lecture 8

–Leads to hypercapnia and hypoxemia

–Caused by certain drugs, disorders such as obesity, myasthenia gravis, chest wall damage, or paralysis of respiratory muscles

the delivery of air to the alveoli is insufficient this deficieny leads to hypercapnia (increase CO2 in blood) and hypoemia (decrease in O2 in blood)

Your not blowing out CO2 so it builds up the increase in alveolar CO2 displaces the O2, contributed to obesity

Myasthenia gravis: a breakdown of the motor end plate of the muscle is gone lossing muscle control causeing hypoventilation

–Leads to hypocapnia

–Caused by hypoxia, pain, fever, or anxiety

decrease O2 in blood

–Caused by high altitude, hypoventilation, and airway obstruction

decreased O2 in tissues

–Caused by high altitude, hypoventilation, and airway obstruction

–Disturbed gas exchange resulting in abnormal arterial blood gas levels

–Hypoxemia develops because of mismatched perfusion and ventilation

• –Hypercapnia develops due to
• inadequate alveolar ventilation

pt becomes confuesed not enough o2 to brain, dizziness, depressed conciousness, tremors, pt will attempt to take in O2 àtachypnea, increased HR, whenever you have decreased O2 tension àvasodilation àhypotension

occurs with any condition that increases the resistance of the pulmonary vasulature also related to cardio genic

Idopathic not sure what causes it but associated with it are serosis of the liver, appetite supresive drugs, seen in HIV, rapid progression and prognosis poor, more common in women

Most commonly due to increased airway resistance, as in chronic bronchitis and advanced emphysema

coming from DVT and increase in pulmonary pressure -->right sided HF

• PE: pts will presetn with tachycardia and pnea, severe chest pain may or may not occuring with very large PE,
• SOB -->very anxious and restlessness, symptoms of RHF (kussmals sign-disteneded superficial jugular vein, peripheral edema, spleenomeglia)

• Squamous cell carcinomas
• Adenocarcinoma
• Large cell carcinoma
• Smalle cell carcinoma

Metastasizes to regional lymph nodes

• common can b detected by ctyological examination of
• sputum. Propensity to mestastisize to regional lymph nodes

develop in bronchial tree

Metastasis occurs in distant organs

located in the perphery of the lungs no easily detected

causes increased sputum

develops in parenchyma

Metastasis occurs in distant organs

develops in parenchyma

worst type and resistant to treatment, grows rapidly

widespread metastasis is common

mutates a lot causing more and more resistance to the intervention used

develops in the bronchial tree

Obstruction from conditions of the wall of the lumen

Most common chronic disease in childhood

Lung disease characterized by

-Airway obstruction, usually reversible

-Airway inflammation

-Increased airway responsiveness to stimuli

common in children often related to heat loss and water loss more common in winter lack of humidity

associated with aspirin (affects the cygooxynase cycle so that gets kicked out to ipooxygenase pathwayà increase din leukitrine production, NSAIDs,

mild to life threatening depending on the degree of airway obstruction

• Acute inflammation of trachea and bronchi, typically caused by viruses (influenza virus A or B, parainfluenza virus, rhinovirus, etc.) and bacteria (Streptococcus
• pneumoniae, Haemophilus influenza, etc.)

Heat, smoke inhalation, inhalation of irritant chemicals, and allergic reactions can also induce acute bronchitis

Cough and a low grade fever, bronchi and trachea bc obstructed complaining of dyspnea and chest pain

Considered more dangerous in children bc of the smallness of their airways and a smaller diameter but evquivelant response

• 1. capillary dilation
• 2. increased exudation of fluid
• 3. increased mucus secreations
• 4. loss of mucilary cilliary esculator

• Presistent narrowing of the airways, due to chronic inflammation, excessicve mucsous production (lining
• the bronchi) leading to poor ventilation and poor gas defrusion

Major cause is cigarette smoking (paralyzing mucous cilliary esculator à> repeated airway infection

Remaining cause is inhalation of chemical irritants

Key is chronic obstruction

• excess body fluid (edemal plethora)
• Chronic cough
• SOB on exertion
• increased sputum
• cyanosis (late sign)

"blue bloaters"

generalized pulmonary vasoconstriciton, pulmonary hypertension and right ventrivular hypertrophy (cor pulmonale)

right sided HF may occur bc of the high pulmonary resistance

by destructive changes of the alveolar walls and abnormal enlargement of the distant air sacs

Cigarette smoking is a major cause of emphysema

long period and is seen more frequently in persons older than 50

alveolardestruction associated with the release of proteolytic enzymes from inflammatory cells (neutrophils and macrophages)

alveolar destruction associated with the release of proteolytic enzymes from inflammatory cells (neutrophils and macrophages)

reduction in the pulmonary capillary bed and a decrease in overall gas exchange

due to alastic in alveolar walls in broken down when inhale there is no elastic in there to bring it back to normal size resulting in abnormal size in lungs

• Elsatic fibers also keep the small airways open, when lungs expand the lungs stretch and expands and the
• elastic fibers are pulled in all direction and small airways are collapsed à the obstruction is they cant get the air out staying in the lungs, lost radial traction and that’s what keeps the small airways open

• use of accessory muscles to breath
• pursed lip breathing
• minimal or absent cough
• leaning forward to breathe
• barrel chest
• digital clubbing
• dyspnea on exertion

Characterized by recurrent infection and inflammation of bronchial walls, leading to persistent dilation of medium-sized bronchi and bronchioles

recurrent infection inflammation --> a lot of purulent exudate (puss and foul smell yellow greenish)à airway obstruction

wide spread inflammation of bronchials, due to respiratory sincidial virus or influenza virus,

• what happens is the obstruction is due to inflammation associated with a inflammatory exudateà releaseing inflammatiory mediateorsà broncho constriction and
• fibrosis

• -obstruction typically takes place in the
• smallest broncials

Autosomal recessive disorder of exocrine glands

CF gene on chromosome 7, mutation in gene for transmembrane conductance regulator, which is involved in Chloride ion transport

• CF affects lungs (hypersecretion of thickened mucus), intestinal tract (excessive mucus secretions),
• sweat glands (high salt content in sweat) and pancreas (decreased production of pancreatic enzymes)

Heart-lung or lung transplantation is the only definitive treatment

first sign in children is said to have a salty kiss (bc chloride isnt working)

Requires immediate treatment

Causes include aspiration of a foreign body, laryngospasm, trauma, epiglottitis, swelling from smoke inhalation, etc.

can be complete or partial

trachea or larnex

typically in bronchi usually one bronchi often times the right bronchus

• Rapidly progressive cellulitis of the epiglottis
• and adjacent tissues

Typically caused by H. influenzae

Most often seen in children 2 to 4 years of age

Difficulty swallowing saliva with evidence of drooling is common

A number of acute viral inflammatory diseases of the larynx

Typically occur in late fall and early winter and affect children from 6 months to 3 years of age

typically present w/ a barking cough and stridor