Term
| An abnormal reduction in pulmonary ventilation |
|
Definition
| Restrictive lung dysfunction (RLD) |
|
|
Term
| With restrictive lung dysfunction the volume of air moving in and out is ___ |
|
Definition
|
|
Term
| Is restrictive lung dysfunction a dz? |
|
Definition
|
|
Term
| With RLD, chest wall and/or lung compliance is ___. The lungs are stiff and difficult to expand. |
|
Definition
|
|
Term
| With RLD, resistance to lung expansion is ___ |
|
Definition
|
|
Term
| With RLD, the work of breathing is ___ due to need for greater transpulmonary pressure |
|
Definition
|
|
Term
| With RLD, if its permanent, then the treatment consists of __ measures. |
|
Definition
|
|
Term
| With RLD, if it is reversible, then the treatment is __ and __ |
|
Definition
Corrective (chest tube)
Supportive (Temporary mechanical ventilation) |
|
|
Term
| Name 3 abnormalities in fetal lung development |
|
Definition
Agenesis
Aplasia
Hypoplasia |
|
|
Term
|
Definition
| Absence or lack of development |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| This is a hyaline membrane disease that is a disorder of prematurity or lack of complete lung maturation |
|
Definition
| Respiratory Distress Syndrome |
|
|
Term
| Respiratory Distress Syndrome is linked to what? |
|
Definition
|
|
Term
| This is caused by abnormalities is surfactant system and inadequate surfactant production. Mechanical ventilation is disruptive to fragile structures. |
|
Definition
| Respiratory Distress Syndrome |
|
|
Term
| Name 2 treatments for Respiratory Distress Syndrome |
|
Definition
1. Surfactant replacement therapy or extracorporeal membrane oxygenation (ECMO)
2. Administration of corticosteroids to mother before birth |
|
|
Term
| Aging of lungs may be complicated by environmental factors such as what 5 things? |
|
Definition
Pollution
Noxious Gases
Occupational Exposures
Drug Use
Cigarettes |
|
|
Term
| Lung compliance decreases at about __ years; maximum voluntary ventilation decreases and so does vital capacity. |
|
Definition
|
|
Term
| With aging, chemoreceptors become less __ and decalcification occurs in ribs and arthritic changes. |
|
Definition
|
|
Term
| With aging there is an __ in air spaces and elastic recoil diminishes because of the increased stiffness. |
|
Definition
|
|
Term
| Name 3 treatments that are possible to help with the effects of normal aging. |
|
Definition
1. No specific tx is required
2. Need to keep aerobically exercising
3. Strength training |
|
|
Term
| What does DLCO stand for? |
|
Definition
| Diffusion of Carbon Monoxide in lungs |
|
|
Term
| This is an inflammatory process of the alveolar wall. Results in patchy focal lesions scattered, inflammatory changes then scar and become fibrotic which result in increased stiffness. |
|
Definition
| Idiopathic Pulmonary Fibrosis |
|
|
Term
| There are many treatments for Idiopathic Pulmonary Fibrosis. Name some. |
|
Definition
-Corticosteroids
-Cytotoxic drugs
-Smoking Cessation
-Maintaining adequate oxygenation/ventilation
-Good nutrition
-Treatment of infection
-Lung transplantation |
|
|
Term
| This is an interstitial lung dz caused by inhalation of coal dust. Results from inhalation of coal dust over a long period of time - 10 to 12 years. Coal macules develop |
|
Definition
| Coal Worker's Pneumoconiosis |
|
|
Term
| What are some treatments for Coal Worker's Pneumoconiosis? |
|
Definition
| Supportive includes cessation of exposure to coal dust, good nutrition, interventions to ensure adequate oxygenation/ventilation, progressive exercise |
|
|
Term
| A diffuse interstitial pulmonary fibrotic disease caused by asbestos exposure. |
|
Definition
|
|
Term
| People at risk for this dz include miners, construction workers, shipbuilders, insulation workers, and pipe fitters. |
|
Definition
|
|
Term
| What is the latency period for asbestosis? |
|
Definition
