emphysema
3 clinical manifestations
dyspnea
quiet chest --> no coughing
"barrel chest"
definition of pneumonia and ways to diagnose
infection of lower respiratory tract caused by bacteria/viruses etc.
restrictive lung disease: lungs are restricted from fully expanding --> cannot fully fill lungs with air
WBC count, chest x rays, cultures of moth and throat
T/F can be cured by cessation of the irritant
false
characterized by what symptom
productive cough
systemic effects
muscle weakness
weight loss
what can be used to evaluate a patient with emphysema
spirometry
H and P
pneumonia is highly communicable in ____ because _____
hospitals, spread thru aspirations of oropharyngeal secretions (cough/sneeze)
T/F chronic bronchitis and emphysema can overlap and a combination of both can lead to COPD
True
emphysema is pathologic whereas chronic bronchitis is a ____
T/F emphysema and chronic bronchitis can both lead to hypoxemia and hypoxia
true
definition of emphysema
abnormal permanent enlargement of acini accompained by destruction of alveolar walls without obvious fibrosis
3 clinical manifestations
fever/chills
productive or dry cough
malaise (overall body weakness)
pleural pain
dyspnea
hemoptysis (coughing up blood)
2 environmental factors and 1 genetic factor
smoking, occupational exposure, air pollution
a-1 antitrypsin
T/F chronic bronchitis can result in bronchial and peripheral edema
true
peripheral edema because of lack of being able to transport O2
emphysema causes a ___ V/Q ratio
(what is V/Q, ideal ratio, what does it mean)
high
V/Q: ventilation to alveoli/perfusion of blood to alveoli, ideal ratio 1:1 (0.8)
means that there is poor perfusion/blood flow to the alveoli bc of high compliance (less resistance so blood flows in 1 direction unequally)
3 results that occur due to the destruction
enlarged air spaces
impaired gas diffusion
air trapping on expiration
Red hepatization
Gray hepatization
red: RBC, neutrophils, and fibrin in alveoli
2nd sage: days 3-4
gray: RBC broken down, leaving behind fibrin deposits
3rd stage: days 5-7
what happens to the bronchiolar walls
fibrosis and thickening
inflammation causes
increased oxidative stress
inflammatory mediators
cytokines
there are 7 clinical manifestations of pulmonary alterations. name as many as possible
dyspnea (trouble breathing)
cough (natural reflex to clear airway)
abnormal sputum (pus) (dead wbc)
hemoptysis (coughing up blood)
abnormal breathing patterns (hypo- and hyper- ventilation)
cyanosis (cardinal sign) (blueing of skin)
clubbing (due to vasodilation to get more O2 and blood supply thru, also linked to growth factors that may exist in blood under certain respiratory conditions)
pathology starting from the genetic factor
a-1 antitrypsin deficiency --> increased neurtrophil elastase and matric metalloproteinases/inhibition of normal endogenous antiproteases --> increased protease activity/degrade elastin by proteolysis --> destruction of alveolar walls and capillaries, and loss of elastic recoil of bronchial walls
list 3 things found in an injured alveoli in acute phase and why its detrimental/what would be normally found/add on
sloughing of bronchial epithelium (cells fall off and die = pus)
active macrophage (release cytokines and is there normally as part of innate immune)
necrotic or apoptotic type 1 cells (norm: type 1 cells provide structural support (type 2 secrete surfactant)
denuded/removal basement membrane (norm: intact basement membrane needed for gas diffusion)
cellular debris (from immune response/protease)
rbc (red hepatization)
activated neutrophils (release of oxidants and cytokines)
impeded alveolar air space (norm: open air space allows gas exchange)
4 hypothesis for COPD
hypersecretion of mucus (CB)
airway hyperactivity (CB)
destruction and inability to repair alveoli (EM)
protease-antiprotease/a-1 antitrypsin (EM)
why is chronic bronchitis considered a chronic obstructive disease
COD: persistent obstruct bronchial airflow, making it difficult to exhale air from lungs
continuous bronchial irritation and inflammation
hypersecretion of mucus --> narrowing of small airways
definition of:
hypercapnia
cor pulmonale
hypoxemia
bonus: acini
hypercapnia: high levels of CO2 in blood
cor pulmonale: right sided heart failure
hypoxemia: low levels of O2 in blood
acini: cells of alveolar wall