Pvd And Respiratory Path

Front 1

What is peripheral vascular disease

Back 1

progression of atherosclerosis in periphery

Front 2

What areas of the periphery does PVD affect?

Back 2

aorta, carotids, cerebral, renal, iliac, femoral, popliliteal, tibial arteries

Front 3

What are the PVD symptoms of;
Aorta? Cerebral? Renal? Peripheral?

Back 3

Aorta - angina or abdominal pain
Cerebral - headaches, confusion, TIAs, CVAs
Renal - swollen feet, palpitations, weakness
Peripheral - claudication, tightness, cramping

Front 4

What is the PVD prognosis?

Back 4

20% non fatal MI/CVA wihin 5 years
30% mortality rate

Front 5

what are the risk factors for PVD?

Back 5

smoking, hyperlipidemia, hypertension, diabetes, obesity, sedentary lifestyle

Front 6

Treatment of PVD?

Back 6

lifestyle modification, lipid lowering agents, control of diabetes& hypertension, peripheral bypass, STENTS, ambutations

Front 7

What is the purpose of respiration

Back 7

supply oxygen to cells and remove carbon dioxide from cells

Front 8

What is the respiratory mucosa lining the respiratory tract made up of?

Back 8

pseudostratified ciliated epithelium and goblet cells

Front 9

cilia structure and mucous blanket serve to..?

Back 9

filter and trap particles

Front 10

nasal cavity serves to ...?

Back 10

warm filter and humidify air

Front 11

What is the glottis purpose?

Back 11

to protext lower respiratory tract

Front 12

where are the conducting airways? what are their purpose?

Back 12

from nasal pharynx to terminal bronchioles. Serce as an air conduit for gas exchange areas of lung

Front 13

where does gas exchange occur and what is it made up of?

Back 13

acinus - respiratory bronchioles, alveolar ducts, terminal alveolar air sacs

Front 14

Surface tension tends to ____ expansion on inspiration and favours _____ on expiration

Back 14

resist, collapse

Front 15

What lipoprotein prevents surface tension

Back 15

surfactant

Front 16

How many lobes on left and right lungs

Back 16

2 on left and 3 on right

Front 17

Name the pleura of the lungs and their location

Back 17

parietal - lines thoracic cavity of chest
visceral - encases each lung

Front 18

What pressure is the pleural space?

Back 18

below atmospheric

Front 19

Where is the respiratory center located?

Back 19

pons and medulla

Front 20

what is the primary stimulus and receptor that controls breathing?

Back 20

changes in paco2 and changes in ph stimulate central chemoreceptors

Front 21

at what pa02 are the peripheral chemoreceptors stimulated

Back 21

60mmHg

Front 22

What are the morphologic respiratory diagnostic procedures?

Back 22

radiological, endoscopy, boipsy, sputum studies

Front 23

What are the physiologic respiratory diagnostic procedures?

Back 23

blood gases, ventilatory function tests

Front 24

what are the benefits of radiological techniques? (5 things)

Back 24

xray can penetrate aerated lungs producing radian shadows. can provide status of thoracic cage. can show size contour and position of mediastinum, hilus, root of bronchial trees, heart, aorta, lymph nodes. Degree of aeration of lungs. Size, shape number and location of pulmonary lesions, cavitations, fibrous markings and zones of consolidations

Front 25

What areas of the respiratory system can a CT scan show abnormalities in?

Back 25

trachea, major bronchi, pleura, mediastinum, vasculature

Front 26

What radiological technique exposes patient and examiner to large amounts of radiation?

Back 26

fluroscopy

Front 27

What is bronchography ideal for detecting?

Back 27

bronchiectasis

Front 28

what is bronchiectasis and what is it caused by?

Back 28

chronic dilation of one or more bronchi. caused by bronchial obstruction and infection

Front 29

What is the utility of angiography of pulmonary vessels?

Back 29

locate massive embolism and determine extent of pulmonary infarction

Front 30

what are the uses of bronchoscopy?

