Pulmonary Embolism (TU1) by Pauline Wong https://padlet.com/paulinewong1/hbfslzybrobvrqwb NUR5923 Respiratory Pathophysiology en-us 2023-03-08 00:40:22 UTC 2023-06-05 06:50:58 UTC hello@padlet.com 1. Brief definition paulinewong1 https://padlet.com/paulinewong1/hbfslzybrobvrqwb/wish/2507739721 Pulmonary embolism refers to the obstruction of the pulmonary artery or one of its branches by a thrombus that originates somewhere in the venous system or in the right side of the heart.

That is - there is compromised perfusion of the pulmonary capillaries because it is blocked by something such as fat (post orthopaedic surgery or rupture of atherosclerosis plaque), air, blood clots (eg from a DVT), amniotic fluid, or septic thrombus.]]> 2023-03-08 00:40:22 UTC https://padlet.com/paulinewong1/hbfslzybrobvrqwb/wish/2507739721 2. Is it obstructive or restrictive? Why? paulinewong1 https://padlet.com/paulinewong1/hbfslzybrobvrqwb/wish/2507739723 Neither- The lung isn't the issue (it's a perfusion issue)!
The presence of blood clot getting lodged within the blood vessels of the lungs is limiting blood flow, causing a redistribution of blood flow from occluded pulmonary arteries to  nonoccluded arteries. 

When the lungs become ischemic and inflammation occurs, it becomes an restrictive issue

]]> 2023-03-08 00:40:22 UTC https://padlet.com/paulinewong1/hbfslzybrobvrqwb/wish/2507739723 3. How does the condition effect lung compliance and/or airway resistance? paulinewong1 https://padlet.com/paulinewong1/hbfslzybrobvrqwb/wish/2507739725 The Condition would not effect Lung Compliance and Airway resistance. 
Both would be normal due since PE represent only a clot which hinders blood flow.
In the long term of this condition Lung Compliance may decrease as the clot can cause ischeamia reducing the lungs ability to inflate and deflate]]> 2023-03-08 00:40:22 UTC https://padlet.com/paulinewong1/hbfslzybrobvrqwb/wish/2507739725 4. Explain the role of V/Q mismatch in this condition. paulinewong1 https://padlet.com/paulinewong1/hbfslzybrobvrqwb/wish/2507739727
With the nature of the occlusion in the arteries, the capillaries are being hypo perfused despite normal ventilation.  

 V/Q mismatch occurs due to redistribution of blood from occluded pulmonary arteries to the nonoccluded vessels. This results in extremely high or infinite V/Q units in the embolized areas and low V/Q units in the nonembolized regions due to over perfusion.

In conclusion, the V/Q ration would be high. Lungs are being ventilation but the arteries are not perfused.


]]> 2023-03-08 00:40:22 UTC https://padlet.com/paulinewong1/hbfslzybrobvrqwb/wish/2507739727 5. How is oxygenation and ventilation affected? Eg. consider O2 content, O2 delivery, alveolar ventilation paulinewong1 https://padlet.com/paulinewong1/hbfslzybrobvrqwb/wish/2507739729 Oxygenation is affected but ventilation is not affected.
O2 perfusion is affected due to dead space ventilation (High V/Q). 

Poor perfusion will cause low PaO2 and SaO2 content. Oxygen used up in arteries (by cells) and unable to get "fresh o2" due to the poor perfusion.
 ]]> 2023-03-08 00:40:22 UTC https://padlet.com/paulinewong1/hbfslzybrobvrqwb/wish/2507739729 6. What type of respiratory failure would this condition lead to? paulinewong1 https://padlet.com/paulinewong1/hbfslzybrobvrqwb/wish/2507739730 Type 1

There is a failure to increase PaO2 so the body will try and compensate by breathing faster and harder. CO2 will be eliminated so it is not type 2 respiratory failure.]]> 2023-03-08 00:40:22 UTC https://padlet.com/paulinewong1/hbfslzybrobvrqwb/wish/2507739730 7. What are the typical ABGs and why? paulinewong1 https://padlet.com/paulinewong1/hbfslzybrobvrqwb/wish/2507739731 Respiratory alkalosis

Increase in RR (hyperventilation), blowing off more CO2 (alkalosis) but not getting enough oxygen 
Properties of CO2 makes it easier to diffuse (relative to O2) in other non-obstructive areas

Reduced PO2 (hypoxemia) 
Reduced PCO2 (hypocapnia) 

]]> 2023-03-08 00:40:22 UTC https://padlet.com/paulinewong1/hbfslzybrobvrqwb/wish/2507739731 8. What are the typical clinical manifestations/ patient assessment data? (relate these to pathophysiology concepts already described) paulinewong1 https://padlet.com/paulinewong1/hbfslzybrobvrqwb/wish/2507739732 Pain, SOB, Hypoxemia, Increased RR, Tachycardia

Air entry to the lungs will normal. Auscultation would be normal. 

Deranged coagulation --> Consider a D-Dimer test]]> 2023-03-08 00:40:22 UTC https://padlet.com/paulinewong1/hbfslzybrobvrqwb/wish/2507739732 9. OPTIONAL: Important vocabulary (include list of key vocabulary referenced; if you do not know the term(s), look up and add a definition for the word(s)) paulinewong1 https://padlet.com/paulinewong1/hbfslzybrobvrqwb/wish/2507739734 CO2 easier to diffuse than O2 - so easier to eliminate CO2 than to exchange O2.

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