Nr 507: Advanced Pathophysiology
Midterm Exam With Complete Correct
Responces
Asthma - CORRECT✅✅Chronic disease due to bronchoconstriction and an excessive
inflammatory response in the bronchioles
What are 5 s/s of asthma - CORRECT✅✅coughing
wheezing
shortness of breath
rapid breathing
chest tightness
Pathophysiology of asthma (5) - CORRECT✅✅-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 - CORRECT✅✅smaller passageways that originate from the bronchi that
become the alveoli
3 layers of the bronchioles - CORRECT✅✅innermost layer
middle layer - lamina propria
outermost layer
lamina propria - CORRECT✅✅the middle layer of the bronchioles
structure of the lamina propria - CORRECT✅✅embedded with connective tissue cells
and immune cells
purpose of the lamina propria - CORRECT✅✅white blood cells are present to help
protect the airways
How does the lamina propria effect the lungs in regards to asthma - CORRECT✅✅the
WBCs protective feature goes into overdrive causing an inflammatory response that
damages host tissue
What does the innermost layer of the bronchioles contain - CORRECT✅✅columnar
epithelial ells and mucus producing goblet cells
,What does the outermost layer of the bronchioles contain - CORRECT✅✅smooth
muscle cells
what does the outermost layer of the bronchioles do - CORRECT✅✅control the
airways ability to constrict and dilate
alveolar hyperinflation - CORRECT✅✅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? - CORRECT✅✅the ongoing inflammatory process of
asthma produces mucus and pus plug that the bronchial walls collapse around
Effect of hyperinflation of the alveolar - CORRECT✅✅-expanded thorax and
hypercapnia (retention of CO2)
- respiratory acidosis
What are two anticholinergic drugs used for asthma - CORRECT✅✅tiotropium and
ipratropium
What do anticholinergics do in the lungs? - CORRECT✅✅These drugs block the
effects of the parasympathetic nervous system
- increasing bronchodilation
MOA of anticholinergic drugs for asthma - CORRECT✅✅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 - CORRECT✅✅inflammation of the bronchial tubes
3 characteristics of bronchitis - CORRECT✅✅bronchial inflammation
hypersecretion of mucus
chronic productive cough for at least 3 consecutive months for at least 2 successive
years
Perfusion - CORRECT✅✅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 - CORRECT✅✅cyanosis
right to left shunting
chronic hypoxemia
,Why is there cyanosis with chronic bronchitis - CORRECT✅✅there is hypoxia due to
unfavorable conditions for gas exchange
Right to left shunting - CORRECT✅✅when blood passes from the right ventricle
through the lungs and to the left ventricle without perfusion
Causes of bronchitis - CORRECT✅✅-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 - CORRECT✅✅-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? - CORRECT✅✅tobacco product smoke
what does long term exposure to irritants promote in bronchitis? (5) - CORRECT✅✅-
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? - CORRECT✅✅causes
increased bronchoconstriction
Hypertrophy and hyperplasia of goblet cells do what in the bronchials -
CORRECT✅✅promotes hypersecretion of mucus
What are characteristics of epithelial cell metaplasia? - CORRECT✅✅squamous cells
become nonciliated and are less protective; allow passage of toxins and WBCs
What does the migration of WBCs to the bronchials do? - CORRECT✅✅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? - CORRECT✅✅leads to further narrowing of the bronchial passageways
What acid-base disorder is seen in chronic bronchitis? - CORRECT✅✅respiratory
acidosis
how does chronic bronchitis lead to respiratory acidosis? -
CORRECT✅✅hyperinflation of the alveoli causes CO2 retention
, Where does air enter the body? - CORRECT✅✅naso and oropharynx (mouth and
nose)
Where does air go after it passes through the nose and mouth? - CORRECT✅✅it
passes through the trachea
After air passes through the trachea where does it go? - CORRECT✅✅goes into the
left or right bronchi
Where does air flow after the bronchi? - CORRECT✅✅into the smaller bronchioles
Where does air flow after the bronchioles? - CORRECT✅✅into the alveoli
Describe how blood flows to become oxygenated - CORRECT✅✅- 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 - CORRECT✅✅CO = HR x SV
cardiac reserve - CORRECT✅✅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? -
CORRECT✅✅inverse
low HR = longer fill time = increase stroke volume
high HR = lower fill time = lower stroke volume
What is preload? - CORRECT✅✅the degree of stretch on the heart before it
contracts/ amount of blood entering the ventricles during diastole
average amount of preload? - CORRECT✅✅120-130 mls
When fibers stretch during diastole how does that effect contraction? -
CORRECT✅✅contraction is stronger
What happens when cardiac fibers overstretch during diastole? -
CORRECT✅✅decreased contraction due to fibers being unable to snap back
What can cause increased preload - CORRECT✅✅CHF and hypervolemia
