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Respiratory system
Respiratory system
98
Pathology
Undergraduate 2
04/02/2011

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Term
more than 95 percent of primary lung cancers are..?
Definition
carcinomas
Term
metastatic tumors of the lungs begin...?
Definition
at the epitheleal lining of the major bronchi
Term
how do we get local areas of hemorrhage with lung cancer?
Definition
when the cancer udnergoes central necrosis
Term
What 4 categories can lung cancer be subdivided into?
Definition
squamous cell carcinoma, adenocarcinoma, small cell carcinoma, large cell carcinoma
Term
For the purposes of staging, cancers are commonly identified as?
Definition
small cell lung carcinoma (SCLC) or non small lung carcinoma (NSCLC)
Term
small cell lung cancer
Definition
small about the size of a lymphocyte. grow in clusters. huge association with smoking.
Term
SCLS's might arise from?
Definition
they may arise from neuroendocrine cells of the bronchial epithelium
Term
SCLC's are...?
Definition
highly malignant and tend to infiltrate easily, brain metastases are common
Term
non small cell lung cancers
Definition
tey are a part of squamous cell carcinoma, adenocarcinoma's and large cell carcinoma's
Term
non small lung cancers have the cpacity to synthesize?
Definition
bioactive products and produce paraneoplastic syndromes. 
Term
Squamous cell carcinoma
Definition
common in men and smokers. originates in central bronchi. produces hypercalcemia
Term
how does sqaumous cell carcinoma spread?
Definition
spreads from central bronchi to the lymph nodes and disseminates at the thorax
Term
adenocarcinoma
Definition
most common with women. originte in alveolar or bronchiolar tissue. has scarring.
Term
large cell carcinoma
Definition
poor prognosis due to intense spreading. originate in periphery of the lung
Term
what are the most common sites of cancer metastasis?
Definition
the brain, the bones, and the liver
Term
what are some early symptoms of lung cancer?
Definition
chronic cough, shortness of breath, wheezing, hemoptyosis, restrosternal pain
Term
where are pain receptors of the chest located?
Definition
parietal pleura, mediastinum, blood vessels and peribronchial afferent vagal fiber's
Term
tumors that invade the mediastinum may cause..?
Definition
hoarseness and difficulty swallowing bc of compression of the esophagus
Term
superior vena cava syndrom is?
Definition
interuption of blood flow to a vessel from compression of a tumor. stops draining.
Term
paraneoplastic disorders are unrelated to?
Definition
metastasis
Term
what are some more long term symptoms of lung cancer?
Definition
watsting of muscles in pelvis/shoulder girdles, decreased deep tendon reflexes
Term
NSCLC's are classified according to..?
Definition
cell types (i.e.squamous cell carcinoma) and are staged using the TNM staging system
Term
what are SCLC's not staged?
Definition
because it is assumed that there are micormetastasis's already present
Term
hypoexemia
Definition
the reduction in O2 lovels. 
Term
hypoexemia can result from
Definition
an inadequate amount of O2 in the air, disease of respiratory system
Term
continued....
Definition
inadequate circulation of blood and mismatching of ventilation and perfussion
Term
how does hyoexemia produce it's effects ?
Definition
through the tissues via hypoxia and compensatory mechanism's
Term
what are the compensatory mechanism's?
Definition
the way the body reacts to low oxygen and tries to adapt to the lowered oxygen
Term
if pO2 falls bellow a certain level what happens?
Definition
aerobic metabolism will cease and anaerobic metabolism takes over. 
Term
anearobic metabolism causes
Definition
lactic acid to build up
Term
an increase in lactic acid will cause what to happen to the bodies ph and serum?
Definition
serum lactate levels will increase and acidosis will occur
Term
what are some symptoms of hypoexemia?
Definition
increased heart rate and BP, diaphoresis, change in mental status and visual acuity
Term
what are some of the lab results of hypoexemia?
Definition
PO2 is 60 mmhg and hemoglobin saturation is 90%
Term
what is PO2?
Definition
the amount of O2 dissolved in the blood
Term
very pronounce hypoexmia causes what symptoms?
Definition
personality changes, restlessnes, euphoria,delerium, stupor, coma, coma
Term
how does the body compensate for chronic hypoexemia?
Definition
by increased ventilation, pulmonary vasocontriction,increased RBC release
Term
what does polycythemia cause?
Definition
it increases red blood cell concentration and oxygen carrying capacity
Term
what hemoglobin levels do we need for cyanosis to occur?
Definition
5g/dL of deoxygenated blood
Term
who is least likely to exhibite cyanosis?
Definition
people with anemia and low hemoglobin counts
Term
t or f: a person with a high hemoglobin count due to polycythemia can be cyanotic wihtout being hypoxic
Definition
true!
Term
what do we use to treat angina?
Definition
nitrites
Term
whatare the two types of cyanosis?
Definition
central and peripheral. central found in mouth, peripheral in arms and legs etc
Term
the analysis of arterial blood gases gives us a direct measure of?
Definition
O2 content
Term
what does SVO2 do?
Definition
