pulmoary system PATHO

Retractions

The kin sinks in during breathing because of the use of accessory muscles

Expectoration

Coughing up sputum

What inner ages the diaphragm

The phrenic nerve

Describe respiratory failure

The body fails to provide enough oxygen and/or remove enough CO2

What is a VQ mismatch

Where the ventilation and perfusion do not match up - the amount of air flow through the alveoli does match up with the capillary blood flow

What is a cause of a VQ mismatch

Pulmonary embolism - the clot blocks a capillary and the perfusion level decreases causing a mismatch

What is a pulmonary function test

A test that helps determine how much air you can breathe in and out

What is acute rhinitis

A sudden short term infection caused by a viral infection that causes inflammation of the mucous membrane

What is chronic rhinitis

A long term or recurring inflammatory condition that is caused by allergies, irritants or underlying conditions, and causes inflammation of mucous membranes

What are the symptoms of bacterial rhinitis

Thick elbow or green mucous, facial pain or pressure, and post nasal drip

What are the symptoms of viral rhinitis

Clear watery discharge, sore throat, caught, sneezing, congestion

What are the symptoms of allergic rhinitis

Itchy eyes, nose and throat, red, watery eyes

What are the symptoms of sinusitis

Clear watery discharge, sore throat cough, sneezing, with nasal congestion (very similar to bacterial Rh.

Rhinitis vs sinusitis

Rh - inflammation of nasal passages

Sinusitis - inflammation of sinuses

Acute pharyngitis

Sudden inflammation of the pharynx (throat)

What causes bacterial pharyngitis

Streptococcus pyrogenes

What other organs can strep pyrogens affect

Kidneys - bacterimia, necrotizing faciatus, strep shock syndrome

What are the symptoms of bacterial pharyngitis

Sore throat, painful swallowing, fever, red/swollen tonsils, rash

How does hyper apnea change the blood vessels

Vasodilation

How does hypoxia change the blood vessels

Vasoconstriction

Tonsillitis vs pharyngitis

Pharyngitis is the whole throat, while tonsillitis is specifically in the tonsils

What is acute bronchitis

Inflammation of the bronchioles

Anoxia

Very sever hypoxia can lead to cell and people death

What are the symptoms of acute bronchitis

Cough, fatigue, sore throat, runny nose, muscle aches, low-grade fever

What are the diagnostic criteria for chronic bronchitis

Productive cough for at least 3 months of the year, for two consecutive years

What can cause hypoxemic failure

Pneumonia, chemical poisoning, pulmonary embolism

What can cause hypercapnic failure

COPD (air trapping), asthma

What are the two categories of pneumonia

Community and hospital acquired

What is the normal bicarbonate level form an ABG

22-26

What can cause community acquired bacterial pneumonia

Strep. Pneumonia

What can cause community acquired viral pneumonia

Flu, RSV

What can cause hospital acquired bacterial pneumonia

MRSA

What can cause HAP fungal

HIV/AIDS

What causes VAP

Ventilator acquired pneumonia

What is the patho behind pneumonia

Infection causes an inflammatory response (sends macrophages and neutrophils) this causes and accumulation of pus and fluid, which affects gas exchange and a obstructs airway

How is pneumonia diagnosed?

Chest x-ray, ct scan, sputum cultures can help determine pathogens

Latent TB

The TB bacteria are in the lungs, but are surrounded by granulomas and are contained

Active TB

TB bacteria have escaped the granulomas and are multiplying. TB can be spread in this phase and you would have symptoms

What other body tissues in the body can TB cause?

Bones and joints - Pott’s disease

Damages kidneys

Fluid buildup in heart

What are the symptoms of active TB

Persistent cough >3wks, chest plain, coughing up sputum (possibly hemoptysis), weakness, weight loss

Define restrictive lung disease

A category of conditions that limit how much air the lungs can hold - deals with inflation

Define obstructive lung disease

A category of conditions that obstruct airflow airflow into lungs - think narrowing

What is the primary risk for lung disease

Smoking!!!!!

What is bronchodilation

Widening of the airways

What part of the nervous system causes bronchodilation, what receptors are responsible?

Sympathetic, beta-2

What part of the nervous system causes bronchoconstriction? What are the chemical mediators?

Parasympathetic, acetylcholine, histamine, thrombosis’s, prostaglandins

What type of pressure is the pleural membrane under?

Negative

Why is the pleural membrane important?

It allows the lungs to slide easily

What is a pleural effusion

The accumulation of fluid in the pleural space

What is a pneumothorax

The accumulation of air in the pleural space

When a pt has chronic hypoxia, what hormone is released by the kidneys?

Erythropoietin

What are the three characteristics of asthma

AHOI - airway hyper resistance, obstruction, inflammation

What is one thing about asthma that makes it “special”

It’s reversibility - spontaneous or with treatment

How do chronic asthma attacks affect the lungs

Can cause airway remodeling, smooth muscle hypertrophy, and epithelial damage

Name some causes of asthma

Allergens , irritant, respiratory infections, emotional stress, exercise

What is status asthmaticus

Severe prolonged asthma attack that does not respond to treatments

What are the layers of the pleural membrane?

Visceral and parietal

Is the main issue of COPD hypoxia or hypercapnia?

Hypercapnia

What does “blue bloater” mean with COPD pts

They tend to be cyanotic, and have edema because of right sided heart failure (cor pulmonae)

What part of the lungs does emphysema affect

Alveoli

What is a key symptom of emphysema and why are they called “pink puffers”

High respiratory rate - they must hyperventilate to stay normal

How does COPD lead to cor pulmonale

Decreased oxygen levels → vasoconstriction → pulmonary hypertension (BP is higher bc the tube it smaller) → Right ventricular hypertrophy (the heart must work harder to push the blood bc of smaller tubes and higher pressure) → eventually the heart becomes weak and fails

When are symptoms the worse for asthma pts

At night - histamine levels go up at night

How to diagnose asthma

Pulmonary function test (PFT)

Describe the pathology of bronchiectesis

Insult → inflammation → less mucous moving → more bacterial w greater risk of infection → chronic inflammation → damages bronchi → airway remodeling

What is the difference between obstructive sleep apnea and central sleep apnea

Obstructive - airway is blocked

Central - brain doesn’t send proper signals to breathe

What is a latrogenic pneumothorax

Air trapped btw lung and chest wall cause by a medical procedure

What is a tension pneumothorax

Where air enters the chest and cannot escape, ventilator can increase risk

What can cause ARDS

Sepsis, pneumonia, trauma, aspiration

What is ARDS? Patho of it?

Inflammation and widespread damage to alveoli, causing impaired gas exchange and collapse