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79 Cards in this Set
- Front
- Back
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Hypercapnia
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increased carbon dioxide in the arterial blood (increased Paco2), is caused by hypoventilation of the alveoli
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What is a pulmonary right to left shift shunt
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A pulmonary right-to-left shunt exists when blood passes through portions of the pulmonary capillary bed that receive no ventilation, either because the airway leading to the alveoli is completely obstructed or because the alveoli are collapsed or filled with fluid and cellular debris. Blood flows through the pulmonary circulation without being oxygenated. This results in decreased systemic Pao2and hypoxemia. Paco2is usually not affected except by severe shunting.
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Bronchiolitis
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inflammatory obstruction of the small airways or bronchioles. It is most common in children. In adults it usually occurs with chronic bronchitis but can occur in otherwise healthy individuals in association with a viral infection, such as respiratory syncytial virus (RSV), or inhalation of toxic gases. Atelectasis or emphysematous destruction of the alveoli may develop distal to the inflammatory lesion. Bronchiolitis is usually diffuse. A decrease in the ventilation-perfusion ratio results in hypoxemia and carbon dioxide retention.
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Pneumothorax
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the presence of air or gas in the pleural space caused by a rupture in the visceral pleura (which surrounds the lungs) or the parietal pleura and chest wall. As air separates the visceral and parietal pleurae, it destroys the negative pressure of the pleural space. This disrupts the state of equilibrium that normally exists between elastic recoil forces of the lung and chest wall.
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Plural Effusion
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the presence of fluid in the pleural space. The source of the fluid is usually blood vessels or lymphatic vessels lying beneath either pleura, but occasionally the source is an abscess or other lesion that drains into the pleural space. Because the pleura is a relatively permeable membrane, fluids that accumulate in the lung can cross into the pleural space.
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Pulmonary Fibrosis
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an excessive amount of fibrous or connective tissue in the lung. It can be caused by healing (formation of scar tissue) after active disease (e.g., ARDS, tuberculosis) or by inhalation of harmful substances (e.g., coal dust, asbestos). When no specific cause for the development of fibrosis is known, it is called idiopathic pulmonary fibrosis.
Fibrosis causes a marked loss of lung compliance. The lung becomes stiff and difficult to ventilate, and the diffusing capacity of the alveolocapillary membrane may decrease, causing hypoxemia. Diffuse pulmonary fibrosis is treated with oral corticosteroids but response rates are poor. |
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abnormal enlargement of distal air sacs
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Enphysema
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Hypersecretion of bronchial mucosa
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Chronic bronchitis
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Millary TB
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Bacillus that attacks O2 rich organs
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V/Q ratio
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take in 4lt of air and move 5ltr of blood
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What is High v/q
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High ventilation
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what part of the lungs has the most blood for perfussion
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Continous perfusion is in the lower lobes but we have more air in the upper part
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where are the large eveoli
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in the top of the lungs
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Low ventilationn perfusion
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Low V/Q
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High V/Q
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this would be when there is an embolis blocking the alveoli there will be no perfusion but lots of ventilation
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Excersise
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the mendula has to do with breathing faster and deeper
the pons has to do with the respiratory pattern |
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Shunting, why would the right to left shunt happen
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It is called right to left because the blood goes from the right side of the heart to the left without picking up any O2
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right to left shunt is a low V/Q ratio
what can a patient do and we do to help |
coughing
diaretic antibiotic |
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Hypoventilation
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narcotic
alchohol neuro disease obesity sleep apnea chest wall injury, all of this will cause a low V/Q |
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Hyperventilation
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anxiety
pain brain damage |
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Medula is the pattern
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Pons is the rate and depth
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Hypoximia
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low O2 concentration of the blood
measure with pulse ox or ABG |
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Hypoxia
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Tissue not getting enough O2
turniquit example or an emboli blocking blood flow is a good example |
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the goal of oxygenation is
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Pa02 greater than 60mmhg this equals an o2 sat of greater than 90% 60mmhg is the min but should be 80 to 90 mmhg
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Pao2 should be between
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80 or 100 mmhg but 60mmhg is min
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COPD what is it
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Chronic Obstructive pulmonary disease.
