A 10-year-old boy who is having an acute asthma attack is brought to the ER. He is observed to be sitting up and struggling to breathe. His breathing is accompanied by use of accessory muscles, a weak cough, and audible wheezing sounds. His pulse is rapid and weak, and both heart and breath sounds are distant on auscultation. His parents relate that his asthma began to worsen after he developed a “cold,” and now he doesn’t get relief from his albuterol inhaler.

Explain the changes in physiologic function underlying his signs and symptoms.

Your Answer:

Swelling of the bronchial walls, mucus secretion, constriction of the airway. Bronchial hyper-responsiveness to stimuli causes the airway to constrict or narrow.

Recruitment of inflammatory cells from the bloodstream into the bronchial wall, where they directly attack the invading organisms and secrete inflammatory chemicals that are toxic to the organisms causes airway inflammation. Swelling of the bronchial wall, mucus secretion, constriction of the airway; bronchial hyper- responsiveness to stimuli causes airway obstruction or narrowing. They may discuss on a cellular level as well: Upon a trigger, the cascade of neutrophils, eosinophils, lymphocytes, and mast cells cause epithelial injury. This causes airway inflammation, which further increases hyperresponsiveness and decreased airflow. Mast cells release histamine and leukotrienes. These cause major bronchoconstriction, inflammation, and mucus secretion. Mast cells can trigger multiple cytokine release, which causes more airway inflammation. The contraction of the airways and subsequent swelling leads to further airway obstruction.

Question 16^ 10 / 10 pts

Short answer:

An 18-year-old woman is admitted to the ER with a suspected drug overdose. Her respiratory rate is slow (4-6 breaths/minute) and shallow. Arterial blood gases reveal a PCO 2 of 80 mm Hg and a PO 2 of 60 mm Hg.

What is the cause of this women’s high PCO 2 and low PO 2?

Hypoventilation almost always causes an increase in PCO2. Explain.

Your Answer:

respiratory acidosis

when the respiratory rate is decreased you're not exhaling enough carbon dioxide.

Respiratory acidosis; with a decreased respiratory rate, you are not exhaling enough carbon dioxide and it accumulates.

Question 17 6 / 10 pts

Short answer:

Explain why the oxygen flow rate for people with COPD is normally titrated to maintain the arterial PO 2 between 60 and 65 mm Hg.

Your Answer:

Their medullary respiratory center is used to the Co Level causing there to be no reaction when there is an increase to the PCO levels.

Their medullary respiratory center has adapted to the elevated CO 2 levels and no longer responds to increases in PCO 2. Therefore, a decrease in PO 2 becomes the stimulus for respiration. If oxygen is given at too high of a rate, it suppresses the stimulus and the respiratory drive.

Thus, a decrease in PO2 becomes the stimulus for breathing

Short answer:

1.) Hemoglobin’s affinity for oxygen is decreased by. Name one factor:

Question 18^ 10 / 10 pts

2.) Blood that moves from the right to the left side of circulation without being oxygenated is referred to as a.

Your Answer: body

temperature shunt

1.) Any of the following - decreased pH (acidosis), increased CO 2 concentration, fever

2.) shunt

Fill in the blank

Question 19^ 5 / 5 pts

are alveoli that are ventilated but not perfused.

Your Answer:

Alveolar dead space

Multiple Choice:

Each of the following disorders are correctly paired with related characteristics

except:

Question 20^ 5 / 5 pts

Pneumothorax – decreased breath sounds

Correct! (^) Atelectasis – worsening pain on inspiration

Asthma – wheezing on expiration

Pneumothorax – subcutaneous emphysema

Multiple Choice:

Each of the following can be daily treatments for asthma except:

Bronchodilators

Correct! (^) Oxygen therapy

Question 21^ 5 / 5 pts

Multiple Choice:

Each of the following are helpful treatments for COPD patients except:

Oxygen therapy

Bronchodilators

Correct! Anticoagulants

Pneumococcal

Inhaled corticosteroids

Leukotriene modifiers

Question 22 5 /^5 pts

Influenza vaccination