NR 507: Advanced Pathophysiology Questions & Answers 2024/2025

NR 507: Advanced Pathophysiology Questions & Answers 2024/2025 Asthma - ANSWER-Chronic disease due to bronchoconstriction and an excessive inflammatory response in the bronchioles What are 5 s/s of asthma - ANSWER-coughing wheezing shortness of breath rapid breathing chest tightness Pathophysiology of asthma (5) - 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 - ANSWER-smaller passageways that originate from the bronchi that become the alveoli 3 layers of the bronchioles - ANSWER-innermost layer middle layer - lamina propria outermost layer lamina propria - ANSWER-the middle layer of the bronchioles structure of the lamina propria - ANSWER-embedded with connective tissue cells and immune cells purpose of the lamina propria - ANSWER-white blood cells are present to help protect the airways How does the lamina propria effect the lungs in regards to asthma - 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 - ANSWER-columnar epithelial ells and mucus producing goblet cells What does the outermost layer of the bronchioles contain - ANSWER-smooth muscle cells what does the outermost layer of the bronchioles do - ANSWER-control the airways ability to constrict and dilate alveolar hyperinflation - 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? - ANSWER-the ongoing inflammatory process of asthma produces mucus and pus plug that the bronchial walls collapse around Effect of hyperinflation of the alveolar - ANSWER--expanded thorax and hypercapnia (retention of CO2) - respiratory acidosis What are two anticholinergic drugs used for asthma - ANSWER-tiotropium and ipratropium What do anticholinergics do in the lungs? - ANSWER-These drugs block the effects of the parasympathetic nervous system - increasing bronchodilation MOA of anticholinergic drugs for asthma - 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 - ANSWER-inflammation of the bronchial tubes 3 characteristics of bronchitis - ANSWER-bronchial inflammation hypersecretion of mucus chronic productive cough for at least 3 consecutive months for at least 2 successive years Perfusion - 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 - ANSWER-cyanosis right to left shunting chronic hypoxemia Why is there cyanosis with chronic bronchitis - ANSWER-there is hypoxia due to unfavorable conditions for gas exchange Right to left shunting - ANSWER-when blood passes from the right ventricle through the lungs and to the left ventricle without perfusion Causes of bronchitis - 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 - 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? - ANSWER-tobacco product smoke what does long term exposure to irritants promote in bronchitis? (5) - 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? - ANSWER-causes increased bronchoconstriction Hypertrophy and hyperplasia of goblet cells do what in the bronchioles - ANSWER-promotes hypersecretion of mucus What are characteristics of epithelial cell metaplasia? - ANSWER-squamous cells become conciliated and are less protective; allow passage of toxins and WBCs What does the migration of WBCs to the bronchioles do? - 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? - ANSWER-leads to further narrowing of the bronchial passageways What acid-base disorder is seen in chronic bronchitis? - ANSWER-respiratory acidosis how does chronic bronchitis lead to respiratory acidosis? - ANSWER-hyperinflation of the alveoli causes CO2 retention Where does air enter the body? - ANSWER-naso and oropharynx (mouth and nose) Where does air go after it passes through the nose and mouth? - ANSWER-it passes through the trachea After air passes through the trachea where does it go? - ANSWER-goes into the left or right bronchi Where does air flow after the bronchi? - ANSWER-into the smaller bronchioles Where does air flow after the bronchioles? - ANSWER-into the alveoli Describe how blood flows to become oxygenated - ANSWER-- deoxygenated systemic blood flows from the vena cava to R atrium - Tricuspid valve opens to flow to R ventricle -Pulmonary semilunar valve opens and blood flows to the alveolar capillaries for gas exchange from the pulmonary trunk and L & R pulmonary arteries - blood goes from alveolar capillaries to pulmonary veins to return oxygenated blood to the left atrium - bicuspid valve opens to allow blood to go to left ventricle - aortic semilunar valve opens and blood goes to the aorta - aorta pushes oxygenated blood out to the body What is the formula for cardiac output - ANSWER-CO = HR x SV cardiac reserve - ANSWER-difference between resting and maximal CO; should be about 4-5x as high but does decrease 1% per year after age 30 What type of relationship does heart rate and stroke volume have? - ANSWER-inverse low HR = longer fill time = increase stroke volume high HR = lower fill time = lower stroke volume What is preload? - ANSWER-the degree of stretch on the heart before it contracts/ amount of blood entering the ventricles during diastole average amount of preload? - ANSWER-120-130 mls When fibers stretch during diastole how does that effect contraction? - ANSWER-contraction is stronger What happens when cardiac fibers overstretch during diastole? - ANSWER-decreased contraction due to fibers being unable to snap back What can cause increased preload - ANSWER-CHF and hypervolemia What can cause decreased preload - ANSWER-cardiac tamponade and hypovolemia Continues...