Back 30

confirm diagnosis of bronchogenic carcinoma, remove foreign body from bronchiole

Front 31

what can sputum analysis reveal?

Back 31

bacterial or viral infection

Front 32

What is utility of physiologic techniques?

Back 32

show effects of disease but doesn't make diagnosis

Front 33

ventilatory function tests can show

Back 33

restrictive and obstructive conditions

Front 34

what does D-dimer indicate

Back 34

elevated fibrinogen level in blood

Front 35

what ventilatory function parameters are changed in obstructive disease?

Back 35

Increases in; RV, FRC, PaCO2
Decreases in; FEV1, FEV1:FVC, PaO2

Front 36

What ventilatory function parameters are changed in restrictive disease?

Back 36

Increases - n/a
Decreases - RV, FRC, TLC, VC, FVC,

Front 37

what are normal values for CO2 and O2 tension, O2 % sat., pH, HCO3-

Back 37

CO2- 36-44mmhg
o2 - 80-100mmhg
O2 sat. 97
pH - 7.35-7.45
HCO3- - 21-28

Front 38

respiratory alkalosis leads to what ph, hco3-, co2 changes?

Back 38

ph - increase
hco3- - decrease
paco2 - decrease

Front 39

respiratory acidosis leads to what ph, hco3-, co2 changes?

Back 39

ph - decrease
hco3 - increase
paco2 - increase

Front 40

metabolic alkalosis leads to what ph, hco3-, co2 changes?

Back 40

ph - increase
hco3 - increase
paco2 - increase

Front 41

metabolic acidosis leads to what ph, hco3-, co2 changes?

Back 41

ph - decrease
hco3- - decrease
co2 - decrease

Front 42

What is the purpose of a cough and when should it be further investigated?

Back 42

natural way of clearing lower airway - longer than three weeks investigated

Front 43

Stimuli of coughing are?

Back 43

tumors (bronchogenic carcinoma), smoke, toxins, chronic bronchitis, TB, pnemonia

Front 44

How is mucous transported?

Back 44

by cilia to pharynx

Front 45

what causes excess sputum?

Back 45

physical damage, chemical damage (tobacco), infection (pneumonia, pleuritic pain)

Front 46

what do yellow, green and rust colour sputum indicate?

Back 46

yellow = infection
green = stagnant pus
rust colour = pneumoccal pneumonia or tb

Front 47

what is hemoptysis?

Back 47

blood in sputum

Front 48

what causes hemoptysis?

Back 48

anything that alters continuity of blood vessels may result in bleeding ie pneumothorax,TB, bronchogenic carcinoma, pulmonary infarction, lung abscess

Front 49

Dyspnea signs and symptoms?

Back 49

shortness of breath, suffocation

Front 50

dyspnea results from

Back 50

heart failure, hemodynamic abnormalities, anxiety, pulmonary disease

Front 51

signs and symptoms of respiratory disease

Back 51

sputum, cough, hemoptysis, dyspnea, chest pain, digital clubbing, cyanosis (peripheral/central)

Front 52

what are the causes of chest pain in respiratory disease?

Back 52

pleurisy (inlfammation), pulmonary infection, pulmonary infarction

Front 53

what sort of chest pain is associated with respiratory disease?

Back 53

localized, cutting and sharp

Front 54

What is digital clubbing and what respiratory disease is it associated with?

Back 54

peculiar change in shape of fingers.
bronchogenic carcinoma, bronchiectases, lung abscess, TB

Front 55

what is cyanosis?

Back 55

bluish coloration resulting from increase in absolute amount of hemoglobin not bound to O2

Front 56

where is central cyanosis observed?

Back 56

face, lips, ear lobes, under tongue

Front 57

what is peripheral cyanosis resulting from?

Back 57

severly reduced blood flow caused by great reduction in venous saturation

Front 58

what causes peripheral cyanosis

Back 58

cardiac insufficiency, obstruction of blood flow, vasococnstriction due to cold

Front 59

What is COPD characterized by

Back 59

increased resistance to air flow

Front 60

What are three COPD's?

