Pulmonary Pathophysiology Arkansas State University肺病理生理学阿肯色州立大学.pptVIP

Pulmonary Pathophysiology Reduction of Pulmonary Function Inadequate blood flow to the lungs – hypoperfusion Inadequate air flow to the alveoli - hypoventilation Nosocomial infections Factors that reduce airflow also compromise particle clearance and predispose to infection. Restricted lung movement and ventilation may arise due to: Positioning Constricting bandages Central nervous system depression Coma High rate of pneumonia in hospital patients due in large part to impaired ventilation and clearance. Signs and Symptoms of Pulmonary Disease Dyspnea – subjective sensation of uncomfortable breathing, feeling “short of breath” Ranges from mild discomfort after exertion to extreme difficulty breathing at rest. Usually caused by diffuse and extensive rather than focal pulmonary disease. Dyspnea cont. Due to: Airway obstruction Greater force needed to provide adequate ventilation Wheezing sound due to air being forced through airways narrowed due to constriction or fluid accumulation Decreased compliance of lung tissue Signs of dyspnea: Flaring nostrils Use of accessory muscles in breathing Retraction (pulling back) of intercostal spaces Cough Attempt to clear the lower respiratory passages by abrupt and forceful expulsion of air Most common when fluid accumulates in lower airways Cough may result from: Inflammation of lung tissue Increased secretion in response to mucosal irritation Inhalation of irritants Intrinsic source of mucosal disruption – such as tumor invasion of bronchial wall Excessive blood hydrostatic pressure in pulmonary capillaries Pulmonary edema – excess fluid passes into airways When cough can raise fluid into pharynx, the cough is described as a productive cough, and the fluid is sputum. Production of bloody sputum is called hemoptysis Usually involves only a small amount of blood loss Not threatening, but can indicate a serious pulmonary disease Tuberculosis, lung abscess, cancer, pulmonary infarction. If sputum is purulent, and infection of lu