NRMS 5190
‘/ Stuvia:thebest studymaterialfromyourfellowstudents ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
Advanced PathophysiologyExam 2 StudyGuide ‘/ ‘/ ‘/ ‘/ ‘/
Chapter 3o Respiratory Disorder ‘ / ‘/ ‘/
The movement of air between the atmosphere and the lungs follows the laws of physics as they relate to
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
gases. The air in the alveoli contains a mixture of gases, including nitrogen, oxygen, carbon dioxide, and
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
water vapor..
‘/ ‘/
Thepressureinsidetheairwaysandalveoli ofthelungsiscalled intrapulmonary(oralveolar) pressure;
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
thepressureinthepleuralcavityiscalledpleuralpressure;
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
andthepressureinthethoraciccavityiscalledintrathoracicpressure.
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
Thediaphragmistheprincipal muscleofinspiration, assisted bytheexternal intercostal muscles.
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
Surfactantmolecules, producedbytypeII alveolarcells, reducethesurfacetension inthelungsand thereby
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
increase lung compliance.
‘/ ‘/ ‘/
** Lungvolumes and lungcapacities = reflectthe amount ofairthatis exchanged duringnormal and forced
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
breathing.
‘/
KNOW: Thetidal volume(VT) is theamount ofairthat moves intoand outofthelungs duringnormal
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
breathing.
‘/
The respiratorsystem consists ofairpassages and lungs, where gasexchange takes place. The air
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘ / ‘/
passagescanbedividedinto2parts,theconductingairwaysthroughwhichairmovesasitpassesinto and out
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
ofthe lungs, and the respiratorytissue where gas exchange actuallytakes place.
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
• Respirationrequiresventilation,orthemovementofgasesintoandoutofthelungs; perfusion, or ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘ / ‘/ ‘/
movementofblood through the lungs; and diffusion ofgases between thelungs and the blood.
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
• Ventilationdependsontheconductingairways, includingthenasopharynx, oropharynx, larynx and ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
tracheobronchialtree,whichmoveairintoandoutofthelungsbutdonotparticipateingas exchange,
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
• Gas exchange takes place in the respiratory airways of the lungs where gases diffuse across the
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
alveolar-capillary membrane as theyare exchanged between the air in the lungs and the blood that
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
flows through the pulmonary capillaries.
‘/ ‘/ ‘/ ‘/ ‘/
• ConductingZone: Upperrespiratorytract ‘/ ‘ / ‘/ ‘/
• RespiratoryZone: LowerAirways ‘/ ‘/ ‘/
• Conducting airways: nasal passages, mouth, pharynx, larynx, trachea, bronchi and ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
bronchioles. Conductingairways actasa conduit forairflowbutalsowarms, filters and
‘/ ‘ / ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
humidifies air as it moves through these structures.
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
See all study documents for NRMS 5190 ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
,NRMS 5190
‘/ Stuvia:thebest studymaterialfromyourfellowstudents ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
KNOW *The conducting airways are lined with a mucociliary blanket — a protective layer
‘/ ‘ / ‘ / ‘ / ‘ / ‘ / ‘ / ‘ / ‘ / ‘ / ‘/ ‘ / ‘ /
with
‘ /
mucous and cilia (cells with hairlike projections that help sweep and trap particles such as
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
bacteria,dustandotherforeignsubstances—thisisinanupwardmotion thatbringsbacktothe
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
oropharynx where it is expectorated or swallowed. ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
• ** Lung volumes and lung capacities reflect the amount of air that is exchanged during normal and
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
forced breathing. The tidal volume (VT) is the amount of air that moves into and out of the lungs
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
during normal breathing.
‘/ ‘/ ‘/
• Common Cold- viral infection ofthe upper respiratorytract. Adults can have 3-4peryear, ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘ / ‘/ ‘/ ‘/ ‘/ ‘/
school age child may have 6-8 per year.
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
• **Rhinovirus are most common causeforcold, others areparainfluenza virus, respiratory ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
syncytial virus (RSV), human metapneumovirus (hMPV), coronaviruses, adenoviruses.
