Final Exam: NUR631/ NUR 631 (Latest 2023/2024 Update) Advanced Physiology and Pathophysiology Exam| Questions and Verified Answers with Rationales| 100% Correct| Grade A- GCU
Final Exam: NUR631/ NUR 631 (Latest
2023/2024 Update) Advanced Physiology and
Pathophysiology Exam| Questions and
Verified Answers with Rationales| 100%
Correct| Grade A- GCU
Q: Fluid in the pleural space characterizes which condition?
a. Pleural effusion
b. Atelectasis
c. Bronchiectasis
d. Ischemia
Answer:
a. Pleural Effusion
Rationale: Pleural effusion is the presence of fluid in the pleural space. page1254
Q: Which medication classification is generally included in the treatment of silicosis?
a. Corticosteroids
b. Antiboitics
c. Bronchodilators
d. Expectorants
Answer:
a. Corticosteroids
Rationale: No specific treatment exists for silicosis, although corticosteroids may produce some
improvement in the early, more acute stages. page 1259
Q: The risk for respiratory distress syndrome (RDS) decreases for premature infants when they
are born between how many weeks of gestation?
a. 16 and 24
b. 20 and 24
c. 24 and 30
d. 30 and 36
Answer:
d. 30 and 36
Rationale: Surfactant is secreted into fetal airways between 30 and 36 weeks. The other options
are not true regarding the timeframe when the risk for RDS decreases. page 1292
Q: What is the chief predisposing factor for respiratory distress syndrome (RDS) of the
newborn?
a. Low birth weight
b. Alcohol consumption during pregnanc
c. Premature birth
d. Smoking during pregnancy
Answer:
a. Premature birth
Rationale: RDS of the newborn, also known as hyaline membrane disease (HMD), is a major
cause of morbidity and mortality in premature newborns. page 1301
Q: What is the primary cause of respiratory distress syndrome (RDS) of the newborn?
a. Immature immune system
b. Small alveoli
c. Surfactant deficiency
d. Anemia
Answer:
c. Surfactant deficiency
Rationale: RDS is primarily caused by surfactant deficiency and secondarily by a deficiency in
alveolar surface area for gas exchange. page 1301
Q: What is the primary problem resulting from respiratory distress syndrome (RDS) of the
newborn?
a. Consolidation
b. Pulmonary edema
c. Atelectasis
d. Bronchiolar plugging
Answer:
c. Atelectasis
Rationale: The primary problem is atelectasis, which causes significant hypoxemia and is
difficult for the neonate to overcome because a significant negative inspiratory pressure is
required to open the alveoli with each breath. None of the other options are considered a primary
problem associated with RDS. page 1301
Q: Which statement best describes cystic fibrosis?
a. Obstructive airway disease characterized by reversible airflow obstruction, bronchial
hyperreactivity, and inflammation
b. Respiratory disease characterized by severe hypoxemia, decreased pulmonary compliance, and
diffuse densities on chest X-ray imaging
c. P!ulmonary disorder involving an abnormal expression of a protein-producing viscous mucus
that obstructs the airways, pancreas, sweat ducts, and vas deferens
d. Pulmonary disorder characterized by atelectasis and increased pulmonary
resistance as a result of a surfactant deficiency
Answer:
c. Pulmonary disorder involving an abnormal expression of a protein-producing viscous mucus
that obstructs the airways, pancreas, sweat ducts, and vas deferens
Rationale: Cystic fibrosis is best described as a pulmonary disorder involving an abnormal
expression of a protein-producing viscous mucus that obstructs the airways, pancreas, sweat
ducts, and vas deferens. This selection is the only option that accurately describes cystic fibrosis.
pages 1310-1311
Q: Cystic fibrosis is caused by which process?
a. Autosomal recessive inheritance
b. Autosomal dominant inheritance
c. Infection
d. Malignancy
Answer:
a. Autosomal recessive inheritance
Rationale: Cystic fibrosis is an autosomal recessive inherited disorder that is associated with
defective epithelial ion transport. None of the other options cause cystic fibrosis. page 1310
Q: What are the abnormalities in cytokines found in children with cystic fibrosis (CF)?
