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78 Cards in this Set
- Front
- Back
What lung alterations take place with restrictive pulmonary disorders?
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-lung parenchyma, pleura, chest wall, neuromuscular apparatus
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What 4 capacities are decreased with restrictive pulmonary disorders?
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1. total lung capacity
2. vital capacity 3. functional residual capacity 4. residual volume |
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List 4 pulmonary restrictive disorders:
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1. diffuse interstitial pulmonary fibrosis
2. Sarcoidosis 3. Hypersensitivity pneumonitis 4. Atelectasis |
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pulmonary fibrosis:
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-not common
-can be autoimmune -thickening of alveolar interstitum -may be immune reaction -survival rate is 4 yrs |
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What effect does pulmonary fibrosis have on the body?
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-rapid, shallow breathing
-exertional dyspnea -clubbing |
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Dx of pulmonary fibrosis:
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-transbronchial biopsy
-xray (see honeycomb appearance with infiltrates and increased markings) -decreased PF and O2 |
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Tx for pulmonary fibrosis:
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-corticosteroids
-lung transplantation |
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sarcoidosis:
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-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 |
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What effect does sarcoidosis have on the body?
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-malaise, fever, dyspnea
-skin rashes, hepatoplenomegaly and lymphadenopathy -pulmonary infiltration and fibrosis -lacrimal and parotid involvement can be seen |
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malaise:
mal-Aze' |
A vague feeling of bodily discomfort, as at the beginning of an illness
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Dx of sarcoidosis:
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-positive Kveim skin test
-trasnbronchial lung biopsy -xray noting parenchymal involvement and hilar lymphadenopathy -decreased PF |
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Tx of sarcoidosis:
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-corticosteroids
-treatment of symptoms |
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hypersensitivity pneumonitis:
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-extreme sensitivity to inflammation of lung tissue
-caused by inhalation of organic dusts |
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What effects does hypersensitivity pneumonitis have on the body?
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-symptoms occur 4-6 hrs after exposure
-general and respiratory symptoms -rales in lung bases -fibrosis in a chronic form |
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Dx of hypersensitivity pneumonitis:
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-infiltrates and increased markings on xray
-skin testing |
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Tx of hypersensitivity pneumonitis:
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-to prevent further exposure
-possible corticosteroids |
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atelectasis:
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-total or partial collapse of the lung
-congenital condition characterized by the incomplete expansion of the lungs at birth |
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atelectasis vs. pneumothorax:
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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 |
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3 Extrapulmonary restrictive disorders:
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1. diseases of the pleura
2. diseases of the chest wall 3. neuromuscular disorders |
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2 Diseases of the pleura:
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1. pneumothorax
2. pleural effusion |
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3 types of pneumothorax:
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1. spontaneous (males 20-40)
2. secondary (complication of a disease) 3. tension (from trauma) |
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Tension pneumothorax:
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-emergency situation
-air enters during inspiration but cannot escape during expiration -shifts lung due to pressure (mediastinal shift) -decreases venous return and cardiac output |
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What effect does pneumothorax have on the body?
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-decreased to almost absent breath sounds
-hyperresonance -tension and large spontaneous are emergencies |
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Dx of pneumothorax:
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-xray
-physical findings |
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Tx of pneumothorax:
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< 15% treated with bedrest
> 15% treated with chest tube -thoracotomy if the lung further collapses and large blebs are formed |
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pleural effusion:
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-an abnormal collection of fluid in the pleural cavity
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5 types of pleural effusion:
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1. transudates
2. exudates 3. empyema (purulent drainage) 4. hemothorax 5. chylothorax |
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transudate:
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-(thin) fluid substance passed thru a membrane or extruded from the blood
-common in CHF and nephrosis |
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exudate:
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-(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 |
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What 2 forms are common with pleural effusions caused by trauma?
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hemothorax and chylothorax
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chylothorax:
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-can be caused by trauma or tuberculosis
-An accumulation of chyle in the thoracic cavity |
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chyle:
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-a milky fluid consisting of lymph and emulsified fats
-formed in the small intestine during digestion of ingested fats |
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What effects does pleural effusion have on the body?
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-pt are asymptomatic if condition is small
-symptoms formed from irritation or air occupying space |
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What pressures are affected with a pleural effusion?
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hydrostatic
colloid intrapleural |
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Dx of pleural effusion:
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-fluid analysis
-cytology |
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Tx of pleural effusion:
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-treat the underlying cause
-thoracentesis |
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thoracentesis:
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-puncturing the chest wall so as to let out liquids contained in the cavity of the chest
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3 diseases of the chest wall:
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1. Kyphoscoliosis
2. Ankylosing spondylitis 3. Obesity |
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Kyphoscoliosis:
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-backward and lateral curvature of the spine
-reduces chest capacity -symptoms and treatment related to degree of severity |
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Dx of pleural effusion:
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-fluid analysis
-cytology |
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Ankylosing spondylitis:
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-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 |
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Tx of pleural effusion:
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-treat the underlying cause
-thoracentesis |
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Obesity as a disease of the chest wall:
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-increases abdominal size
-causes hypoventilation |
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thoracentesis:
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-puncturing the chest wall so as to let out liquids contained in the cavity of the chest
|
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Tx for ankylosing spondylitis:
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-breathing and mobility exercise
-non-steroidal medication |
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3 diseases of the chest wall:
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1. Kyphoscoliosis
2. Ankylosing spondylitis 3. Obesity |
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5 neuromuscular disorders:
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1. Poliomyelitis
2. Amyotrophic lateral sclerosis 3. Muscular dystrophies 4. Myasthenia gravis 5. Guillain-Barre syndrome |
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Kyphoscoliosis:
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-backward and lateral curvature of the spine
-reduces chest capacity -symptoms and treatment related to degree of severity |
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poliomyelitis:
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-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 |
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Ankylosing spondylitis:
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-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 |
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amyotrophic lateral sclerosis:
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-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. |
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Obesity as a disease of the chest wall:
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-increases abdominal size
-causes hypoventilation |
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Tx for ankylosing spondylitis:
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-breathing and mobility exercise
-non-steroidal medication |
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5 neuromuscular disorders:
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1. Poliomyelitis
2. Amyotrophic lateral sclerosis 3. Muscular dystrophies 4. Myasthenia gravis 5. Guillain-Barre syndrome |
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chylothorax:
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-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
|
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muscular dystrophy:
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-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
|
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myasthenia gravis:
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-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. |
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Guillain-Barre syndrome:
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-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 |