NR 507: Advanced Pathophysiology Midterm
1. Asthma: Chronic disease due to bronchoconstriction and an excessive inflammatory response in the bronchioles
2. What are 5 s/s of asthma: coughing
wheezing shortness
of breath rapid
breathing chest
tightness
3. Pathophysiology of asthma (5): -airway inflammation, bronchial hyper-reactivity and smooth muscle spasm
-excess mucus production and accumulation
-hypertrophy of bronchial smooth muscle
-airflow obstruction
-decreased alveolar ventilation
4. Bronchioles: smaller passageways that originate from the bronchi that become the alveoli
5. 3 layers of the bronchioles: innermost layer
middle layer - lamina propria outermost
layer
6.lamina propria: the middle layer of the bronchioles
7.structure of the lamina propria: embedded with connective tissue cells and immune cells
8.purpose of the lamina propria: white blood cells are present to help protect the airways
9.How does the lamina propria effect the lungs in regards to asthma: the WBCs
protective feature goes into overdrive causing an inflammatory response that damages host tissue
10. What does the innermost layer of the bronchioles contain: columnar epithelial ells and mucus producing goblet cells
11. What does the outermost layer of the bronchioles contain: smooth muscle cells 12. what does the outermost layer of the
bronchioles do: control the airways ability to constrict and dilate
13. alveolar hyperinflation: When air is unable to move out of the alveolar like it should due to bronchial walls collapsing
around possible mucus plug thus trapping air inside
14. how does hyperinflation occur?: the ongoing inflammatory process of asthma produces mucus and pus plug that the
bronchial walls collapse around
15. Effect of hyperinflation of the alveolar: -expanded thorax and hypercapnia (retention of CO2)
- respiratory acidosis
16 What are two anticholinergic drugs used for asthma: tiotropium and ipratropium
17. What do anticholinergics do in the lungs?: These drugs block the effects of the parasympathetic nervous system
- increasing bronchodilation
, .
18. MOA of anticholinergic drugs for asthma: the parasympathetic system is stimulated by the
vagal nerve to release acetylcholine which binds to the cholinergic receptors of the respiratory tract to cause bronchial
constriction = decreased airflow
- blocking the cholinergic receptors prevents acetylcholine binding preventing the bronchial constriction
19. bronchitis: inflammation of the bronchial tubes
20. 3 characteristics of bronchitis: bronchial inflammation hypersecretion of mucus
chronic productive cough for at least 3 consecutive months for at least 2 successive years
21. Perfusion: The supply of oxygen to and removal of wastes from the cells and tissues of the body as a result of the flow of
blood through the capillaries.
22. results of chronic bronchitis/ low perfusion: cyanosis right to left shunting chronic hypoxemia
23. Why is there cyanosis with chronic bronchitis: there is hypoxia due to unfavorable conditions for gas exchange
24. Right to left shunting: when blood passes from the right ventricle through the lungs and to the left ventricle without
perfusion
25. Causes of bronchitis: -long term exposure to environmental irritants
-repeated episodes of acute infection (RSV infection in early infancy)
-Factors affecting gestational childhood lung development (preterm birth)
26. Pathogenesis of bronchitis: -Exposure to airborne irritants
- Irritant activates bronchial smooth muscle constriction and mucus secretion
- Triggers release of inflammatory mediators from immune cells located in the lamina propria
27. most common irritant with bronchitis is?: tobacco product smoke
28. what does long term exposure to irritants promote in bronchitis? (5): - smooth muscle hypertrophy
- hypertrophy and hyperplasia of goblet cells
- epithelial cell metaplasia
- migration of more WBC to site
- thickening and rigidity of bronchial basement membrane
29. What does smooth muscle hypertrophy do in lungs?: causes increased bronchoconstriction
30. Hypertrophy and hyperplasia of goblet cells do what in the bronchials: promotes hypersecretion of mucus
31. What are characteristics of epithelial cell metaplasia?: squamous cells become nonciliated and are less protective; allow
