PATHOPHYSIOLOGY EXAM 1

0.0(0)
studied byStudied by 27 people
learnLearn
examPractice Test
spaced repetitionSpaced Repetition
heart puzzleMatch
flashcardsFlashcards
Card Sorting

1/137

flashcard set

Earn XP

Description and Tags

Study Analytics
Name
Mastery
Learn
Test
Matching
Spaced

No study sessions yet.

138 Terms

1
New cards
Endocytosis
process by which a cell takes material into the cell by infolding of the cell membrane
2
New cards
Exocytosis
a process by which the contents of a cell vacuole are released to the exterior through fusion of the vacuole membrane with the cell membrane.
3
New cards
Hypoxic Injury
rise in the need for glucose in the cells to maintain ATP production due to a lack of O2 damaging the cell membrane
-ischemia is the most common cause
4
New cards
hypoxia etiology
-loss of hemoglobin (carries O2)
-decreased O2 in the air (altitude)
-Decreased oxygen delivery due to low cardiac output (circulation)
-poisoning of cytochromes (cyanide poisoning)
5
New cards
Hypoxia manifestations
-increasing membrane permeability because the Na/K pump is not maintained (lack of ATP)
-cell death due to the influx of calcium causing membrane potentials to not be maintained
-water follows Na+, so if Na is stuck in the cell, water will follow and the cell will swell and lyse
6
New cards
Reperfusion injury
More damage than hypoxic injury due to the production of reactive O2 species that bind with nucleic acids, proteins, and membrane lipids
-causes myocytes to become necrotic, so the goal is to restore blood flow, but fresh blood pushes the reactive O2 species through the heart causing irritation of the myocardium (irritation usually manifests as V.tach or V.fib)
7
New cards
Reactive Oxygen Species
oxygen free radicals, hydrogen peroxide, superoxide, and hydroxyl radicals
8
New cards
Reactive Oxygen etiology
-inflammatory cells
-hypoxia
-oxygen toxicity
-reperfusion
-exogenous oxidants (environmental pollutants, cigarette smoke, chemotherapeutic agents, hyperoxia, radiation exposure)
9
New cards
Reactive oxygen mechanism of injury
bind with nucleic acids, proteins, and membrane lipids that can cause mitochondrial injury
10
New cards
antioxidant therapies
vitamin E, mannitol, surfactant, methylene blue, beta keratin, etc gather reactive oxygen species from the body and eliminate them
11
New cards
bacteria
produce endocrine/exo toxins that can damage cell tissue and activate the arachidonic acid cascade
12
New cards
endotoxins
produced by gram negative cells upon death (liposaccharide A)
13
New cards
Viruses
require a permissive host, can be RNA or DNA, have an envelope or not
14
New cards
Direct Chemical injury
injures by breaking down the cell wall (ex. heavy metals like mercury, lead, iron)
15
New cards
Indirect chemical injury
injury caused by a metabolite
16
New cards
Blunt force injury
initial trauma causes swelling and increased intracranial pressure but secondary inflammation causes the primary damage 48-72 hours later
17
New cards
Temperature Extremes
Cells die due to hypothermia, vasoconstriction causes perfusion injury and ischemia
18
New cards
atrophy
decrease in size and function of a cell (most common in brain, heart, skeletal muscle, and secondary sex organs) due to reduced functional demand, inadequate O2 supply, insufficient nutrients, persistent cell injury, and/or aging
19
New cards
Hypertrophy
An increase in the cell size accompanied by augmented functional capacity (physiologic or increased functional demand)
can be adaptive (athletes) or maladaptive (left ventricle increase during heart failure)
20
New cards
hyperplasia
increase in the number of cells in an organ or tissue due to increased functional demand (BPH), perisistent cell injury
atypical form can be precancerous
21
New cards
metaplasia
increase in the conversion of one differentiated cell type to another
(ex. smoking can turn columnar epithelial cells in lungs to squamous epithelial cells)
22
New cards
Dysplasia
Alteration in the size, shape, and organization of the cellular components of a tissue
strong indicator of cancer
most often seen in lungs and cervix
23
New cards
Hydropic Swelling etiology
chemical, biotoxins, ischemia, physical injury
24
New cards
hydropic swelling mechanism
injurious agents cause swelling by increasing the permeability of the plasma
membrane to sodium, exceeding the capacity of the pump, damaging the sodium pump directly interfering with the synthesis of ATP
organelles become swollen and decrease function which decreases the output of ATP from mitochondria due to swelling
25
New cards
necrosis
-irreversible injury (cells swell and die)
-the sum of cellular changes after local death
-necrosis appears the same no matter how the cell has been killed