a. Deficit of interleukin(IL)-1 and an excess of IL-4, IL-12, and interferon-alpha (IFN-α)
b. Deficit of IL-6 and an excess of IL-2, IL-8 and granulocyte colony-stimulating factor (G-CSF)
c. Deficit of IL-10 and an excess of IL-1, IL-8 and TNF α
d. Deficit of IL-3 and an excess of IL-14, IL- 24 & colony-stimulating factor (CSF)
Answer:
c. Deficit of IL-10 and an excess of IL-1 , IL-8 and TNF α
Rationale: Abnormal cytokine profiles have been documented in CF airway fluids, including
deficient IL-10 and excessive IL-1, IL-8, and TNF-α, all changes conducive to promoting
inflammation. pages 1311-12
Q: Which hormone is required for water to be reabsorbed in the distal tubule and collecting
duct?
a. Antidiuretic hormone
b. Aldosterone
c. Cortisol
d. Adrenocorticotropin hormone
Answer:
a. Antidiuretic hormone
Rationale: Antidiuretic hormone is required for water to be reabsorbed in the distal tubule and
collecting duct. The later, straight segment of the distal tubule and the collecting duct are
permeable to water as controlled by antidiuretic hormone. The other options are not involved in
this process. page 1331
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Urticaria
is mediated by the IgE-stimulated release of histamine, bradykinin, or kallikrein from mast cells or basophils, or both, which causes the endothelial cells of skin blood vessels to contract.
Scleroderma
sclerosis of the skin and is associated with immune dysregulation and several autoantibodies
Pityriasis rosea
begins as a single lesion known as a herald patch. This lesion is circular, demarcated, and salmon pink; it measures approximately 3 to 4 cm in diameter and is usually located on the trunk.
Mast cells
release histamine and play a role in hypersensitivity reactions in the skin
Herpesvirus—varicella-zoster virus (VZV)
causes both herpes zoster (shingles) and varicella (chickenpox). Varicella is the primary infection, followed years later by herpes zoster, particularly among those who are immunosuppressed.
Langerhans cells
In allergic contact dermatitis, only, process the antigen and carry it to T cells that then become sensitized to the antigen-releasing cytokines and chemokines, leading to leukocyte infiltration and inflammation.
Tinea corporis (ringworm)
is a fungal infection of the skin.
Heat loss can be regulated by varying blood flow through the skin by opening and closing the arteriovenous anastomoses in conjunction with evaporative heat loss of sweat.
a-adrenergic receptors
the sympathetic nervous system regulates vasoconstriction and vasodilation through
Stage 1 pressure ulcers
Nonblanchable erythema of intact skin, usually over bony prominences, characterizes
Superficial pressure ulcers
should be covered with flat, non-bulky dressings that cannot wrinkle or cause increased pressure or friction. Spontaneous healing will occur more quickly if the ulcer is kept moist with an occlusive dressing.
Onychomycosis
is the only term used to identify a fungal or dermatophyte infection of the nail plate that occurs in 2% to 18% of the population.
Plaque psoriasis
lesions are well-demarcated, thick, silvery, scaly, erythematous plaque surrounded by normal skin.
Basal cell carcinoma
arises as a consequence of ultraviolet-associated mutation in only the TP53 tumor-suppressor gene leading to the loss of keratinocyte repair functions and apoptosis resistance of DNA-damaged cells.
Frostbite
Immersion in a warm-water bath (40° to 42° C [104° to 107.6° F]) until frozen tissue is thawed is the best treatment for
Keloids
Abnormal wound healing with excessive fibroblast activity and collagen formation during dermal connective tissue repair cause. typically send out clawlike prolongations.
allergic contact and stasis dermatitis
Erythema and Pruritus are exhibited with both
Latex allergy
can be either a type IV hypersensitivity to chemicals used in latex rubber processing or a type I immediate hypersensitivity, with IgE antibodies formed in response to latex rubber protein.
Squamous cell carcinoma (SCC)
is a tumor of the epidermis and the second most common human cancer. Two types are characterized: (1) in situ (Bowen disease) and (2) invasive.
Eccrine sweat glands
are distributed over the body, with the greatest numbers in the palms of the hands, soles of the feet, and forehead. These secretions are important in thermoregulation and cooling of the body through evaporation.
Fibroblasts
secrete the connective tissue matrix and collagen.
Basal cell carcinoma
has depressed centers with rolled borders. Lesions are most often observed on people who live in regions with intense sunlight and on those areas of the skin most exposed—namely, the face and neck.
Endothelial cell
is thought to be the progenitor of Kaposi sarcoma.
