1. define dyspnea
    subjective sensation of uncomfortable breathing
  2. subjective sensation of uncomfortable breathing when in horizontal position
  3. define paroxysmal nocturnal dyspnea
    Wake up at night gasping for air and have to sit up or stand for relief
  4. paroxysmal nocturnal dyspnea is seen with what?
    L ventricular failure
  5. increased ventilatory rate, very large tidal volumes, no expiratory pause.
    kussmaul respirations (Hypernpnea)
  6. kussmaul respirations happen in
    • strenuous exercise
    • metabolic acidosis
  7. Hypoventilation
    inadequate alveolar ventilation r/t metabolic demands
  8. hypercapnia
    CO2 removal does not keep up with production and CO2 rises in blood
  9. Hyperventilation
    alveolar ventilation that exceeds metabolic demands
  10. lungs remove C2  at a faster rate than it is produced; means low levels of CO2 in blood
  11. hemoptysis
    coughing up blood or bloddy secretions
  12. Cyanosis
    decreased arterial oxygenation or decreased cardiac output
  13. bulbous enlargement of the end of the finger or toe
  14. hypoxemia happens when?
    • high altitude
    • hypoventilation
    • emphysema
    • atelectasis
  15. ________ caused by fracture of ribs or sternum
    flail chest
  16. air or gas in pleural space collapses the lung partially or totally caused by rupture of pleura or spontaneous rupture of pleural bleb
  17. collapse of lung tissue

    caused by external pressure from tumor, fluid, or air in pleural space
  18. persistent abnormal dilation of bronchi

    caused by obstruction of airway, atelectasis, infection
  19. fibrous tissue or nodule in lungs

    caused by silicosis, anthracosis (inhalation of coal dust), and asbestosis
  20. excess water in lungs
    pulmonary edema

    caused by heart disease that increases pulmonary capillary hydrostatic pressure, ARDS or inhalation of toxic gases that injure capillaries and increases permeability, or blockage of lymphatic vessels by CHF
  21. s&s of ARD
    • Tachypnea
    • Dyspnea
    • Retractions
    • Hypoxia
    • Tachycardia
    • decreased pulmonary compliance
  22. ABGs of ARDS
    • decreased Po2
    • Increased Dyspnea

    (Pt is NOT getting better even with increased flow rate of oxygen)
  23. Causes of ARDS
    • Trauma
    • Pulmonary infection/aspiration
    • Prolonged cardiopulmonary bypass
    • Shock
    • Fat emboli
    • Sepsis
  24. What does ARDS look like?
    white lung
  25. What is asthma
    • acute
    • intermittent bronchial inflammation
    • smooth muscle spasm
    • mucosal edema
    • increased thick mucus production cause airway obstruction
  26. What is emphysema
    • enlargement and destruction of alveoli
    • loss of elasticity
    • trapping of air during expiration causes airway obstruction

    Risk factors: Alpha-1 antitrypsin deficiency and cigarette smoke
  27. Chronic bronchitis
    inflamed and thick mucus membrane, impaired cilia
  28. Fungal
    • infrequent
    • can occur in immunosuppressed
  29. Community acquired
    most common cause is strep pneumonia, lobar pneumonia
  30. Pneumonia
    acute inflammation of lower respiratory tract caused by microorganisms
  31. Nosocomial pneumonia
    staphylococcus aureus and Klebsiella pneumonia, usually in pts with other health problems such as COPD
  32. pneumococcal pneumonia
    involved lobe has 4 phases of inflammatory response
  33. Phases of pneumococcle pneumonia
    Phase 1- CONSOLIDATION: solidification of the tissue caused by filling with exudate

    Phase 2: STAGE OF RED HEPATIZATION: alveoli fill with blood cells, fibrin, edematous fluid and pneumocci. Lungs look red

    Phase 3: GRAY HEAPTIZATION: affected tissue becomes gray b/c of fibrin and neutrophils in consolidated alveoli. phagocytosis taking place

    Phase 4: RESOLUTION: increasing numbers of machrphages appear in alveolar spaces, neutrophils degenerate, fibrin threads and bacteria digested. Removed lymphatic vessels
  34. Tuberculosis is caused by
    • aerobic mycobacterium tuberculosis
    • -acid-fast bacillus
  35. TB usually affects
    lungs but may invade other body systems
  36. TB has ceseation necrosis, which is
    infected tissues within the tubercle die and form a cheeselike material

    collagenous scar then forms
  37. tb can be
  38. Pulmonary vascular diseases
    Disrupt blood flow through the lungs by occluding blood vessels, increase pulmonary vascular resistance, or destroy vascular bed
  39. caused by blood-borne substances from venous stasis in legs, vessel injury, or hypercoagulation lodge in a branch of pulmonary artery and obstructs blood flow to lung parenchyma
  40. PA pressure elevated by increased Left atrial pressure, increased blood flow in pulmonary circulation
    Pulmonary hypertention
  41. Pulmonary hypertension symptoms
    • englarges PA and right ventricle hypertrophies on x-ray or EKG
    • JVD
    • Fatigue
    • CP
    • Tachypnea
    • DOE
  42. COR pulmonale
    • R heart failure b/c of primary
    • pulmonary disease and long-standing pulmonary HTN
    • secondary heart sound or closure of pulmonic valve accentuated¬†
    • tricuspid valve murmur
  43. Lip cancer
    more prevalent in men exposed to sun, wind, cold over years
  44. Laryngeal cancer
    increased risk by tobacco smoked, increased when combined with alcohol consumption
  45. Lung cancers or bronchogenic carcinomas arise from
    epithelium of respiratory tract
  46. adrenocarcinoma
    moderate growth rate, early metastasis
  47. squamous cell carcinoma
    slow growth rate, late metastasis
  48. Large cell undifferentiated carcinoma
    rapid growth rate, eartly and widespread metastasis
  49. Small cell (oat cell) carcinoma
    very rapid growth rate, very early metastasis to mediastinum or distally to lung
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