-usually related to the loss of plasma membrane
26
New cards
apoptosis
programmed cell death
27
New cards
normal pH
7.35-7.45
28
New cards
PaO2
80-100 mmHg
29
New cards
PaCO2
35-45 mmHg
30
New cards
HCO3
22-26 mEq/L
31
New cards
O2 sats
95-100%
32
New cards
metabolic acidosis
pH less than 7.35
HCO3 less than 22
33
New cards
metabolic acidosis etiology
increased production of metabolic acids, decreased acid secretion by kidney, excessive loss of bicarbonate
34
New cards
metabolic acidosis manifestations
(neuro) weakness, lethargy, confusion, coma
(cardiovascular) cardiac arrhythmias, decreased HR
(gastrointestinal) anorexia, nausea and vomiting, abdominal pain
35
New cards
metabolic alkalosis
pH greater than 7.45
HCO3 greater than 26
36
New cards
metabolic alkalosis etiology
loss of hydrogen ions (vomiting, removal of gastric secretion, hyperaldosteronism) and increased retention of bicarbonate
37
New cards
metabolic alkalosis manifestations
(neuro) hyperexcitability of tissues including seizures, mental confusion, hyperactive reflexes, tetany
(cardiovascular) hypotension, dysrhythmias
38
New cards
Respiratory Acidosis
pH less than 7.35 and PaCO2 greater than 45mmHg
39
New cards
Respiratory Acidosis etiology
impaired function of medullary respiratory center in the medulla, chest injury, weakness of respiratory muscles (ALS), chronic obstructive pulmonary disease, kyphoscoliosis, extreme obesity, pneumonia, anesthetics, opioids and sedatives, 3rd trimester pregnancy
40
New cards
respiratory acidosis manifestations
impaired consciousness, headache, irritability, muscle twitching, weakness
41
New cards
Respiratory alkalosis
pH greater than 7.45 PaCO2 less than 35 mmHg
42
New cards
respiratory alkalosis etiology
hyperventilation syndrome, hyperventilation due to fever, O2 deficiency, encephalitis, anxiety
43
New cards
respiratory alkalosis manifestations
(neuro) hyper excitability of the nervous system-tingling in toes, fingers- , dizziness, positive Chvostek's and Trousseau's sign because calcium levels drop, tetany, seizure
(cardiovascular) cardiac dysrhythmias
44
New cards
oxygenation factors
cardiac output (SVxHR), hemoglobin, oxygenation
45
New cards
upper airways and nasal cavity
warm, filter and humidify air
46
New cards
cilia
filters debris; affected by smoking and tracheostomy
47
New cards
lower respiratory tract
trachea, bronchi, lungs
48
New cards
trachea
-the last cartilage (carina) is very sensitive
49
New cards
bronchi and bronchioles
Smaller airways leading into the lungs
50
New cards
alveoli
gas exchange occurs in the capillaries here
51
New cards
dead air space
air that occupies the space between the mouth and alveoli but that does not actually reach the area of gas exchange
52
New cards
tidal volume
Amount of air that moves in and out of the lungs during a normal breath (usually 400-500)
53
New cards
inspiratory reserve volume
Amount of air that can be forcefully inhaled after a normal tidal volume inhalation
-IRV + TV= Inspiratory lung capacity
54
New cards
Vital capacity
The total volume of air that can be exhaled after maximal inhalation.
55
New cards
expiratory reserve volume
Amount of air that can be forcefully exhaled after a normal tidal volume exhalation
56
New cards
residual volume
Amount of air remaining in the lungs after a forced exhalation, prevents lung collapse
57
New cards
functional residual capacity
expiratory reserve volume + residual volume
58
New cards
hypoxemia
deficient amount of oxygen in the blood
59
New cards
hypoxia
deficiency in the amount of oxygen reaching the tissues
60
New cards
ventilation-perfusion ratio
the ratio of the amount of air reaching the alveoli to the amount of blood reaching the alveoli
-apex is 3
-zone 2 is 1
-zone 3 is .63
61
New cards
patient positioning
GRAVITY
-good lung should always be down because in impaired lung there is poor gas exchange
62
New cards
Obstructive Pulmonary Disorders
decreased FEV1/FVC
asthma, COPD, bronchiolitis, cystic fibrosis, acute bronchitis
63
New cards
Bronchiolitis
inflammation of the bronchioles
64
New cards
bronchiolitis etiology
-RSV (respiratory syncytial virus) is most common
-influenza (mostly small children)
65
New cards
bronchiolotis manifestations
-exudate in airways
-increased lymphocytes in airways
-increased inflammatory response causes the airway to narrow
-dyspnea causes wheezing
-course crackles
-retractions (mainly in kids)
-nasal flaring
-elevated WBC count
-atelectasis
66
New cards
asthma
recurring attacks of diffuse wheezing, dyspnea, and cough resulting from spasmodic contractions of the bronchi and inflammation
67
New cards
asthma etiology
constriction of the airway due to inflammation and muscular contraction of the bronchioles, known as "bronchospasm"

