Patho Study Guide Exam 4

Upper respiratory tract

Nose, pharynx, larynx → warms, filters, humidifies air

Lower respiratory tract

Trachea, bronchi, bronchioles, lungs

Right lung

3 lobes

Left lung

2 lobes

Right bronchus

Wider, shorter, more vertical → aspiration risk

Bronchioles

No cartilage, more smooth muscle

Alveoli

Site of gas exchange with thin walls and macrophages for protection

Epiglottis

Prevents aspiration

Carina

Divides right and left bronchi

Mucociliary blanket

Cilia move mucus + trapped particles upward, protects lungs from infection

Medulla

Respiratory control center (sets rhythm)

Pons

Controls breathing patterns

Eupnea

Normal breathing

Bradypnea

Slow breathing

Tachypnea

Fast breathing

Apnea

No breathing

Chemoreceptors

Central: respond to pH/CO₂ changes; Peripheral: respond to ↑ CO₂ / ↓ O₂

Phrenic nerve

Controls diaphragm (C3-C5)

Compliance

Ease of lung expansion

Resistance

Opposition to airflow

Ventilation

Air movement in and out of lungs

Perfusion

Blood flow through pulmonary capillaries

Dyspnea

Subjective feeling of shortness of breath

Cough

Protective reflex to clear airway

Chest X-ray (CXR)

Shows size/shape of lungs and heart; identifies fractures, fluid, tumors

Chest CT scan

More detailed; detects tumors, abscesses, TB, pleural effusion

Normal SpO₂

95-100%

Life-threatening SpO₂ level

< 85% (severe hypoxia)

Pneumonia

Acute inflammatory infection of bronchioles and alveoli caused by microbes

Aspiration pneumonia

Inhalation of foreign material (food, fluids, secretions) into lungs

Atelectasis

Collapse of alveoli → ↓ gas exchange

Acetylcysteine (mucolytic)

Breaks down thick mucus → easier to cough up

Tuberculosis (TB)

Infection caused by Mycobacterium tuberculosis; airborne transmission

Directly Observed Therapy (DOT)

Healthcare worker watches patient take meds to ensure compliance and prevent drug resistance.

Drug-Resistant TB

MDR-TB: resistant to INH + Rifampin; XDR-TB: resistant to multiple drugs.

Isoniazid (INH)

Action: kills active + dormant TB; Use: first-line, latent TB; Adverse Effects: Hepatotoxicity, Peripheral neuropathy; Nursing: Give Vitamin B6, Monitor liver function, Avoid alcohol.

Rifampin

Action: inhibits RNA synthesis; Use: active TB; Adverse Effects: Hepatotoxicity, Orange body fluids; Nursing: Warn about discoloration, Monitor liver, Decreases birth control effectiveness.

Pyrazinamide

Action: kills active TB; Adverse Effects: Hepatotoxicity, Gout; Nursing: Monitor liver, Avoid alcohol.

Ethambutol

Action: bacteriostatic; Adverse Effects: Optic neuritis (vision changes); Nursing: Monitor vision, Stop if vision changes.

Streptomycin

Action: kills extracellular TB; Adverse Effects: Nephrotoxicity, Ototoxicity; Nursing: Monitor hearing, Monitor kidney function.

Liver function tests (LFTs)

Tests to monitor for INH, Rifampin, Pyrazinamide.

Renal function

To be monitored for Streptomycin.

Vision

To be monitored for Ethambutol.

Sputum cultures

To assess effectiveness of TB treatment.

COPD

A progressive disease characterized by airflow limitation that is not fully reversible.

Risk Factors for COPD

Smoking, Secondhand smoke, Occupational exposure to irritants, Air pollution, Aging, Alpha-1 antitrypsin deficiency.

Clinical Manifestations of COPD

Chronic cough, Wheezing, Dyspnea, Prolonged exhalation, Pursed-lip breathing, Accessory muscle use, Tripod positioning, Barrel chest.

Diagnosis of COPD

Pulmonary Function Tests (PFTs), Pulse oximetry, CBC, Chest X-ray.

Asthma

A chronic inflammatory airway disease with reversible airway obstruction.

Risk Factors for Asthma

Genetics, Family history, Allergens, Respiratory infections, Environmental irritants, Exercise, Stress, Hormonal changes, Cold air, GERD.

Status Asthmaticus

A severe asthma attack that does not respond to standard treatment and may lead to respiratory failure.

Peak Expiratory Flow Meter

Measures how fast air leaves the lungs and helps detect early asthma worsening.

Exercise-Induced Asthma Management

Use short-acting bronchodilator before exercise, Leukotriene modifier, Warm-up before exercise.

Short-acting beta2 agonist

Initial drug of choice for acute asthma, e.g., Albuterol.

Rescue Inhalers

Used during an asthma attack, fast acting, e.g., Albuterol.

Maintenance Inhalers

Used daily to prevent inflammation, long acting, e.g., Salmeterol.

Montelukast (Singulair)

Used for prevention of asthma; take once daily at bedtime, not for acute attacks.

Nystatin Oral Suspension

Used to treat oral candidiasis caused by inhaled corticosteroids.

Normal Theophylline Level

Therapeutic range: 5 - 15 mcg/mL; Toxic level: ≥20 mcg/mL.

Inhaler Patient Teaching

Shake inhaler before use, Exhale before inhaling medication, Hold breath 10 seconds.

Labs to Monitor with Beta2 Agonists

Potassium (↓), Blood glucose (↑).

Corticosteroids

Reduce airway inflammation, decrease mucus production, increase beta2 receptor sensitivity.

Adverse Effects of Corticosteroids

Oral candidiasis, Hoarseness, Dry mouth, Hyperglycemia, Osteoporosis.