2-13-12 Monday

PHYS/PATH

Abnormal ventilation
hyperventilation
-high 02/low co2 (hypocapnea)
-increase blood pH
Hypoventilation
-insufficient air in alveoli
-decrease in blood pH

Breathing Pattern
adults: 12-20 breath/min
kids: 20-40
infants: 40+

Altered breath
hyperpnea: increase depth and rate of breathing
hypopnea: decrease rate and depth
tachypnea: excessive rate of breathing (exercise)
apnea: cessation of breathing
dyspnea: difficult/labored breathing
orthopnea: difficult breathing relieved by sitting up
Kussmaul respiratory: abnormal
Cheyne-Stokes respiratory: final breath in death

inadequate breathing
cyanosis: turning blue/purple- lack of O2
hypoxia: not enough o2 in tissue
hypoxemia: lower than normal o2 in arterial blood
suffocation: cessation of respiration/ mechanical blockage

Age-less likely to get fever with lung infection
rigid

PATH
chap 7

Acute Bronchitis: inflammation of bronchial tree
usually viral
smokers, miners more likely
elderly and immunosuppressed
tube swells, cilia damaged, mucous not getting out
last 10 days
S&S: cough, starts dry becomes productive; fever, mm aches, chest pain, fatigue
If 101F or more, possible pneumonia
Tx: warm, humid air, rest
M: contra because acute infection/ you at risk

Common Cold: 200 viruses, upper resp. tract infect (URTI)
last about a week
should be getting 1-2/yr.
etiology: rhinoviruses,
coronaviruses
adenoviruses
resp. syncytial viruses: can infect epiglottis- life threatening
incubation 12hrs
s&s: runny nose, sneezing ....
less than 2 wks
may go to lungs
OTC prolong, vit c (acidic blood), echinacea, rest, fluids
hydro: hot water on feet (soak), cold socks on with wool socks over, lay down; or cold on forehead or opposite
M: no

Influenza: viral infect of lungs
higher fever, mm aches, head aches
most worried with young, old, immunosuppressed
type A: can transfer with species: associated with epidemics; mutates easily
type B,C: mild
incubation: 2-3 days, airborne
S&S: cad cold: 2 wks, no such thing as stomach flu (endnovirus?)
don't eat solid foods during high fever because GI isn't working
vaccine picks the most likely

Pneumonia: infection in lung itself (kids; viral. adults; bacteria (usually))
gas exchange isn't happening: drown in own secretion
consolidation: fluid gets solid
BAD SICK
alveoli filled with pus
infect of pleural fluid (empyema)
cause: viruses, short lived, not serious for most
bacteria more serious, more sick; diff dx: tuberculosis or legionella
mycoplasma: walking pneumonia
fungi: PCP in immunosuppressed
Forms of pneumonia
-primary: rare attack on lungs
-secondary: more common; complication from other problem
double pneumonia is having it in both lungs
nosocomial: hospital acquired
S&S: can look like flu but more intense


Sinusitis: inflammation mucous membrane in nose/sinuses
infection or allergies, weather etc.
can have teeth sensitivity
cause-
acute or chronic(6months)
irritants, smoke, cocaine(can spread HIV and hep)
S&S: headache, local pain, postnasal drip, fever, chills
Tx: humid air, fluids, drugs
M: no acute

Tuberculosis: TB, bump, bacteria infection of macrophages; usually pus filled bumps in lungs
not prevalent here, more likely in homeless or close quarters)
more in underdeveloped air
spread: air borne bacteria
prolong and repeated exposure
primary infection: engulfed by macrophages (doesn't work); builds up wall around it
secondary: re-occurrences; 10% of people; cough with rust
risk factors: alcoholic, immunosuppressed, constant exposure
myasium; thin, mountain, fresh air, new job every 3 months
S&S: primary: mild flu
active phase- fever, sweating
cought with phlegm
Dx: within weeks positive skin test
Tx: previously sanatoria
M: safe in latent phase, not acute/active

