NR 507: Advanced Pathophysiology Midterm
Exam – Comprehensive Practice Questions
and Exam Preparation Guide.
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 the WBCs protective feature goes into overdrive causing an
lungs in regards to asthma inflammatory response that damages host tissue
What does the innermost layer of the columnar epithelial ells and mucus producing goblet cells
bronchioles contain
What does the outermost layer of the smooth muscle cells
bronchioles contain
what does the outermost layer of the control the airways ability to constrict and dilate
bronchioles do
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 tiotropium and ipratropium
asthma
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
Exam – Comprehensive Practice Questions
and Exam Preparation Guide.
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 the WBCs protective feature goes into overdrive causing an
lungs in regards to asthma inflammatory response that damages host tissue
What does the innermost layer of the columnar epithelial ells and mucus producing goblet cells
bronchioles contain
What does the outermost layer of the smooth muscle cells
bronchioles contain
what does the outermost layer of the control the airways ability to constrict and dilate
bronchioles do
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 tiotropium and ipratropium
asthma
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