-extrinsic (allergic asthma usually occurring in children and young adults)
-intrinsic (caused by respiratory infections, usually occurring in middle age)
-exercise induced asthma
-occupationsal asthma (fumes, formaldehyde, NSAIDs)
68
New cards
asthma manifestations
-wheezing
-tightness in chest
-dyspnea
-productive (has sputum, assess color and consistency)
-decreased peak expiratory flow rate
-Decreased FEV1
69
New cards
Status Asthmaticus
severs attack, unresponsive to therapy
-in constant bronchospasm, no wheezing
-all air is trapped (silent chest indicates no movement)
70
New cards
COPD
chronic obstructive pulmonary disorder; developed by serious smokers; emphysema and chronic bronchitis
71
New cards
chronic bronchitis population characteristics
-40 year old make, incidence in women is increasing
-overweight
-smokers
-acute bronchitis can become chronic
72
New cards
chronic bronchitis etiology
-smoking
-repeated viral or bacterial respiratory infections
-physical or chemical irritants
-normal aging process (causes airway thickening)
73
New cards
chronic bronchitis pathogenesis
-chronic inflammation
-scarring and swelling of the bronchial mucosa
-impaired mucociliary elevator function due to metaplasia
-increased thickness of mucosal wall (increased chance of infection)
74
New cards
chronic bronchitis manifestations
-shortness of breath
-excessive sputum production
-chronic cough
-fatigue, hypoxia, CO2 retention
-loss of libido
-insomnia
-decreased FEV1
-Elevated PaCO2, decreased PaO2
75
New cards
hypoxic drive
A condition in which chronically low levels of oxygen in the blood stimulate the respiratory drive; seen in patients with chronic lung diseases (COPD)
76
New cards
Acute Bronchitis
an inflammation of the lower respiratory tract that is usually due to infection.
77
New cards
acute bronchitis etiology
bacterial infection
78
New cards
acute bronchitis pathogenesis
Airways become inflamed/narrowed from capillary dilation

