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Patho Ch. 26
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85
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Undergraduate 4
04/24/2012

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Term
What's normal rate of respiration?
Definition
16-18 per minute
one breath about every four heart beats
Term
pnea
Definition
relationship to breathing
Term
tachypnea
Definition
rapid breathing
Term
hyperpnea
Definition
increase in rate and depth of respiration
Term
bradypnea
Definition
abnormally slow respiratory rate
Term
hyperventilation
Definition
ventilation in excess of that needed to maintain a normal level of arterial PCO2
Term
What are vesicular breath sounds a result of?
Definition
air moving through the bronchioles and alveoli
Term
What are rales and rhonchi?
Definition
abnormal sounds that result from passage of air through secretions in the lung or passage of air moving through narrowed air passages
Term
periodic breathing
Definition
breathing pattern in which there are periods of apnea
Term
apnea
Definition
absence of breathing
Term
Cheyne-Stokes breathing
Definition
type of period breathing characterized by period of slowing waxing and waning respirations, seperated by period of apnea that lasts up to 30 seconds
Term
What are the two types of disease conditions that cause predisposition to Cheyne-Stoke breathing?
Definition
congestive heart failure
impaired function of the breat centers regulating the feedback mechanisms that control respiration
Term
Dyspnea
Definition
subjective sensation of difficulty in breathing
related to the work or effort of breathing
Term
Inspiratory dyspnea
Definition
occurs primarily when there is obsturction of the trachea or large airways
often accompanied by a low-pitched crowing sound (stridor) and retraction of the chest structures
Term
Expiratory dyspnea
Definition
associated with obstruction of the bronchioles and smaller bronchi
causes prologonation of the expiratory phase of respiration and may be accompanied by wheezing or whistling sound and bulging of the intercostal spaces due to air trapping
Term
How much sputum does a normal adult produce each day?
Definition
100 ml
Term
What does yellow sputum mean?
Definition
infectoin
Term
What does the presence of verdoperoxidase in sputum mean?
Definition
stagnant pus to turn green
Term
What does frothy blood-tinged sputum mean?
Definition
pulmonary edema
Term
hemoptysis
Definition
coughing up blood-tinged sputum
Term
Digital Clubbing
Definition
change in shape of tips of fingers and toes, characterized by bulbous appearance
Term
What's the most common cause of digital clubbing?
Definition
pulmonary disease--70-80%
Term
Cyanosis
Definition
bluish coloration of skin and mucous membranes which develops as a result of increase in absolute amount of reduced hemoglobin
Term
Two types of cyanosis
Definition
central
peripheral
Term
When is cyanosis detected?
Definition
not until absolute amount of reduced hemoglobin is 5g/100 ml
Term
central cyanosis
Definition
results from insufficient oxygenation of hemoglobin in lungs and most easily observed on face, lips, and earlobes
Term
peripheral cyanosis
Definition
occurs when severly reduced blood flow causes a great reduction in venous saturation, therby turning an area blue
may result from cardiac insufficiency, obstruction of blood flow, or vasoconstriction to cold temperatures
Term
hypoxemia
Definition
values of PaO2 which are abnormally low in arterial blood and is frequently associated wtih hypoxia, or inadequate tissue oxygenation
Term
What's are common causes of hypoxia?
Definition
an abnormal ventilation/perfusion ratio
decreased oxygen content of inspired air
hypoventilation
diffusion abnormalities
pulmonary right-to-left shunt
Term
Pulmonary Edema
Definition
excess water in the lung
due to changes in pressures at capillary-alveolar membrane
Term
Atelectasis
Definition
collapse of alveoli due to lack of surfactant or to airway obstruction
Term
Absorption atelectasis
Definition
obstruction of airway prevents air from entering alveoli distal to obstruction
bronchus can be obstructed by mucus plug that forms within airway
air in alveoli is slowly absorbed into the bloodstream
Term
Compression atelectasis
Definition
results from external pressure due to fluid, tumor mass, exudate or other cause in area surrounding airway
Term
bronchiectasis
Definition
abnormal dilatation of the bronchioles associated with chronic necrotizing infectino of the bronchi
Term
What are the causes of bronchiectasis?
Definition
congenital abnormalities, cystic fibrosis, immunologic deficiencies, respiratory tract infections, and exposure to corrosive gases
Term
What is bronchiectasis characterized by?
Definition
infection and obstruction of bronchioles
Term
What are the clinical manifestations with bronchiectasis?
Definition
severe cough and recurrent broncho-pulmonary infectino with excessive production of purulent sputum
Term
Cystic fibrosis
Definition
hereditary disease transmitted as an autosomal recessive trait
affects 1 in 2000 children
Term
What cystic fibrosis characterized by?
Definition
elevation of sweat electrolytes, pancreatic insufficiency, and chronic lung disease
excessive sodium and chloride in sweat
Term
What causes atelectasis?
Definition
mucus plugs can result in total obsturciton of an airway
Term
What can pleural abnormalities restrict?
Definition
expansion of lungs, alveoli, or both
Term
Pneumothorax
Definition
accumulation of air or gas in pleural cavity, resulting in collapse of lung on affected side
Term
artificial pneumothorax
Definition
surgical procedure sometimes used in treatment of TB or following pneumonectomy
involves injection of measured amounts of air into pleural cavity to collapse lung and immobilize it while healing takes place
Term
Pleural effusion
Definition
collection of fluid in pleural cavity
Term
Hemothorax
Definition
collection of blood in pleural cavity
Term
Chylothorax
Definition
presence of lymph in pleural cavity
Term
Pulmonary fibrosis
Definition
causes marked loss of lung compliance
excessive amount of connective tissue in lung
may follow any disease process of lung which produces inflammation or necrosis (coal, mold hay, etc.)
