Pathophysiology

• Acute or Chronic
• Obstructive or Restrictive
• Infectious or Noninfectious

is greatly influenced by conditions of the environment, occupation, and personal and/or social habits

• Dyspnea
• Abnormal Breathing Patterns
• Hypoventilation
• Hyperventilation
• Cough
• Hemoptysis
• Cyanosis
• Pain
• Clubbing

• SOB; air hunger
• Can be dyspnea on exertion; orthopnea (lying down); paroxysmal nocturnal dyspnea

• Kussmaul respirations (hyperpnea-breathe too quickly)
• Cheyne-Stokes Repirations (time breaks between breathing)

• hypercapnia-too much CO2
• (not breathing enough)

• Paper bag
• Hypocapnia
• too little CO2

• reproductive reflex
• acute or chronic

• Coughing up bloody sputum
• not same as vomiting blood
• (ex-TB, chronic bronchitis)

• Turning blue
• blood doesn't have enough oxygen

• friction rub
• pleural effusion
• chest tube

• painless
• chronic oxygen loss
• COPD

• Hypercapnia
• Hypoxemia
• Acute Respiratory Failure
• Pulmonary Edema
• Hypoxia

increased CO2

• excess water in lungs
• Hypoxemia versus hypoxia

• reduced arterial blood
• PaO2 (amount of O2 in alveoli)
• caused by respiratory alterations

• decreased oxygen in tissues
• can be caused by hypoxemia
• decreased cardiac output, cyanide poisoning

• Excess water in lungs
• most common cause is heart disease
• Left ventricle fails-pressures on left side of heart fail-fluid from capillaries in lung pushed back into lungs

• Tumors
• Edema
• Fibrotic tissue

• Drowning feeling
• Dyspnea
• Inspiratory crackles (alveoli stuck together, breathe in "pop")
• Pink frothy sputum (if severe)
• GET RID OF FLUID!

• inadequate gas exchange leading to tissue hypoxia and hypoxemia
• PaO2 less than 60 mmHg or PaCO2 greater than 50 with pH less than 7.25

the passage of fluid and solid foods into the lungs

• collapse of lung tissue
• -OR-
• incomplete expansion of a lung

• Airway Obstruction- most common
• Lung compression (pneumothorax)
• Pleural Effusion

• tachypnea
• tachycardia
• dyspnea
• cyanosis
• signs of hypoxemia
• diminished chest expansion
• absence of breathe sounds

a thrombus obstructing flow to upper lobe

• aka Acute Laryngotracheobronchitis
• common in children 6 months to 5 years
• commonly cause by virus (parainfluenza, flu A or RSV)
• caused by subglottic edema
• usually occurs after an episode of rhinorrhea, dore throat or fever

• Seal-like barking cough
• nasal flaring indicates worsening of symptoms
• presence of inspiratory stridor or respiratory ditress-severe croup

• deep retractions
• stridor
• aditation
• tachycardia
• pallor or cyanosis

• similar hoarseness, cough and stridor to croup
• usually in older children
• sudden onset, usually at night, and with no previoius viral illness
• resolves quickly

• sever, rapidly progressive, LIFE-THREATENING infection of the epiglottis and surrounding area
• death can occur in a few hours
• Children 2 to 7 years old

• historically caused by Haemophilius influenzae type B
• decreased incidence due to HIB vaccination
• current cases caused primarily by group A strep

• sudden onset
• fever
• sore throat
• inspiratory stridor
• severe respiratory distress
• muffled voice
• drooling

• keep child calm and undisturbed
• do NOT attempt to examine throat
• emergency airway and antibiotics

• autosomal recessive multisystem disease
• exocrine or mucus-producing glands secrete abnormally thick mucus
• obstructs airway
• obstructs pancreatic and biliary ducts
• Thick secretions obstruct the bronchioles and predispose the lungs to chronic infections

• High concentrations of NaCl in sweat
• Less Na and water in respiratory mucus and in pancreatic secretions
• Mucus is thicker
• *Children are ar greater risk for salt depletion episodes
• *chronic bronchiolitis and bronchitits are the initial lung manifestations

• Disease of unknown cause
• Incidence lower during first month of life, increases in the second month, and peaks at 3 to 4 months; more common in male infants
• Unexplained sudden death of an infant under 1 year of age
• Seasonal variation- higher in winter months
• ----possible relationship to respiratory infections
• ----wide range of risk factors

inadequate gas exchange leading to tissue hypoxia and hypoxemia

the passage of fluid and solid foods into the lungs

collapse of lung tissue or incomplete expansion of a lung

• direct injury to lungs, airways, or chestwall
• indirect injury elsewhere- brain or spinal cord

Acute Respiratory Failure

• atelectasis
• pneumonia
• pulmonaary edema
• pulmonary emboli

• frequent turning
• deep breathing
• early ambulation
• humidified air (loosens secretions)
• incentive spirometer
• supplemental oxygen
• antibiotics

• passage of fluid and solid particles into the lungs
• when normal swallowing mechanisms and cough reflexes impaired by CNS, PNS

