What type of white blood cell is useful against allergic reactions and defends against parasitic infestations?
What type of white blood cell typically is most prevalent in the circulating blood?
What term is used for red blood cells?
Which of the following is/are associated with consolidation clinical scenario?
Increased opacity (lacking transparency or translucence) on the chest radiograph, Decreased FRC, and Bronchial breath sounds
According to the aerosolized medication protocol, a patient with COPD could be treated with all of the following medications except
According to the oxygen therapy protocol, what should be done with a patient who has severe trauma when hypoxemia is suspected?
Initiate supplemental oxygen
Abnormally low arterial oxygen tension (PaO2) in the blood; When analyzing the PaO2 on a blood gas, looking at the amount of oxygen dissolved in the blood can reflect hypoxemia; Frequently results in hypoxia, which can be determined by evaluating the total oxygen content and delivery to the tissues
When performing a therapist-driven protocol (TDP), the severity assessment refers to
The frequency of performing a treatment modality
Which of the following is commonly seen on the lateral neck X-ray of a patient with Laryngotracheobronchitis (LTB)?
Pencil point narrowing of the upper airway, Haziness in the subglottic area, and steeple point narrowing of the upper airway
Most cases of Laryngotracheobronchitis (LTB) occur during which season(s) of the year?
Fall and winter
Your patient has epiglottitis. This condition will affect which of the following?
Aryepiglottic folds and False vocal cords
When a patient has Laryngotracheobronchitis (LTB), what is the primary anatomic alteration that is found?
Edema of the mucous membranes
In severe cases of tissue necrosis related to an abscess, what can occur?
Fluid ruptures into a bronchus, and Fluid ruptures into the intra-pleural space
In the mid-western part of the United States, what is the most common fungal infection of the lungs?
Fungal lung infections are usually spread by
The preferred stain that is used to identify the tuberculosis (TB) organism is called
Fluorescent acid-fast stain
A negative tuberculin test would be demonstrated by an induration (wheal) of what size?
5 mm or less
A patient has been found to have tuberculosis (TB) in several organs of the body. What term is used to describe this situation?
A condition under oxygenation, which is an inadequate level of tissue oxygenation for cellular metabolism
Which of the following is the most common route of lower respiratory tract infection?
Aspiration of oropharyngeal secretions
Viral pneumonia is usually
Mild and self-limiting, however it often sets the stage for a secondary bacterial infection
If a microorganism gets past the upper defense mechanisms, like the cough reflex, or mucociliary clearance, the next line of defense is
The alveolar macrophage
Most carbon dioxide in the blood is transported
In the form of bicarbonate; Approximately 60 percent of the CO2 in venous blood and 90 percent of the CO2 in arterial blood are carried in the form of bicarbonate
CO2 in venous blood
CO2 in arterial blood
Which condition is a fulminant (disease or symptom severe and sudden in onset) form of respiratory failure characterized by acute lung inflammation and diffuse alveolocapillary injury?
Acute respiratory distress syndrome (ARDS)
Which structure(s) in acute respiratory distress syndrome (ARDS) release inflammatory mediators such as proteolytic enzymes, oxygen-free radicals, prostaglandins, leukotrienes, and platelet-activating factor?
The role of neutrophils is central to the development of
Acute respiratory distress syndrome (ARDS); Activated neutrophils 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 mem- brane permeability
Which condition is not a cause of chest wall restriction?
Which condition involves an abnormally enlarged gas-exchange system and the destruction of the lungs alveolar walls?
Which term is used to identify a circumscribed area of suppuration (formed pus) and destruction of lung parenchyma?
What causes pneumoconiosis?
Inhalation of inorganic dust particles
The functional tissue of an organ as distinguished from the connective and supporting tissue
What is the most common cause of pulmonary edema?
Left-heart failure; Left-heart failure (commonly called congestive heart failure [CHF]) is the most common cause of pulmonary edema. Right-heart failure is found with cor pulmonale. While decreased intrapleural pressure can cause pulmonary edema, it is rarely seen. Decreased oncotic pressure can cause pulmonary edema.
The normal lung is kept dry by what?
Lymphatic drainage; a balance among capillary hydrostatic pressure, oncotic pressure (which holds fluid in the capillary), and capillary permeability; and surfactant lining the alveoli REPEL water, keeping fluid from entering the alveoli
Clinical manifestations of edema
Dyspnea, hypoxemia, increased work of breathing, crackles (rales), and dullness of percussed bases
Supplemental O2, mechanical ventilation with positive end expiratory pressure (PEEP), fluid restriction, and steroids
Aspiration of acidic gastric fluid may cause
Severe lung inflammation, or sever pneumonitis. Acidic fluid damages the alveolocapillary membrane, leading to hermorrhagic pneumonitis, which leads to further edema and collapse.
