Patho Exam 2

Digestive, Endocrine, Electrolytes, Urinary, Respiratory

What are the two major functions of the respiratory system?

1. Make oxygen available to the tissues for metabolism

2. Carry CO2 away

How does the respiratory system carry out its functions?

ventilation and gas exchange

What is ventilation?

the movement of air in and out of the respiratory system

What does air in the body moved based on?

pressure gradients

What are vacuums?

negative pressures in the plural space that help keep the lungs expanded against the chest wall

What does elastic energy help the respiratory system with?

It helps the alveoli expand during gas exchange

What is surfactant made up of?

phospholipids and proteins

What does surfactant do?

helps reduce surface tension

At the end of exhalation, most of the lung volume is…?

Air

How much of lung mass is blood volume?

about 50%

What are the two categories of lung diseases?

obstructive and restrictive lung disorders

What are obstructive lung disorders?

conditions that obstruct the airways and may hamper inspiration and exhalation, especially when a person is breathing out

What do restrictive lung disorders affect?

diffusion and gas transport through the respiratory epithelium

obstructive lung disorders can be…?

acute and chronic

Asthma can be acute or chronic depending on..?

Extent of inflammation or inflammatory response due to exposure to environmental allergens

Asthma is a common (chronic/acute) disease?

chronic

how many people does astham affect?

300 million ppl globally

How many yearly deaths are the result of asthma?

about 346,000

Asthma is higher in males (less than/greater than) age 18?

less than

Asthma is higher in females (less than/ greater than) age 18?

greater than

What is chronic obstructive pulmonary disease (COPD)?

a broad term to describe conditions of progressive, often irreversible obstructions of airflow

What is emphysema?

It is damage of lung connective tissue resulting in enlarged air spaces.

What is the result of emphysema?

gas exchange units and walls between alveoli are destroyed

What is chronic bronchitis?

a clinical history of productive cough for 3 months for 2 consecutive years

What is the result of chronic bronchitis?

1. long term inflammation

2. loss of cilia

3. overproduction of mucus

What causes emphysema?

chronic coughing which causes an imbalance of between lung oxidant, antioxidants, and anti-elastates

What is asthma?

increased constriction of the lower respiratory tract due to a variety of stimuli

What does asthma cause?

1. muscle tightening

2. inflammation

3. excess mucus

The persistent respiratory systems of COPD are (primary or secondary) to airway and alveolar abnormalities?

secondary

What is the clinical presentation of COPD?

1. Chronic bronchitis

2. emphysema

What pulmonary disorder is chronic bronchitis a type of?

it is a type of COPD that is a long-term irritation of the bronchial tree’s epithelium

What causes chronic bronchitis?

an obstructed and inflamed airway

What are the clinical manifestations of chronic bronchitis?

1. cough with sputum production

2. wheezing

What is an example of an internal oxidant?

superoxide anion

What is an example of an external oxidant

cigarette smoke

What are the 3 changes that occur due to emphysema?

1. destruction of alveoli

2. loss of alveoli-capillary bed

3. loss of supporting structures of lung

Is emphysema damage reversible?

NOOOO

What are restrictive pulmonary disorders

lung disorders that restrict the alveoli or reduce lung compliance resulting in decreased lung inflation

What is alveolar fibrosis?

scarring of the alveoli

What are the functions of the kidney?

1. excretion of waste through urine

2. regulation of blood volume

3. delivery of urine from the body to the bladder

4. control of urine production

What kidney functions are associated with other systems?

1. Vitamin D synthesis: skeletal system for calcium deposit

2. Renin and eythropoietin production: cardio and endocrine system

3. Elimination of wastes: excretory systems

What waste is excreted through the urine?

nitrogenous by-products of metabolism

What is the pH range of the kidneys?

4.5-8

What is the blood pH range?

7.32-7.45

What % of cardiac output do the kidneys receive?

about 20%

How often is the total blood volume filtered through the kidneys?

every 60 min

How much waste do the kidneys generate?

1.5-2 liters

What are the components of the nephron?

1. glomerulus

2. arterioles

3. bowmans capsule

4. podocytes

5. renal tubule

6. PCT

7. LOH

8. DCT

9. CD

What is the nephron surrounded by?

the vasa recta capillary bed

What are podocytes?

holes on the outer layer of the glomerulus which allow for and help with blood filtration

What is the function of the glomerulus?

filtration

what is the process of the renal tubules?

processing of the filtrate

How much filtrate is generated every 10 minutes?

