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It is a subjective experience of breathing discomfort, difficulty breathing,
change of posture, caused when a person is lying flat, can be from heart failure
Paroxysmal nocturnal dypnea:
- Generally with l/v failure,
- With obesity
- Abnormal breathing patters:
- Tachypnea: breathing too fast
- Bradypnea: too slow
- Apnea:not breathing
- Kussmaul respirations(hyperpnea);trying to fix something, metabolic acidosis,incresed ventilator rate, high tidal volume, no expiratory pause.
- Cheyne-strokes-apnea 10 t0 60 sec,tachypnea deep and shallow breathing neurological impairement to the brain stem
inadequate alveolar ventilation in relations to meeting metabolic demands, co2 is high and then blood aterial blood increases(paco2)causing hypercapnia, Results in respiratory acidosis.
exceeding metabolic rate, the lungs remove co2 faster than it should causing decrease in paco2 hypocapnia, Results in respiratory alkalosis
is a protective reflex that helps clear the airway by an explosive expiration,
Changes in the amount of color and consistency of sputum provide information about progression of disease and effectiveness of therapy.
Is a bluish discoloration of the skin and mucous membranes by reduced hemoglobin in the blood, in adults cyanosis is not evident until severe hypoxemia, anemia, carbon monoxide poisoning,
associated with diseases that cause chronic hypoxemia, or congenital heart failure.
increased carbon dioxide concentrations in the arterial blood, increases paco2, is caused by hypoventilation, depression of the respiratory center by drugs, diseases of the medulla, including infections of the CNS, Spinal conduction pathways, neuromuscular abnormalities, large airway obstruction, emphysema increased work of breathing
Reduces oxygenation in the arterial blood is caused by respiratory alterations, caused by one or more of the major mechanisms of breathing, 1. oxygen delivery to the alveoli 2. diffusion of oxygen from the alveoli into the blood, 3.Perfusion of the alveolar capillaries
is a diffuse inflammatory obstruction of the small airways or bronchioles tract infections, a fibrotic process that occludes airways and causes permanent scarring of the lungs, late stage
is the presence of air or gas in the pleural space by a rupture in the visceral pleura, it destroys negative pressure of the pleura and disrupts the equilibrium between elastic recoil forces of the lung and chest wall, then the lungs collapse toward the hilium
air pressure in the pleural space equals barometric pressure because the air is drawn into the pleural space during ispiration is forced back out during expiration
One way airflow, allowing to enter through inhalation but preventing its escape by closing through expiration, air enters PIP only in inhalation hurts the heart. Life threatening may resulted from severe hypoxemia,Low BP
idiopathic, begins with sudden pleura pain, tachypnea,dypnea absent breath sounds,
Pleural abnormalities: Transudative effusion
acute, clear, diffuses out of the capillaries beneath the pleura, cardiovascular disease that cause high pulmonary capillary pressure, liver or kidney disease that disrupts plasma protein production, hypoproteinemia(decreased oncotic pressure in blood vessels.
Fluid rich in cells and proteins(leukocytes,plasma cells), infection inflammation that stimulates mast cells to release biochemical mediators that increase capillary permeability
hemorrhage into the pleural space, traumatic injury rupture or something that damages blood vessels
containing lymph and fatty droplets that moves from lymphatic vessels into pleural space by injury or infection
asbestos-of dust often in mines
Obstructive Pulmonary disease:COPD
airway obstruction that is worse with expiration, dyspnea and wheezing, bronchial walls collapse
Chronic inflammatory disorder of the airways, hypersensitivity Type1, hyperrespinsiveness and constriction of the airways, Can lead to obstruction and status asthmaticus-that doesn't respond to inhaled bronchodilators, Dyspnea expiratory wheezing,tachypnea
hypersecretion of mucus and chronic productive cough for at least 3 months of the year, infection of the bronchioles, inspired irritants increase mucus production and the size and number of mucous glands but in chronic bronchitis you don't have an infection
is an abnormal permament enlargement of the gas-exchange airways accompanied by destruction of alveolar walls without obvious fibrosis, decrease surface area, loss of elastic recoils, obstruction occurs from changes in the tissue rather than mucous production, alveolar destruction, hyperexpansion of the chest,
- active infection, inflammation of lung alveoli,
- *Community acquired(streptococcus pneumonia bacterial.
- *hospital acquired nonsocomial-pneumococcal antibiotical resistant.
is an infection caused by Mycobacterium tuberculosis, droplet, it is and acid fast, Usually in the upper lobe,some migrate through the lymphatics where they encounter lymphocytes and initiate the immune response, infected tissues within the turbercle die forming cheeslike material caseation necrosis,PPD
Acute infection or inflammation of the airways or bronchi, commonly follows a viral illness, caused by bacteria, common with COPD, they have no infiltrates-substance such as pus,blood protein, consolidation-lung that has filled with liquid
Pulmonary Vascular disease:
- embolism: occlusion of a potion of the pulmonary vascular bed by a thrombus,embolus,tissue fragment,lipids, or an air bubble.
- *commonly arise from thrombi of deep veins in the thigh, blood clotting factors
Mean above normal >25mmHG, enlarged right heart border, right ventricular hyperthrophy,
- Primarily due to right ventricular enlargement(failure),
- Secondary to pulmonary hypertension-create chronic pressure overload in the right ventricle
- -Blood backs up in the venous system, during excersise testing,
Bronchogenic carcinomas, most common with cigarette smoking, heavy smokers have 20x more greater chance in developing lung cancer, larynx,oral cavities, esophagus, urinary bladder epithelium of the respiratory tract, surgical resection,