Back 60

Chronic Bronchitis, emphysema, asthma

Front 61

What are causes of chronic bronchitis

Back 61

cigarette smoking, air pollution

Front 62

What does chronic bronchitis present as?

Back 62

chronic cough and production of sputum 3mo/year for 2 years consecutively

Front 63

What signs and symptoms of other disorders are similar to chronic bronchitis?

Back 63

bronchectasis, TB

Front 64

What are causes of pulmonary emphysema

Back 64

cigarette smoking, air pollution

Front 65

What is pulmonary emphysema characterized by and what does it result in?

Back 65

characteristics - abnormal enlargement of alveoli and alveolar ducts
results in - alteration of lung pernchyma and destruction of alveolar walls

Front 66

What are the two subsets of pulmonary emphysema?

Back 66

contrilobular and panlobular

Front 67

Centrilobular pulmonary emphysema effects...(part of lungs, men/women?)

Back 67

respiratory bronchioles and upper portion of the lungs

Front 68

Panlobular pulmonary emphysema leads to

Back 68

uniform enlargement and destruction of alveoli distal to terminal bronchiole

Front 69

What is panlobular pulmonary emphysema probably due to ?

Back 69

deficiency in alpha anti-trypsin enzyme which protect against protease

Front 70

What is the treatment for bronchitis and emphysema?

Back 70

stop smoking, avoid air pollutants, antibiotics for LRI, adequate hydration(produce mucus and ward off bacteria), expectorants (help bring up mucus), bronchodilators, beta agonists, corticosteroids, breathing exercises

Front 71

What is asthma

Back 71

hypersensitivity of the tracheo-bronchial tree to various stimuli

Front 72

What is asthma caused by?

Back 72

bronchospasm, mucosal edema (anaphylactic shock), increased secretion of viscous mucous

Front 73

Is asthma increasing or decreasing worldwide?

Back 73

increasing

Front 74

What is allergic asthma caused by?

Back 74

lint, dust, animal dander, milk

Front 75

What is intrinsic asthma caused by?

Back 75

lower respiratory infection, cold temp, exercise, emotional stress

Front 76

What is used as asthma therapy?

Back 76

bronchodilators, beta agonists, corticosteroids, avoidance of known allergens, desensitization

Front 77

What is restrictive lung disease characterized by and what sort of breathing pattern is present?

Back 77

characteristics - lung stiffness, increased thorax stiffness
mechanical breathing

Front 78

what are the physiologic consequences of restrictive lung disease?

Back 78

alveolar hypoventilation, inability to maintain normal blood gas

Front 79

what does alveolar hypoventilation cause?

Back 79

air sacs wont move which leads to infection and collapse of airways

Front 80

name some other extrapulmonary disorders that cause alveolar hypoventilation (CNS, PNS, muscular, chest cage)

Back 80

CNS - PaCO2 >70mmHg
PNS - guillian barre syndrome
Muscle - muscular dystrophy
Chest Cage - obesity, kyphoscoliosis

Front 81

what do diseases of the pleura and pleura space cause?

Back 81

restriction of the expansion of the lungs, alveoli or both

Front 82

what are diesease of the pleura and pleura space caused by

Back 82

an accumulation of; air, fluid, blood, pus

Front 83

What is pleural effusion and what are the two types?

Back 83

collection of fluid in the pleural cavity. can be either transudates or exudates

Front 84

what does a transudates pleural effusion result from?

