PATHO EXAM 1
ventilation - ANSWER movement of air in and out of the lungs
distribution of air: alveoli
maintenance of O2 and removal of CO2 (perfusion)
measures of ventilation - ANSWER four lung volumes
four lung capacities
tidal volume - ANSWER a normal breath or amount of gas entering or leaving lung during normal
breathing
typical tidal volume - ANSWER 500 mL per breath
residual volume - ANSWER volume of gas left in lungs at end of maximal expiration
typical residual volume - ANSWER 1.2 L
total lung capacity - ANSWER amount of gas contained in lungs at maximal inspiration
typical total lung capacity - ANSWER 6 L
hypoventilation pathology - ANSWER air delivered to alveoli is insufficient to provide O2 and remove
CO2 -> Increased PaCO2 and hypoxemia
causes of hypoventilation - ANSWER sedative drugs, obesity, myasthenia gravis, obstructive sleep
apnea, thorax or abd surgery/trauma
hyperventilation patho - ANSWER increase volume of air entering alveoli -> decreased PaCO2 and
hypoxia
hypocapnia - ANSWER low PaCO2
,hypercapnia - ANSWER High PaCO2
causes of hyperventilation - ANSWER pain, anxiety, obstructive and restrictive lung diseases, sepsis,
brainstem injury
hypoxemia - ANSWER deficient amount of oxygen in the blood
low PaO2 and low hemoglobin saturation
ventilation perfusion matching - ANSWER measure of volume of air in alveoli and blood flow
V - ANSWER ventilation (air)
Q - ANSWER perfusion (blood)
V/Q - ANSWER ratio of ventilation to perfusion
what does a V/Q match represent? - ANSWER adequate volume of air in the alveoli with adequate
blood flow
high V/Q - ANSWER underperfused: alveolar unit is ventilated but not perfused
low V/Q - ANSWER underventilated: airways are partially obstructed and airflow rates are low
is low V/Q responsive to oxygen treatment? - ANSWER yes
shunt - ANSWER blood doesn't benefit from ventilation: lowering of PaO2
is a shunt responsive to oxygen therapy? - ANSWER no
pulmonary embolus - ANSWER an undissolved, detached material (blood clot, fat emboli, air) that
occludes blood vessels
,where do 90% of thromboembolism originate from? - ANSWER deep veins of lower extremities
factors causing thromboemboli formation - ANSWER venous stasis
hypercoaguability
damage to vessel wall
pathogenesis of pulmonary embolus - ANSWER thrombus dislodged from point of origin by: trauma,
exercise, and changes in blood flow
clinical manifestations of pulmonary embolus - ANSWER depends on size of thrombus
restlessness
anxiety
sudden dyspnea
tachycardia
tachypnea
chest pain (on inspiration)
diagnosis of pulmonary embolus - ANSWER ventilation/perfusion scan
many other imaging techniques
ABG
history
treatment of pulmonary embolus - ANSWER treat underlying problems
prevention measures: avoid prolonged bedrest, active ROM, compression hose, medication
what treatment is used with a confirmed PE - ANSWER heparin drip
thrombolytics
oxygen
bedrest
, pediatric considerations - ANSWER their respiratory differences increase the work of breathing/rate
pediatrics:obstruction and inspiratory resistance - ANSWER increase mucus
decrease size of anatomy
pediatrics: flexible ribs with less elastic recoil - ANSWER primary diaphragmatic and abdominal
breathing
pediatrics: increases aspiration and infection - ANSWER higher positioning of upper airway structures
difference in neonates respiratory - ANSWER less capillary network
geriatric considerations - ANSWER -decrease elastic recoil and stiffer chest wall
-strength of diaphragm, intercostal muscles, and accessory muscles declines
-decreased cough effectiveness
-increased mucus production, V/Q mismatch with decreased gas exchange and cough effectiveness
-alveolar enlargement, increased residual vol and V/Q mismatch
-decreased pulmonary artery blood flow, shunt and high V/Q
-increased work of breathing/rate
obstructive pulmonary disorders - ANSWER manifested by increase resistance to airflow leading to
decreased airflow
obstructive pulmonary disorders are result of and obstruction of/from - ANSWER wall in lumen
loss of lung parenchyma/tissue
airway lumen
obstruction of wall lumen disorders - ANSWER acute bronchitis
COPD
obstruction of airway lumen disorders - ANSWER bronchiectasis
bronchiolitis