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘ / ‘/
• Pneumonia is the 8th leadingcause ofdeath in the US, especiallyin the elderlyand those with ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
compromised immune function.
‘/ ‘/ ‘/
• TB affects 1/3 of the world's population.
‘/ ‘/ ‘ / ‘/ ‘/ ‘ /
• People who have compromised immune systems may be susceptible to a virus causing serious gas
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘ /
exchange or ventilation problems —in addition to other types oforganisms such as bacteria and
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
‘fungus which can cause lung infections. If patient has underlying history of asthma, this
/ ‘ / ‘ / ‘ / ‘ / ‘/ ‘ / ‘/ ‘/ ‘ / ‘/ ‘/ ‘/ ‘ /
may be exacerbated by presence of a virus
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
• Viral infections can damage bronchial epithelium, obstruct airways and lead to secondary
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
bacterial infections.
‘/ ‘/
• Common cold is an acute and self limiting illness in otherwise healthy people — ‘ / ‘ / ‘/ ‘ / ‘ / ‘ / ‘/ ‘/ ‘/ ‘ / ‘/ ‘/ ‘/
• ””Rhinovirus are the most common cause ofcolds. The common cold spreads easily, ‘/ ‘/ ‘/ ‘/ ‘ / ‘/ ‘ / ‘ / ‘ / ‘ / ‘ /
handwashing is very important because fingers are the greatest source of spread and the nasal
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
‘mucosa and conjunctival surface of eyes are most common portal of entry for virus. Symptoms
/ ‘ / ‘/ ‘ / ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘ / ‘/ ‘/ ‘/ ‘ /
begin with dryness and stuffiness in the nasopharynx, followed by excessive production of nasal
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
secretions and tearing of the eyes. Secretions are usually clear and watery. Other symptoms —
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
erythema and swelling of mucous membranes of upper respiratory tract , postnasal drip, sore
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘ / ‘ / ‘ /
throat, hoarseness, headaches and generalized malaise. Fevers chills and exhaustion can
‘/ ‘ / ‘ / ‘ / ‘ / ‘ / ‘ / ‘ / ‘ / ‘ / ‘ /
‘be seen in severe cases. Treatment is rest, OTCs (decongestants can cause systemic
/ ‘/ ‘ / ‘ / ‘/ ‘ / ‘/ ‘/ ‘ / ‘/ ‘/ ‘ / ‘/
vasoconstriction and elevation of BP so should be avoided in people with yTT,, heart disease, ‘ / ‘ / ‘ / ‘ / ‘/ ‘/ ‘ / ‘/ ‘ / ‘ / ‘/ ‘/ ‘ / ‘/
diabetes, etc)
‘/ ‘/
• Rhinosinusitis is inflammation involvingnasal sinuses. Themost common conditions arethose that ‘/ ‘/ ‘/ ‘/ ‘/ ‘ / ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
obstruct the narrow ostia that drain the sinuses. Rhinosinusitis develops when a viral upper
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
respiratory tract infection or allergic rhinitis causes mucosal swelling and obstructs the ostia and
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
impairs the mucociliary clearance mechanism.
‘/ ‘/ ‘/ ‘/ ‘/
• **The Mucociliary clearance mechanism helps keepthe sinuses sterile bymoving fluid and
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
microorganisms out of the sinuses and into the nasal cavity.
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
,NRMS 5190
‘/ Stuvia:thebest studymaterialfromyourfellowstudents ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
• AMucociliary clearance mechanism helps keep the sinuses sterile bymoving fluid and
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
microorganisms out of the sinuses and into the nasal cavity.
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
• Viral rhinosinusitis can bedifficult todifferentiate from common cold and allergic rhinitis. The S/S
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘ / ‘/
include facial pain, headache, purulent nasal discharge, diminished sense of smell and fever. ****
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
Fever and facial pain are more commonly associated with rhinosinusitis rather than the common
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
cold. Symptoms usually resolve in 5-7 days without medical treatment.