| 15-20 years after exposure |
|
|
Term
| Results in alveolitis in respiratory bronchioles and plaques |
|
Definition
|
|
Term
| What is the treatment for asbestosis? |
|
Definition
| No cure, dz progresses even when exposure ceases; symptomatic support may be available |
|
|
Term
| A chronic pulmonary syndrome in neonates who have been ventilated and received high concentrations of O2 |
|
Definition
| Bronchopulmonary Dysplasia |
|
|
Term
| A fibrotic lung dz that affects small airways. Produces restrictive and obstructive lung dysfunction. |
|
Definition
|
|
Term
| In pediatrics, this dz is associated with viral infection. |
|
Definition
|
|
Term
| In adults, this dz is associated with toxic fume inhalation (painters) |
|
Definition
|
|
Term
| This dz results in necrosis of respiratory epithelium. |
|
Definition
|
|
Term
| What is the treatment in children for bronchiolitis obliterans? |
|
Definition
| Supportive, corticosteroids |
|
|
Term
| What is the treatment for adults with Bronchiolitis Obliterans? |
|
Definition
| O2, fluid balance, corticosteroids |
|
|
Term
| This dz causes an incomplete expansion of lung or loss of volume. |
|
Definition
|
|
Term
| Name 3 types of atelectasis |
|
Definition
Obstructive
Scar and/or postoperative
Compression |
|
|
Term
| What will a chest radiograph show with atelectasis? |
|
Definition
|
|
Term
| What is the treatment for atelectasis? |
|
Definition
Deep breathing or incentive spirometry
Coughing |
|
|
Term
| An inflammatory process of the lung parenchyma (the functional unit of the lung) |
|
Definition
|
|
Term
| This dz begins as an infection in the lower respiratory tract because that is where things tend to pull. It may be community or hospital acquired. |
|
Definition
|
|
Term
| There are 2 types of pneumonia; bacteria and virus. Which is worse? |
|
Definition
|
|
Term
| What are the 2 most common routes of infection for pneumonia? |
|
Definition
|
|
Term
| What are some treatments for pneumonia? |
|
Definition
-Drug Therapy
-O2
-Mechanical ventilation or non-invasive ventilation
-Postural Drainage
-Airway Clearance Techniques |
|
|
Term
| Name 12 types of bacterial pneumonias |
|
Definition
1. Streptococcus Pneumoniae
2. Legionella Pneumophila
3. Haemophilus Influenzae
4. Klebsiella Pneumoniae
5. Pneumonias
6. Viral Pneumonias
7. Pseudomonas Aeruginosa
8. Staphylococcus Aureus
9. Mycoplasma
10. Fungal Pneumonias
11. Pneumocystis carinii
12. Chlamydial Pneumonias |
|
|
Term
| This is caused by an acute lung injury and results in severe hypoxemia (acute respiratory failure) |
|
Definition
| Adult Respiratory Distress / Acute Lung Injury |
|
|
Term
| This dz results in increased permeability of alveolar-capillary membrane and changes for air-filled to fluid-filled organ. |
|
Definition
| Adult Respiratory Distress |
|
|
Term
| Name 6 causes for Adult Respiratory Distress Syndrome |
|
Definition
1. Trauma
2. Aspiration
3. Drug
4. Inhaled toxins
5. Metabolic
6. Pneumonias |
|
|
Term
| What are some treatments for Adult Respiratory Distress Syndrome? |
|
Definition
-Treat precipitating cause
-Support adequate gas exchange and tissue oxygenation
-Supportive - manage pt's nutritional status and fluid balance
-Prevent or treat complications (may be bacterial pneumonia) |
|
|
Term
| A malignant growth of abnormal epithelial cells in the bronchus. Current classification is non-small cell lung cancer and small cell lung cancer |
|
Definition
|
|
Term
| Name the 4 types of bronchogenic carcinoma |
|
Definition
Squamous cell
Small cell
Large cell
Adenocarcinoma |
|
|
Term
| What are the 2 classifications of bronchogenic carcinoma? |
|
Definition
Non-small cell lung cancer
Small cell lung cancer |
|
|
Term
| What is the primary causative factor for bronchogenic carcinoma? |
|
Definition
|
|
Term
| Besides cigarette smoking, what is another cause of bronchogenic carcinoma? |
