-symptoms and treatment related to degree of severity
3 Extrapulmonary restrictive disorders:
1. diseases of the pleura
2. diseases of the chest wall
3. neuromuscular disorders
2 Diseases of the pleura:
1. pneumothorax
2. pleural effusion
3 types of pneumothorax:
1. spontaneous (males 20-40)
2. secondary (complication of a disease)
3. tension (from trauma)
Tension pneumothorax:
-emergency situation
-air enters during inspiration but cannot escape during expiration
-shifts lung due to pressure (mediastinal shift)
-decreases venous return and cardiac output
What effect does pneumothorax have on the body?
-decreased to almost absent breath sounds
-hyperresonance
-tension and large spontaneous are emergencies
Dx of pneumothorax:
-xray
-physical findings
Tx of pneumothorax:
< 15% treated with bedrest
> 15% treated with chest tube
-thoracotomy if the lung further collapses and large blebs are formed
pleural effusion:
-an abnormal collection of fluid in the pleural cavity
5 types of pleural effusion:
1. transudates
2. exudates
3. empyema (purulent drainage)
4. hemothorax
5. chylothorax
transudate:
-(thin) fluid substance passed thru a membrane or extruded from the blood
-common in CHF and nephrosis
exudate:
-(thick) fluid, cells, or other substances that have slowly escaped from blood vessels and have been deposited in tissues or on tissue surfaces
-high in protein content
-common in malignancies, infections, embolism, sarcoidosis
What 2 forms are common with pleural effusions caused by trauma?
hemothorax and chylothorax
muscular dystrophy:
-group of progressive muscle disorders caused by a defect in one or more genes that control muscle function and characterized by gradual irreversible wasting of skeletal muscle
myasthenia gravis:
-aka Goldflam disease
-disease characterized by progressive fatigue and generalized weakness of the skeletal muscles, especially those of the face, neck, arms, and legs, caused by impaired transmission of nerve impulses following an autoimmune attack on acetylcholine receptors.
Guillain-Barre syndrome:
-ascending pattern of weakness
-temporary inflammation of the nerves, causing pain, weakness, and paralysis in the extremities and often progressing to the chest and face
-typically occurs after recovery from a viral infection or, in rare cases, following immunization for influenza