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What are the 3 kinds of COPD
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Asthma
chronic Bronchitis Emphesema |
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Signs of COPD
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clubbing
pursed lip breathing cor plmonale, is right heart failure from lungs backing up easily fatigued barrel chest, wheezing, skinny, tripod position, frequent respiratory infection |
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Asthma
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Hypersensitivity,
inflamation due to allergins the bronchial linings over react. constricts airway this causes wheezing. lots of mucus production, swollen mucosa and the muscles squeeze the airway. COPD? |
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cure for asthma flair up
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steroid
albuteral cough |
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Can you outgrow asthma
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yes and you can get it as an adult
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Chronic bronchitis
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irriversible because the cells hypertrophy and hyperplasia and meteplasiea the mucos cells and goblet cells go through this
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the mucosa of the bronchials in chronic bronchitis
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are inflamed or swollen due to dust and chemicals that results in scaring and changing of broncial walls they thicken and plasia takes place changes also move to alvelioi and they become impaired. right to left shunt
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metaplasia
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cells change from cilia cells to squemes cells
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blue bloater
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chronic bronchitis due to hypoximia and bloater due to cor pulmonel, hypertrophy to the right side of the heart because it is hard to get blood through the lungs causing failure and everything behind the right side of heart, bloating occurs in belly, feet etc
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chronic bronchitis
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collapsed alveoli
is caused by pollutants |
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Cor pulmonale
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valve sounds change
pulmonary hypertension right heart failure |
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Emphesema
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destroys the alveoli
either central lobular or panulobular, causes a deacreased amount of space for the exchange to take place, inflimation causes neutraphils and macrophages to destroy lung tissue. Bullae comes into play here |
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antitripson
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stops the break down to protien
smoking destroys this enzyme |
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tripson and inflamation
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big causes for emphesema
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Bullae
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big baloons that are the alveoli if they burst it could cause air rushing in the pleural space
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Bleb
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a big blister on the lung tissue if it pops it will cause a spontanous pneumothorax
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Pink puffers
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emphesema
they work hard to breath and constantly c-pap themselves they breath fast and try to keep the alvaoli open, they speak in short sentences and skinny people due to all the work and they get a barral chest because of the work |
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cystic fibroses or pulmonary toilet
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impaired mucus control chlorine chanell does not work chloried stays in cells and this leads to thick mucus production and drowning this is a genetic disease and effects other organs the cells in the airway creat more and more mucus and impairs cillia
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Croup
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cause by a virus that causes inflamation just below the vocal cords causing edema, steroids are given to slow inflamation steroids stop inflamation. this will stop the seal bark.
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Bronchiectasis
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is a disease that causes localized, irreversible dilatation of part of the bronchial tree. Involved bronchi are dilated, inflamed, and easily collapsible, resulting in airflow obstruction and impaired clearance of secretions. Bronchiectasis is associated with a wide range of disorders, but it usually results from necrotizing bacterial infections, such as infections caused by the Staphylococcus or Klebsiella species or Bordetella pertussis.[1]
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Bronchiolitis
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The term usually refers to acute viral bronchiolitis, a common disease in infancy. This is most commonly caused by respiratory syncytial virus (RSV, also known as human pneumovirus
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RSV
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RSV can cause bronchiolitis, leading to severe respiratory illness requiring hospitalization Human respiratory syncytial virus (RSV) is a negative-sense, single-stranded RNA virus of the family Paramyxoviridae,
very serious in children and can cause hospitalization |
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flail chest
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section of 2 or more ribs broke and move independantly
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Polio
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restrict breathing due to neuro muscle
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obesity
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reduces vital capacity
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vital capacity
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the absalute most air that you can take in
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idiopathic pulmonary fibrosis
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caused by chronic inflamation which turns your lungs into leather.
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avelior macrophages
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these usually protect our lungs but during fibrosis they give off lysosomes and breaks up the normal lung tissue
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who gets idiopathic pulmonary fibrosisi
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useually young people 20 or 30s
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how do you help someone breath with idiopathic pulmonary fibrosis
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they have bad compliance due to the chronic infection and the macrophages, these people are on vents and a lot of pressure even with this they will become hypoxemic
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How long will someone live with pulmonary fibrosis
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4 to 5 years because the membrane becomes too thick for O2 to pass through to the capilaries.
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pneumoconiosis or black lung disease
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exposure to black dust or aspestis this causes the lungs to shred
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protections that are in the respiratory tract
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cilia, smoking will destroy this
alvelor machrophages |
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Pleural space problems like pneumothorax
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air in the pleural space which could cause a tension pneumo caused by a knife or a spontanious pneumo due to a rubture bleb.
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Plueral effusion
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Fluid or puss is cought in the plural space, caused by cancer, puss etc it will not cause the lung to collapse
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how much fluid do we have in the pleural space
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5 to 15 ml
300 is a problem |
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pneumonia another type of restrictive lung disease
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aspiration is common and it ususlly goes to the lower lobes, listen in the front right side under booby
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mucas
sneezing cilia response cough response |
these are the 4 things that bacteria or viral need to overcome
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viral or bacerial pneumonia
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will be diffuse throughout the lung could
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Viral pneumonia
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this is residing in your own cell, no puss, low grade fever
less sputum |
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Bacterial pneumonia
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you will cough up green and yellow pus , high fever, lots of sputem, maybe bleeding and feel like shit
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TB tuberculosis
travel on droplets, so wear a mask and clean room etc |
it resides in the hilirary region because they love O2 it is a bacillis and enters your lungs, renal cortex, brain,bone marrow travels via the lymph symptom.
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what stops tb
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the alveloriar machrophages attack and lyse the little bacteria
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If you have the bacteria of tb you may not show signs
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antibodies are made for tb
but you can take I and H to help your body fight it but dont drink while you are taking it |
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Gontubule
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TB that is covered by machrophages making a little rock or pustuel, if her imune system gets week TB is released
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steroids what do they do
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decrease your inflamitory response, this could be a problem for someone that is fending off TB
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what are they looking for in the x-ray for TB
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TB eats the lungs and so they are looking for little holes or pockets on the lungs also they ae looking for the gathering of the bugs
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pulmonary embolism
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can be made from a blood clot, cancer, air , fat, amniotic fluid
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does a pulmonary embolism hurt
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yes it is like a tourniquit very painfull.
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virchows triad
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venous stasis
hypercouaguability venous wall damage |
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what does a PE block
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the pulmonary arterie
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restrictive
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PE,
pneumonia pulmonary fibrosis TB flail chest pulmonary effusion |
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obstructive
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bronchitis
asthma emphesema |
