CH 13 Think About Chapter Notes
1. Describe the common upper respiratory tract infections.
Pathogen is directly inhaled or spread by secretions on hands or contaminated objects such as
facial tissue. The infection is highly contagious because the virus is shed in large numbers from
the infected nasal mucosa during the first few days of the infection and can survive for several
hours outside the body.
2. Explain how secondary bacterial infections occur in the respiratory tract.
As the exudate accumulates, pressure builds up inside the sinus cavity, causing severe pain in the
facial bone. The pain may be confused with headache (ethmoid sinus) or toothache.
3. Compare the different types of pneumonia.
4. Differentiate the effects of primary from secondary tuberculosis.
secondary or reinfection tuberculosis is the stage of active infection. It often arises years
after primary infection, when the bacilli, hidden in the tubercles, are reactivated, usually
because of decreased host resistance. Occasionally there is a new invasion of microbes.
As the organisms multiply, tissue destruction occurs, forming a large area of necrosis.
Cavitation occurs, with formation of a large open area in the lung and erosion into the
bronchi and blood vessels.
Primary infection occurs when the microorganisms first enter the lungs, are engulfed by
macrophages, and cause a local inflammatory reaction, usually on the periphery of the
upper lobe. Some bacilli migrate to the lymph nodes, activating a type IV or cell-
mediated hypersensitivity response
5. Describe the pathophysiology and complications of cystic fibrosis.
In the lungs, the mucus obstructs airflow in the bronchioles and small bronchi, causing air
trapping or atelectasis with permanent damage to the bronchial walls (Fig. 13.14). Because
stagnant mucus is an excellent medium for bacterial growth, infections are common and add to
the progressive destruction of lung tissue. Organisms commonly causing infection in patients
with cystic fibrosis include P. aeruginosa and S. aureus. Bronchiectasis and emphysematous
changes are seen frequently as fibrosis and obstructions advance. Eventually respiratory failure
or cor pulmonale.
6. Describe the etiology and pathophysiology of bronchogenic carcinoma.
Found on the periphery of the lung, making them less symptomatic and more difficult to detect
in the early stages. The cells of adenocarcinomas may secrete mucin. Small cell or “oat cell”
, CH 13 Think About Chapter Notes
carcinomas are a rapidly growing type of lung cancer often located near a major bronchus in the
central part of the lung. They tend to be invasive and metastasize early in their development.
Large cell carcinomas are usually found on the periphery and consist of undifferentiated large
cells. Cigarette smoking is the major factor in its development. “Second-hand smoke” in the
environment has been implicated in a significant number of cases. Occuptaional exposure to
carcinogens such as silica, vinyl chloride, or asbestos is the other major cause of lung cancer, and
the risk is greatly increased if a second factor such as cigarette smoking is also present in an
occupationally exposed individual.
7. Describe the possible outcomes of aspiration.
• Coughing and choking with marked dyspnea
• Stridor and hoarseness are characteristic of upper airway obstruction
• Wheezing
• Tachycardia and tachypnea
• Nasal flaring, chest retractions, and marked hypoxia
• Total obstruction at the larynx or trachea prevents any sounds or cough from being produced;
a person may reach for the chest or neck area
• Cardiac or respiratory arrest quickly ensues
8. Compare the types of asthma and describe the pathophysiology and manifestations of an acute
attack.
• Cough, marked dyspnea, a tight feeling in the chest, and agitation develop as airway
obstruction increases. The patient is unable to talk.
• Wheezing is characteristic as air passes through the narrowed bronchioles.
• Breathing is rapid and labored, with use of accessory muscles and possible chest retractions.
Thick and tenacious or sticky mucus is coughed up.
• Tachycardia occurs and perhaps pulsus paradoxus when the pulse differs on inspiration and
expiration. Paradoxical pulse is observed when a blood pressure measurement is taken during an
asthma attack. The sounds registering systolic pressure are heard first during expiration, and
there is a gap of 10 mm Hg or more before the sounds of both inspiration and expiration are
heard.
• Hypoxia develops. Respiratory alkalosis develops initially because of hyperventilation.
