Term
| How do chest x-rays differ from CT scans for dx'ing lungs? |
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Definition
| CT scan is more detailed, more anatomical detail |
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Term
| Why are x-rays preferred to CT scans? |
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Definition
| Less radiation received by the pt |
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Term
| What is pulmonary angiography used to dx? |
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Definition
| pulmonary emboli and arteriovenous malformations; general ischemia |
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Term
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Definition
| measures pt lung volume and velocity of respiration |
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Term
| What is on the y axis of spirometry graphs? |
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Definition
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Term
| What is on the x axis of spirometry graphs? |
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Definition
| instantaneous lung volume |
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Term
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Definition
| tidal volume = normal, at rest breathing volume |
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Term
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Definition
| Inspiratory reserve volume = extra are volume which can be brought into the lungs with effort BEYOND tidal volume |
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Term
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Definition
| Expiratory reserve volume = extra air that can be expired forcefully |
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Term
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Definition
| Vital capacity = total air volume that can be changed |
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Term
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Definition
| Functional Residual Capacity = amt of air remaing in lungs at end of normal expiration |
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Term
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Definition
| Residual volume = volume of air in lungs that remains after most forced expiration (minimum possible volume in lungs) |
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Term
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Definition
| Total lung capacity = maximum volume of lungs |
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Term
| How is residual volume measured? |
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Definition
| have pt inspire helium, it mixes with the residual volume and upon expiration the change in helium concentration is measured |
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Term
| What are blood gases that are measured in arterial blood to measure lung and kidney fxn? |
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Definition
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Term
| What blood ion is regulated by the kidneys? |
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Definition
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Term
| What blood concentration is controlled by the lungs? |
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Definition
|
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Term
| What does decreased blood pH indicate? |
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Definition
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Term
| What can cause respiratory induced blood acidosis? |
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Definition
hypoventilation
head injuries
meds
brain tumors |
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Term
| In blood acidosis, what level will be high, what level will be normal or slightly increased? |
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Definition
| CO2 is high, but HCO3- may be normal or just slightly elevated |
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Term
| What causes metabolic acidosis? |
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Definition
Inability of kidneys to excrete acidic ions
kidney dysfxn
shock
DM!! (most commonly seen by OD's)
Cardiac arrest |
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Term
| What is higher in blood acidosis? |
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Definition
CO2 concentration
therefore breathing rate increases to expel the excess CO2 |
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Term
| What are the two major categories of lung dz? |
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Definition
Obstructive pulmonary dz
Restrictive pulmonary dz |
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Term
| What are hallmarks of obstructive pulmonary dz? |
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Definition
limitation of airflow, especially on exhalation
makes breathing harder
e.g. asthma, emphysema |
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Term
| What are hallmarks of restrictive pulmonary dz? |
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Definition
reduced expansion of lung parenchyma
decreased lung capacity
minimizes or prevents gas exchange
e.g. collagen vascular dz, sarcoidosis |
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Term
| What pulmonary dz's will also have ocular SE? |
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Definition
TB
sarcoidosis
histoplasmosis
Collagen vascular disorders |
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Term
| What are ocular SE of pulmonary dz meds? |
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Definition
optic atrophy
glaucoma
cataract
blurred vision
tear effects |
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Term
| What ocular dz's can present more often with pulmonary dz? |
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Definition
glaucoma
ARMD
Retinal vascular changes
optic nerve head changes
This is probably all related to decreased O2 in blood due to pulmonary dysfunction! |
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Term
| Can pulmonary dz CI ocular meds? |
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Definition
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Term
| What anatomical changes are seen in obstructive pulmonary dz? |
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Definition
change in lumen size
thickening of airway wall
changes in supporting structure around airway
altered secretions --> decreased lumen size |
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Term
| What changes in spirometry results with obstructive pulmonary dz's? |
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Definition
VC goes down
RV goes up
FRC goes up |
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Term
| What happens to the diaphragm in obstructive pulmonary dz? |
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Definition
| High RV --> diaphragm is flatter after expiration --> decreased ability to change lung volume |
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Term
| Do obstrutive pulmonary dz's cause increased effort to breathing? |
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Definition
| Yes, this causes fatigue in and of itself, let alone the poor O2 exchange |
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Term
| What happens to the flow volume loop in obstructive pulmonary dz? |
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Definition
| Overall volume goes down, rest tidal volume is much closer to the exercising tidal volume |
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Term
| What are 4 common obstructive pulmonary dz's? |
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Definition
Asthma
Cystic Fibrosis
Emphysema
Chronic Bronchitis |
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Term
| Is asthma considered a form of COPD? |
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Definition
| No, that term is for emphysema, chronic bronchitis, etc |
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Term
| What is the prevalence of asthma? |
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Definition
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Term
| What type of hypersensitivity is asthma? |
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Definition
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Term
| What predisposes a pt to asthma? |
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Definition
| genetic predisposition to type 1 hypersensitivities |
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Term
| What can aggravate asthma? |
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Definition
heat
stress
cold
exercise
dust
tobacco
dander |
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Term
| Is asthma considered a progressive dz leading to tissue damage over time? |
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Definition
|
|
Term
| How many people are killed by asthma every year? |
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Definition
| 3k, generally due to poor control |
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|
Term
|
Definition
chronic cough
wheezing
chronic episodic dyspnea
sympathetic discharge
tachypnea |
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Term
| Are astham pt's normal between attacks? |
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Definition
| yes, they will be asymptomatic if not in an active attack |
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Term
| What is acute severe asthma also called? |
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Definition
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Term
| What peculiar childhood behavior can reduce the likelihood of asthma? |
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Definition
| eating dirt (immune system conditioning) |
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Term
| What are the hallmarks of acute severe asthma? |
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Definition
| severe attack that does not respond to routine therapy |
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Term
| What are s/sx of acute severe asthma? |
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Definition
difficulty talking
diaphoresis
pulsus paradoxus
orthopnea
diaphoresis
decreasted mental status
use of accessory respiratory muscles |
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Term
| What must be done for someone having an acute severea asthma attack? |
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Definition
| trip to ER/dial 911. Needs emergency tx. |
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Term
| What is the main pathophysiology of asthma? |
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Definition
| inflammation due to hypersensitivity |
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Term
| What Ab is associated with asthma? |
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Definition
|
|
Term
| What does IgE initiate in asthma pts? |
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Definition
|
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Term
| What do activated mast cells release? |
|
Definition
histamines
prostaglandins
tryptase
leukotrienes |
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Term
| What are tissue responses to asthma induced inflammation? |
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Definition
smooth muscle constriction (bronchospasm)
mucosal edema
hypersecretion of mucus |
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Term
|
Definition
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Term
| Does asthma actively remodel the tissues of the lungs? |
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Definition
| Yes, asthmatics have 10x more cells |
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Term
| What is pulsus paradoxus? |
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Definition
| decreased systolic BP by >20 mmHg upon inspiration of lungs |
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