ventilation - ANSWER movement of air in and out of the lungs
distribution of air: alveoli
maintenance of O2 and removal of CO2 (perfusion)
measures of ventilation - ANSWER four lung volumes
four lung capacities
tidal volume - ANSWER a normal breath or amount of gas entering or leaving lung during normal
breathing
typical tidal volume - ANSWER 500 mL per breath
residual volume - ANSWER volume of gas left in lungs at end of maximal expiration
typical residual volume - ANSWER 1.2 L
total lung capacity - ANSWER amount of gas contained in lungs at maximal inspiration
typical total lung capacity - ANSWER 6 L
hypoventilation pathology - ANSWER air delivered to alveoli is insufficient to provide O2 and remove
CO2 -> Increased PaCO2 and hypoxemia
causes of hypoventilation - ANSWER sedative drugs, obesity, myasthenia gravis, obstructive sleep
apnea, thorax or abd surgery/trauma
hyperventilation patho - ANSWER increase volume of air entering alveoli -> decreased PaCO2 and
hypoxia
hypocapnia - ANSWER low PaCO2
,hypercapnia - ANSWER High PaCO2
causes of hyperventilation - ANSWER pain, anxiety, obstructive and restrictive lung diseases, sepsis,
brainstem injury
hypoxemia - ANSWER deficient amount of oxygen in the blood
low PaO2 and low hemoglobin saturation
ventilation perfusion matching - ANSWER measure of volume of air in alveoli and blood flow
V - ANSWER ventilation (air)
Q - ANSWER perfusion (blood)
V/Q - ANSWER ratio of ventilation to perfusion
what does a V/Q match represent? - ANSWER adequate volume of air in the alveoli with adequate
blood flow
high V/Q - ANSWER underperfused: alveolar unit is ventilated but not perfused
low V/Q - ANSWER underventilated: airways are partially obstructed and airflow rates are low
is low V/Q responsive to oxygen treatment? - ANSWER yes
shunt - ANSWER blood doesn't benefit from ventilation: lowering of PaO2
is a shunt responsive to oxygen therapy? - ANSWER no
pulmonary embolus - ANSWER an undissolved, detached material (blood clot, fat emboli, air) that
occludes blood vessels
,where do 90% of thromboembolism originate from? - ANSWER deep veins of lower extremities
factors causing thromboemboli formation - ANSWER venous stasis
hypercoaguability
damage to vessel wall
pathogenesis of pulmonary embolus - ANSWER thrombus dislodged from point of origin by: trauma,
exercise, and changes in blood flow
clinical manifestations of pulmonary embolus - ANSWER depends on size of thrombus
restlessness
anxiety
sudden dyspnea
tachycardia
tachypnea
chest pain (on inspiration)
diagnosis of pulmonary embolus - ANSWER ventilation/perfusion scan
many other imaging techniques
ABG
history
treatment of pulmonary embolus - ANSWER treat underlying problems
prevention measures: avoid prolonged bedrest, active ROM, compression hose, medication
what treatment is used with a confirmed PE - ANSWER heparin drip
thrombolytics
oxygen
bedrest
, pediatric considerations - ANSWER their respiratory differences increase the work of breathing/rate
pediatrics:obstruction and inspiratory resistance - ANSWER increase mucus
decrease size of anatomy
pediatrics: flexible ribs with less elastic recoil - ANSWER primary diaphragmatic and abdominal
breathing
pediatrics: increases aspiration and infection - ANSWER higher positioning of upper airway structures
difference in neonates respiratory - ANSWER less capillary network
geriatric considerations - ANSWER -decrease elastic recoil and stiffer chest wall
-strength of diaphragm, intercostal muscles, and accessory muscles declines
-decreased cough effectiveness
-increased mucus production, V/Q mismatch with decreased gas exchange and cough effectiveness
-alveolar enlargement, increased residual vol and V/Q mismatch
-decreased pulmonary artery blood flow, shunt and high V/Q
-increased work of breathing/rate
obstructive pulmonary disorders - ANSWER manifested by increase resistance to airflow leading to
decreased airflow
obstructive pulmonary disorders are result of and obstruction of/from - ANSWER wall in lumen
loss of lung parenchyma/tissue
airway lumen
obstruction of wall lumen disorders - ANSWER acute bronchitis
COPD
obstruction of airway lumen disorders - ANSWER bronchiectasis
bronchiolitis