‘/ ‘ / ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
• Bacterial rhinosinusitis — the symptoms that worsen after 5-7 days or persist beyond 10 days. ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
People who are immunocompromised can present with fever of unknown origin, rhinorrhea or
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
facial edema.
‘/ ‘/
• In chronic rhinosinusitis symptoms may consist of sinus pressure with nasal congestion. The
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
patient maycomplain ofheadache that is dull and constant. Sinus headaches are exaggerated by
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘ / ‘/ ‘/ ‘/ ‘/
bending forward, coughing or sneezing. The epithelial changes that occur during acute
‘/ ‘/ ‘/ ‘/ ‘/ ‘ / ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
rhinosinusitis are usually reversible but the mucosal changes that occur with chronic rhinosinusitis
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
are often irreversible.
‘/ ‘/ ‘/
• Pt may need CTfor cases ofchronic rhinosinusitis tomake sure there are no polyps or
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
deformities that could be causing obstruction of drainage.
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
• Treatments: 2/3rds of cases of acute bacterial rhinosinusitis improve without antibiotics. Most ‘ / ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
people with viral sinusitis improve within a week. Some people require antibiotics which can be
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘ / ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
3-4weeks, theymayneed nasal irrigation and intranasal, decongestants (should be limited 3-5
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
days to prevent rebound vasodilation) - Saline spray, mist humidification.
‘/ ‘/ ‘/ ‘/ ‘/ ‘ / ‘/ ‘/ ‘/ ‘/
• Mucosal changes are not permanent. ‘ / ‘/ ‘/ ‘/
• Influenza, combined with pneumonia, is the 8th leading cause of death in the US, and highest ‘ / ‘ / ‘ / ‘ / ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘ / ‘ / ‘/ ‘ / ‘ /
rates are in children and older adults. Transmission is not by contact but by inhalation of
‘/ ‘ / ‘ / ‘ / ‘ / ‘ / ‘ / ‘ / ‘ / ‘ / ‘ / ‘/ ‘ / ‘ / ‘ / ‘ /
droplet nuclei. *The incubation period for influenza is 1-4 days with 2 days being the average.
‘/ ‘ / ‘ / ‘/ ‘ / ‘ / ‘/ ‘ / ‘ / ‘/ ‘/ ‘ / ‘/ ‘/ ‘/ ‘/
People become infectious starting 1 day before their symptoms begin and remain infectious for about
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘ /
1 week after illness onset.
‘/ ‘/ ‘/ ‘/ ‘/
• Influenza starts with abrupt onset of fevers and chills, rigors, malaise, muscle aches, headaches, ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
‘profuse watery nasal discharge, nonproductive cough and sore throat. The rapid onset of
/ ‘/ ‘/ ‘ / ‘ / ‘/ ‘/ ‘/ ‘/ ‘ / ‘/ ‘/ ‘/
profound malaise is a distinguishing feature of an influenza infection. Secondary
‘/ ‘ / ‘/ ‘ / ‘ / ‘/ ‘/ ‘/ ‘ / ‘ / ‘ /
complications are pneumonia, sinusitis, otitis media, bronchitis, bacterial pneumonia, croup in
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
children. People with secondary bacterial pneumonia may say that they began to feel better
‘/ ‘/ ‘/ ‘ / ‘ / ‘ / ‘ / ‘ / ‘/ ‘ / ‘ / ‘ / ‘ / ‘ /
‘but they experienced a return of fever, chills, pleuritic chest pain and productive cough
/ ‘ / ‘/ ‘ / ‘ / ‘/ ‘/ ‘ / ‘ / ‘/ ‘/ ‘ / ‘/ ‘/
• Influenza C is more like the common cold. ‘ / ‘/ ‘ / ‘/ ‘/ ‘/ ‘ /
• Viral pneumonia is a complication of the flu in older adults or people with cardiopulmonary disease
‘ / ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
but can be seen in pregnant women and health people as well. Viral pneumonia usually manifests
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘ / ‘ / ‘/ ‘/
within 1 day after onset of influenza and also has a rapid progression of symptoms, it progresses
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘ / ‘/ ‘/ ‘/ ‘ / ‘/ ‘/ ‘/ ‘ / ‘/
‘quickly and can cause hypoxemia and death within a few days of onset. Survivors can
/ ‘/ ‘ / ‘ / ‘ / ‘ / ‘ / ‘ / ‘ / ‘ / ‘/ ‘ / ‘/ ‘ / ‘/
develop diffuse pulmonary fibrosis.