Cutaneous vasculitis
involves the deposit of immune complexes, initiating an uncontrolled inflammatory response and causing the lesions that are often polymorphic.
Seborrheic keratosis
is a benign proliferation of cutaneous basal cells that produces smooth or warty elevated lesions. The pathogenetic origin is unknown. Seborrheic keratosis usually occurs in older people as multiple lesions on the chest, back, and face. The color varies from tan to waxy, yellow, flesh-colored, or dark brown to black.
furuncle, or “boil,
is used to identify an inflammation of the hair follicles (root) that may develop from a preceding folliculitis and spread through the follicular wall into the surrounding dermis.
Carbuncle
is used to identify a collection of infected hair follicles occurring most often on the back of the neck, the upper back, and the lateral thighs. The lesion begins in the subcutaneous tissue and lower dermis as a firm mass that evolves into an erythematous, painful, and swollen mass and drains through many openings.
Skin biopsy
with immunofluorescent observation reveals lumpy deposits of immunoglobulins, especially IgM, in some individuals. This immunoglobulin is the only one associated with discoid lupus erythematosus.
Eczema or dermatitis
The most common inflammatory disorder of the skin general terms that describe a particular type of inflammatory response in the skin—these terms can be used interchangeably. Pruritus, lesions with indistinct borders, and epidermal changes generally characterize diseases that are considered eczematous.
Administering ibuprofen
to individuals being treated for frostbite because it inhibits prostaglandins.
Intradermal nevus
is characterized by a small (less than 1 cm) lesion with regular edges and bristle-like hairs with a color change that can range from skin tones to light brown.
Langerhans cells (a type of dendritic cell)
and dermal dendritic cells initiate an immune response by presenting processed antigen to T cells, thus providing a defense against environmental antigens.
Tinea corporis
Contact with only kittens and puppies is considered a common source of
A port-wine stain
is present at birth or within a few days after birth and does not fade with age
In the acute phase of atopic dermatitis
inflammation is associated with the activation of T helper 1 (Th-1) cells with an overexpression of cytokines (interleukin [IL]-4, IL-5, and IL-13) and chemokine ligand 1 (CCL1) and 18 (CCL18) with increases in IgE, eosinophils, and macrophages.
C. albicans infection
is a superficial fungal infection that commonly occurs in children. C. albicans is part of the normal skin flora in certain individuals and invades susceptible tissue sites if the predisposing factors are not eliminated.
Rubella
is a common communicable disease in children and young adults and is caused only by a ribonucleic acid (RNA) virus that enters the bloodstream through the respiratory route. has an incubation period that ranges from 14 to 21 days and a duration of 1 to 4 days.
Scabies
is the only contagious disease caused by the itch mite, Sarcoptes scabiei.
Varicella-zoster viral infection
produces chickenpox (varicella) and herpes zoster (shingles).
body louse (pediculosis)
The primary lesion of the exhibits a pinpoint red macule, papule, or wheal with a hemorrhagic puncture site.
Itching
is considered a hallmark of atopic dermatitis, and rubbing and scratching to relieve the itch are responsible for many of the clinical changes of atopic dermatitis.
A virus
is the cause of molluscum contagiosum. The poxvirus is the only organism that induces epidermal cell proliferation and blocks immune responses that would control the virus as noted with molluscum contagiosum.
Rubeola
a highly contagious acute disease in children, is a result of only a viral infection.
tinea corporis
are often erythematous, round, or oval-scaling patches that peripherally spread with clearing in the center, creating the ring appearance, which is why this disease is commonly referred to as ringworm.
Prodromal symptoms of Rubeola
include high body temperature (up to 40.5° C [104.9° F]), malaise, enlarged lymph nodes, runny nose, conjunctivitis, and a “barking” cough.
Prodromal symptoms of Rubella
are few but may include enlarged cervical and postauricular lymph nodes, low-grade fever, headache, sore throat, runny nose, and cough.
Scabies
has symptoms that appear 3 to 5 weeks after infestation. The burrows, papules, and vesicular lesions cause severe itching that worsens at night.
Miliaria
is characterized by a vesicular eruption after prolonged exposure to perspiration, with subsequent obstruction of the eccrine ducts.
Thrush
is the term used to describe the presence of Candida in the mucous membranes of the mouth of infants and, less commonly, in the mouth of adults.
Impetigo
is a common bacterial skin infection in infants and children and is particularly infectious among people living in crowded conditions with poor sanitary facilities or in settings such as daycare facilities.
