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Lobar pneumonia definition
- Fluid builds up in a specific lobe (congestion)
- May consalidate
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Broncho pneumonia definition
purulent exudate builds up in diffuse pattern in lungs
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Atypical pneumonia definition
- Forms diffuse inflammation
- no great amount of exudate
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Lobar pneumonia etiology
streptococcus pneumonia
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Broncho pneumonia etiology
many different bacteria
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atypical pneumonia etiology
influenza virus or mycoplasma
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Clinical findings lobar pneumonia
- Pleura inflammed
- sudden/acute onset with fever/chills
- rales/no breath sound
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Clinical findings broncho pneumonia
- mild fever, insidious onset
- productive cough, yellow green
- dyspnea
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Clinical findings atypical pneumonia
- fever, HA
- Aching muscles
- Non-productive cough
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Medical tx lobar pneumonia
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medical tx broncho pneumonia
- antibiotics
- sputum culture
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medical tx atypical pneumonia
self limiting usually
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COPD emphysema definition
- Tissue degeneration and obstruction
- debilitatingirreversible
- progressive
- Cor pulmonate (R CHF) from vasoconstriction of pulmonary blood vessels
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emphysema patho
- destruction of alveolar walls
- inflated alveolar air spaces
- lung tissue lost as blebs developdecrease capillaries available
- decrease elasticity of lungs
- fibrosis and thickening of bronchial walls
- difficultly with expiration (trapped air)
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emphysema etiology
- cigarettes
- air pollution
- genetic (early onset
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emphysema clinical findings
- insidious
- dyspnea on exertion/rest
- prolonged expiration
- barrel chest from hyperinflation of lungs
- anorexia, fatigue, wt loss
- Hypoxia
- Clubbed fingers
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Emphysema medical tx
- avoidance of irritants (cigs)
- nutrition/hydration
- breathing techniques- pursed lips breathingBronchodilators
- Antibiotics
- O2
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Chronic Bronchitis etiology
exposure to smoking and/or industrial pollution
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Chronic bronchitis clinical findings
- constant productive cough especially in morning
- SOB, tachypnea
- rhonchi
- hypoxia and cyanosis
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Chronic bronchitis medical tx
- decreased exposure to irritants
- expectorant
- broncho dilator
- postural draining/percussion
- O2 low flow
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CF patho
- Exocrine glads secrete excessive, thick, tenacious mucus in lungs and pancreas and lungs
- sticky mucus obstructs ducts; in lungs the trapped air results in permanent dmg
- provides excellent growth medium for bacterial growtheventually respiratory failure or cor pulmonate (R CHF)
- Blocking of pancreas ducts results in lack of digestive enzymes and malabsorption of food
- my also effect liver, salivary glands, sweat glands, small intestine, reproductive system
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CF etio
- Genetic 7th chormosome, autosomal recessive
- May be dx pre-natal
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CF clinical findings
- meconium ilium at birth
- salty taste on skin
- malabsorption
- stool changes (no wt gain)
- unable to absorb food
- chronic cough/respiratory infections
- hypoxia
- chest over inflated (air trapped)
- ex intolerant/fatigue
- children not meet norm growth milestones
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CF med tx
- team
- enzyme replacement (pancreas)
- well balanced diet, low fat
- intense PT including postural drainage, percussion/cough instruction
- aggressive tx of infetions
- hydrating fluids (decrease mucus thickness)
- O2
- heart/lung implants
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Asthma definition
- Episodic bronch constriction from inflam
- may lead to perm dmg
- 3 types
- -Conventional
- -Occupational
- -Ex induced
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Astham patho
- antigen binds with IgE on mast cells releasing histamine, prostaglandin, and other chemical mediators
- Histamine causes constriction of smooth muscles (broncho constriction)
- Inflam with edema and increase secretion of thick mucous may totally obstruct air flow
- may develop hypoxia
- status asmaticus- persistent severe attack, can be fatal.