Asthma: inflammation and constricting in bronchial
triggers: stress, emotion, exercise, irritant
classified as COPD: chronic obstructive pulmonary disease
but not really a COPD
atopic triangle: hay fever, asthma, eczema
hyperractive bronchioles
-chronic inflammation
-dilation (sympathetic); constriction (parasympathetic)
-membrane secrete excess mucus
S&S: dyspnea, wheezing
Dx: rule out other things, spirometry test
p. 313 of Mem
-tidal volume:
-residual volume: get wind knocked out
-inspiration/expiration reserve volume
Tx: manage exposure to stimuli
beta-agonist inhalers: short term
inhaled or oral steroids: long term
allergy shot
recognized warning signs
M: contra during episode; triggers could be the oils/frags you use

Chronic Bronchitis: part of COPD
long term irritation of bronchi and bronchioles with or without infection
typically smoking leads to this
progressive and irreversible can lead to emphysema
can't get o2 in (blue floaters/bloaters?)
M>W; whites
destruction of cilia: mucus in lungs
scarring harder to breath; acidosis; lead to right heart failure
edema in extremities; look bloated?
S&S: slow onset, cough 3 month, short breath, cynotic
Tx: stop smoking
M: lying down may be issue

Emphysema: part of COPD; work hard to get air out of lungs
"pink puffers" blown up, inflated
barrel chest
smoking #1 causes
genetic problem: lack alpha 1; antitrypsin
elastic in alveoli: don't rebound
reduced surface area
breathing is effort
S&S: takes time, weight loss
comp: pneumothorax; right side heart failure
tX: stop progression
M: positional

Cystic Fibrosis: autosomal recessive genetic disorder
thick, viscous exocrine secretion
respiration tract and digestion, integumentary, reproductive syst.
not able to get **chloride out- too much water absorb
Dx: by age 2
salty sweat
CF most common lethal inherited disease of whites
cupping lungs; usually live to 35
growth medium for infection
GI too thick can't poop, not absorbing
skin: increase risk heat stroke
reproduction: sterile in M; women not
S&S: clubbing finger
complication: lots
Tx: supplements, manage sympt
M: within tolerance

Lung Cancer: growth malignant cell in lung
85-90% related to tobacco exposure
small cell lung cancer
-aka, oat cell carcinoma
15-25% of lung cancer
grows fast, spread quick, most deadly
non-small cell lung cancer
75-85%
squamous cell carcinoma
grows slowly hard to detect
others: carcinoid tumors, mesothelioma
risk: smoking, environment toxins
S&S: no early signs, smoker cough, blood stained phlegm, may put pressure on other areas
Dx: chest film, radiography, usually metastasized before detection
Tx: surgery, radiation, chemo
M: health care team

PHYS
Mem chapter 19
2 kidneys
2 ureters
1 bladder
1 urethra

Excretion
urinary
digest
respir
integ

Kidney activity
-Excretion
urea (amonia first)
-H2o balance maintenance
-body fluid acid-base regulation
-bp reg (main controler of it)-H. secretino of renin?
angiotensin
aldosterone
-rbc production (epo)

structure
-membranous renal capsule
-adipose capsule
-fascia anchors to peritoneum and ab wall
-retroperitoneal space
-left higher than right- accommodation of liver

Blood supply
renal artery supply
branches of ab aorta
subdivides in kidneys
nephrons are functional unit
renal vein drains blood
carries to inferior vena cava

cortex, medullary priamids

Organizatino
-hilum (indent)
-cortex (outer)
-medulla (inner)

afferent arteriole, efferent arteriole, proximal tubule, cuboidial, loop of Henle, distal, collecting duct

nephron:
glomerular (bowman) capsule
afferent
glomerulus
peritubular capil
proximal convoluted tubule
nephron loop (henle)
decending
ascending
distal convoluted tube
collectin duct
blood supply:
afferent arteriole
glomerulus
efferent arteriole
peritubular capillaries