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69 Cards in this Set
- Front
- Back
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Respiratory Disorders types
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Restrictive
Obstructive |
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Restrictive Disorders
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Limitation to full lung expansion: pulmonary edema, atelectasis (collapsed lung), pheumothorax (air where it shouldn't be), pleural effusion, pneumonia
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Obstrutive
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Any process that limits airflow on EXPIRATION: Asthma, chronic bonchitis, emphysema, chronic obstructive pulmonary disease
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COPD
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Composit of chronic bronchitis and emphasema.
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Respiratory condition manifestations
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Dyspnea
Abnormal breathing patters Hypoventilation Hyperentilation Cough Hemoptysis Cyanosis Clubbing Hyperapnia Hypoxemia Acute respiratory failure Pumonary edema |
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Dyspnea
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Sensation of uncomfortable breathing
Orthopnea (diff. breaths lying down); paroxysmal nocturnal dyspnea (at night) |
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Abnormal breathing patterns
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Kussmaul respirations (hypernea) - fash/shallow
Cheyne Stokes respirations (apnea periods) |
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3 pillow orthopnea
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Patient may sleep with 3 pillows if have COPD.
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Hypoventilation
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Not enough. Leads torespiratory ACIDOSIS
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Hyperventilation
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too much; Leades torespiratory ALKALOSIS
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cough
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Acute - r/t something stuck
Chronic - determined to length of time |
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Hemoptysis
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bloody sputum
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Cyanosis
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a late phase of disease - blue.
Is NOT always r/t respiratory. May be cold, renauds,frost bite. |
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Clubbing
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nails
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Hypercapnia
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High CO2
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Hypoxemia
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Low O2 in blood
Ventilation - perfusion abnormalities (Shunting) |
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Shunting
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compensatory mechanism to shunt blood if have hypoxemia
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Acute respiratory failure
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disease / disorders & symptom
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Pulmonary Edema
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Excess water in lungs (disease / disorders & symptom)
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Aspiration
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Passage of fluid and solid particles into lungs
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Which lung will we likely aspirate to? Why?
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Right. (lower lobe) The angle is greater than 90 degrees. The left lung is more of a 90 degree.
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Shunting
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Hypoxemia can be caused by inadequate ventilation of well-perfused ares of lung. Mismatching of this type, called SHUNTING, occurs in atelectasis, asthma and pulmonary edema and pneumonia
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Pulmonary Edema
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Excess water in the lung. Results sin impaired gas exchange (see arterial blood gases)
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What can lead to pulmonary edema?
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Most common cause is heart disease.
Injury to capillary endothelium Blockage of lymphatic vells |
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Pneumothorax
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Air in plural spaced betwqeen lung an dchest wall
Disease w/in lungs r/t direct force so air goes in or tension |
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Types of pneumothorax
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Open
Tension Spontaneous Secondary Ex: r/t fractured rib |
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Flail Chest
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Results form muliiple rib or sternum fractures.
Chest wall is sperated from chest cage Instability of a portion of chest wall. Pardoxical breathing (Chest moves in non-sequence. NOT effective breathing) |
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Pleural Effusion
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Pleural= lining
Fluid moving into pleura |
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Empyema
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Infected pleural effusion = puss in lung / pleuritic pain (rubbing)
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Abscess
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formation and cavitation
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Pulmonary fibrosis
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connectivee tissue (can't expand). Excessive amount of fibrous or connective tissue in lung
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Chest wall restriction
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deformation, immobilization, &/or obesity. "pectavestabotom (concave chest)?????
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Inhalation Disorders
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r/t toxic gases
Pneumoconiosis (silicosis, coal, asbestosis) Allergic alveolitits |
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ARDS
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Acute/Adult Respiratory Distress Syndrome
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ARDS defined
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Acute lung inflamm. and diffuse alveolar capillary injury
Injury to pulmonary capillary endothelium Inflammation & platelet activation Inability of cels to produce surfactant Atelectasis (ventilation-perfusion abnorm., Decreased lung compliance) Usually FATAL |
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ARDS Manifestations
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SEVERE dyspnea
Rapid, shallow breathing Respiratory alkalosis Decreased lung compliance Acute hypoxemia **Problem w/ ventilation perfussion...usually FATAL. |
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Respiratory Failure (ARDS)
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Lots of issues lead to respiratory failure (Pneumonia, shunt,...pg 1280??)