passage of toxins and WBCs
1. Asthma: Chronic disease due to bronchoconstriction and an excessive inflammatory response in the bronchioles
2. What are 5 s/s of asthma: coughing
wheezing shortness
of breath rapid
breathing chest
tightness
3. Pathophysiology of asthma (5): -airway inflammation, bronchial hyper-reactivity and smooth muscle spasm
-excess mucus production and accumulation
-hypertrophy of bronchial smooth muscle
-airflow obstruction
-decreased alveolar ventilation
4. Bronchioles: smaller passageways that originate from the bronchi that become the alveoli
5. 3 layers of the bronchioles: innermost layer
middle layer - lamina propria outermost
layer
6.lamina propria: the middle layer of the bronchioles
7.structure of the lamina propria: embedded with connective tissue cells and immune cells
8.purpose of the lamina propria: white blood cells are present to help protect the airways
9.How does the lamina propria effect the lungs in regards to asthma: the WBCs
protective feature goes into overdrive causing an inflammatory response that damages host tissue
10. What does the innermost layer of the bronchioles contain: columnar epithelial ells and mucus producing goblet cells
11. What does the outermost layer of the bronchioles contain: smooth muscle cells 12. what does the outermost layer of the
bronchioles do: control the airways ability to constrict and dilate
13. alveolar hyperinflation: When air is unable to move out of the alveolar like it should due to bronchial walls collapsing
around possible mucus plug thus trapping air inside
14. how does hyperinflation occur?: the ongoing inflammatory process of asthma produces mucus and pus plug that the
bronchial walls collapse around
15. Effect of hyperinflation of the alveolar: -expanded thorax and hypercapnia (retention of CO2)
- respiratory acidosis
16 What are two anticholinergic drugs used for asthma: tiotropium and ipratropium
17. What do anticholinergics do in the lungs?: These drugs block the effects of the parasympathetic nervous system
- increasing bronchodilation
, .
18. MOA of anticholinergic drugs for asthma: the parasympathetic system is stimulated by the
vagal nerve to release acetylcholine which binds to the cholinergic receptors of the respiratory tract to cause bronchial
constriction = decreased airflow
- blocking the cholinergic receptors prevents acetylcholine binding preventing the bronchial constriction
19. bronchitis: inflammation of the bronchial tubes
20. 3 characteristics of bronchitis: bronchial inflammation hypersecretion of mucus
chronic productive cough for at least 3 consecutive months for at least 2 successive years
21. Perfusion: The supply of oxygen to and removal of wastes from the cells and tissues of the body as a result of the flow of
blood through the capillaries.
22. results of chronic bronchitis/ low perfusion: cyanosis right to left shunting chronic hypoxemia
23. Why is there cyanosis with chronic bronchitis: there is hypoxia due to unfavorable conditions for gas exchange
24. Right to left shunting: when blood passes from the right ventricle through the lungs and to the left ventricle without
perfusion
25. Causes of bronchitis: -long term exposure to environmental irritants
-repeated episodes of acute infection (RSV infection in early infancy)
-Factors affecting gestational childhood lung development (preterm birth)
26. Pathogenesis of bronchitis: -Exposure to airborne irritants
- Irritant activates bronchial smooth muscle constriction and mucus secretion
- Triggers release of inflammatory mediators from immune cells located in the lamina propria
27. most common irritant with bronchitis is?: tobacco product smoke
28. what does long term exposure to irritants promote in bronchitis? (5): - smooth muscle hypertrophy
- hypertrophy and hyperplasia of goblet cells
- epithelial cell metaplasia
- migration of more WBC to site
- thickening and rigidity of bronchial basement membrane
29. What does smooth muscle hypertrophy do in lungs?: causes increased bronchoconstriction
30. Hypertrophy and hyperplasia of goblet cells do what in the bronchials: promotes hypersecretion of mucus
31. What are characteristics of epithelial cell metaplasia?: squamous cells become nonciliated and are less protective; allow
passage of toxins and WBCs