|
Definition
|
|
Term
| What are 3 treatments for bronchogenic carcinoma? |
|
Definition
-Surgery to remove tumor
-Radiation - targets all types, but small cell is most radiosensitive followed by squamous
-Chemotherapy - low effect on non-small cell; treatment of choice for small cell |
|
|
Term
| An accumulation of fluid within the pleural space. Results in a disruption of balance of pleural fluid resorption. |
|
Definition
|
|
Term
| An accumulation of fluid within the pleural space. Results in a disruption of balance of pleural fluid resorption. |
|
Definition
|
|
Term
| ___ effusions associated with hydrostatic pressure in pleural capillaries |
|
Definition
|
|
Term
| ___ effusions associated with increase in permeability of pleural surfaces |
|
Definition
|
|
Term
| What are some possible treatments for pleural effusions? |
|
Definition
Target the underlying cause
Diagnostic thoracentesis |
|
|
Term
| An enigmatic multisystem dz characterized by the presence of noncaseating epitheloid granulomas in many organs |
|
Definition
|
|
Term
| This dz commonly affects young adults. It is a multisystem dz with the lung mostly involved. |
|
Definition
|
|
Term
| What are the 3 distinct features of sarcoidosis? |
|
Definition
-Alveolitis
-Formation of well-defined round or oval granulomas
-Pulmonary fibrosis |
|
|
Term
| What is the treatment for Sarcoidosis? |
|
Definition
|
|
Term
| A dz characterized by an increase in the amount of fluid within the lung |
|
Definition
|
|
Term
| What are the 2 primary causes of Pulmonary Edema? |
|
Definition
-Increase in pulmonary capillary hydrostatic pressure
-Increase in alveolar capillary membrane permeability |
|
|
Term
| What are the treatments for pulmonary edema aimed at? |
|
Definition
| Decreasing cardiac preload and maintaining oxygenation |
|
|
Term
| Name 3 Maturational Causes of Restrictive Lung Dysfunction |
|
Definition
-Abnormalities in fetal lung development
-Respiratory Distress Syndrome
-Normal Aging |
|
|
Term
| Name 11 Pulmonary Causes of Restrictive Lung Dysfunction |
|
Definition
1. Idiopathic Pulmonary Fibrosis
2. Coal Worker's Pneumoconiosis
3. Asbestosis
4. Bronchopulmonary Dysplasia
5. Bronchiolitis Obliterans
6. Atelectasis
7. Pneumonia
8. Adult Respiratory Distress Syndrome
9. Bronchogenic Carcinoma
10. Pleural Effusions
11. Sarcoidosis |
|
|
Term
| Name 2 Cardiovascular Causes of Restrictive Lung Dysfunction |
|
Definition
Pulmonary edema
Pulmonary embolism |
|
|
Term
| A complication of venous thrombosis where thrombi travel from systemic vein to pulmonary circulation. |
|
Definition
|
|
Term
| With pulmonary emboli, where do the thrombi most commonly form? |
|
Definition
|
|
Term
| Results in an occlusion of pulmonary arterial branches and causes edema and hemorrhage (congestive atelectasis) |
|
Definition
|
|
Term
| What is the treatment for pulmonary emboli? |
|
Definition
| Prevention of DVT with exercise and medications; heparin therapy most common to treat DVT |
|
|
Term
| Name 7 neuromuscular causes of restrictive lung dysfunction |
|
Definition
1. SCI
2. ALS
3. Poliomyelitis
4. Guillain-Barre
5. Myasthenia Gravis
6. Tetanus
7. Muscular Dystrophy (mainly Duchenne) |
|
|
Term
| A chronic neuromuscular dz characterized by progressive muscular weakness on exertion. Autoimmune attack on acetylcholine receptors at the postsynaptic neuromuscular junction. |
|
Definition
|
|
Term
| With this dz, the antibody IgG binds to acetylcholine receptor site |
|
Definition
|
|
Term
| What is the treatment for Myasthenia Gravis? |
|
Definition
| Anticholinesterase and plasmapheresis; corticosteroids, immunosuppressive drugs and thymectomy |
|
|
Term
| A dz of the neuromuscular system caused by neurotoxin produced by CLostridium Tetani |
|
Definition
|
|
Term
| This dz blocks the release of inhibitory transmitter and causes severe ms spasticity with tonic convulsions which cause chest wall immobilization |