Term
Alveolar hypoventilation
Definition
disorders affecting medullary respiratory center
Term
kyphoscoloiosis
Definition
backward and lateral curvature of spine
severe shows marked asymmetry of chest and leads to abnormal functioning and positioning of respiratory muscles and to compression of lungs
Term
pectus excavatum
Definition
funnel chest
congenital malformation of chest wall characterized by pronounced funnel-shaped depression with its apex over lower end of sternum
caused by shortening of central portion of diaphragm, which pulls sternum backward during inhalation, and by growth of ribs
decreases ability of child to engage in sustained exercise
Term
Thoracoplasty
Definition
surgical removal of ribs, allowing chest wall to collapse a diseased lung
Term
ankylosing spondylitis
Definition
symmetrical reduction in mobility of bony thorax as result of ossification of vertebral joints and ligaments
mild ventilatory restriction
Term
closed chest wall injury
Definition
rib fracture, flail chest
ventilatory restriction of tidal volume, increased respiratory rate and frequency, inhibition of cough
Term
pickwickian syndrome
Definition
association of extreme obestiy, hypersomnia, polycythemia, chornic alveolar hypoventilation and excessive appetite
respiratory problems are caused by increased work of ventilation in moving ponderous thorax and abdomen
Term
respiratory insufficiency
Definition
condition in which respiratory function is inadequate to meet body needs during exertion
Term
respiratory failure
Definition
refers to a PO2 level of 50 mm Hg or less, and hypercapnia to a PCO2 level greater than 50 mm Hg
Term
hypoxemia
Definition
blood oxygen levels insufficient to meet oxidative requirements
Term
What are compensatory mechanisms of hypoxemia?
Definition
tachycardia, anxiety, peripheral vasoconstriction, diaphoresis, and mild increase in blood pressure
Term
Hypercapnia
Definition
too much CO2
CO2 has direct vasodilatory effect on many blood vessels and a sedative effect on nervous system
Term
What are signs and symptoms of hypercapnia?
Definition
headache, conjunctival hyperemia, flushed skin, increased sedation, mild to moderate increases in blood pressure, tachycardia, diaphoresis
Term
Asthma
Definition
characterized by intermittent periods of reversible airway obstruction
Term
Chronic bronchitis
Definition
excessive mucus production by mucosal cells of bronchi and chronic productive cough that has persisted for at least 3 months per year for two successive years or more
Term
atopic asthma
Definition
results from allergy to outside materials, especially inhalants
bronchi are the "shock tissues" of the allergic reaction
inflammatory mediators are released from sensitized mast cells
Term
nonatopic asthma
Definition
not related to allergy since individual doesn't have an elevation of IgE antibodies or a history of allergy symptoms
usual onset is after age 35
attacks frequently precipitated by factors such as infection, weather changes, exercise, stress, emotion, and various drugs, including aspirin
Term
chronic bronchitis
Definition
results in obstructed airflow causing imbalance of ventilation and perfusion
Term
emphysema
Definition
enlargement and destruction of air spaces distal to terminal bronchioles
Term
What are the two principal types of emphysema?
Definition
centrilobular and panlobular
Term
centrilobular emphysema
Definition
affects respiratory bronchioles, with initial preservation of alveolar ducts and sacs
Term
panlobular emphysema
Definition
affects peripheral alveoli
Term
pneumonias
Definition
inflammation of lung wiht consolidation and exudation
Term
lobar pneumonia
Definition
affects a segment or an entire lobe of the lung
Term
double pneumonia
Definition
when both lungs are affected with pneumonia
Term
broncial
Definition
smaller area affected
inflammation is localized in or around bronchi, and causes lung to be spotted with clusters of infected tissue
Term
primary atypical pneumonia
Definition
occurs in young adults, often found in military camps and due to various viruses or to mycoplasma pneumonaie
Term
chemical pneumonia
Definition
inhalation of gases
Term
aspiration pneumonia
Definition
accidental inhalation of food or liquids
Term
traumatic pneumonia
Definition
blow or injury to chest that interferes with normal respiration
Term
hypostatic pneumonia
Definition
due to lying on back
Term
interstitial pneumonia
Definition
increase of interstitial tissue and decrease of proper lung tissue with induration
Term
friedlanders pneumonia
Definition
characterized by massive mucoid inflammatory exudates in lobe of lung due to klebsiella pneumoniae
Term
primary tuberculosis
Definition
usually initiated in alveolar wall as result of inhaling tubercle bacilli
sometimes called childhood tuberculosis
Term
miliary tuberculosis
Definition
minute lesions resulting from this type of dissemination and may involve almost any organ, particularly brain, meninges, liver, kidney, and bone marrow
Term
secondary tuberculosis
Definition
results from reactivation of a previously healed primary lesion
occurs in situations of impaired body defense mechanisms
Term
What are the primary tuberculosis clinical manifestations?
Definition
positive tuberculin skin test and presence of calcified lesions on chest x-ray film
Term
What are the secondary tuberculosis clinical manifestations?
Definition
onset of afternoon elevation of temperature, night sweats, weakness, fatigability, and loss of appetite and weight
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