NR 507: Advanced Pathophysiology Midterm (2022/2023)
Chamberlain College of Nursing
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)
Chamberlain College of Nursing
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)