‘/ ‘/ ‘/ ‘/
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‘/ Stuvia:thebest studymaterialfromyourfellowstudents ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
Advanced PathophysiologyExam 2 StudyGuide ‘/ ‘/ ‘/ ‘/ ‘/
Chapter 3o Respiratory Disorder ‘ / ‘/ ‘/
The movement of air between the atmosphere and the lungs follows the laws of physics as they relate to
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
gases. The air in the alveoli contains a mixture of gases, including nitrogen, oxygen, carbon dioxide, and
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
water vapor..
‘/ ‘/
Thepressureinsidetheairwaysandalveoli ofthelungsiscalled intrapulmonary(oralveolar) pressure;
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
thepressureinthepleuralcavityiscalledpleuralpressure;
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
andthepressureinthethoraciccavityiscalledintrathoracicpressure.
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
Thediaphragmistheprincipal muscleofinspiration, assisted bytheexternal intercostal muscles.
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
Surfactantmolecules, producedbytypeII alveolarcells, reducethesurfacetension inthelungsand thereby
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
increase lung compliance.
‘/ ‘/ ‘/
** Lungvolumes and lungcapacities = reflectthe amount ofairthatis exchanged duringnormal and forced
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
breathing.
‘/
KNOW: Thetidal volume(VT) is theamount ofairthat moves intoand outofthelungs duringnormal
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
breathing.
‘/
The respiratorsystem consists ofairpassages and lungs, where gasexchange takes place. The air
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘ / ‘/
passagescanbedividedinto2parts,theconductingairwaysthroughwhichairmovesasitpassesinto and out
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
ofthe lungs, and the respiratorytissue where gas exchange actuallytakes place.
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
• Respirationrequiresventilation,orthemovementofgasesintoandoutofthelungs; perfusion, or ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘ / ‘/ ‘/
movementofblood through the lungs; and diffusion ofgases between thelungs and the blood.
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
• Ventilationdependsontheconductingairways, includingthenasopharynx, oropharynx, larynx and ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
tracheobronchialtree,whichmoveairintoandoutofthelungsbutdonotparticipateingas exchange,
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
• Gas exchange takes place in the respiratory airways of the lungs where gases diffuse across the
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
alveolar-capillary membrane as theyare exchanged between the air in the lungs and the blood that
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
flows through the pulmonary capillaries.
‘/ ‘/ ‘/ ‘/ ‘/
• ConductingZone: Upperrespiratorytract ‘/ ‘ / ‘/ ‘/
• RespiratoryZone: LowerAirways ‘/ ‘/ ‘/
• Conducting airways: nasal passages, mouth, pharynx, larynx, trachea, bronchi and ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
bronchioles. Conductingairways actasa conduit forairflowbutalsowarms, filters and
‘/ ‘ / ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
humidifies air as it moves through these structures.
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
See all study documents for NRMS 5190 ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
,NRMS 5190
‘/ Stuvia:thebest studymaterialfromyourfellowstudents ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
KNOW *The conducting airways are lined with a mucociliary blanket — a protective layer
‘/ ‘ / ‘ / ‘ / ‘ / ‘ / ‘ / ‘ / ‘ / ‘ / ‘/ ‘ / ‘ /
with
‘ /
mucous and cilia (cells with hairlike projections that help sweep and trap particles such as
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
bacteria,dustandotherforeignsubstances—thisisinanupwardmotion thatbringsbacktothe
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
oropharynx where it is expectorated or swallowed. ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
• ** Lung volumes and lung capacities reflect the amount of air that is exchanged during normal and
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
forced breathing. The tidal volume (VT) is the amount of air that moves into and out of the lungs
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
during normal breathing.
