NR 507: Advanced Pathophysiology
Midterm
Asthma - AnswerChronic disease due to bronchoconstriction and an excessive
inflammatory response in the bronchioles
What are 5 s/s of asthma - Answercoughing
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 - Answersmaller passageways that originate from the bronchi that
become the alveoli
3 layers of the bronchioles - Answerinnermost layer
middle layer - lamina propria
outermost layer
lamina propria - Answerthe middle layer of the bronchioles
structure of the lamina propria - Answerembedded with connective tissue cells and
immune cells
purpose of the lamina propria - Answerwhite blood cells are present to help protect
the airways
How does the lamina propria effect the lungs in regards to asthma - Answerthe WBCs
protective feature goes into overdrive causing an inflammatory response that damages
host tissue
What does the innermost layer of the bronchioles contain - Answercolumnar epithelial
ells and mucus producing goblet cells
What does the outermost layer of the bronchioles contain - Answersmooth muscle
cells
,what does the outermost layer of the bronchioles do - Answercontrol the airways
ability to constrict and dilate
alveolar hyperinflation - AnswerWhen 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? - Answerthe 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 - Answertiotropium and
ipratropium
What do anticholinergics do in the lungs? - AnswerThese drugs block the effects of
the parasympathetic nervous system
- increasing bronchodilation
MOA of anticholinergic drugs for asthma - Answerthe 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 - Answerinflammation of the bronchial tubes
3 characteristics of bronchitis - Answerbronchial inflammation
hypersecretion of mucus
chronic productive cough for at least 3 consecutive months for at least 2 successive
years
Perfusion - AnswerThe 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 - Answercyanosis
right to left shunting
chronic hypoxemia
, Why is there cyanosis with chronic bronchitis - Answerthere is hypoxia due to
unfavorable conditions for gas exchange
Right to left shunting - Answerwhen 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? - Answertobacco 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? - Answercauses increased
bronchoconstriction
Hypertrophy and hyperplasia of goblet cells do what in the bronchials -
Answerpromotes hypersecretion of mucus
What are characteristics of epithelial cell metaplasia? - Answersquamous cells
become nonciliated and are less protective; allow passage of toxins and WBCs
What does the migration of WBCs to the bronchials do? - Answerincreases
inflammation of the cite and causes fibrosis in the bronchial wall
How does the thickening and rigidity of bronchial basement membranes effect the
lungs? - Answerleads to further narrowing of the bronchial passageways
What acid-base disorder is seen in chronic bronchitis? - Answerrespiratory acidosis
how does chronic bronchitis lead to respiratory acidosis? - Answerhyperinflation of
the alveoli causes CO2 retention
Midterm
Asthma - AnswerChronic disease due to bronchoconstriction and an excessive
inflammatory response in the bronchioles
What are 5 s/s of asthma - Answercoughing
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 - Answersmaller passageways that originate from the bronchi that
become the alveoli
3 layers of the bronchioles - Answerinnermost layer
middle layer - lamina propria
outermost layer
lamina propria - Answerthe middle layer of the bronchioles
structure of the lamina propria - Answerembedded with connective tissue cells and
immune cells
purpose of the lamina propria - Answerwhite blood cells are present to help protect
the airways
How does the lamina propria effect the lungs in regards to asthma - Answerthe WBCs
protective feature goes into overdrive causing an inflammatory response that damages
host tissue
What does the innermost layer of the bronchioles contain - Answercolumnar epithelial
ells and mucus producing goblet cells
What does the outermost layer of the bronchioles contain - Answersmooth muscle
cells
,what does the outermost layer of the bronchioles do - Answercontrol the airways
ability to constrict and dilate
alveolar hyperinflation - AnswerWhen 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? - Answerthe 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 - Answertiotropium and
ipratropium
What do anticholinergics do in the lungs? - AnswerThese drugs block the effects of
the parasympathetic nervous system
- increasing bronchodilation
MOA of anticholinergic drugs for asthma - Answerthe 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 - Answerinflammation of the bronchial tubes
3 characteristics of bronchitis - Answerbronchial inflammation
hypersecretion of mucus
chronic productive cough for at least 3 consecutive months for at least 2 successive
years
Perfusion - AnswerThe 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 - Answercyanosis
right to left shunting
chronic hypoxemia
, Why is there cyanosis with chronic bronchitis - Answerthere is hypoxia due to
unfavorable conditions for gas exchange
Right to left shunting - Answerwhen 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? - Answertobacco 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? - Answercauses increased
bronchoconstriction
Hypertrophy and hyperplasia of goblet cells do what in the bronchials -
Answerpromotes hypersecretion of mucus
What are characteristics of epithelial cell metaplasia? - Answersquamous cells
become nonciliated and are less protective; allow passage of toxins and WBCs
What does the migration of WBCs to the bronchials do? - Answerincreases
inflammation of the cite and causes fibrosis in the bronchial wall
How does the thickening and rigidity of bronchial basement membranes effect the
lungs? - Answerleads to further narrowing of the bronchial passageways
What acid-base disorder is seen in chronic bronchitis? - Answerrespiratory acidosis
how does chronic bronchitis lead to respiratory acidosis? - Answerhyperinflation of
the alveoli causes CO2 retention
