6. Pulmonary

This set of flashcards captures essential vocabulary, anatomy, physiology, pathophysiology, diagnostic tests, clinical signs, and major obstructive and restrictive diseases discussed in the Pulmonary Disease lecture. Use them to reinforce key terms and definitions for exam preparation.

Chronic Obstructive Pulmonary Disease (COPD)

Group of chronic, generally non-reversible obstructive lung disorders (most often emphysema + chronic bronchitis) marked by prolonged expiratory time and reduced airflow.

Restrictive Lung Disease (RLD)

Category of lung disorders characterized by reduced total lung capacity and vital capacity with relatively normal flow rates; patients cannot take a full deep breath.

Pulmonary Function Test (PFT)

Primary diagnostic method for staging & classifying lung disease by measuring lung volumes, capacities, and flow rates.

Conducting Zone

Air passages from trachea through terminal bronchioles (≈23−24 bifurcations) that move air but do not participate in gas exchange.

Respiratory Zone

Region from respiratory bronchioles to alveoli where actual gas exchange across the alveolar-capillary membrane occurs.

Alveolar Type I Cell

Thin epithelial cell forming the structural wall of the alveolus; main site of gas exchange.

Alveolar Type II Cell

Specialized alveolar cell that produces pulmonary surfactant to lower surface tension and prevent alveolar collapse.

Alveolar Type III Cell

Alveolar macrophage responsible for phagocytosis and “housekeeping” in the alveoli.

Ventilation

Mechanical movement of air into and out of lungs driven by thoracic musculature, compliance, and airway resistance.

Respiration (Gas Exchange)

Diffusion of O₂ and CO₂ across the alveolar-capillary membrane in the respiratory zone.

Hypercapnic Drive

Primary neurologic control of breathing stimulated by elevated arterial CO₂ levels detected in cerebrospinal fluid.

Hypoxic Drive

Secondary ventilatory stimulus arising from low arterial O₂, sensed by carotid bodies—important in some chronic CO₂ retainers.

Accessory Inspiratory Muscles

Sternocleidomastoid, scalenes, trapezius, pectoralis major/minor, and external intercostals recruited during active or labored inspiration.

Accessory Expiratory Muscles

Internal intercostals, abdominal muscles, serratus, latissimus dorsi engaged during forced expiration.

Sign vs. Symptom

Sign: objective finding noted by examiner; Symptom: subjective complaint perceived by patient.

Digital Clubbing

Painless enlargement & cyanotic bulb-shaped appearance of distal phalanges associated with chronic hypoxemia.

Stridor

High-pitched inspiratory sound indicating upper-airway obstruction.

Wheeze

Musical, mostly expiratory sound produced by air flowing through narrowed airways.

Crackles (Rales)

Crackling inspiratory sounds caused by sudden opening of small airways or alveoli.

Cheyne–Stokes Respiration

Cyclic waxing-and-waning pattern of breaths alternating with apnea, often seen in heart failure or stroke.

Kussmaul’s Respiration

Deep, rapid (hyperpneic + tachypneic) breathing pattern typical of metabolic acidosis (e.g., DKA).

Senile Emphysema

Age-related loss of alveolar surface area and elastic recoil producing larger air spaces and reduced gas exchange.

Pack-Years

Smoking exposure metric: (packs per day) × (years smoked); >60 pack-years strongly linked to COPD.

Global Initiative for Chronic Obstructive Lung Disease (GOLD)

NHLBI/WHO standards for worldwide diagnosis, staging, and management of COPD.

Acute Bronchitis

Short-term inflammation of trachea and bronchi, usually viral or bacterial, causing cough and sputum.

Asthma

Reversible airway disease marked by hyperreactivity, bronchospasm, and mucous production triggered by intrinsic or extrinsic stimuli.

Extrinsic (Allergic) Asthma

IgE-mediated, trigger-related asthma commonly beginning in childhood.

Intrinsic (Non-Allergic) Asthma

Adult-onset asthma triggered by irritants, cold air, exercise, drugs, or stress and not IgE-dependent.

Status Asthmaticus

Intractable, severe asthma attack unresponsive to usual therapy; medical emergency.

FEV₁

Forced Expiratory Volume in the first second; key spirometric value lowered during obstructive events.

Emphysema

Permanent destruction of alveolar walls and capillaries causing air trapping, hyperinflation, and loss of elastic recoil.

Centrilobular Emphysema

Smoking-related emphysema affecting respiratory bronchioles in proximal lobule.

Panlobular Emphysema

Genetic α₁-antitrypsin deficiency–related emphysema involving entire acinus; diffuse.

α₁-Antitrypsin Deficiency

Inherited lack of protease inhibitor leading to auto-digestion of lung tissue and panlobular emphysema.

Cor Pulmonale

Right-sided heart failure secondary to pulmonary hypertension from chronic lung disease.

Pursed-Lip Breathing

Exhalation technique that increases airway back-pressure to keep alveoli open, often used by “pink puffers.”

Chronic Bronchitis

Clinical diagnosis of productive cough ≥3 months/year for 2 consecutive years with airway inflammation and mucus hypersecretion.

