NR 507: Advanced Pathophysiology
Midterm
Asthma - ANS Chronic disease due to bronchoconstriction and an excessive inflammatory
response in the bronchioles
What are 5 s/s of asthma - ANS coughing
wheezing
shortness of breath
rapid breathing
chest tightness
Pathophysiology of asthma (5) - ANS -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 - ANS smaller passageways that originate from the bronchi that become the alveoli
3 layers of the bronchioles - ANS innermost layer
middle layer - lamina propria
outermost layer
lamina propria - ANS the middle layer of the bronchioles
structure of the lamina propria - ANS embedded with connective tissue cells and immune cells
purpose of the lamina propria - ANS white blood cells are present to help protect the airways
How does the lamina propria effect the lungs in regards to asthma - ANS the WBCs protective
feature goes into overdrive causing an inflammatory response that damages host tissue
What does the innermost layer of the bronchioles contain - ANS columnar epithelial ells and
mucus producing goblet cells
What does the outermost layer of the bronchioles contain - ANS smooth muscle cells
, what does the outermost layer of the bronchioles do - ANS control the airways ability to
constrict and dilate
alveolar hyperinflation - ANS 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? - ANS the ongoing inflammatory process of asthma produces
mucus and pus plug that the bronchial walls collapse around
Effect of hyperinflation of the alveolar - ANS -expanded thorax and hypercapnia (retention of
CO2)
- respiratory acidosis
What are two anticholinergic drugs used for asthma - ANS tiotropium and ipratropium
What do anticholinergics do in the lungs? - ANS These drugs block the effects of the
parasympathetic nervous system
- increasing bronchodilation
MOA of anticholinergic drugs for asthma - ANS 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 - ANS inflammation of the bronchial tubes
3 characteristics of bronchitis - ANS bronchial inflammation
hypersecretion of mucus
chronic productive cough for at least 3 consecutive months for at least 2 successive years
Perfusion - ANS 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 - ANS cyanosis
right to left shunting
chronic hypoxemia
Why is there cyanosis with chronic bronchitis - ANS there is hypoxia due to unfavorable
conditions for gas exchange
Right to left shunting - ANS when blood passes from the right ventricle through the lungs and to
the left ventricle without perfusion
Midterm
Asthma - ANS Chronic disease due to bronchoconstriction and an excessive inflammatory
response in the bronchioles
What are 5 s/s of asthma - ANS coughing
wheezing
shortness of breath
rapid breathing
chest tightness
Pathophysiology of asthma (5) - ANS -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 - ANS smaller passageways that originate from the bronchi that become the alveoli
3 layers of the bronchioles - ANS innermost layer
middle layer - lamina propria
outermost layer
lamina propria - ANS the middle layer of the bronchioles
structure of the lamina propria - ANS embedded with connective tissue cells and immune cells
purpose of the lamina propria - ANS white blood cells are present to help protect the airways
How does the lamina propria effect the lungs in regards to asthma - ANS the WBCs protective
feature goes into overdrive causing an inflammatory response that damages host tissue
What does the innermost layer of the bronchioles contain - ANS columnar epithelial ells and
mucus producing goblet cells
What does the outermost layer of the bronchioles contain - ANS smooth muscle cells
, what does the outermost layer of the bronchioles do - ANS control the airways ability to
constrict and dilate
alveolar hyperinflation - ANS 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? - ANS the ongoing inflammatory process of asthma produces
mucus and pus plug that the bronchial walls collapse around
Effect of hyperinflation of the alveolar - ANS -expanded thorax and hypercapnia (retention of
CO2)
- respiratory acidosis
What are two anticholinergic drugs used for asthma - ANS tiotropium and ipratropium
What do anticholinergics do in the lungs? - ANS These drugs block the effects of the
parasympathetic nervous system
- increasing bronchodilation
MOA of anticholinergic drugs for asthma - ANS 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 - ANS inflammation of the bronchial tubes
3 characteristics of bronchitis - ANS bronchial inflammation
hypersecretion of mucus
chronic productive cough for at least 3 consecutive months for at least 2 successive years
Perfusion - ANS 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 - ANS cyanosis
right to left shunting
chronic hypoxemia
Why is there cyanosis with chronic bronchitis - ANS there is hypoxia due to unfavorable
conditions for gas exchange
Right to left shunting - ANS when blood passes from the right ventricle through the lungs and to
the left ventricle without perfusion