• Respiratory acidosis develops
9. Compare emphysema and chronic bronchitis.
1. Describe the common upper respiratory tract infections.
Pathogen is directly inhaled or spread by secretions on hands or contaminated objects such as
facial tissue. The infection is highly contagious because the virus is shed in large numbers from
the infected nasal mucosa during the first few days of the infection and can survive for several
hours outside the body.
2. Explain how secondary bacterial infections occur in the respiratory tract.
As the exudate accumulates, pressure builds up inside the sinus cavity, causing severe pain in the
facial bone. The pain may be confused with headache (ethmoid sinus) or toothache.
3. Compare the different types of pneumonia.
4. Differentiate the effects of primary from secondary tuberculosis.
secondary or reinfection tuberculosis is the stage of active infection. It often arises years
after primary infection, when the bacilli, hidden in the tubercles, are reactivated, usually
because of decreased host resistance. Occasionally there is a new invasion of microbes.
As the organisms multiply, tissue destruction occurs, forming a large area of necrosis.
Cavitation occurs, with formation of a large open area in the lung and erosion into the
bronchi and blood vessels.
Primary infection occurs when the microorganisms first enter the lungs, are engulfed by
macrophages, and cause a local inflammatory reaction, usually on the periphery of the
upper lobe. Some bacilli migrate to the lymph nodes, activating a type IV or cell-
mediated hypersensitivity response
5. Describe the pathophysiology and complications of cystic fibrosis.
In the lungs, the mucus obstructs airflow in the bronchioles and small bronchi, causing air
trapping or atelectasis with permanent damage to the bronchial walls (Fig. 13.14). Because
stagnant mucus is an excellent medium for bacterial growth, infections are common and add to
the progressive destruction of lung tissue. Organisms commonly causing infection in patients
with cystic fibrosis include P. aeruginosa and S. aureus. Bronchiectasis and emphysematous
changes are seen frequently as fibrosis and obstructions advance. Eventually respiratory failure
or cor pulmonale.
6. Describe the etiology and pathophysiology of bronchogenic carcinoma.
Found on the periphery of the lung, making them less symptomatic and more difficult to detect
in the early stages. The cells of adenocarcinomas may secrete mucin. Small cell or “oat cell”
, CH 13 Think About Chapter Notes
carcinomas are a rapidly growing type of lung cancer often located near a major bronchus in the
central part of the lung. They tend to be invasive and metastasize early in their development.
Large cell carcinomas are usually found on the periphery and consist of undifferentiated large
cells. Cigarette smoking is the major factor in its development. “Second-hand smoke” in the
environment has been implicated in a significant number of cases. Occuptaional exposure to
carcinogens such as silica, vinyl chloride, or asbestos is the other major cause of lung cancer, and
the risk is greatly increased if a second factor such as cigarette smoking is also present in an
occupationally exposed individual.
7. Describe the possible outcomes of aspiration.
• Coughing and choking with marked dyspnea
• Stridor and hoarseness are characteristic of upper airway obstruction
• Wheezing
• Tachycardia and tachypnea
• Nasal flaring, chest retractions, and marked hypoxia
• Total obstruction at the larynx or trachea prevents any sounds or cough from being produced;
a person may reach for the chest or neck area
• Cardiac or respiratory arrest quickly ensues
8. Compare the types of asthma and describe the pathophysiology and manifestations of an acute
attack.
• Cough, marked dyspnea, a tight feeling in the chest, and agitation develop as airway
obstruction increases. The patient is unable to talk.
• Wheezing is characteristic as air passes through the narrowed bronchioles.
• Breathing is rapid and labored, with use of accessory muscles and possible chest retractions.
Thick and tenacious or sticky mucus is coughed up.
• Tachycardia occurs and perhaps pulsus paradoxus when the pulse differs on inspiration and
expiration. Paradoxical pulse is observed when a blood pressure measurement is taken during an
asthma attack. The sounds registering systolic pressure are heard first during expiration, and
there is a gap of 10 mm Hg or more before the sounds of both inspiration and expiration are
heard.
• Hypoxia develops. Respiratory alkalosis develops initially because of hyperventilation.
• Respiratory acidosis develops
9. Compare emphysema and chronic bronchitis.
