NR 507: ADVANCED PATHOPHYSIOLOGY MIDTERM COMPLETE SOLUTION GRADED A+ Asthma - Chronic disease due to bronchoconstriction and an excessive inflammatory response in the bronchioles What are 5 s/s of asthma - coughing wheezing shortness of breath

NR 507: ADVANCED PATHOPHYSIOLOGY MIDTERM COMPLETE SOLUTION GRADED A+ Asthma - Chronic disease due to bronchoconstriction and an excessive inflammatory response in the bronchioles What are 5 s/s of asthma - coughing wheezing shortness of breath rapid breathing chest tightness Pathophysiology of asthma (5) - -airway inflammation, bronchial hyper-reactivity and smooth muscle spasm -excess mucus production and accumulation -hypertrophy of bronchial smooth muscle -airflow obstruction -decreased alveolar ventilation Bronchioles - smaller passageways that originate from the bronchi that become the alveoli 3 layers of the bronchioles - innermost layer middle layer - lamina propria outermost layer lamina propria - the middle layer of the bronchioles structure of the lamina propria - embedded with connective tissue cells and immune cells purpose of the lamina propria - white blood cells are present to help protect the airways How does the lamina propria effect the lungs in regards to asthma - the WBCs protective feature goes into overdrive causing an inflammatory response that damages host tissue What does the innermost layer of the bronchioles contain - columnar epithelial ells and mucus producing goblet cells What does the outermost layer of the bronchioles contain - smooth muscle cells what does the outermost layer of the bronchioles do - control the airways ability to constrict and dilate alveolar hyperinflation - When air is unable to move out of the alveolar like it should due to bronchial walls collapsing around possible mucus plug thus trapping air inside how does hyperinflation occur? - the ongoing inflammatory process of asthma produces mucus and pus plug that the bronchial walls collapse around Effect of hyperinflation of the alveolar - -expanded thorax and hypercapnia (retention of CO2) - respiratory acidosis What are two anticholinergic drugs used for asthma - tiotropium and ipratropium What do anticholinergics do in the lungs? - These drugs block the effects of the parasympathetic nervous system - increasing bronchodilation MOA of anticholinergic drugs for asthma - the parasympathetic system is stimulated by the vagal nerve to release acetylcholine which binds to the cholinergic receptors of the respiratory tract to cause bronchial constriction = decreased airflow - blocking the cholinergic receptors prevents acetylcholine binding preventing the bronchial constriction bronchitis - inflammation of the bronchial tubes 3 characteristics of bronchitis - bronchial inflammation hypersecretion of mucus chronic productive cough for at least 3 consecutive months for at least 2 successive years Perfusion - The supply of oxygen to and removal of wastes from the cells and tissues of the body as a result of the flow of blood through the capillaries. results of chronic bronchitis/ low perfusion - cyanosis right to left shunting chronic hypoxemia Why is there cyanosis with chronic bronchitis - there is hypoxia due to unfavorable conditions for gas exchange Right to left shunting - when blood passes from the right ventricle through the lungs and to the left ventricle without perfusion Causes of bronchitis - -long term exposure to environmental irritants -repeated episodes of acute infection (RSV infection in early infancy) -Factors affecting gestational childhood lung development (preterm birth) Pathogenesis of bronchitis - -Exposure to airborne irritants - Irritant activates bronchial smooth muscle constriction and mucus secretion - Triggers release of inflammatory mediators from immune cells located in the lamina propria most common irritant with bronchitis is? - tobacco product smoke what does long term exposure to irritants promote in bronchitis? (5) - - smooth muscle hypertrophy - hypertrophy and hyperplasia of goblet cells - epithelial cell metaplasia - migration of more WBC to site - thickening and rigidity of bronchial basement membrane What does smooth muscle hypertrophy do in lungs? - causes increased bronchoconstriction Hypertrophy and hyperplasia of goblet cells do what in the bronchials - promotes hypersecretion of mucus What are characteristics of epithelial cell metaplasia? - squamous cells become nonciliated and are less protective; allow passage of toxins and WBCs What does the migration of WBCs to the bronchials do? - increases inflammation of the cite and causes fibrosis in the bronchial wall How does the thickening and rigidity of bronchial basement membranes effect the lungs? - leads to further narrowing of the bronchial passageways What acid-base disorder is seen in chronic bronchitis? - respiratory acidosis how does chronic bronchitis lead to respiratory acidosis? - hyperinflation of the alveoli causes CO2 retention Where does air enter the body? - naso and oropharynx (mouth and nose) Where does air go after it passes through the nose and mouth? - it passes through the trachea After air passes through the trachea where does it go? - goes into the left or right bronchi Where does air flow after the bronchi? - into the smaller bronchioles Where does air flow after the bronchioles? - into the alveoli Describe how blood flows to become oxygenated - - deoxygenated systemic blood flows from the vena cava to R atrium