Blue Bloater

Nickname for chronic bronchitis patient with cyanosis, hypoxia, and early cor pulmonale.

Asthma Trigger – Leukotriene Pathway

TH2-cell activation leading to mast-cell degranulation and leukotriene-mediated bronchoconstriction.

Cystic Fibrosis (CF)

Autosomal recessive disorder (CFTR mutation on chromosome 7) causing thick secretions in lungs, pancreas, and other exocrine glands.

CFTR Protein

Cystic Fibrosis Transmembrane Conductance Regulator, a chloride channel impaired in CF, leading to dehydrated mucus.

Sweat Test

Diagnostic test measuring elevated NaCl in sweat to confirm cystic fibrosis.

Percussion Vest

Mechanical airway-clearance device used in CF to mobilize secretions via chest wall vibrations.

Bronchiectasis

Irreversible dilation & destruction of bronchi with chronic infection; severe form of obstructive disease.

Obstructive Sleep Apnea (OSA)

Sleep-disordered breathing caused by pharyngeal collapse leading to apneas, hypoxia, and daytime sleepiness; treated with CPAP.

Total Lung Capacity (TLC)

Maximum volume of air in lungs after maximal inspiration; decreased in restrictive disease.

Vital Capacity (VC)

Maximum air volume exhaled after maximal inspiration; reduced in restrictive disorders.

Pleural Effusion

Excess fluid accumulation in pleural space causing restrictive ventilation mechanics.

Pneumothorax

Air in pleural space resulting in lung collapse and acute restrictive dysfunction.

Atelectasis

Airless state of lung tissue due to alveolar collapse or failure of expansion at birth.

Pulmonary Edema

Fluid accumulation in alveoli/interstitium, often from left-heart failure, impairing gas exchange.

Acute Respiratory Distress Syndrome (ARDS)

Acute lung injury with alveolar-capillary damage, severe hypoxemia, and high mortality; “shock lung.”

Tuberculosis (TB)

Airborne infection by Mycobacterium tuberculosis causing granulomas, caseous necrosis, and cavitations.

Ghon Focus

Calcified primary lesion formed around Mycobacterium tuberculosis in primary TB infection.

Primary TB

Initial infection acquired by inhalation of MTB; often asymptomatic but positive skin test.

Secondary (Reactivation) TB

Endogenous reactivation of dormant MTB producing active, contagious pulmonary disease.

Isoniazid (INH)

First-line anti-TB drug inhibiting mycolic acid synthesis; used 6–9 months.

Rifampin

Anti-TB antibiotic blocking bacterial RNA synthesis; orange discoloration of secretions common.

Aspiration Pneumonia

Inflammation of lungs from inhalation of food, liquids, or vomitus; often polymicrobial.

Pleural Pleurisy

Inflammation of pleura causing sharp chest pain that worsens with breathing.

Hemoptysis

Expectoration of blood from respiratory tract, sign of pulmonary pathology.

Cyanosis

Bluish skin discoloration from unsaturated hemoglobin indicating hypoxemia.

Dyspnea

Subjective sensation of difficult or uncomfortable breathing.

Hyperventilation

Increased alveolar ventilation leading to decreased arterial CO₂ (hypocapnia).

Hypoventilation

Insufficient ventilation resulting in elevated arterial CO₂ (hypercapnia).

V/Q Ratio

Ventilation/Perfusion matching; near normal in emphysema due to compensatory breathing techniques.

Sleep Polysomnography

Overnight diagnostic study recording brain waves, breathing, and O₂ levels to detect sleep disorders.

Postural Drainage

Chest physiotherapy positioning technique that uses gravity to aid secretion removal from specific lung segments.

Energy Conservation Techniques

Strategies taught to COPD patients to reduce oxygen demand during activities of daily living.

Inspiratory Muscle Trainer

Device providing resistance to strengthen diaphragm and other inspiratory muscles.

Carotid Bodies

Peripheral chemoreceptors that sense changes in arterial O₂, CO₂, and pH for ventilatory control.

Blood–Brain Barrier (BBB)

Barrier regulating substances between blood and cerebrospinal fluid; involved in central CO₂ detection for breathing control.

Obesity Hypoventilation

Restrictive ventilatory impairment due to excessive body mass limiting chest wall expansion.

Meconium Ileus

Intestinal obstruction in newborns from thick meconium; classic early sign of cystic fibrosis.

Polycythemia

Excess red blood cell production often secondary to chronic hypoxia in COPD patients.

Pulmonary Hypertension

Elevated pulmonary arterial pressures frequently leading to right-heart strain (cor pulmonale).

Sarcoidosis

(Not in notes) – omitted.

Surfactant

Phospholipid produced by Type II cells that reduces alveolar surface tension, preventing collapse.

Hypoxic Hypoxia

Low arterial O₂ content causing tissue hypoxia; can trigger hypoxic ventilatory drive.

Bradypnea

Abnormally slow respiratory rate.

Tachypnea

Abnormally rapid respiratory rate without necessarily large volumes.