When does atelectasis tend to occur?
After surgery; Patients may breath shallowly, position may remain the same, and may produce viscous secretions that pool in dependent portions of the lung
Two types of atelectasis
Compression and Absorption
External pressure exerted by tumor, fluid or air in pleural space, or by abdominal distention
Inhalation of concentrated O2 or anesthetics, results from removal of air from hypo-ventilated alveoli
Prevention of atelectasis
Deep breathing, frequent position changes, and early ambulation; Deep breathing and use of an incentive spirometer helps open connections between collapsed alveoli
Pneumothorax is the presence of
Air in the pleural space caused by rupture in the visceral pleural, parietal pleura, and chest wall
Known as communicating pneumothorax; Air pressure in the pleural space equals barometric pressure due to air that is able to move in and out even though integrity of pleural space is impaired
Known as tension pneumothorax; The pleural rupture is like a one way valve, in that it can enter on inspiration, yet cannot leave on expiration; As more air enters, pleural space air pressure in the pneumothorax EXCEEDS barometric pressure; The pressure pushes against already recoiled lung, causing COMPRESSION ATELECTASIS, compressing heart and great vessels
Clinical manifestations of closed pneumothorax
Pleural pain, dyspnea, hyper-resonance to percussion, decreased breath sounds, tracheal deviation, severe hypoxemia; Causes tachycardia, then bradycardia (squashed). Bradycardia says the pressure is exceeding the ability of the heart of compensate; Hypotension-blood volume decreases due to decreased cardiac output, so blood pressure decreases
The young, athletes, alveoli rupture spontaneously, and if the alveoli rupture, air is released in pleural space; Symptoms may not be that exacerbated as with distention pneumothorax
Diagnosis of pneumothorax is made by
Chest radiograph and/or computed tomography. Treated: chest tube with suction
Empyema occurs with
Older adults and children; It develops as a complication of pulmonary infections like pneumonia, lung abscesses, infected wounds, surgery, and tumor
Exudative pleural effusion accumulates
Fluid rich in cells and proteins (leukocytes, plasma proteins) that migrate out of capillaries; This is associated with infection or inflammation of pleura that stimulates Mast cells to release biochemical mediators that increase capillary permeability
Besides dyspnea, what is the most common characteristic associated with pulmonary disease?
Cough; 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
How does emphysema affect lung compliance?
It is increased; The lungs or chest wall is abnormally easy to inflate and has lost some elastic recoil
How does ARDS, pneumonia, pulmonary edema, and fibrosis affect lung compliance?
It is decreased; The lungs or chest wall is abnormally stiff or difficult to inflate
Structure(s) that engage in exchange of respiratory gases include(s)
Pulmonary capillaries and Alveoli
The lower airway includes structures below the larynx
The trachea, bronchi, bronchioles, and alveoli
Chronic bronchitis is defined as
Hyper-secretion of mucus and productive cough for at least three months of the year or for at least two consecutive years
A telling difference between asthma and chronic bronchitis
The nature of inflammation, which is primarily eosinophilic and CD4-driven in asthma, and neutrophilic and CD8-driven in COPD
Best treatment for chronic bronchitis is
Prevention; Pathologic changes are not reversible; By the time a person seeks treatment, considerable airway damage is present; Bronchodilators and chest therapy are employed to control cough, and reduce dyspnea; Techniques to reduce dyspnea may include pursed-lip breathing
Acute exacerbations of chronic bronchitis require use of
Antibiotics and steroids, and oral steroids should be last resort; Severe hypoxemia may lead to home O2 therapy
Which is true about lung compliance?
Represents lung expandability, decreases in the elderly, can be decreased by obesity, abdominal distention, pregnancy, and affected by body position
The tendency of the chest wall to recoil by expanding is balanced by the tendency of the lungs to recoil or collapse around the hila; It is the measure of the lung and chest wall distensibility, representing the relative ease with which these structures can be stretched
Which two factors affect lung compliance?
Lung tissue elasticity and alveolar surface tension; It involves the surface tension, elastic recoil of the lung and chest wall; For example, collagen increases elasticity, and in turn decreases lung compliance
Increased lung compliance
Indicates the lungs or chest wall is abnormally easy to inflate and has lost some elastic recoil
Decreased lung compliance
Indicates the lungs or chest wall is abnormally stiff or difficult to inflate
Respirations that are characterized by alternating periods of deep and shallow breathing are a result of
Decreased blood flow to the medulla oblongata
Which of the following is not a cause of chest wall restriction?
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