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Asthma etio
- Hypersensitive airways
- internal causes
- -genetic predisposition
- external causes
- -ex
- -cold air
- -cig smoke
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Asthma clinical findings
- cough
- dyspnea
- tight chest
- wheezing
- thick tenacious mucus
- tachycardia
- respiratory failure; decrease responsiveness, decreased O2 and increased CO2
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Asthma Med tx
- Avoid triggers
- good ventilation/air exchange at work/home
- breathing techniques to decrease anxiety and severity
- for children regular swimming
- inhalers; bronchodilator
- drugs
- -corticosteroids to decrease inflam
- -preventative to decrease hypersensitive response
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Bronchiectasis
- Usually secondary problem develops in condition such as CF or COPD
- irreversible abnormal widening, primarily the medium sized bronchi
- arise from recurrent infection and inflam in the airways
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TB infection patho
- primarily infects lungs
- bacteria become walled off in lungs
- may carry but be dormant
- with low resistance it may become active
- lung tissue destroyed and bacteria spread to other tissue
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TB risk factors
- malnutrition
- crowding
- alcohol and chronic disease
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Pulm edema patho
- fluid in alveoli from high capillary pressure
- difficulty expanding lungs and eventually collapse
-
pulm embolus etio
- usually thrombus dislodged from leg vein thrombo or phlebo
- fat emboli from bone fx (trauma)
- tumor embolism (cancer)
- amniotic fluid (pregnancy especially, during delivery
- Air emboli injected into vein
- Immob/dehydration
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Pulm embolus clinical findings
- Sudden onset of chest pain, tachypnea, dyspnea
- SNS response- nervous, restless
-
Pulm edema etio
- L CHF
- Kidney/liver disorders
- inflam from inhaled toxic gases
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Pulm embolus tx
- Preventitive with risk factors
- If due to thromb then O2, heparin
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Atelectasis
Collapse of lung or part of lung
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Atelectasis etio
- obstruct of airflow from tumor, mucus
- compress of lung
- increased pleural cavity pressure
-
Atelectasis clinical findings
- If small no SnS
- If large dyspnea, increased HR and RR, chest pain
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Types of obstructive diseases
- Peripheral airway disease (COPD)
- Chronic bronchitis (COPD)
- emphysema (COPD)
- Asthma
- CF
- Bronchioectasis
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Obstructive disease changes
- narrowing and obstruction of airways
- Inflam of airways
- Destruction of alveolar and bronchial walls
- Increase production and retention of mucus
- Abnormal pulmonary function
-
Obstructive disease impairments
- Dyspnea on exertion (sob with exertion)
- Chronic productive cough
- Freq respiratory infections
- Associated postural defects
- Lung volume changes
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Restrictive diseases etio
- Inability of the lungs to fully expand as a result of extrapulmonary/pulmonary disease or restriction (difficulty taking in a deep breath)
- Lung volume changes
-
Pulmonary causes
- Tumor
- Interstitial pulmonary fibrosis (pneumonia, TB, asbestosis)
- Edema or pulmonary embolism
- Hyaline membrane disease
- Normal aging
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Extrapulmonary sources
- Chest wall pain secondary to trauma or surgery
- Chest wall stiffness associated with extrapulmonary disease (scleraderma or ankylosing spondylitis)
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Postural deformities effecting pulmonary
- Scoliosis and kyphosis
- Ventilatory muscle weakness (neruopathic or myopathic)
- -SCI, CP, PD, MD
- Pleural disease
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Factors increasing restrictive pulmonary patho
- General anesthesia
- Intubation
- Incisional pain
- Pain med
- General inactivity, weakness/fatigue
- Hx of smoking
- Thoracic surgery
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Tidal Volume (TV)
- 500ml
- Amount of air entering lungs with each normal breath
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Residual Volume (RV)
- 1200ml
- Amount of air remaining in the lungs after forced expiration
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Inspiratory Reserve (IRV)
- 3000ml
- Max volume of air inspired in excess of normal tidal volume
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Expiratory reserve (ERV)
- 1100ml
- Max volume of air expelled following a passive expiration
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Vital Capacity (VC)
- 4600ml
- Max amount of air expired following a max inspiration
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Total Lung Capacity (TLC)
- 5800
- Total volume of air in the lungs after max inspiration
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