Pathophysiology, Chp. 13 - Respiratory System Disorders Part 1

The upper respiratory tract is responsible for conducting air, while the lower respiratory tract is responsible for gas exchange.

They prevent the collapse of the trachea and keep the airway open even with the pressure changes.

An exercise tolerance/stress test

Spirometry

A bronchoscopy

Sneezing is a reflex response when there is irritation in the upper respiratory tract. Coughing can be a result of nasal discharge dripping down into the oropharynx and also be caused by inhaled irritants.

Yellowish-green, clouds and thick: bacterial infection

Rusty/dark-coloured: pneumococcal pneumonia

Purulent with foul odor: bronchiectasis

Thick, sticky: asthma or cystic fibrosis

Blood tinged: chronic cough, tumor or TB

Hemoptysis: blood-tinged, frothy --> pulmonary edema

Eupnea - 10-18 per minute and is effortless

Kussmaul respirations - deep and rapid, "air hunger"

Wheezing (whistling) indicate obstruction in the small airways. Stridor usually indicates upper respiratory airway obstruction.

Rales - light bubbly or crackling w/ serous secretions

Rhonchi - deeper/harsher sounds w/ thicker mucus

Absence - no sound from non-aeration or collapse of sounds

- flaring of nostrils

- using accessory respiratory muscles

- retraction (pulling in) of the muscles between or above the ribs

pulmonary congestion

Chronic hypoxia associated with respiratory or cardiovascular diseases.

Hypoxemia is an inadequate amount of O2 in blood. Hypercapnia is an increased CO2 in the blood.

LAV (live attenuated) - vaccine created by reducing virulence of a pathogen (where it's alive).

Inactivated - made from microorganisms where it' sbeen killed. Not guaranteed to cause an immune response.

- respiratory synctial virus (RSV)

- necrosis

- inflammation in the bronchioles --> edema

- obstruction of small airways

Signs and symptoms:

- wheezing

- dyspnea

- rales

- cough

- fever

- causative agent (viral, bacterial, fungal)

- location of infection (both lungs, or consolidated)

- pathophysio. changes

- epidemiological data (nosocomial, community)

Agent: usually streptococcus pneumoniae

Location: all or one of the lobes

Pathophysio: sudden and acute, inflammation and vascular congestion from the exudate formed in the alveoli --> interferes with O2 diffusion. Pleuritic pain.

Agent: several, often bacterial; Staph. A., Haemophilius influenzae, E. coli.

Location: both lungs, usually lower

Pathophysio: exudate forms in alveoli interfering with O2 diffusion.

Primary can be bacterial or viral, not just bacterial. Because of the inflammation of the interstitial tissue it tends to produce nonproductive cough (because the fluid isn't in the alveoli and has no way of being relieved). It can also manifest differently, meaning we can feel fine, but the other two are more serious (hospitalized).

A type of atypical pneumonia which is caused by a fungus. Once inhaled it causes necrosis and insterstitial inflammation. The alveoli then fill with exudate and fungi. This is a serious infection for immunocompromised individuals.

False; Covid-19 (20%) for hospitalizations and SARS is 20-30%. SARS also has a higher mortality rate.

SARS-CoV-2 virus

Myocobacterium tuberculosis.

True.

- bacteria is resistant to many disinfectants

- survives in dried sputum

- normal neutrophil response doesn't occur

- immunity works slowly, allowing the bacteria to proliferate

When the organism first enters the lungs. Inflammation occurs and initiates a type IV cell-mediated hypersensitivity (delayed) reaction. WBCs clump together forming a tubercle containing the organism --> lesions in the lungs which will be walled off by fibrous tissue (Ghon complexes).

When the individual has the infection, but is latent. This is due to the organism being hidden in the tubercles and are reactivated. Multiplication --> necrosis of lung tissue. Eventually a cavity will open up in the lungs (cavitation) which will erode the bronchi and blood vessels. The bacteria can exit the lungs and enter other organs from the cavities.

patient's cell-mediated immunity is impaired

- stress

- malnutrition

- HIV

- age

- tuberculin skin test

- staining sputum test

- CT scan

- sputum culture and sensitivity

An inherited disorder in kids. Exocrine glads create sticky, tenacious mucus which obstructs the airflow in the bronchioles. This causes air to be trapped in the lungs which will eventually cause the collapse of the lung(s).

- meconium ileus (small intestine is blocked by mucus at birth)

- salty skin

- signs of malabsorption (steatorrhea, abdo. distention)

- chronic cough and resp. infections

- replacement therapy for pancreatic enzymes

- well-balanced diet (^protein, low fat, vit. supplements)

- intensive chest physiotherapy (for removal of tenacious mucus)

- humidifiers and bronchodilators

periphery of lungs.

A rapidly growing cancer found in the major bronchus. It's highly invasive and spreads early.

Carcinomas consisting of undifferentiated large cells that grow rapidly and spread early. Usually found on the periphery of lung.

An aggressive and deadly cancer. Pleural mesothelioma most often affects the pleura of the lungs.

- abnormal breath sounds and dyspnea (from obstruction of bronchus)

- cough, hemoptysis (from the inflammation and bleeding)

- pleural effusion (^fluid in pleura)

- pneumothorax

- paraneoplastic syndrome

The passage of food, fluid, emesis and other foreign material into the trachea and lungs.

- penumonia (inflammation --> gas diffusion is impaired)

- respiratory distress syndrome

- pulmonary abscess (from microbes in the aspirate causing an infection)

When the pharyngeal tissue collapses during sleep --> random stops of breathing --> not as much O2 received during sleep.

- CPAP (continuous positive airway pressure pump)

- Oral appliances that reduce collapse of pharyngeal tissue.

Disease that involves periodic episodes of severe and reversible bronchial obstruction in people with hypersensitive/hyperresponsive airwars.

Extrinsic: acute episodes triggered by type I hypersensitivity reactions (typical allergic reactions)

Intrinsic: onset during adulthood, where the tissue in airway initiates episode.

- inflammation of the mucosa with edema

- contraction of smooth muscle (bronchoconstriction)

- increased secretion of thick mucus

These create partially or totally obstructed airways and interfere with airflow and O2 supply.

- respiratory alkalosis (^hyperventilation to compensate for lack of O2 from obstructed airways)

- respiratory acidosis (from trapped air; CO2 which is acidic can't leave causing the body to be more acidic)

- severe respiratory distress (hypoventilation --> hypoxemia and respiratory acidosis)

A persistent severe attack of asthma, which is a medical emergency. Fatal because of severe hypoxia and acidosis.