‘/ ‘/ ‘/
• Common Cold- viral infection ofthe upper respiratorytract. Adults can have 3-4peryear, ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘ / ‘/ ‘/ ‘/ ‘/ ‘/
school age child may have 6-8 per year.
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
• **Rhinovirus are most common causeforcold, others areparainfluenza virus, respiratory ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
syncytial virus (RSV), human metapneumovirus (hMPV), coronaviruses, adenoviruses.
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘ / ‘/
• Pneumonia is the 8th leadingcause ofdeath in the US, especiallyin the elderlyand those with ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
compromised immune function.
‘/ ‘/ ‘/
• TB affects 1/3 of the world's population.
‘/ ‘/ ‘ / ‘/ ‘/ ‘ /
• People who have compromised immune systems may be susceptible to a virus causing serious gas
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘ /
exchange or ventilation problems —in addition to other types oforganisms such as bacteria and
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
‘fungus which can cause lung infections. If patient has underlying history of asthma, this
/ ‘ / ‘ / ‘ / ‘ / ‘/ ‘ / ‘/ ‘/ ‘ / ‘/ ‘/ ‘/ ‘ /
may be exacerbated by presence of a virus
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
• Viral infections can damage bronchial epithelium, obstruct airways and lead to secondary
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
bacterial infections.
‘/ ‘/
• Common cold is an acute and self limiting illness in otherwise healthy people — ‘ / ‘ / ‘/ ‘ / ‘ / ‘ / ‘/ ‘/ ‘/ ‘ / ‘/ ‘/ ‘/
• ””Rhinovirus are the most common cause ofcolds. The common cold spreads easily, ‘/ ‘/ ‘/ ‘/ ‘ / ‘/ ‘ / ‘ / ‘ / ‘ / ‘ /
handwashing is very important because fingers are the greatest source of spread and the nasal
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
‘mucosa and conjunctival surface of eyes are most common portal of entry for virus. Symptoms
/ ‘ / ‘/ ‘ / ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘ / ‘/ ‘/ ‘/ ‘ /
begin with dryness and stuffiness in the nasopharynx, followed by excessive production of nasal
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
secretions and tearing of the eyes. Secretions are usually clear and watery. Other symptoms —
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
erythema and swelling of mucous membranes of upper respiratory tract , postnasal drip, sore
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘ / ‘ / ‘ /
throat, hoarseness, headaches and generalized malaise. Fevers chills and exhaustion can
‘/ ‘ / ‘ / ‘ / ‘ / ‘ / ‘ / ‘ / ‘ / ‘ / ‘ /
‘be seen in severe cases. Treatment is rest, OTCs (decongestants can cause systemic
/ ‘/ ‘ / ‘ / ‘/ ‘ / ‘/ ‘/ ‘ / ‘/ ‘/ ‘ / ‘/
vasoconstriction and elevation of BP so should be avoided in people with yTT,, heart disease, ‘ / ‘ / ‘ / ‘ / ‘/ ‘/ ‘ / ‘/ ‘ / ‘ / ‘/ ‘/ ‘ / ‘/
diabetes, etc)
‘/ ‘/
• Rhinosinusitis is inflammation involvingnasal sinuses. Themost common conditions arethose that ‘/ ‘/ ‘/ ‘/ ‘/ ‘ / ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
obstruct the narrow ostia that drain the sinuses. Rhinosinusitis develops when a viral upper
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respiratory tract infection or allergic rhinitis causes mucosal swelling and obstructs the ostia and
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impairs the mucociliary clearance mechanism.
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• **The Mucociliary clearance mechanism helps keepthe sinuses sterile bymoving fluid and
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microorganisms out of the sinuses and into the nasal cavity.
