NURS 231 Pathophys Module 5

NURS 231 Pathophys Module 5 The respiratory system can be divided into what 2 structures? Ans- Conducting airways and respiratory tissues What are the levels of branching? Ans- Trachea, bronchi, bronchioles, alveoli Where is the site of gas exchange? Ans- Alveoli What cells are in the alveolar epithelium? Ans- Type 1 and II alveolar cells, macrophages Describe what happens during inspiration and expiration: Ans- During inspiration, air is drawn into the lungs as the respiratory muscles expand the chest cavity. During expiration, air moves out of the lungs as the chest muscles relax and the chest cavity becomes smaller. What occurs with the diaphragm during inspiration and expiration? Ans- The diaphragm is the main muscle of inspiration. When the diaphragm contracts (inspiration), the chest expands. Upon expiration, the chest cavity decreases and pressure inside increases. What is lung compliance? What factors affect it? Ans- Lung compliance is the ease with which lungs can be inflated. Elastin, collagen, elastic recoil, and surface tension can affect lung compliance. Lung Volumes Ans- The amount of air exchanged from a single event during ventilation (measure by a spirometer) Tidal Volume (Vt) Ans- normal volume of air inhaled or exhaled with each breath Inspiratory Reserve Volume (IRV) Ans- amount of air that can be forcefully inhaled after taking a normal breath Expiratory Reserve Volume (ERV) Ans- Amount of air that can be forcefully exhaled after taking a normal breath Residual Volume (RV) Ans- Air remaining in the lungs after forced expiration (cant be measured with spirometer) Vital Capacity (VC) Ans- amount of air that can be exhaled after maximal inhalation. (VC=Vt + IRV + ERV) Inspiratory Capacity (IC) Ans- Max amount of air that can be inhaled following a normal expiration (IC= Vt + IRV) Functional Residual Capacity (FRC) Ans- the amount of air that remains in the lungs after a normal expiration (FRC= RV + ERV) Total Lung Capacity (TLC) Ans- sum of all lung volumes (TLC= IRV + Vt + ERV + RV) pulmonary function tests Ans- Observe pulmonary flow in relation to time. Used to diagnose respiratory disease or to examine respiratory complaints. Or can be used as a pre op anesthesia or surgical risk evaluation Maximum voluntary ventilation Ans- measures volume of air a person can move in and out of the lungs under max effort in 12-15 seconds (L/min) Forced Expiratory Volume (FEV) Ans- measures volume of air that can be quickly and forcefully exhaled following full inspiration (to total lung capacity) Forced inspiratory vital flow (FIF) Ans- measures respiratory response during rapid maximal inspiration Ventilation Ans- the movement of gases into and out of the lungs Perfusion Ans- the process that allows blood flow to help facilitate gas exchange Diffusion Ans- the movement of gases across the alveolar-capillary membrane. Shunt Ans- when blood moves from pulmonary circulation (right side of heart) without being oxygenated This results in perfusion without ventilation—low ventilation-perfusion ratio Dead air space Ans- ventilation without perfusion, resulting in high ventilation-perfusion ratio What is oxyhemoglobin? Ans- Oxyhemoglobin is the term to describe when hemoglobin is bound with oxygen. What is affinity? Ans- The ability of the hemoglobin molecule to bind oxygen in the lungs and release it in the tissues depends on the affinity of the molecule. How is carbon dioxide transported in the blood? Ans- As dissolved carbon dioxide, attached to hemoglobin, becomes bicarbonate How is breathing controlled? Ans- The automatic regulation is controlled by both chemoreceptors and lung receptors. Chemoreceptors monitor blood levels of oxygen, carbon dioxide, and pH and adjusts ventilation accordingly. Lung receptors monitor breathing patterns and lung function. What are the characteristics of COPD? Ans- The pathogenesis of COPD includes inflammation and fibrosis of the bronchial wall, hypertrophy of the submucosal glands and hypersecretion of mucus, and loss of elastic lung fibers and alveolar tissue. This airflow obstruction causes a mismatch in ventilation and perfusion. Alveolar tissue destruction leads to a decreased surface area for gas exchange. What is the leading risk factor for COPD? Ans- Smoking Be familiar with the disease pathology, clinical presentation, diagnosis, and treatment of COPD. Ans- 1. Pathology: inflammation and fibrosis of the bronchial wall, hypertrophy of the submucosal glands and hypersecretion of mucus, and loss of elastic lung fibers and alveolar tissue. This airflow obstruction causes a mismatch in ventilation and perfusion. Alveolar tissue destruction leads to a decreased surface area for gas exchange. 2. Clinical presentation: - fatigue, exercise intolerance, cough, sputum -Viral or bacterial infections, respiratory infections and chronic respiratory failure 3. diagnosis: 1. history, physical exam, PFTs, chest xray, lab tests 4. treatment - stop smoking to slow disease progression - pneumonia and flu vax - inhaled short and long acting bronchodilators, to relax airway smooth muscle - oxygen therapy when PCO2 levels drop below 55 mmHg What are the characteristics of asthma? Ans- Asthma is a chronic respiratory disease characterized by airway obstruction, bronchial hyperresponsiveness, airway inflammation, and in some cases, airway remodeling. chronic bronchitis and emphysema Ans- -Chronic bronchitis is a clinical diagnosis: chronic cough productive of sputum for at least 3 months per year for at least 2 consecutive years. -Emphysema is a pathologic diagnosis: permanent enlargement of air spaces distal to terminal bronchioles due to destruction of alveolar walls What is atopy? Ans- Atopy is the genetic tendency for developing IgE-mediated hypersensitivity reactions in response to environmental allergens. It is one of the strongest predisposing factors for developing asthma. Be familiar with the risk factors, disease pathology, clinical presentation, diagnosis, and treatment of asthma. Ans- 1. risk factors 1. atopy, family history of asthma, allergies, prenatal exposure to tobacco smoke and pollution, gastro-esophageal reflux disease, exercise, cold air, bei