Respiratory Inflammation, Infection, and Pulmonary Assessment: Chapter 20

What are the common types of respiratory infections?

Upper respiratory infections, ranging from the common cold to tuberculosis (TB).

How many people worldwide are affected by tuberculosis?

Approximately 2 billion.

What is the anatomical difference between the left and right lungs?

The left lung has two lobes (upper and lower), while the right lung has three lobes (upper, middle, and lower).

Why is there an increased risk of pulmonary aspiration in the right lung?

The right bronchus is straighter, making it easier for material from the oropharynx to enter.

Where is normal flora found in the respiratory system?

Normal flora is present in the upper respiratory tract (mouth, nose, throat) but not in the lower respiratory tract and alveoli.

What is the function of the mucociliary apparatus?

It helps to clear the lower respiratory tract of infectious agents through the movement of mucus and inhaled particles.

What cells are involved in the mucociliary apparatus?

Ciliated pseudostratified epithelial cells and goblet cells (which secrete mucus).

What factors can damage the mucociliary apparatus?

Respiratory infections and smoking.

What is oxyhemoglobin?

Hemoglobin with oxygen attached.

What does SaO2 represent?

The percentage of saturation of hemoglobin with oxygen.

What is the significance of the partial pressure of oxygen (PaO2)?

It is the factor on which the saturation of hemoglobin with oxygen (SaO2) depends.

How is SaO2 measured?

Using a pulse oximeter placed on the fingertip.

What stimulates the release of erythropoietin (EPO)?

Hypoxemia (low oxygen levels in the blood).

What is the response of EPO in the body?

It stimulates the bone marrow to produce red blood cells (RBCs) to compensate for hypoxia.

What is the role of the diaphragm during inspiration?

The diaphragm moves downward.

What is the role of the diaphragm during expiration?

The diaphragm moves upward.

What is the origin of the phrenic nerve?

It originates from the C4 spinal nerve.

What happens if there is a spinal cord injury at C4 or above?

It interrupts motor and sensory conduction, affecting diaphragm function.

Which spinal nerves are critical for diaphragm function?

C3, C4, and C5.

What are the primary muscles used in respiration?

External intercostals, internal intercostals, sternocleidomastoids, scalenes, and abdominals.

What does the ventilation-perfusion (V-Q) ratio measure?

The ratio of air reaching the alveoli compared to the amount of blood reaching the alveoli.

What is the ideal ventilation-perfusion ratio?

Ventilation and perfusion are matched, meaning areas of the lungs that are ventilated receive blood flow.

What happens to pulmonary arteries in response to low ventilation?

They vasoconstrict as a built-in compensation mechanism.

What does a V-Q scan measure?

It measures the ventilation-perfusion ratio.

What effect does hypoxia have on pulmonary arteries?

Hypoxia stimulates pulmonary arterial vasoconstriction.

What condition may result from chronic hypoxia?

Chronic pulmonary vasoconstriction, which can lead to pulmonary hypertension.

What is a common cause of ventilation-perfusion mismatching?

Pulmonary embolism, where a clot prevents blood flow to the alveolus.

What are central chemoreceptors and where are they located?

They are located in the medulla and sense changes in CO2 and pH.

What stimulates increased ventilation in response to hypercapnia?

Hypercapnia, or increased CO2 levels.

What is dyspnea?

Shortness of breath.

What is orthopnea?

Dyspnea that occurs when lying flat.

What does expectoration refer to?

Coughing up of sputum.

What is hemoptysis?

Coughing up blood-containing sputum, usually bright red.

What is atelectasis?

Collapse of a small number of alveoli due to compressive force or obstruction.

What is hypoxia?

Insufficient oxygen for the body's needs.

What is hypoxemia?

Insufficient oxygen in the blood.

What is respiratory failure?

Failure to oxygenate blood or remove CO2.

What is the normal respiratory rate?

12 to 20 breaths per minute.

What is bradypnea?

A respiratory rate of less than 12 breaths per minute.

What is tachypnea?

A respiratory rate of greater than 20 breaths per minute.

What are abnormal breath sounds associated with inflamed bronchi called?

Rhonchi.

What is a friction rub?

A grating, scratchy sound indicating inflammation of the pleural surfaces.

What does clubbing of fingertips indicate?

Chronic hypoxia.

What is the purpose of culture and sensitivity testing of sputum?

To identify the causative organism of a pulmonary infection and determine its sensitivity to antibiotics.

What does NAAT stand for in pulmonary diagnostics?

Nucleic Acid Amplification Test, used for detecting tuberculosis (TB).

What is a V-Q scan?

A ventilation-perfusion scan used to assess blood flow and air flow in the lungs.

What are pulmonary function tests (PFTs) used for?

To measure lung function, including airflow and lung volumes.

What do arterial blood gases measure?

The levels of oxygen and carbon dioxide in the blood, indicating lung function.

What is the significance of pulse oximetry?

It measures the oxygen saturation (SaO2) of the blood.

What imaging techniques are used to diagnose pulmonary disorders?

Chest x-ray, CT scan, and MRI scan.

What is bronchoscopy used for?

To visualize the larynx, trachea, and bronchi.

What is thoracocentesis?

A procedure to remove pleural fluid from the chest cavity.

What are common signs and symptoms of pulmonary dysfunction?

Dyspnea, cough, abnormal sputum, hemoptysis, labored breathing, cyanosis, and abnormal breath sounds.

What does dyspnea refer to?

Shortness of breath (SOB).

What are the types of upper respiratory tract infections?

Acute rhinitis, acute pharyngitis, acute sinusitis, acute tonsillitis, epiglottitis, and laryngitis.

What is infectious rhinitis commonly known as?

The common cold, a viral upper respiratory infection.

What is pneumonia?

An infection of the lungs that can be bacterial, viral, or fungal.

What are the types of pneumonia based on acquisition?

Community-acquired pneumonia (CAP), hospital-acquired pneumonia (HAP), and ventilator-acquired pneumonia (VAP).

What is tuberculosis (TB)?

A bacterial infection caused by Mycobacterium tuberculosis, transmitted through airborne droplets.

What are classic signs of tuberculosis?

Cough, weight loss, night sweats, and hemoptysis.

What is the pathophysiology of pneumonia?

An inflammatory reaction to pathogens leading to fluid accumulation in the alveoli.

What diagnostic tests are used for pneumonia?

Chest x-ray and sputum culture.

What treatments are commonly used for pneumonia?

Antibiotics, oxygen therapy, IV fluids, and bronchodilators.

What preventive measures are recommended for pneumonia?

Vaccination, standard precautions, and wearing masks.