Bullous impetigo
is a rare variant of impetigo caused by S. aureus. The staphylococci produce a bacterial toxin called exfoliative toxin (ET), which causes a disruption in desmosomal adhesion molecules with blister formation characteristic of bullous impetigo.
Strawberry hemangiomas
involute by 5 to 6 years of age, usually without scarring; therefore self resolution is the usual treatment plan.
vesicular impetigo
lesions that begin as small vesicles with a honey-colored serum are the hallmark clinical manifestation of bullous impetigo. Yellow to white-brown crusts form as the vesicles rupture and extend radially.
diaper dermatitis
secondarily infected with C. albicans.
decrease in surface tension caused by surfactant
is also responsible for keeping the alveoli free of fluid. In the absence of surfactant, the surface tension tends to attract fluid into the alveoli. If surfactant production is disrupted or surfactant is not produced in adequate quantities, then the alveolar surface tension increases, causing alveolar collapse, decreased lung expansion, increased work of breathing, and severe gas-exchange abnormalities. The decrease in surface tension caused by surfactant is also responsible for keeping the alveoli free of fluid.
A shift to the right
depicts hemoglobin’s decreased affinity for O2 or an increase in the ease with which oxyhemoglobin dissociates and O2 moves into the cells. The oxyhemoglobin dissociation curve is shifted to the right by acidosis (low pH) and hypercapnia (increased partial pressure of arterial carbon dioxide [PaCO2]).
aspirated fluids or foreign particles tend to enter
The right mainstem bronchus extends from the trachea more vertically than the left main bronchus; therefore the right lung rather than the left or any of the other locations listed.
Stretch receptors
are located in the smooth muscles of airways
Central chemoreceptors
are located near the respiratory center
The basic automatic rhythm of respiration is set by the DRG
a cluster of inspiratory nerve cells located in the medulla that sends efferent impulses to the diaphragm and inspiratory intercostal muscles.
The trachea The division occurs only at the Carina
which is supported by U-shaped cartilage, connects the larynx to the bronchi, the conducting airways of the lungs. The trachea divides into the two main airways, or bronchi, at the carina
Histamine and prostaglandin
Constriction occurs if the irritant receptors in the airway epithelium are stimulated by irritants in inspired air, by endogenous substances (e.g., histamine, serotonin, prostaglandins), by many drugs, and by humoral substances. cause constriction.
Two major types of epithelial cells appear in the alveolus
Type I alveolar cells and type II alveolar cells
Type I alveolar cells
provide structure
type II alveolar cells
secrete surfactant, a lipoprotein that coats the inner surface of the alveolus and facilitates its expansion during inspiration, lowers alveolar surface tension at end-expiration, and thereby prevents lung collapse.
Central chemoreceptors
indirectly monitor arterial blood by sensing changes in the pH of cerebrospinal fluid (CSF). The central chemoreceptors are sensitive to very small changes in the pH of CSF (equivalent to a 1 to 2 mm Hg change in partial pressure of carbon dioxide [PCO2]) and are able to maintain a normal partial pressure of arterial carbon dioxide (PaCO2) under many different conditions, including strenuous exercise.
alveolocapillary membrane.
Gas exchange occurs only across
decrease in compliance
indicates that the lungs or chest wall is abnormally stiff or difficult to inflate.
Pressure in the pleural space
is usually negative or subatmospheric (-4 to -10 mm Hg).
The respiratory center
is made up of several groups of neurons located bilaterally in the brainstem: the DRG, the VRG, the pneumotaxic center, and the apneustic center.
DRG group in the medulla oblongata
receives afferent impulses in the situation described.
Spirometry measures
volume and flow rate during forced expiration.
alveolar-arterial oxygen gradient
is used to evaluate the cause of hypoxia.
Diffusing capacity
is a measure of the gas diffusion rate at the alveolocapillary membrane.
Arterial blood gas analysis
can be used to determine pH and oxygen and carbon dioxide concentrations.
acinus
No lymphatic structures are located.
bicarbonate
Approximately 60% of the CO2 in venous blood and 90% of the CO2 in arterial blood are carried in the form
Peripheral chemoreceptors
are located in the aortic bodies, aortic arch, and carotid bodies at the bifurcation of the carotids, near the baroreceptors.
Zone 1
Alveolar pressure exceeds pulmonary arterial and venous pressures in The capillary bed collapses, and normal blood flow ceases.