1 liter

How much filtrate is generated in 24 hours?

144 L

What is urethritis?

inflammation of the urethra

what is cystitis?

inflammation of the urinary bladder

what is nephritis?

kidney disease or inflammation of the kidney

___ (males or females) are more susceptible to UTIs

females

why are females more susceptible to UTIs

1. they have a shorter urethra

2. urethra has a closer proximity to the anus and the vagina

What is the size difference of urethra in males and females?

male urethra is about 8 in. and the female urethra is less than 2 in.

A UTI can spread to..?

the renal pelvis (pyelitis) or renal cortex (pyeloenephritis)

What is hydronephrosis?

It is the buildup of urine in the kidney

What causes hydronephrosis?

results when the flow of urine from the kidney is blocked

What can block urine flow?

1. kidney stones

2. blood clots

3. tumors

4. birth defects that cause a narrowing of the ureter

What is the order of progression of hydronephrosis

obstruction → urine backs up → pressure increase → hydronephrosis → possible kidney damage

what is polycystic kidney disease (PKD) ?

it is an inherited disorder that causes multiple cysts to form on the kidneys

What are kidney stones?

calcium or uric acid precipitates that may block the flow of urine in the ureters

What can be used to break down kidney stones?

Lithotripsy

What is lithotripsy?

a procedure where kidney stones are broken down with energy waves, which allows the stones to be more easily passed through the urethra

What is important when determining danger of kidney stones?

location and obstruction rather than just appearance

What is medical term for kidney stones?

nephrolithiasis or renal calculi

What is neurogenic bladder?

disruption of the nerve input to the bladder resulting in loss of normal control of voiding

What is proteinuria?

protein in the urine

What is hypoalbuminemia?

low albumin in the blood

what is edema?

tissue swelling due to accumulation of fluid

what is the progression of glomerular disorders?

glomerular damage → proteinuria → decreased blood albumin → decreased oncotic pressure → edema

What is acute renal failure?

abrupt reduction in kidney function

What is chronic renal failure?

slow, progressive condition resulting in gradual loss of nephrons

Is chronic or acute renal failure potentially reversible?

acute

Is chronic or acute renal failure irreversible?

chronic

How is kidney function assessed?

by assessing filtration, waste and urine output

What are the characteristics of stage 1 kidney (normal) function?

1. remaining healthy nephrons compensate by enlarging and taking over the function of the lose nephrons

2. BUN test is kept within normal limits even though up to 75% of nephrons are lost

What is the BUN test?

blood-urea-nitrogen test

What are the characteristics of stage 2 (mild) kidney function/loss

1. Kidney can no longer adapt to the loss of nephrons

2. remaining healthy nephrons cannot handle the urea load

3. BUN level spikes

4. Loss exceeds compensation What

What are the characteristics of stage 3 (complete renal failure) kidney function?

1. kidney stops functioning

What is the clinical presentation of acute kidney disease?

1. rapid deterioration of renal function due to accumulation of nitrogenous wastes in blood

2. urine output is less than 0.5 mL/kg/h for at least 6 hours

What are the phases of acute kidney disease (AKD)

1. Prerenal

2. intrarenal

3. acute tubular necrosis

4. postrenal

What are the causes of prerenal AKD?

1. sepsis

2. drugs

what are the causes of intrarenal AKD?

1. sepsis

2. inflammatory diseases like vasculitis and glomerulonephritis

What are the causes of acute tubular necrosis?

1. ischemia

2. GN

3. Toxic injury

Prerenal AKD is associated with what kind of problem?

perfusion (flow) problems

Intrarenal AKD is associated with what kind of problems?

Kidney tissue problems

What are the causes of postrenal AKD?

urinary tract obstructions

What is an example of an INTRINSIC urinary tract obstruction?

kidney stones

What is an example of an EXTRINSIC urinary tract obstruction?

retroperitoneal mass compression of the ureter

What is postrenal AKD?

obstruction of urine flow after the kidney and urine cannot get out

What is the defining patho of prerenal AKD?

not enough blood is reaching the kidney

What is the defining patho of intrarenal AKD?

damage within the kidney

What do all forms of AKD result in?

acute tubular necrosis

What is the result of acute tubular necrosis?

1. hypoxia → ischemic damage

2. dysregulation of structural elements of tubular cell scaffolding → leaky filtrate into tubular lumen