Obstructive Pulmonary Disorders

Flashcards about obstructive pulmonary disorders, asthma, bronchitis, and emphysema.

What are obstructive pulmonary disorders?

These disorders are characterized by the ability to get air in, but difficulty getting it out.

What are restrictive lung disorders?

These disorders are characterized by difficulty getting air in, but no problem getting it out.

What are the three mechanisms that obstructive pulmonary disorders can be conceptually categorized as causing?

An obstruction from something in the wall of the lumen of the respiratory tree, an obstruction of the airway lumen itself, and pressure being exerted from outside the tube or lumen wall.

What are the key features of asthma?

Largely reversible, airway inflammation, and characterized by hyperactive or hyperreactive airways.

What are some factors that increase the risk of developing asthma?

A genetic predisposition for some, African Americans and inner-city dwellers being at a higher risk, and premature low birth weight children.

What are some predisposing factors for asthma?

Family history of eczema, hay fever, smaller airways, and allergies.

How long does asthma last?

Lifelong and has no cure.

What happens during an allergic reaction in the context of asthma?

Immunoglobulin E attaches to Fc receptors on mast cells, causing mast cell degranulation and the release of histamine, cytokines, and mucus.

What does Histamine do?

Main chemical mediator which causes vasodilation and that causes bronchoconstriction

What are leukotrienes?

Slow reactors that bring about anaphylaxis.

What happens during the inflammatory process in asthma?

Neutrophils release chemical mediators that destroy cells and tissue, leading to repair, mucus production, and smooth muscle reinforcement.

What is the long-term consequence of only mitigating asthma symptoms?

Airway remodeling, characterized by a narrow tube with extra smooth muscle, mucus-producing cells, and collagen deposition.

What should asthma patients do as much as needed to manage their symptoms?

Use a short-acting inhaler.

What is the key to treating asthmatics since it's a chronic disease?

Address the underlying issue to make sure you don't have airway remodeling, which means prevention and getting rid of all the triggers

What causes wheezing?

The narrowed lumen of the respiratory tree, usually in the bronchioles.

What should asthmatics need to do to their mucus?

Drink fluids to keep the mucus watery

What indicates a severe asthma attack?

The use of scaling muscles and the pectoralis minor.

What do CBC levels show for allergies?

Elevated WBCs and eosinophils.

How is asthma treated?

Avoid triggers, use refrigerated air (air conditioning), and undergo preventative therapy such as steroids and desensitization.

What is the effect of Beta-two agonists?

Causes vasoconstriction and a wee bit of bronchodilation.

What is acute bronchitis?

Something that's reversible and is usually caused by a microbe, heat, or chemical irritants. It is inflammation of the trachea bronchi.

What happens during the inflammatory process of acute bronchitis?

The airways become inflamed and narrow, capillaries dilate, and fluid comes out, with increased mucus production.

What are the clinical manifestations of acute bronchitis?

Low-grade fever, substernal chest discomfort, sore throat, postnasal drip, and fatigue.

How is acute bronchitis treated?

Antibiotic therapy (if bacterial), codeine-containing medications (when necessary), fluid intake, and avoidance of smoke.

What does chronic bronchitis have everything to do with?

Bronchitis has nothing to do with microbes.

What is the speaker implying when they say 'you are on your way to killing yourself'?

Killing yourself by patient's own hand.

What are patients presenting symptoms when diagnosed with chronic bronchitis?

The patient has had two years in a row, a cough that wouldn't go away for a solid three or more months each time.

What are the clinical symptoms of chronic bronchitis?

A cough that's worse in the morning, excess mucus and sputum, shortness of breath on exertion, and edema in hypervolemia.

What do pulmonary function tests show for chronic bronchitis?

Decreased FEV1, normal lung capacity, and increased residual volume.

What is found for blood gases analysis?

Elevated arterial CO2 levels because of you're able to get air in, you can't get air out.

What is the treatment for chronic bronchitis?

Short-acting bronchodilators, parasympathetic inhibitors, cough suppressants, steroids, antimicrobial agents, theophylline, and O2 therapy.

What are key care considerations for chronic bronchitis?

Reconditioning unimpaired parts of the lung to become more efficient and rest for the patient

What is type A COPD also known as (Emphysema)?

Pink puffer and is extremely unusual for anybody 50 to have it.

What is the most common cause of emphysema in people under 50?

Alpha-one antitrypsin deficiency.

What causes emphysema?

Neutrophils release elastase, which digests elastic fibers in the alveoli.

What does it mean for the damaged air sacs of the patient with Emphysema?

The alveoli get bloated and filled with air, but they're never able to let the air come back out again, ever.

What are the clinical manifestations of emphysema?

There's shortness of breath, a barrel chest, and pursed-lip breathing.

Why do Emphysema patients have so Little Cough?

Little to no cough because they're completely unable to generate enough air going out to get to 100 millimeters of mercury pressure.

What are the physical findings in emphysema?

Decreased breath and heart sounds and a flattened diaphragm.

What do arterial blood gases show for emphysema?

Mild increase in arterial O2 and normal arterial CO2 levels (elevated in late stages).

What physical characteristics do the Emphysema patients present with?

A barrel chest, but they have very little muscular development elsewhere.

What is physical reconditioning?

Those parts of the lung in chronic bronchitis that have not been directly or overtly impaired or impaired yet can be reconditioned so that those parts of the lung can become more efficient

What is typically known for the cause of Bronchiectasis?

Usually happens in kids and at least half of all the cases in kids are directly related to cystic fibrosis.

What is the key characteristic of Cystic Fibrosis?

The person doesn't make enough or any chloride channels in cells, impairing water movement and causing tenacious mucus.

What is the typical lifespan of people who have cystic Fibrosis?

They usually don't live past 30, 32 years of age.

What does a tenaciously thick mucus do to other microbes in body?

That fluid static brings about infection.

What causes bronchiectasis?

Recurring infection leading to persistent dilation of the bronchial walls and inflammatory response.

What is a common symptom of Bronchiectasis?

Chromic Productive Cough.

What is the relation between work and ATP?

The work of breathing is very difficult and you burn through a bunch of ATP, so malnutrition can happen.

What is the gold standard test for cystic fibrosis?

A sweat test to determine if there are elevated sodium chloride levels.

What is something for the patient with Cystic Fibrosis that happens often when they have a lot of money to spend?

People qualify for heart, lung or lung transplants

Where does acute tracheobronchial obstruction most often occur when someone aspirates something?

Right lung, because the right primary bronchus is much steeper.

What is the key to treat acute tracheobronchial obstruction?

Is to get rid of the obstruction, open the airway as quickly as possible with Hemat maneuver immediately.

What percentage means means no significant obstrction?

76%.

What percentage is considered as mildly obstructed?

Between 60 and 75%.

What percentage is considered as obstructed?

Below 60%.

What number is a positive diagnosis on obstructive airway disease?

A. FEV sub one improvement of greater than 15% after administration.