Zone II
is the portion where alveolar pressure is greater than venous pressure but not greater than arterial pressure. Blood flows through zone II, but it is impeded to a certain extent by alveolar pressure. Zone II is normally above the level of the left atrium.
zone III
arterial and venous pressures are greater than alveolar pressure and blood flow is not affected by alveolar pressure. Zone III is in the base of the lung. Blood flow through the pulmonary capillary bed increases in regular increments from the apex to the base.
Surfactant
a lipoprotein produced by type II alveolar cells, has a detergent-like effect that separates the liquid molecules, thereby decreasing alveolar surface tension.
arterial blood gas analysis
Observation of the ventilatory rate, pattern, or effort cannot determine the adequacy of alveolar ventilation. If a health care professional needs to determine the adequacy of ventilation, then an arterial blood gas analysis must be performed to measure partial pressure of arterial carbon dioxide (PaCO2)
sternocleidomastoid and scalene muscles
The accessory muscles of inspiration
aspirated fluids or foreign particles
The right mainstem bronchus extends from the trachea more vertically than the left mainstem bronchus tend to enter the right lung rather than the left.
pulmonary artery constriction
The most important cause of pulmonary artery constriction is a low alveolar PaO2
peripheral chemoreceptors
The PaO2 must drop well below normal (to approximately 60 mm Hg) before the____________________have much influence on ventilation.
vagus nerve
Fibers of the parasympathetic division of the autonomic nervous system (ANS) travel only in the_______to the lung.
ciliated epithelial cells
The submucosal glands of the bronchial lining produce mucus, contributing to the mucous blanket that covers the bronchial epithelium. The______rhythmically beat this mucous blanket toward the trachea and pharynx, where it can be swallowed or expectorated by coughing.
Pores of Kohn
Tiny passages called______permit some air to pass through the septa from alveolus to alveolus, promoting collateral ventilation and even distribution of air among the alveoli.
Ventilation
is the only term used to identify the mechanical movement of gas or air into and out of the lungs.
Normal alterations
include (1) loss of elastic recoil, (2) stiffening of the chest wall, (3) alterations in gas exchange, and (4) increases in flow resistance. The number of alveoli is not affected by age.
Oxygen is transported
in the blood in two forms. A small amount dissolves in plasma, and the remainder binds to hemoglobin molecules.
Increased capillary permeability
a hallmark of ARDS, allows fluids, proteins, and blood cells to leak from the capillary bed into the pulmonary interstitium and alveoli. The resulting pulmonary edema and hemorrhage severely reduce lung compliance and impair alveolar ventilation.
alveolocapillary membrane
Diffusion of oxygen through the alveolocapillary membrane is impaired if the______is thickened or if the surface area available for diffusion is decreased. Abnormal thickness, as occurs with edema (tissue swelling) and fibrosis (formation of fibrous lesions), increases the time required for diffusion across the alveolocapillary membrane.
abscess
An______is a circumscribed area of suppuration and destruction of lung parenchyma.
ARDS
is a fulminant form of respiratory failure characterized by acute lung inflammation and diffuse alveolocapillary injury. A condition that can result from either a direct or indirect pulmonary insult. It is defined as respiratory failure of acute onset characterized by severe hypoxemia that is refractory to treatment with supplemental oxygen, bilateral infiltrates on chest x-ray imaging, and no evidence of heart failure, as well as decreased pulmonary compliance.
Pneumoconiosis
abnormal condition caused by dust in the lungs, with chronic inflammation, infection, and bronchitis
Pleural effusion
is the presence of fluid in the pleural space.
avoidance of allergens and other triggers.
Chronic management of asthma begins with
individual stops smoking
By the time an individual seeks medical care for symptoms, considerable airway damage is present. If the______then disease progression can be halted. If smoking is stopped before symptoms occur, then the risk of chronic bronchitis decreases considerably and eventually reaches that of nonsmokers.
Absorption atelectasis
is a result of the gradual absorption of air from obstructed or hypoventilated alveoli or from inhalation of concentrated oxygen or anesthetic agents.
emphysema
usually have dyspnea on exertion that later progresses to significant dyspnea, even at rest (see Table 35-3). Little coughing and very little sputum are produced. The individual is often thin, has tachypnea with prolonged expiration, and must use accessory muscles for ventilation. The anteroposterior diameter of the chest is increased (barrel chest), and the chest has a hyperresonant sound with percussion.