|
Definition
|
|
Term
| Besides Duchenne's MD, name 3 other types. |
|
Definition
Facioscapulohumeral
Limb-girdle
Myotonic |
|
|
Term
| A genetically determined, progressive degenerative myopathy where the muscle fibers hypertrophy and necrosis with degeneration. Loss of motor end plates occurs. |
|
Definition
|
|
Term
| With Duchenne MD, what is affected 1st, then 2nd? |
|
Definition
1st - pelvic girdle
2nd - shoulder |
|
|
Term
| What are treatments for Duchenne MD? |
|
Definition
No cure
Supportive therapy
Preserve pts mobility
Prevent respiratory infections |
|
|
Term
| What is another term for Duchenne MD? |
|
Definition
|
|
Term
| The loss or impairment of motor function of diaphragm due to a lesion in the neurological or muscular system. |
|
Definition
| Diaphragmatic Paralysis or paresis |
|
|
Term
| Name 5 Musculoskeletal Causes of Restrictive Lung Dz |
|
Definition
Diaphragmatic Paralysis or Paresis
Kyphoscoliosis
Ankylosing Spondylitis
Pectus Excavatum
Pectus Carinatum |
|
|
Term
| The cause of this is commonly injury of the phrenic nerve during a surgical procedure. Leads to the diaphragm being pulled downward and anterior ribs pulled inward. Results in alveolar hypoventilation |
|
Definition
| Diaphragmatic paralysis or paresis |
|
|
Term
| What is normal transdiaphragmatic pressure? |
|
Definition
98 cm H2O
If <20 cm H20, respiratory distress occurs |
|
|
Term
| What is the treatment for diaphragmatic paralysis or paresis if there is unilateral involvement? |
|
Definition
|
|
Term
| What is the treatment for diaphragmatic paralysis or paresis if there is bilateral involvement? |
|
Definition
| Requires a level of mechanical ventilation |
|
|
Term
| A combination of excessive anteroposterior and lateral curvature of the thoracic spine. Idiopathic in 85% of cases. |
|
Definition
|
|
Term
| A significant spinal curvature must be present before pulmonary symptoms develop. Angles of <70 degrees result in no pulmonary dysfunction. Angles of 70-120 degrees result in some pulmonary dysfunction. Angles greater than 120 degrees result in severe RLD and respiratory failure |
|
Definition
|
|
Term
| What are the treatments for kyphoscoliosis? |
|
Definition
-Conservative with orthotic devices and exercise
-Surgical placement of Harrington distraction strut bars
-Preventive and supportive measures for pulmonary compromise |
|
|
Term
| A chronic inflammatory dz of the spine characterized by immobility of sacroiliac and vertebral joints and ossification of paravertebral ligaments |
|
Definition
|
|
Term
| An inherited arthritic condition. Markedly decreased compliance of the chest wall. |
|
Definition
|
|
Term
| What are treatments for ankylosing spondylitis? |
|
Definition
No cure
Maintain good body alignment
Maintain good thoracic mobility |
|
|
Term
| An inherited arthritic condition. Markedly decreased compliance of the chest wall. |
|
Definition
|
|
Term
| What are treatments for ankylosing spondylitis? |
|
Definition
No cure
Maintain good body alignment
Maintain good thoracic mobility |
|
|
Term
| With this dz, the pt will walk with a really stiff forward posture and cannot straigthen up. |
|
Definition
|
|
Term
| Also known as funnel chest. A congenital abnormality. |
|
Definition
|
|
Term
| Sternal depression and decreases anteroposterior diameter. If the deformity is sever, may have decreased TLC, VC, and maximum voluntary ventilation. |
|
Definition
|
|
Term
| Also known as pigeon breaths. Sternum protrudes anteriorly. Associated with prolonged childhood asthma |
|
Definition
|
|
Term
| Name 6 Connective Tissue Causes of Restrictive Lung Dysfunction |
|
Definition
1. Rheumatoid Arthritis
2. Systemic Lupus Erythmatosus
3. Drug-Induced Systemic Lupus Erythmatosus
4. Scleroderma
5. Polymyositis
6. Dermatomyositis |
|
|
Term
