NR 507: Advanced Pathophysiology Midterm
Asthma - (correct Answer) - Chronic disease due to bronchoconstriction and an excessive inflammatory
response in the bronchioles
What are 5 s/s of asthma - (correct Answer) - coughing
wheezing
shortness of breath
rapid breathing
chest tightness
Pathophysiology of asthma (5) - (correct Answer) - -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 - (correct Answer) - smaller passageways that originate from the bronchi that become the
alveoli
3 layers of the bronchioles - (correct Answer) - innermost layer
middle layer - lamina propria
outermost layer
lamina propria - (correct Answer) - the middle layer of the bronchioles
structure of the lamina propria - (correct Answer) - embedded with connective tissue cells and immune
cells
purpose of the lamina propria - (correct Answer) - white blood cells are present to help protect the
airways
How does the lamina propria effect the lungs in regards to asthma - (correct Answer) - the WBCs
protective feature goes into overdrive causing an inflammatory response that damages host tissue
What does the innermost layer of the bronchioles contain - (correct Answer) - columnar epithelial ells
and mucus producing goblet cells
,What does the outermost layer of the bronchioles contain - (correct Answer) - smooth muscle cells
what does the outermost layer of the bronchioles do - (correct Answer) - control the airways ability to
constrict and dilate
alveolar hyperinflation - (correct Answer) - 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? - (correct Answer) - the ongoing inflammatory process of asthma
produces mucus and pus plug that the bronchial walls collapse around
Effect of hyperinflation of the alveolar - (correct Answer) - -expanded thorax and hypercapnia (retention
of CO2)
- respiratory acidosis
What are two anticholinergic drugs used for asthma - (correct Answer) - tiotropium and ipratropium
What do anticholinergics do in the lungs? - (correct Answer) - These drugs block the effects of the
parasympathetic nervous system
- increasing bronchodilation
MOA of anticholinergic drugs for asthma - (correct Answer) - 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 - (correct Answer) - inflammation of the bronchial tubes
3 characteristics of bronchitis - (correct Answer) - bronchial inflammation
hypersecretion of mucus
chronic productive cough for at least 3 consecutive months for at least 2 successive years
Perfusion - (correct Answer) - 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 - (correct Answer) - cyanosis
right to left shunting
chronic hypoxemia
, Why is there cyanosis with chronic bronchitis - (correct Answer) - there is hypoxia due to unfavorable
conditions for gas exchange
Right to left shunting - (correct Answer) - when blood passes from the right ventricle through the lungs
and to the left ventricle without perfusion
Causes of bronchitis - (correct Answer) - -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 - (correct Answer) - -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? - (correct Answer) - tobacco product smoke
what does long term exposure to irritants promote in bronchitis? (5) - (correct Answer) - - 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? - (correct Answer) - causes increased
bronchoconstriction
Hypertrophy and hyperplasia of goblet cells do what in the bronchials - (correct Answer) - promotes
hypersecretion of mucus
What are characteristics of epithelial cell metaplasia? - (correct Answer) - squamous cells become
nonciliated and are less protective; allow passage of toxins and WBCs
What does the migration of WBCs to the bronchials do? - (correct Answer) - 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? - (correct
Answer) - leads to further narrowing of the bronchial passageways
What acid-base disorder is seen in chronic bronchitis? - (correct Answer) - respiratory acidosis
Asthma - (correct Answer) - Chronic disease due to bronchoconstriction and an excessive inflammatory
response in the bronchioles
What are 5 s/s of asthma - (correct Answer) - coughing
wheezing
shortness of breath
rapid breathing
chest tightness
Pathophysiology of asthma (5) - (correct Answer) - -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 - (correct Answer) - smaller passageways that originate from the bronchi that become the
alveoli
3 layers of the bronchioles - (correct Answer) - innermost layer
middle layer - lamina propria
outermost layer
lamina propria - (correct Answer) - the middle layer of the bronchioles
structure of the lamina propria - (correct Answer) - embedded with connective tissue cells and immune
cells
purpose of the lamina propria - (correct Answer) - white blood cells are present to help protect the
airways
How does the lamina propria effect the lungs in regards to asthma - (correct Answer) - the WBCs
protective feature goes into overdrive causing an inflammatory response that damages host tissue
What does the innermost layer of the bronchioles contain - (correct Answer) - columnar epithelial ells
and mucus producing goblet cells
,What does the outermost layer of the bronchioles contain - (correct Answer) - smooth muscle cells
what does the outermost layer of the bronchioles do - (correct Answer) - control the airways ability to
constrict and dilate
alveolar hyperinflation - (correct Answer) - 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? - (correct Answer) - the ongoing inflammatory process of asthma
produces mucus and pus plug that the bronchial walls collapse around
Effect of hyperinflation of the alveolar - (correct Answer) - -expanded thorax and hypercapnia (retention
of CO2)
- respiratory acidosis
What are two anticholinergic drugs used for asthma - (correct Answer) - tiotropium and ipratropium
What do anticholinergics do in the lungs? - (correct Answer) - These drugs block the effects of the
parasympathetic nervous system
- increasing bronchodilation
MOA of anticholinergic drugs for asthma - (correct Answer) - 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 - (correct Answer) - inflammation of the bronchial tubes
3 characteristics of bronchitis - (correct Answer) - bronchial inflammation
hypersecretion of mucus
chronic productive cough for at least 3 consecutive months for at least 2 successive years
Perfusion - (correct Answer) - 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 - (correct Answer) - cyanosis
right to left shunting
chronic hypoxemia
, Why is there cyanosis with chronic bronchitis - (correct Answer) - there is hypoxia due to unfavorable
conditions for gas exchange
Right to left shunting - (correct Answer) - when blood passes from the right ventricle through the lungs
and to the left ventricle without perfusion
Causes of bronchitis - (correct Answer) - -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 - (correct Answer) - -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? - (correct Answer) - tobacco product smoke
what does long term exposure to irritants promote in bronchitis? (5) - (correct Answer) - - 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? - (correct Answer) - causes increased
bronchoconstriction
Hypertrophy and hyperplasia of goblet cells do what in the bronchials - (correct Answer) - promotes
hypersecretion of mucus
What are characteristics of epithelial cell metaplasia? - (correct Answer) - squamous cells become
nonciliated and are less protective; allow passage of toxins and WBCs
What does the migration of WBCs to the bronchials do? - (correct Answer) - 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? - (correct
Answer) - leads to further narrowing of the bronchial passageways
What acid-base disorder is seen in chronic bronchitis? - (correct Answer) - respiratory acidosis