Back 84

increased pulmonary venous pressure (ie CHF)
hypoproteinemia (liver and renal disease)
pressure on vena cava from a tumor

Front 85

Define;
hydrothorax
empyema
fibrothorax
hemothorax
pneumothorax

Back 85

hydrothorax - accumulation of transudates in pleural cavity
empyema - pleural effusion containing pus
fibrothorax - fibrous adhesions welding the parietal and visceral pleura
hemothorax - blood in the pleural cavity often caused by trauma
pneomothorax - air in pleural cavity

Front 86

what pleural effusion can result from CABG

Back 86

fibrothorax

Front 87

what are signs and symptoms of pleura effusion

Back 87

dyspnea, pleuritic pain, trachea deviation, bulging intercostal spaces, diminished/delayed chest movement, flat percussion, decreased breath sounds

Front 88

what are the signs and symptoms of pneumothorax

Back 88

dyspnea if pronounced, severe pleuritic pain, deviated trachea (away from pneumothorax), tachycardia, cyanosis, diminished/delayed chest movement on involved side, hyperresonant percussion, decreased/absent breath sounds over affected side

Front 89

what is atelectasis?

Back 89

inperfect expansion of the alveoli (they become airless and collapse

Front 90

what are the reasons for atelectasis?

Back 90

absorbtion and compression

Front 91

what is absorbtion atelectasis and what causes it?

Back 91

air distal to obstruction in bronchial or bronchiolar is eventually absorbed and alveoli collapse, leads to rention of secretions which may lead to pneumonia and furhter atelectasis. caused by postoperative surgical complications and prolonged bed rest

Front 92

what is compression atelectasis and what causes it

Back 92

extrinsic pressure on all parts of the lung driving air out and causing collapse of lung. caused by pleural effusion, pneumothorax, abdominal distention elevating the diaphragm

Front 93

what are the four protective mechanisms preventing atelectasis?

Back 93

mucous and ciliary action, cough, collateral ventilation, pharyngeal clearing

Front 94

what is pneumonia?

Back 94

acute inflammation of the lung

Front 95

what are the three types of pneumonial infection

Back 95

bacterial, lobular/bronchial, viral/mycoplasmal

Front 96

what does the term pulmonary fibrosis imply?

Back 96

excessive amount of connective tissue in the lung

Front 97

what are the types of pulmonary fibrosis?

Back 97

localized, diffuse

Front 98

What causes localized pulmonary fibrosis?

Back 98

TB, pulmonary abscess, bronchiectisis, unresolved pneumonia

Front 99

what does diffuse pulmonary fibrosis represent?

Back 99

end stage lung disease associated with different occupations/exposures

Front 100

what are organic dusts and what do they cause?

Back 100

cause allergic alveolitis
byssinosis (cotton), bagassosis (sugar), farmers lung (moldy hay)

Front 101

What are inorganic dusts and what do they cause?

Back 101

lead to destruction of macrophages forming fibrotic nodules
silicosis (silica), black lung (coal), siderosis (iron), asbestosis (asbestos), talcosis (talc)

Front 102

what size are most dangerous dust particles?

Back 102

1-5 um (v small)

Front 103

What is repiratory failure defined as?

Back 103

PaO2 <50-60mmHg with or without PaCO2 >50mmHg under resitng conditions at seal level

Front 104

what are some precipitating factors of respiratory failure in chronic lung disease?

Back 104

infection, change in tracheobronchial secretion, bronchospasm, inability to clear secretions, depressants, oxygen therapy, trauma, CHF, PE, pneumothorax

Front 105

name some of the extrinsic causes of respiratory failure

Back 105

respiratory center depression (drug overdose, cerebral trauma, bulbar poliomyelitis, encephalitis), neuromuscular disorders (cervical cord injury, gullian barre syndrome, amyotrophic lateral sclerosis, myasthenia gravis, muscular dystrophy), pleural and chest wall disorders (chest injury, pneumothorax, pleural effusion, obesity)

Front 106

name some of the intrinsic causes of respiratory failure

Back 106

diffure obstructive disorders (COPD, asthma, cystic fibrosis), diffure restrictive disorders (interstitial fibrosis, sarcoidosis, scleroderma, pulmonary edema, atelectasis, consolidated pneumonia), Pulmonary Vascular Disorders (pulmonary emoboli, severe emphysema)