| Chronic inflammation of peripheral joints resulting in progressive destruction of articular and periarticular structures. |
|
Definition
|
|
Term
| This dz can be associated with pleural involvement, pneumonitis, interstitial fibrosis, pulmonary nodules, pulmonary vasculitis, obliterative bronchiolitis, increased incidence of bronchogenic cancer |
|
Definition
|
|
Term
| What are 2 possible treatments for rheumatoid arthritis? |
|
Definition
Corticosteroids
Immunosuppressant Drugs |
|
|
Term
| A chronic inflammatory connective tissue disorder. Involves the autoimmune system. Characterized by a variety of antigen-antibody reactions. |
|
Definition
| Systemic Lupus Erythmatosus |
|
|
Term
| May involve the skin, joints, kidneys, lungs, nervous tissue, and heart. The most common lung dysfunction is pleurisy. Diaphragmatic weakness. |
|
Definition
| Systemic Lupus Erthematosus |
|
|
Term
| Six drugs induce antinuclear antibodies resulting is symptomatic SLE. Condition is reversible in the majority of pts if the drug is discontinued. Treatment includes corticosteroids with plasmapheresis. |
|
Definition
|
|
Term
| A progressive systemic sclerosis. Progressing fibrosing disorder that causes degenerative changes in skin, small blood vessels, esophagus, intestinal tract, lung, heart, kidney, and articular structures. |
|
Definition
|
|
Term
| In the lung, this appears as progressive diffuse interstitial fibrosis. |
|
Definition
|
|
Term
| What are the treatments for scleroderma |
|
Definition
| No effective drug intervention; specific symptoms are treated; supportive care |
|
|
Term
| A systemic connective tissue dz that causes symmetric proximal ms weakness and pain. May involve an autoimmune reaction as well as lung parenchyma. |
|
Definition
|
|
Term
| What is the most common form of polymyositis? |
|
Definition
|
|
Term
| How can you treat polymyositis? |
|
Definition
|
|
Term
| A systemic connective tissue dz primarily by inflammatory and degenerative changes in the skin. |
|
Definition
|
|
Term
| Name 2 Immunological Causes of Restrictive Lung Dysfunction |
|
Definition
Goodpasture's Syndrome
Wegener's Granulomatosis |
|
|
Term
| A dz of immune complex. Interstitial or intraalveolar hemorrhage, glomerulonephritis, anemia. Caused by antiglomerular basement membrane antibodies that react with vascular basement membranes of the alveolus and glomerulus. |
|
Definition
|
|
Term
| How can you treat Goodpasture's Syndrome? |
|
Definition
| Plasmapheresis and immunosuppressive therapy to lower the levels of anit-GBM anitbodies; cyclophosphamide with prednisone |
|
|
Term
| A multisystem dz characteriezed by granulomatous vasculitis of the upper and lower respiratory tracts, glomerulonephritis, and small vessel vasculitis. |
|
Definition
|
|
Term
| This dz starts in the upper respiratory tract with necrotizing granulomas and ulceration in the nasopharynx and paranasal areas. Treat with cyclophosphamide. |
|
Definition
|
|
Term
| In what trimester is the ventilation to dependent regions of lungs impaired due to the fetus? |
|
Definition
|
|
Term
| During pregnancy, there is a decrease in chest wall compliance primarily due to a decreased downward excursion of the what? |
|
Definition
|
|
Term
| When body weight is 20% or more over the ideal body weight. Imbalance between calories ingested and calories expended. The extra tissues require additional oxygen. |
|
Definition
|
|
Term
| In this situation, excess soft tissue on the chest wall decreases compliance of the thorax. Treated via a combination of interventions or even surgery. |
|
Definition
|
|
Term
| A syndrome that results from abnormal carbohydrate metabolism. Results in inadequate insulin secretion and hyperglycemia. |
|
Definition
|
|
Term
| What are some pathological changes that occur with diabetes mellitus? |
|
Definition
Hyperglycemia
Large vessel dz
Microvascular dz