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Postoperative Pulmonary Complications
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PREVENTION IS KEY.
Atelectasis (collapse) Pneumonia Pulmonary edema Pulmonary emboli |
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Prevention of postop pulmonary complications
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frequent turning
deep breathing & incentive spirometry early ambulation air humidification |
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Insentive spirometer
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5-10 x/hour
Deep breathing - using 'sustained max. inhalation" expands aloveli |
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Atelectasis
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Mucous plug = poor exhange and closed pore of Kohn leads to collaps of aloveli.
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Obstructive Disorders
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Mucous Plug leads to obstruction.
Asthma Chronic Bronchitits Emphysema COPD |
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COPD
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Chronic bronchitits & emphysema chronic obstructive pulmonary disease
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Obstructive Disorers manifestations
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Dyspnea
Wheezing Obstruction usually worse w/ EXPIRATION |
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Chronic Obstructive Pulmonary disease
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Air gets in, but can't get out.
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Chronic Bronchitis
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Hypersecretion of mucous
Recurrent of chronic productive coug for minimum of 3 months/yr and for at least 2 consec. years. Hypertrophy & hypersecretion of bronchial mucus secreting glands. Inhaled irritants (SMOKING) increase mucus production and size/number of mucous glands. |
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Empnysema
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Destructive changes in aveloar walls and ENLARGEMENT of the gas-exchange airways.
Decreased lung compliance (don't have recoild = decreased gas xchange). Decreased diffusion capacity Increased airway resistance Co2 up / O2 down |
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Key to Emphysema
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Inherited alpha 1 - antitrypsin deficiency
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Asthma
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Intermittent airway obstruction
Sudden onset. Bronchospasm = airway constricted. |
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Respiratory Infections
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Huge list of causes: community acquired
(bacterial, viral) Nosocomial (pneumonia...) Fungi Parasites |
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Pneumonia
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Community-acquired pneumonia (strptococcus pneumoniae)
Hospital-acquired Pneumococcal pneumonia Viral Pneumonia |
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Pneumococcal Pneumonia
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r/t aspiration of strepptococcus pneumoniae -->inflamm. response -->neutrophils go --> accumulation of fibrinous exudate, rbc, and bacteria -->Leukocytes try to kill!
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Tuberculosis
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just mentioning in passing
Airborn transmission |
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Acute Bronchitits
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Acute infection or inflammation of aiways or bronchi.
Commonly follows viral illness. Symptoms similar to pneumonia but DO NOT HAVE PULMONARY CONSOLIDATION AND CHEST INFILTRATES. |
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Pulmonary Embolism
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If thrombus, venous, in legs goes up to lung-.
Occlusion of portion of pulmonary vascular bed by thrombus, embolus, tissue fragment, lipids or air bubble. |
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Common source of pulmonary embolism
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Deep veins in thigh
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Virchow Triad & Pulmonary Embolism
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= 3 categories of pathologic risks & include:
Venous stasis -not moving (blood) Hypercoagulability (clumping), Vessel injury (endothelial cells - can lead to clot. |
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Do people know they have a Pulmonary Embolism
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No. Lots of people have and don't know it. Don't have to have visible clot in leg. May not find source!
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Pulmonary Hypertension
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Mean pulmonary artery pressure above normal or > 20 mmHg.
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Swan Ganz catheter
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Catheter needed to ID pulmonary hypertension.
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Primary Pulmonary hypertension
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Idiopathic!
Nobody knows mechanism |
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Diseases of respiratory system and hypoxemia are more common causes of
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pulmonary hypertension
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Pulmonary hypertension can lead to
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Right heart failure!
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Lung Cancer
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Primary or metastatic (colon, kidney)
aka: bronchogenic carcinoma |
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Causes of lung cancer
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Cigarette smoking
(heavy smokers 20X increased risk) Environment Occupationsl |
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Smoking is associated with cancers of
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larynx, oral cavity, esophagus, unirnary bladder
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Types of lung cancer
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Small cell carcinoma
Squamous cell carcinoma Adenocarcinoma (MOST COMMON) Large cell |
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Lung Cancer manifestations
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Vary depending on location, type and staging
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Other related cancers
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Lip
Laryngeal |
