Term
| The process of pulmonary gas exchange |
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Definition
| inspiration and delivery of 02 from environment ---> alveoli, diffusion across alveolar capillary membrane --> attaches to Hb, dissolves in blood --> left heart |
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Term
|
Definition
| movement of gases from atmosphere to alveoli (and visa versa) |
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Term
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Definition
| mechanism by which 02 moves across the alveoli and into the pulmonary capillary |
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Term
|
Definition
| 02 leaves alveoli to combine with Hgb (Hb02) or dissolve in blood (Pa02) to be carried to left side fo the heart. |
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Term
| Five factors that ventilation depends on... |
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Definition
-Conducting airway (airway diameter)
-Ventilatory Muscles (diaphram, intercostals must have both muscles in order to breath)
-Thorax (flexibility of rib cage)
-Elasticity of the lungs
-Nervous system/ regulators (autnomic pattern)
(DECREASING FUNCTION OF ANY OF THESE IMPAIRS VENTILATION) |
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Term
| Controller of the regulation of ventilation |
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Definition
Central nervous system (brainstem, cerebral cortex, neurons in spinal cord)
also, group of effectors (muscles) that work in a coordinated factors. |
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Term
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Definition
central chemoreceptors in medulla (increase H+ --> increase ventilation
Peripheral chemoreceptors in aortic arch, carotids: decrease Pa02 in order to increase ventilation
also, increases PaC02, H+ will increase ventilation
(PaC02 = partial arterial oxygen) |
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Term
|
Definition
| movement of molecules from high concentration to low concentration. (mechanism by which 02 moves across alveoli and into blood stream) |
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Term
| Type 1 alveolar epithelial cells |
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Definition
cover the entire surface of the lung, very susceptible to injury.
90% total alveolar surface within lungs
(highly susceptible to injury ---> inflammation) |
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Term
| Type II alveolar epithelial cells |
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Definition
| produce, store, secrete pulmonary surfactant (body produces this because it decreases the surface tension allowing alveoli to never stick together) |
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Term
| Why do we have type 1 epithelial cells |
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Definition
| they are able to keep warm moist atmosphere within the bronchial tree. |
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Term
| What does Surfactant in alveoli do? |
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Definition
| phospholoipid that lowers surface tension of the lungs. stabilizes alveoli, increases pulmonary compliance, eases WOB |
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Term
| in disease, disruption of synthesis/ storage of surfactant --> |
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Definition
| collapse of alveoli, impairment of pulmonary gas exchange |
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Term
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Definition
| take on phagocytic role. they attack to small bacteria. they release enzymes (H202 or hydrogen peroxide) when killing microorganisms |
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Term
| Diffusion of gas across alveolar capillary membrane is affected by 3 factors: |
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Definition
-Pressure gradient (driving pressure)
-Surface area
-Thickness |
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Term
| factors that affect diffusion |
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Definition
PA02 ; PA02 Gradient
Surface Area
Thickness |
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Term
|
Definition
| difference in pressure gradients (concentrations) |
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Term
| increase surface area for diffusion --> ?? |
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Definition
| increases the amount of gas that can diffuse |
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Term
| 4 interventions to increase surface area |
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Definition
-incentive spirometer
-TCDB
-Sighs/ yawn
-Positive and expiratory pressure - pursed lip breathing. |
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Term
| four conditions that increase alveolar capillary membrane thickness |
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Definition
-ARDs (adult respiratory distress syndrome)
-Pneumonia
-Pulmonary edema
-Pulmonary fibrosis |
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Term
| how thickness of alveolar capillary membrane affects diffusion... |
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Definition
| the thicker the alveolar capillary membrane, the slower the rate of diffusion. |
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Term
| Two ways that 02 is transported in the blood |
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Definition
| Bound to hemoglobin and suspended in bood plasma. |
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Term
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Definition
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Term
| How much oxygen is transported via. hemoglobin and how much is transported in the plasma |
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Definition
97% on hemoglobin
3% in plasma |
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Term
| Main cause of 90% of deaths from respiratory infection |
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Definition
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Term
| 6 risk factors for pneumonia |
|
Definition
-absence of cough
-Prior viral infection (common cold)
-Cigarettes or second hand smoke
-Change in mental status (coma, drug)
-Systemic sepsis weakens immune responce
-dysfunctional mucocilliary bed (COPD) |
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Term
| five signs and symptoms of pneumonia |
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Definition
-cough
-fever
-sputum production
-shortness of breath
-tachypnea/ tachycardia |
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Term
| four ways to diagnose pneumonia |
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Definition
chest x-ray
sputum analysis
visual bronchoscopy
bronchial lavage |
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Term
| 6 treatments for pneumonia |
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Definition
appropriate antibiotics
oxygen support
bronchodilators
humidity with mist face tent
Percussion and postal drainage
hydration/ fever control/ nut. support |
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Term
| cause of pulmonary embolism |
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Definition
| blood clot in a deep vein, development of a deep vein thrombosis |
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Term
| 3 time you are at risk factors for pulmonary embolism |
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Definition
after some types of surgery
during a long trip in a care or airplane
if you stay in bed for an extended time |
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Term
| 4 symptoms of pulmonary embolism |
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Definition
shortness of breath
chest pain
cough
decreased oxygen saturations
(vary greatly depending on the clot and how much vasculature is affected) |
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Term
| 6 tests and diagnosis's for pulmonary embolism |
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Definition
chest x ray
ventilation perfusion scan
spiral computerized tomography scan
pulmonary angiogram
d-dimmer blood test
magnetic resonance imaging. |
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Term
| 2 treatments pulmomary embolism using medication |
|
Definition
anticoagulants
thrombolytics |
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Term
| 2 treatments for pulmonary embolism using surgery |
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Definition
clot removal- threading a catheter through the vessels
vein filter - placing a filter into the inferior vena cava |
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Term
| 5 prevention steps to avoid pulmonary embolism |
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Definition
medications (heparin and warfarin)
compression stockings
pneumatic compression
physical activity
adequate fluid intake |
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Term
|
Definition
chronic obstructive pulmonary disease
preventable and treatable disease.