Swelling from exudative fluid

Infiltration with inflammatory cells

Increased mucous production

Decreased function of cilia
79
New cards
acute bronchitis manifestations
-fever
-productive cough
-increased mucous production
80
New cards
Emphysema
destructive changes in the alveolar wall without fibrosis and abnormal enlargement of the distal air sacs
81
New cards
emphysema population
thin males mid 50s
82
New cards
emphysema etiology
-cigarette smoking
-air pollution
-occupational conditions (asbestos)
-normal aging (alpha 1 antitrypsin decreases with age)
83
New cards
emphysema pathogenesis
-inflammation of lung tissue
-loss of alveolar walls (decrease in surface area limits gas exchange)
-loss of elastic tissue in the lungs
-air trapping (barrel chests)
84
New cards
emphysema bronchitis manifestations
-progressive exertional dyspnea
-use of accessory muscle to breathe
-pursed lip breathing
-decreased FEV1
-increased residual volume because of alveolar wall collapse
-slight decrease in in PaO2, normal PaCO2
-lungs are too compliant
85
New cards
Restrictive Pulmonary Disorders
pulmonary fibrosis, neuromuscular, kyphoscoliosis
86
New cards
Pulmonary Fibrosis
thickening of the alveolar interstitium (scarring inside the lungs)
87
New cards
pulmonary fibrosis etiology
-related to immune reaction (lymphocytes, plasma cells, macrophages flood the lungs)
88
New cards
pulmonary fibrosis pathogenesis
-infiltration of lung tissue with lymphocytes, macrophages, and plasma cells
-vital capacity is significantly less
-FEV1 test is normal but total lung volume is less
89
New cards
pulmonary fibrosis manifestations
-rapid, shallow breathing
-dyspnea
-non productive cough
-clubbing
-decreased lung volumes (FVC drop)
90
New cards
Pneumothorax
-disruption of the parietal or visceral pleura; injury to the pleura
-air in the pleural space
-hear nothing
-symptom: O2 drops, tachypnea, dyspnea
91
New cards
Open pneumothorax
-hole in chest wall causes lung collapse (penetrative injury)
-can become infected
-pressure on wound (gauze) can only be applied on 3 sides or it can become a tension pneumothorax
-same symptoms as regular pneumothorax
92
New cards
Tension Pneumothorax
-medical emergency that can result from regular from a regular or open pneumothoarx
-shifting/compresses the side the injury is not on; since the heart is in between, as pressure shifts, the heart is crushed
-symptoms include pneumothorax symptoms and decreased BP, mediastinal shifting and tracheal deviation
-dropped HR/weak pulse, bad cap refill, cold limbs, hypoxemic, short of breath
93
New cards
Hemopneumothorax
-blod buildup in pleural space
-usually results from another trauma
-hematocrit and CO drop
94
New cards
Pleural Effusion
-fluid in the pleural space
-cancer patient, renal failure, shock (septic) patients, older adults
-can cause lungs to collapse
-muffled, waterlogged sound
95
New cards
Acute respiratory failure etiology
ANYTHING THAT DROPS THE PaO2 BELOW 60 AND ELEVATES THE PaCO2 ABOVE 50
-CNS causes like seizure tumors
-Neuromuscular diseases like ALS, muscular dystrophy, virus that causes paralysis
-chest wall problems (flail chest, scoliosis)
-airway problem like trauma to the trachea
-pulmonary parenchymal diseases like ARDS, pneumonia
-vascular diseases (pulmonary embolus)
96
New cards
acute respiratory failure pathogenesis
-ventilation perfusion mismatch
--Ventilation: leaking fluid into alveoli, shunting results in dropped O2, interstitial fluid leaking out of lungs
--Perfusion: alveolar hyperventilation caused by choking or overdose, blood clot, decreased CO
97
New cards
Acute respiratory failure manifestations
-hypoxemia (SOB, dyspnea)
-hypercapnia (tachypnea)
98
New cards
Acute respiratory distress syndrome
damage to the alveolar-capillary membrane causing intrapulmonary shunting
-inflammation response (protein rich fluid, WBC count increase, surfactant decrease causes alveolar collapse)
-40% mortality rate; most common and worst kind of respiratory failure
99
New cards
ARDS etiology
-trauma
-sepsis
-aspiration
-fat emboli
-shock
100
New cards
ARDS pathogenesis
-shunting (oxygenated blood goes back to the heart)
-decreased lung compliance (decreased surfactant)
-decreased functional residual capacity
-infiltrates
-atelectasis due to decreased surfactant