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
,NRMS 5190
‘/ Stuvia:thebest studymaterialfromyourfellowstudents ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
• AMucociliary clearance mechanism helps keep the sinuses sterile bymoving fluid and
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
microorganisms out of the sinuses and into the nasal cavity.
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
• Viral rhinosinusitis can bedifficult todifferentiate from common cold and allergic rhinitis. The S/S
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include facial pain, headache, purulent nasal discharge, diminished sense of smell and fever. ****
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Fever and facial pain are more commonly associated with rhinosinusitis rather than the common
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cold. Symptoms usually resolve in 5-7 days without medical treatment.
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• Bacterial rhinosinusitis — the symptoms that worsen after 5-7 days or persist beyond 10 days. ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
People who are immunocompromised can present with fever of unknown origin, rhinorrhea or
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facial edema.
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• In chronic rhinosinusitis symptoms may consist of sinus pressure with nasal congestion. The
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patient maycomplain ofheadache that is dull and constant. Sinus headaches are exaggerated by
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bending forward, coughing or sneezing. The epithelial changes that occur during acute
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rhinosinusitis are usually reversible but the mucosal changes that occur with chronic rhinosinusitis
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are often irreversible.
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• Pt may need CTfor cases ofchronic rhinosinusitis tomake sure there are no polyps or
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deformities that could be causing obstruction of drainage.
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• Treatments: 2/3rds of cases of acute bacterial rhinosinusitis improve without antibiotics. Most ‘ / ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
people with viral sinusitis improve within a week. Some people require antibiotics which can be
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3-4weeks, theymayneed nasal irrigation and intranasal, decongestants (should be limited 3-5
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days to prevent rebound vasodilation) - Saline spray, mist humidification.
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• Mucosal changes are not permanent. ‘ / ‘/ ‘/ ‘/
• Influenza, combined with pneumonia, is the 8th leading cause of death in the US, and highest ‘ / ‘ / ‘ / ‘ / ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘ / ‘ / ‘/ ‘ / ‘ /
rates are in children and older adults. Transmission is not by contact but by inhalation of
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droplet nuclei. *The incubation period for influenza is 1-4 days with 2 days being the average.
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People become infectious starting 1 day before their symptoms begin and remain infectious for about
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1 week after illness onset.
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• Influenza starts with abrupt onset of fevers and chills, rigors, malaise, muscle aches, headaches, ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
‘profuse watery nasal discharge, nonproductive cough and sore throat. The rapid onset of
/ ‘/ ‘/ ‘ / ‘ / ‘/ ‘/ ‘/ ‘/ ‘ / ‘/ ‘/ ‘/
profound malaise is a distinguishing feature of an influenza infection. Secondary
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complications are pneumonia, sinusitis, otitis media, bronchitis, bacterial pneumonia, croup in
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children. People with secondary bacterial pneumonia may say that they began to feel better
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‘but they experienced a return of fever, chills, pleuritic chest pain and productive cough
/ ‘ / ‘/ ‘ / ‘ / ‘/ ‘/ ‘ / ‘ / ‘/ ‘/ ‘ / ‘/ ‘/
• Influenza C is more like the common cold. ‘ / ‘/ ‘ / ‘/ ‘/ ‘/ ‘ /
• Viral pneumonia is a complication of the flu in older adults or people with cardiopulmonary disease
‘ / ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/
but can be seen in pregnant women and health people as well. Viral pneumonia usually manifests
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘ / ‘ / ‘/ ‘/
within 1 day after onset of influenza and also has a rapid progression of symptoms, it progresses
‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘/ ‘ / ‘/ ‘/ ‘/ ‘ / ‘/ ‘/ ‘/ ‘ / ‘/
‘quickly and can cause hypoxemia and death within a few days of onset. Survivors can
/ ‘/ ‘ / ‘ / ‘ / ‘ / ‘ / ‘ / ‘ / ‘ / ‘/ ‘ / ‘/ ‘ / ‘/
develop diffuse pulmonary fibrosis.
‘/ ‘/ ‘/ ‘/
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