Tension pneumothorax
a type of pneumothorax in which air that enters the chest cavity is prevented from escaping
Chronic management of emphysema
begins with smoking cessation. Pharmacologic management includes inhaled anticholinergic agents, and beta-agonists should be prescribed. Pulmonary rehabilitation, improved nutrition, and breathing techniques all can improve symptoms. Oxygen therapy is indicated in chronic hypoxemia but must be administered with care.
Emphysema
is the presence of pus in the pleural space. The abnormal permanent enlargement of gas-exchange airways (acini) is accompanied by the destruction of alveolar walls without obvious fibrosis.
neutrophils
The role of neutrophils is central to the development of ARDS. Activated______release a battery of inflammatory mediators, among them proteolytic enzymes, oxygen-free radicals (superoxide radicals, hydrogen peroxide, hydroxyl radicals), arachidonic acid metabolites (prostaglandins, thromboxanes, leukotrienes), and platelet-activating factor. These mediators cause extensive damage to the alveolocapillary membrane and greatly increase capillary membrane permeability.
Pulmonary disease
is associated with many signs and symptoms, and their specific characteristics often help in identifying the underlying disorder. The most common characteristics are dyspnea and cough. Others include abnormal sputum, hemoptysis, altered breathing patterns, hypoventilation and hyperventilation, cyanosis, clubbing of the digits, and chest pain.
late asthmatic response
begins 4 to 8 hours after the early response when the release of toxic neuropeptides contributes to increased bronchial hyperresponsiveness.
In tuberculosis
the body walls off the bacilli in a tubercle by stimulating defense, macrophages and lymphocytes release interferon, which inhibits the replication of the microorganism and stimulates more macrophages to attack the bacterium. Apoptotic infected macrophages can also activate cytotoxic T cells (cluster of differentiation [CD] 8).
most common cause of pulmonary edema
is heart disease. When the left ventricle fails, filling pressures on the left side of the heart increase and cause a concomitant increase in pulmonary capillary hydrostatic pressure.
chronic bronchitis
The symptoms that lead individuals with______to seek medical care include decreased exercise tolerance, wheezing, and shortness of breath. Individuals usually have a productive cough (“smoker’s cough”).
Kussmaul respirations
are characterized by a slightly increased ventilatory rate, very large tidal volume, and no expiratory pause.
Hypoxemia, or reduced oxygenation of arterial blood (PaO2),
is caused by respiratory alterations, whereas hypoxia, or reduced oxygenation of cells in tissues, may be caused by alterations of other systems as well.
high altitudes
The presence of adequate oxygen content of the inspired air is the first factor. Oxygen content is lessened at high altitudes. At______none of the remaining options would be the cause of hypoxemia.
Asthma
is a familial disorder, and more than 100 genes have been identified that may play a role in the susceptibility of and the pathogenetic mechanisms that cause asthma, including those that influence the production of interleukin (IL)-4, IL-5, and IL-13; IgE; eosinophils; mast cells; adrenergic receptors; and leukotrienes.
Varicose bronchiectasis
exists when both constrictions and dilations deform the bronchi.
Obstructive pulmonary disease
is characterized by airway obstruction that is worse with expiration. Either more force (i.e., the use of accessory muscles of expiration) or more time is required to expire a given volume of air.
Clubbing
is the selective bulbous enlargement of the end (distal segment) of a digit (finger or toe) and is commonly associated with diseases that interfere with oxygenation, such as bronchiectasis, cystic fibrosis, pulmonary fibrosis, lung abscess, and congenital heart disease.
alveolar dead space
something that impairs blood flow to a segment of the lung results in an area where alveoli are ventilated but not perfused, such as a pulmonary embolus.
Cheyne-Stokes respirations
Alternating periods of deep and shallow breathing
Cheyne-Stokes respirations and are the result of
any condition that slows the blood flow (Decreased blood flow to the medulla oblongata) to the brainstem, which in turn slows impulses that send information to the respiratory centers of the brainstem.
Transudative pleural effusion
the fluid, or transudate, is watery and diffuses out of the capillaries as a result of disorders that increase intravascular hydrostatic pressure or decrease capillary oncotic pressure.
Orthopnea
difficulty breathing when lying down. Generally relieved by sitting up in a forward-leaning posture or supporting the upper body on several pillows.
silicosis
a type of pneumoconiosis resulting from the inhalation of free silica and silica-containing compounds
treatment for silicosis
No specific treatment exists for silicosis, although corticosteroids may produce some improvement in the early, more acute stages.