it reflects the bodies extraction and utilization of of O2 at the tissue levels
Term
where do we get venous blood samples?
Definition
from a pulmonary catheter or a central line
Term
what is the PF ratio?
Definition
it is an indicator of alterations in diffusion of O2 at the lung level
Term
how do we determine the PF ratio?
Definition
it is the ratior between the arterial PO2 and the inspired oxygen (FiO2)
Term
what is FiO2?
Definition
the concentration of oxygen being breathed in. Ex 40 percent oxygen via nasal cannula.
Term
what is a normal PF ratio?
Definition
greater than 300
Term
oxygen at high concentrations can lead to?
Definition
oxygen toxicity. 
Term
atelactasis
Definition
incomplete expansion or portion of a lung. 
Term
what are some cause of atelastasis?
Definition
airway obstruction, lung compression, and loss of surfactant
Term
what are the two types of atelactasis found in babies?
Definition
primary and secondary
Term
primary atelactasis of the newborn
Definition
the lung was never inflated, found in premature or high risk babies
Term
secondary atelactasis
Definition
occurs in infants who begin repirations but later on experiences problems inflating
Term
respiratory distress in the newborn
Definition
lack of surfactant, causes ssecondary atelactasis
Term
symptoms of atelactasis
Definition
tachypnea, tachycardia,dyspnea,cyanosis, signs of hypoexemia, no breath sounds
Term
if the collapsed area of the lung is large then...?
Definition
the mediastinum and trachea move to the affected side
Term
in there is compression atelactasis then ..?
Definition
the medastinum moves away from the affected lung
Term
pulmonary embolism
Definition
blood born substance lodges in a branch of the pulmonary artery and obstructs blood
Term
almost all pulmonary emboli and thrombie that originate from...?
Definition
DVT in the lower extremities
Term
obstruction of the pulmonary blood flow causes?
Definition
bronchoconstriction, wasted ventilation, impaired gas exchange,loss of surfactant
Term
a large embolus that causes massive vasoconstriction can produce?
Definition
pulmonary hypertension and right sided heart failure
Term
what can cause a venous thrombosis?
Definition
venous stasis, endotheleal injury, hypercoaguability
Term
what are symptoms of a pulmonary embolism?
Definition
chest pain, dyspnea, increased respiratory rates, hypoexemia 
Term
symptoms of people wth moderate emboli?
Definition
pleureitic pain, breathlessness, slight fever, blood streaked sputnum
Term
patients with massive emboli present with what symptoms?
Definition
shock, sudden collapse, rapid pulse, low BP, neck veins are distended, diaphoretic
Term
cilia
Definition
moucus secreting goblet cells
Term
what is the function of the conducting repiratory system?
Definition
warmign air, cleaning air
Term
what are the parts of the conducting repiratory system?
Definition
nose, mouth, pharynx,trachea, bronchi, bronchioles. 
Term
the anatomic dead air space has?
Definition
no perfusion
Term
perfusion
Definition
flow of blood in the lungs
Term
diffusion
Definition
transfer of gases between lungs and blood
Term
inflation and deflation depends on...?
Definition
respiratory pressures, repiratory compliance (to inflate) and airway resistance (asthma)
Term
t or f: inspiration is an active process where as expiration is a passive process?
Definition
true!
Term
inspiration
Definition
chest cavity increases, intrathoracic pressure bcomes negative, air comes in
Term
expiration
Definition
recoil of chest muscles, decrease in size of chest cavity, pressure in chest to increase
Term
t or f: surfactant lines the alveoli?
Definition
true!
Term
surfactant
Definition
lowers surface tension, evens inflation, prevents pulmonary edema, increases lung compliance
Term
what prevents alveoli from collapsing?
Definition
surfactant
Term
true or false: pulmonary artery flow must be greater than pulonary venous pressure
Definition
true!
Term
if the pulmonary venous pressure is greater than the arterial pressure, what happens?
Definition
there will be left sided heart failure = pulmonary edema 
Term
what is a normal blood ph?
Definition
7.35-7.45
Term
hemoglobin...?
Definition
can easily bind to O2 and CO2
Term
oxyhemoglobin
Definition
the combination of hemoglobin and oxygen
Term
t or f: when hypoxia NO longer exists it will restore blood flow to that area.
Definition
true!
Term
prolonged hypoxia of the lungs can cause?
Definition
pulmonary hypertension and increased workload of th right side of the heart
Term
hypoexemia causes?
Definition
an abnormal ventilation/ perfussion ratio. (V/Q) most common cause of hypoexemia!
Term
hypoexemia causes...continued...
Definition
hypoventilation and diffusion abnormalities
Term
t or f: equal amounts of air and blood enter the lungs
Definition
true!
Term
adequate gas exchange
Definition
matching of v/q ratio
Term

anatomic shunt

Definition
blood moves from the venous to the arterial circulation without first going to the lungs
Term
physiologic shunt
Definition
blood moving through unventilated parts of the lungs
Term
what are some pulmonary causes of shunting?
Definition
hemorrhage, atelactasis, collapse, pulmonary edema, pneumonia
Term
PE
Definition
impaired perfussion
Term
mucus plug
Definition
impaired ventilation
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