Midterm Exam With Complete Correct
Responces
Asthma - CORRECT✅✅Chronic disease due to bronchoconstriction and an excessive
inflammatory response in the bronchioles
What are 5 s/s of asthma - CORRECT✅✅coughing
wheezing
shortness of breath
rapid breathing
chest tightness
Pathophysiology of asthma (5) - CORRECT✅✅-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 - CORRECT✅✅smaller passageways that originate from the bronchi that
become the alveoli
3 layers of the bronchioles - CORRECT✅✅innermost layer
middle layer - lamina propria
outermost layer
lamina propria - CORRECT✅✅the middle layer of the bronchioles
structure of the lamina propria - CORRECT✅✅embedded with connective tissue cells
and immune cells
purpose of the lamina propria - CORRECT✅✅white blood cells are present to help
protect the airways
How does the lamina propria effect the lungs in regards to asthma - CORRECT✅✅the
WBCs protective feature goes into overdrive causing an inflammatory response that
damages host tissue
What does the innermost layer of the bronchioles contain - CORRECT✅✅columnar
epithelial ells and mucus producing goblet cells
,What does the outermost layer of the bronchioles contain - CORRECT✅✅smooth
muscle cells
what does the outermost layer of the bronchioles do - CORRECT✅✅control the
airways ability to constrict and dilate
alveolar hyperinflation - CORRECT✅✅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? - CORRECT✅✅the ongoing inflammatory process of
asthma produces mucus and pus plug that the bronchial walls collapse around
Effect of hyperinflation of the alveolar - CORRECT✅✅-expanded thorax and
hypercapnia (retention of CO2)
- respiratory acidosis
What are two anticholinergic drugs used for asthma - CORRECT✅✅tiotropium and
ipratropium
What do anticholinergics do in the lungs? - CORRECT✅✅These drugs block the
effects of the parasympathetic nervous system
- increasing bronchodilation
MOA of anticholinergic drugs for asthma - CORRECT✅✅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 - CORRECT✅✅inflammation of the bronchial tubes
3 characteristics of bronchitis - CORRECT✅✅bronchial inflammation
hypersecretion of mucus
chronic productive cough for at least 3 consecutive months for at least 2 successive
years
Perfusion - CORRECT✅✅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 - CORRECT✅✅cyanosis
right to left shunting
chronic hypoxemia
,Why is there cyanosis with chronic bronchitis - CORRECT✅✅there is hypoxia due to
unfavorable conditions for gas exchange
Right to left shunting - CORRECT✅✅when blood passes from the right ventricle
through the lungs and to the left ventricle without perfusion
Causes of bronchitis - CORRECT✅✅-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 - CORRECT✅✅-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? - CORRECT✅✅tobacco product smoke
what does long term exposure to irritants promote in bronchitis? (5) - CORRECT✅✅-
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? - CORRECT✅✅causes
increased bronchoconstriction
Hypertrophy and hyperplasia of goblet cells do what in the bronchials -
CORRECT✅✅promotes hypersecretion of mucus
What are characteristics of epithelial cell metaplasia? - CORRECT✅✅squamous cells
become nonciliated and are less protective; allow passage of toxins and WBCs
What does the migration of WBCs to the bronchials do? - CORRECT✅✅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? - CORRECT✅✅leads to further narrowing of the bronchial passageways
What acid-base disorder is seen in chronic bronchitis? - CORRECT✅✅respiratory
acidosis
how does chronic bronchitis lead to respiratory acidosis? -
CORRECT✅✅hyperinflation of the alveoli causes CO2 retention
, Where does air enter the body? - CORRECT✅✅naso and oropharynx (mouth and
nose)
Where does air go after it passes through the nose and mouth? - CORRECT✅✅it
passes through the trachea
After air passes through the trachea where does it go? - CORRECT✅✅goes into the
left or right bronchi
Where does air flow after the bronchi? - CORRECT✅✅into the smaller bronchioles
Where does air flow after the bronchioles? - CORRECT✅✅into the alveoli
Describe how blood flows to become oxygenated - CORRECT✅✅- 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 - CORRECT✅✅CO = HR x SV
cardiac reserve - CORRECT✅✅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? -
CORRECT✅✅inverse
low HR = longer fill time = increase stroke volume
high HR = lower fill time = lower stroke volume
What is preload? - CORRECT✅✅the degree of stretch on the heart before it
contracts/ amount of blood entering the ventricles during diastole
average amount of preload? - CORRECT✅✅120-130 mls
When fibers stretch during diastole how does that effect contraction? -
CORRECT✅✅contraction is stronger
What happens when cardiac fibers overstretch during diastole? -
CORRECT✅✅decreased contraction due to fibers being unable to snap back
What can cause increased preload - CORRECT✅✅CHF and hypervolemia