• Right lung more than Left lung--causes Obstruction
• (the right is starighter)

• choking
• cough
• vomiting
• dyspnea
• wheezing

occurs after inhaling foreign matter into the lungs

• Bronchial damage-inflammation, loss of ciliary function, bronchospasm
• Alveoli damage-alveolocapillary membrane damage; leads to hemorrhagic pneumonitis

• semirecumbent position
• monitor patients on enteral tube feeding
• use of promotility agents (speed digestion)
• avoid excessive sedation

• Collapse of lung tissue
• 2 types:
• Compression-tumor, fluid, or air in pleural space, or abdominal distention
• Absorption-removal of air from alveoli-(anesthesia or concentrated oxygen)

• tachypnea
• tachycardia
• dyspnea
• cyanosis
• signs of hypoxemia
• diminished chest expansion
• absence of breath sounds
• MAJOR ATELECTASIS SX:
• dyspnea
• cough
• fever
• leukocytosis

persistent abnormal dilation of bronchi

• plugs
• atelectasis
• aspiration of foreign body
• infection
• cystic fibrosis
• TB
• weakened immunity
• bronchietasis

• obstruction of small airways
• inflammatory obstruction of the small airways bronchioles
• most common in children
• Adults=seen with chronic bronchitis, viral infection, or with inhalation of toxic gases

presence of air or gas in pleural space

• rupture in parietal pleura or visceral pleura
• Air seperates the visceral and parietal pleura
• Can cause partial or complete collapse of the affected lung

• open pneumothorax
• tension pneumothorax
• spontaneous pneumothorax
• secondary pneumothorax (trauma)

• LIFE THREATENING
• causes a mediastinal shift
• heart, vessels, trachea are compressed and displaced from midline
• Tx-chest tube

• presence of fluid in pleural space
• fluids migrate through walls of capillaries bordering pleura
• Transudative-watery
• Exudative-WBCx, plasma proteins

• if large will see:
• Dyspnea
• Compression Atelectasis
• Mediastinal shift
• Pleural pain (if pleura inflammed)

• hydrothorax: serous fluid
• empyema: pus, infection
• chylothorax: lymph
• hemothorax: blood
• exam will reveal decreased breath sounds and pleural friction rub heard
• DX: CXR

• compromised chest wall
• deformation, immobilization, and obesity

• instability of a portion of the chest wall
• (put on vent until they go to surgery)

• acute lung inflammation
• dyspnea
• rapid shallow breathing
• crackles on inspiration
• unresponsive to oxygen therapy
• Evaluation and tx: tests, oxygenation and ventilation, surfactant

• atelectasis
• pneumonia
• pulmonary edema
• pulmonary emboli

• frequent turning
• deep breathing
• early ambulation
• air humidification
• incentive spirometer

• airwawy obstruction that is worse with expiration
• common s/s: dyspnea and wheezing

• asthma
• emphysema
• chronic bronchitis

• wheezing
• chest tightness
• breathlessness
• coughing that is worse at night and in the early morning

• use of accessory muscles
• distant breath sounds
• loud wheezing
• fatigue
• anxiety
• DEATH

unknown; although if other people in your family have asthma, you are more likely to develop it. Being exposed early in life to things like tobacco smoke, infections, and some allergens may also increase your chances of developing asthma. Some of the more common things that bring on asthma syptoms include exercise, allergens, irritants, and viral infections

responds to a variety of stimuli. Chronic inflammatory disease that affects airways causing them to become narrower allowing less air flow through the lungs

• Sx: expiratory wheezing, dyspnea, and tachypnea
• Tx: peak flow meters, oral corticosteroids, inhaled beta-agonists, and anti-inflammatories used to treat

Hypersecretion of mucus and chronic productive cough that lasts 3 consecutive months for at least two consecutive years

• middle aged men
• smokers
• expose to air pollutants
• mucus is thicker than normal
• Tx: Bronchodilators, expectorants, and chest physical therapy used to treat

abnormal permanent enlargement of the gas-exchange airways accompanied by destruction of alveolar walls without obvious fibrosis

• loss of elastic recoil
• obstruction occurs from changes in lung tissues rather than mucus production and inflammation

• risk factors: smokers, inhaled irritants, elderly
• patho: traps air, difficult to expel the trapped air due to less elasticity
• manifests: dyspnea, thin, tachypnea, use of accessory muscles (barrel chest)

• infection of lower resp tract
• causes: bacteria, virus, fungi, protozoa, and parasites
• 6th leading cause of death in US

• cause of TB= mycobacterium tuberculosis
• acid faast bacillus
• airborne transmission
• tubercle formation
• positive PPD
• sputum
• CXR

• fatigue
• weight loss
• lethargy
• anorexia
• night sweats
• fever
• cough

• directly observed therapy
• tx after you have been diagnosed with tb

• occlusion
• lungs
• thrombus
• embolus
• tissue fragment
• lipids
• air bubble
• (can arise from the deep veins in the thigh)

• DEATH is imminent
• sudden chest pain, dyspnea, and tachypnea
• obese, immobile, ortho surgery, cancer, oral contraceptives, smokers