Neuropathy |
|
|
Term
| Name 3 traumatic causes of restrictive lung dysfunction |
|
Definition
Crash Injuries
Penetrating Wounds
Thermal Trauma |
|
|
Term
| This is usually caused by blunt trauma that results in physiological damage such as rib fx, flail chest, and lung contusion. The leading cause for this would be a MVA |
|
Definition
|
|
Term
| What physiologically occurs in pts with rib fxs? |
|
Definition
Breathe Shallow
Decreased chest wall excursion
Decreased lung expansion |
|
|
Term
| This is where there is a free-floating segment of ribs due to multiple rib fractures. |
|
Definition
|
|
Term
| This occurs when strikes directly against the chest wall; red blood cells and plasma move to alveoli |
|
Definition
|
|
Term
|
Definition
|
|
Term
| How do you treat flail chest? |
|
Definition
| may need mechanical ventilation |
|
|
Term
| how do you treat lung contusion? |
|
Definition
| may need mechanical ventilation and O2 |
|
|
Term
| This may be caused by shooting or stabbing. Could include pneumothorax, hemothorax, or pulmonary laceration |
|
Definition
|
|
Term
| Entry of free air into the pleural space; difficulty moving air in and out of lungs |
|
Definition
|
|
Term
| The presence of blood in the pleural space |
|
Definition
|
|
Term
| How do you treat penetrating wounds? |
|
Definition
| Application of airtight, sterile dressing and chest tube in pleural space; may need mechanical ventilation and/or supplemental O2 |
|
|
Term
| Due to inhalation injuries, direct burn injuries to the thorax, or a combination of both. Exposure to fire/smoke. Results of smoke inhalation or direct burn injuries to the thorax |
|
Definition
|
|
Term
| How do you treat the lungs for thermal trauma? |
|
Definition
Humidification
Supplemental O2
Bronchodilators
Positioning
Pulmonary Hygiene |
|
|
Term
| Name 2 therapeutic causes of restrictive lung dysfunction |
|
Definition
Surgical therapy
Lung transplantation |
|
|
Term
| Planned entry into the human body by a trained practitioner. Pulmonary dysfunction due to anesthetic agent, surgical incision or procedure, pain postoperation. |
|
Definition
|
|
Term
| How do you treat surgical therapy? |
|
Definition
| Preoperative evaluation and care, NPO prior to surgery, postoperative deep breathing and coughing, incentive spirometer, early mobilization |
|
|
Term
| Replacement of poorly functioning lung tissue in the recipient with better-functioning lung tissue. |
|
Definition
|
|
Term
| What is a major long term complication of lung transplantation |
|
Definition
| Obliterative Bronchiolitis |
|
|
Term
| How do you treat lung transplantation |
|
Definition
| Optimal maintenance of the immunosuppressive drug regimen, prompt diagnosis and treatment of infections and episodes of acute rejection, careful cytomegalovirus matching |
|
|
Term
| More than 100 drugs potentially cause __ |
|
Definition
|
|
Term
| Name 11 pharmaceutical causes of RLD? |
|
Definition
1. Illicit Drugs
2. Muscle Relaxants
3. Anesthetics
4. Poisons
5. Chemotherapeutic
6. Cardiovascular Drugs
7. Anti-inflammatory
8. Antibiotics
9. Oxygen
10. Affect ventilatory pump, ventilatory drive, or chest wall compliance
11. Adversely affect lung parenchyma directly, causing drug-induced interstitial lung dz |
|
|
Term
| The primary complication of irradiation to thorax. Irradiation causes breaks in DNA strands. Radiation responses are seen first in cells with rapid rates of cell replication |
|
Definition
| Radiation Pneumonitis and Fibrosis |
|
|
Term
| Name 2 things that Pulmonary injury includes related to radiology |
|
Definition
1. Acute radiation pneumonitis
2. Chronic radiation fibrosis |
|
|
Term
| How do you treat radiation pneumonitis and fibrosis |
|
Definition
| Corticosteroids for acute radiation pneumonitis, but not chronic radiation fibrosis; O2 therapy, cough suppression, analgesics, antibiotics |
|
|