airflow limitation associated with abnormal inflammatory responce of the lungs |
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Term
|
Definition
| defined as the presence of cough and sputum production for at least three months in each of the consecutive years, it is not necessarily associated with airflow limitation. |
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Term
|
Definition
| lysis of lung tissue by proteolytic enzymes (macrophages releaseing hydrogen perodixde) from neutrophils and macrophages with abnormal permanent enlargement of the air space distal to the terminal bronchioles all the way down to the alveoli. |
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Term
|
Definition
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Term
|
Definition
central part of the lobule
respiratory bronchioles enlarge. walls are destroyed, associated with chronic bronchitis.
more common |
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Term
|
Definition
destruction of whole lobule.
affects bronchioles, alveolar ducts and sacs and alveoli, progressive loss of lung tissue |
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Term
| pathophysiology of chronic bronchitis |
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Definition
hyperplasia of mucus- secreting glands in the trachea and bronchi
increase in goblet cells
disappearance of cilla
chronic inflammatory changes and narrowing of airways
altered function of alveolar macrophages leading to increased bronchial infections |
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Term
| three clinical manifestations of emphysema |
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Definition
-dyspnea
-minimal coughing with little sputum
-barrow chest from over distention of alveoli |
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Term
|
Definition
| alveoli that are filled up with fluid |
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Term
| three mechanisms of bronchodilation |
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Definition
beta-agonists
anticholinergics
theophyllines |
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Term
| action of beta2 andrenergic receptor agonists |
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Definition
| act on b2andrenergic receptors around bronchioles causing smooth muscle relaxation resulting in dilation of bronchial passages and improved airflow |
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Term
| mech of action anticholinergic drugs |
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Definition
| act on many acetylcholine receptors around the bronchi reducing bronchspasms to prevent airway narrowin |
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Term
| 5 side effects of anticholinergic drugs |
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Definition
dry mouth
blurred vision
dry cough
difficulty urinating. |
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Term
| *** no significant difference in exercise performance between drugs given by nebulizer and by spacer |
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Definition
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Term
| Theophylline/Aminophylline (methylxanines) mechanisms of action |
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Definition
bronchodilation
suppression of airway response to stimuli
anti-inflammatory effects |
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Term
| corticosteroids suppress mediator production or secretion of... |
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Definition
histamine
eicosanoids
leukotrienes
cytokines |
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Term
| cortiosteroids act on.... |
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Definition
mast cells
lymphocytes
macrophages
ect.
act on these cells to inhibit inflammation... |
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Term
|
Definition
combine short acting B agonist with short acting anticholinergic.
or
long acting B agonist wtih inhaled corticosteroids |
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Term
|
Definition
| patients oxygen level gets low enough, the patients brain will signal the patient to breathe |
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Term
| NETT trial - Lung volume reduction surgery |
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Definition
removes 20-35 of space occupying lung tissue from each lung.
many risks
by reducing lung size the remaining lung and surrounding muscles (intercostals and diaphragm) are able to work more efficiently. |
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Term
|
Definition
coughing
wheezing
chest tightness
shortness of breath |
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Term
|
Definition
| cannot be cured, can be controlled |
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Term
|
Definition
genetic
immune
environmental factors |
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Term
| asthma characterized by... (three things) |
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Definition
hyper responsiveness
chronic inflammation
airway remodeling |
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Term
|
Definition
cough
shortness of breath
chest tightness
chest pain
wheezing
fatigue
behavior changes |
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Term
| three pharmacologic therapies used with ashthma |
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Definition
beta agonists
anticholinergic
anti-inflammatory therapy |
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