Hyperventilation
is alveolar ventilation that exceeds metabolic demands. The lungs remove carbon dioxide at a faster rate than produced by cellular metabolism, resulting in decreased PaCO2 or hypocapnia.
pneumonia
Physical examination may reveal signs of pulmonary consolidation, such as inspiratory crackles, increased tactile fremitus, egophony, and whispered pectoriloquy, which supports a diagnosis of
Cyanosis
generally develops when 5 g/dl of hemoglobin is desaturated, regardless of hemoglobin concentration.
causes of chest wall restriction.
Severe kyphoscoliosis, Gross obesity, and Neuromuscular disease
Pneumothorax
air in the pleural cavity caused by a puncture of the lung or chest wall
Pulmonary artery hypertension (PAH)
Mean pulmonary artery pressure above 25 mm Hg at rest
Idiopathic, familial, or associated
is characterized by endothelial dysfunction with an overproduction of vasoconstrictors (e.g., thromboxane, endothelin) and decreased production of vasodilators (e.g., nitric oxide, prostacyclin), resulting in narrowed pulmonary capillaries.
Cor pulmonale
develops as pulmonary hypertension and creates chronic pressure overload in the right ventricle similar to that created in the left ventricle by systemic hypertension.
Aspiration of oropharyngeal secretions
is the most common route of lower respiratory tract infection; thus the nasopharynx and oropharynx constitute the first line of defense for most infectious agents.
Cystic fibrosis
is an autosomal recessive inherited disorder that is associated with defective epithelial ion transport.
Asthma develops because
the Th2 response (in which CD4 T-helper cells produce specific cytokines, such as interleukin [IL]-4, IL-5, and IL-13) promotes an atopic and allergic response in the airways.
Confirmation of the diagnosis of asthma
relies on pulmonary function testing using spirometry, which can be accomplished only after the child is 5 to 6 years of age. Reduced expiratory flow rates that are reversible in response to an inhaled bronchodilator would be characteristic abnormalities. For younger children, an empiric trial of asthma medications is commonly initiated.
Chest wall compliance
is higher in infants than it is in adults, particularly in premature infants.
Croup (laryngotracheobronchitis)
in 85% of children with______a virus is the cause, most commonly parainfluenza. However, other viruses such as influenza A or respiratory syncytial virus (RSV) also can cause croup.
heart failure (HF)
When considering the signs and symptoms of acute respiratory distress syndrome (ARDS), the absence of______is considered characteristic. ARDS is characterized by progressive respiratory distress, severe hypoxemia refractory to treatment with supplemental oxygen, decreased pulmonary compliance, bilateral infiltrates on chest x-ray imaging, and no evidence of heart failure.
treatment of respiratory distress syndrome (RDS) of the newborn
include, administering glucocorticoids to women in preterm labor accelerates the maturation of the fetus’s lungs, treatment includes the instillation of exogenous surfactant down an endotracheal tube of infants weighing less than 1000 g, and using continuous positive airway pressure (CPAP) supports the infant’s respiratory function.
The primary cause of respiratory distress syndrome (RDS) of the newborn
is primarily caused by surfactant deficiency and secondarily by a deficiency in alveolar surface area for gas exchange.
Cystic fibrosis is best described as
a pulmonary disorder involving an abnormal expression of a protein-producing viscous mucus that obstructs the airways, pancreas, sweat ducts, and vas deferens.
Acute Epiglottitis
Examination of the throat may trigger laryngospasm and cause respiratory collapse. Death may occur in a few hours. Accurately identifies the life-threatening complication that can result from an examination of the throat of a child who demonstrates the signs and symptoms of
Asthma is defined as
an obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperreactivity, and inflammation.
RSV (respiratory syncytial virus)
The most common associated pathogen in bronchiolitis
atelectasis
The primary problem resulting from respiratory distress syndrome (RDS) of the newborn is______which causes significant hypoxemia and is difficult for the neonate to overcome because a significant negative inspiratory pressure is required to open the alveoli with each breath.
adenotonsillar hypertrophy
The most common predisposing factor to obstructive sleep apnea in children is______which causes physical impingement on the nasopharyngeal airway.
Pulmonary edema usually begins to develop
at a pulmonary capillary wedge pressure or left atrial pressure of 20 mm Hg.
sources