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NURS 548 Patho final Unit 5: Respiratory system pathophysiology Exercise 1: Respiratory tract infections, neoplasia and childhood disorders Rhinosinusitis (sinusitis) – which is not a characteristic of acute sinusitis - Infection or allergy obstructs sinus drainage - Acute: facial p...

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NURS 548 Patho final Unit 5: Respiratory system
pathophysiology
Exercise 1: Respiratory tract infections, neoplasia and childhood disorders



Rhinosinusitis (sinusitis) – which is not a characteristic of acute sinusitis

- Infection or allergy obstructs sinus drainage
- Acute: facial pain, headache, purulent nasal discharge, decreased sense of
smell, fever
- Chronic: nasal obstruction, fullness in the ears, postnasal drip, hoarseness,
chronic cough, loss of taste and smell, unpleasant breath, headache



Tuberculosis: Mycobacterium tuberculosis hominis: which is not a characteristic of
mycobacterium tuberculosis hominis

Tuberculosis: worlds foremost cause of death from a single infections agent, causes
26% of avoidable deaths in developing countries, drug resistant forms

Mycobacterium TB hominis:

- Aerobic
- Protective waxy capsule (enhances resistance to acid fast bacillus
- Can stay alive in suspended animation for years



Milary TB: Know the flow chart

Rare, the organisms erode the blood vessels -> hematogenuous spread (spreads in
vascular system) -> brain, meninges, liver, kidney, bone marrow

- Milary Tb lesions look like grains of millet in the tissues
- Meat inspection was introduced to keep them out of the food supply
- Pasteurization of milk was introduced to keep Tb out of the milk supply

Progessive primary TB:

- Signs of pneumonia
- Bacteria in sputum and exhaled droplets
- Bacteria may erode BV and spread through the body – milary TB

,Neonatal respiratory distress syndrome: incorrect statement

- Lack of surfactant: infants are not strong enough to inflate their alveoli
- Protein rich fluid leaks into the alveoli and further blocks oxygen uptake
- Treatment with mechanical ventilation and lead to bronchopulmonary dysplasia
and chronic respiratory insufficiency



Exercise 2: Disorders of ventilation and gas exchange



Know the definition of atelectasis

Atelectasis: the incomplete expansion of the lung or a portion of the lung



Pneumothorax: incorrect statement

- Air enters the plural cavity
- Air takes up space, restricting lung expansion
- Partial or complete collapse of the affect lung
A. Spontaneous: an air filled blister on the lung ruptures
B. Traumatic: air enters through chest injures
1. Open: air enters pleural cavity through the wound on inhalation and leaves
through exhalation
2. Tension: air enters pleural cavity through the wound on inhalation but
cannot leave on exhalation

Intrinsic (nonatopic) asthma: know the causes of nonatopic asthma

episodes are triggered by:

- Respiratory infections: epithelial damage, IGE production
- Exercise, hyperventilation, cold air: loss of heat and water may cause
bronchospasm
- Inhaled irritants: inflammation, vagal reflex
- Aspirin and other NSAIDS: abnormal arachidonic acid metabolism
- Hormonal changes, airborne pollutants, GERD emotional upset

Initiated by non-immune mechanism

, Chronic Obstructive Pulmonary Disorders: know characteristics of
bronchiectasis:

Chronic and recurrent obstruction of airflow in pulmonary airways – progressive 2 types:
emphysema and chronic obstructive bronchitis

Emphysema:

- Enlargement of air spaces and destruction of lung tissue
- Loss of lung elasticity, enlargement of air spaces (distal to terminal bronchioles),
destruction of alveolar walls and capillary beds

Chronic obstructive bronchitis:

- Obstruction of small airways

Bronchiectasis:

- Infection and inflammation destroy smooth muscles in airways, causing
permeant dilatation
- Obstruction of major and small airways
- Marked increase in goblet cells with excess mucus -> plugs airway lumen,
inflammatory infiltration, and fibrosis of bronchiolar wall



Pink puffer’s vs blue bloaters: Chronic bronchitis incorrect manifestation

Pink puffers (usually emphysema):

- Increase respiration to maintain oxygen levels
- Dyspnea, increased ventilatory effort
- Use accessary muscles: purse lip breathing

Blue Bloaters (usually bronchitis

- Cannot increase respiration enough to maintain oxygen
- Cyanosis and polycythemia
- Cor pulmonale : Right sided heart failure resulting from primary lung disease and
long standing primary or secondary pulmonary HTN

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