categorizing pulmonary diseases

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what are 2 broad categories of pulmonary disease

restrictive and obstructive

Restrictive lung disease mainly causes trouble with what?

inhalation

A common finding in restrictive lung disease?

hypoxemia

How is hypoxemia seen numerically?

low SO2 and/or low PO2

what does V stand for

ventilation

what does Q stand for

perfusion

what is a normal V/Q ratio

about 0.8

What is V/Q mismatch?

when the V/Q ratio is not normal

What test can measure V/Q mismatch?

V/Q scan

Low V/Q means what?

less ventilation than normal

high V/Q means what

less perfusion than normal

Low V/Q disorders have a problem with what?

getting air to the alveoli

What are examples of chest wall restriction?

Kyphosis, obesity, neuromuscular weakness

What diseases can cause neuromuscular weakness and restriction?

polio and myasthenia gravis

What can cause airway restriction?

foreign body, tumors, airway inflammation

What is stridor?

a high-pitched raspy sound on inspiration

what causes stridor

narrowed inflamed upper airways

what is croup

inflammation of the larynx, trachea, and bronchi

who commonly gets croup

infants and very young children

classic signs of croup

fever, increased RR, barking cough, stridor

treatment for croup

cool mist and sometimes steroids

What is pleural effusion?

extra fluid in the pleural space

What can cause pleural effusion?

Cancer, infection, inflammation, heavy coughing

What is pleuritic pain?

Chest pain with deep breathing, coughing, or movement

Why do respirations become shallow with pleural effusion?

Because of pain and fluid buildup

What is pneumothorax?

air in the pleural space

Why is pneumothorax a problem?

It destroys normal negative pressure and the lung can collapse

Main symptoms of pneumothorax?

chest pain and SOB

What is a traumatic pneumothorax?

Pneumothorax caused by injury

What is a spontaneous pneumothorax?

Pneumothorax that happens without trauma

Who is at risk for spontaneous pneumothorax?

Tall, thin smokers or people with lung disease

What is tension pneumothorax?

Air enters the pleural space but cannot get out

Why is tension pneumothorax dangerous?

It can affect the other lung and lower cardiac output

Basic treatment for pneumothorax?

re-establish negative pressure

How is negative pressure restored in pneumothorax?

with a chest tube

What is a water seal drainage system?

a system where water acts like a one-way valve for air

What is pneumonia?

An acute infection of the lower respiratory tract

What organisms can cause pneumonia?

bacteria, viruses, fungi, parasites

Who is at higher risk for pneumonia?

Very young, elderly, immunocompromised, smokers, immobilized

What are the 3 main types of pneumonia?

CAP, nosocomial, aspiration

What does CAP stand for?

Community-acquired pneumonia

CAP is often called what?

Walking pneumonia

What is nosocomial pneumonia?

Hospital-acquired pneumonia

Nosocomial pneumonia is often caused by what?

More virulent organisms, often gram-negative

What is aspiration pneumonia?

Pneumonia caused by inhaling something into the lungs

Who is at risk for aspiration pneumonia?

People with weak gag, cough, or swallow reflexes

Examples of aspiration pneumonia risk?

Elderly, alcohol intoxication, brain injury, post-seizure

What are infiltrates in pneumonia?

Inflammatory/infectious debris in alveoli and tissue

What is atelectasis?

Collapse of alveoli

Why does atelectasis happen in pneumonia?

Mucus/inflammation blocks airflow, so alveoli collapse

What is consolidation?

Infiltrates + atelectasis

What does consolidation do to the lung?

Makes it stiff and less functional

What is lobar pneumonia?

Pneumonia in one lobe

What is bronchopneumonia?

More diffuse/spread-out pneumonia

Common symptoms of pneumonia?

Fever, chills, malaise, pleural pain, cough, dyspnea

What lung sound may be heard in pneumonia?

crackles

Why might breath sounds be decreased in pneumonia?

Consolidated lung tissue has less air movement

What test often looks abnormal in pneumonia?

chest x-ray

How is pneumonia diagnosed?

Chest x-ray, gram stain, sputum culture

How is pneumonia treated?

Antibiotics, hydration, pulmonary toilet

What is pulmonary toilet?

Coughing, turning, deep breathing, suctioning

What is pulmonary edema?

Too much fluid in the alveoli

What are the 2 main types of pulmonary edema?

Cardiogenic and noncardiogenic

What causes noncardiogenic pulmonary edema?

Damage to capillary endothelium

What can damage capillary endothelium and cause noncardiogenic pulmonary edema?

Smoke inhalation or other harmful substances

What happens after capillary injury in noncardiogenic pulmonary edema?

Capillary permeability increases

What leaks into the alveoli in noncardiogenic pulmonary edema?

Fluid and plasma proteins

How does pulmonary edema damage alveoli further?

It damages cells that make surfactant

Why is loss of surfactant bad?

It causes atelectasis

What is atelectasis?

Collapsed alveoli

Why does atelectasis lower oxygenation?

Collapsed alveoli are not available for gas exchange

Common signs of pulmonary edema?

Cough, dyspnea, crackles, pink frothy sputum, hypoxemia

What are 2 causes of atelectasis in these notes?

Mucus blockage and loss of surfactant

How can pneumonia cause atelectasis?

Mucus blocks air flow, so alveoli collapse

How can edema cause atelectasis?

It damages surfactant-making cells, causing alveolar collapse

What is another name for lung cancer

Bronchogenic carcinoma

Where does bronchogenic carcinoma arise from?

The epithelium of the respiratory tract

What is the most common cause of lung cancer?

Cigarette smoking

How does smoking cause lung cancer?

Tobacco carcinogens cause genetic mutations in bronchial cells

What procedure is used to help diagnose lung cancer?

bronchoscopy

What are the 2 main lung cancer types in these notes?

Small cell (SCLC) and non-small cell (NSCLC)

Common signs of lung cancer?

Pleural effusion, cough, sputum, chest pain, SOB, weight loss, anorexia

High V/Q means what kind of problem?

low perfusion

In high V/Q, what is the issue?

Air is present, but not enough blood gets to it

What can cause high V/Q besides emboli?

Vessel strictures, malformations, birth defects

What can a pulmonary embolus be made of?

Blood clot, tissue fragment, or air bubble

What are the 3 parts of Virchow’s triad?

Endothelial injury, hypercoagulability, venous stasis