Respiratory

Pleural effusion

Accumulation of excess fluid in the pleural cavity -Large effusions impair lung expansion, causing dyspnea.

What does pH below 7.35 indicate?

Acidosis

Acute bronchitis

Acute bronchitis is an inflammation of the bronchial tubes, the major airways into the lungs. It may be caused by a variety of bacteria and viruses. Acute bronchitis can last from a few days to 10 days. But the cough that comes with acute bronchitis may last for several weeks after the infection has gone Symptoms: -Cough, which may produce clear, yellow or green -mucus -Wheezing -Low fever -Chest tightness or pain -Shortness of breath (in severe cases)

What does pH above 7.45 indicate?

Alkalosis

Hypoventilation

Alveolar ventilation inadequate to meet the body's oxygen demand or to eliminate sufficient carbon dioxide CO2 removal is slower than CO2 production and the level of CO2 in the arterial blood (PaCO2) increases, causing hypercapnia. -Caused by atelectasis and collapsed alveoli.

What measures arterial oxygenation and carbon dioxide levels?

Arterial blood gases (ABG)

What can cause impaired ventilation?

Asthma, copd -Low V/Q ratio

Cyanosis

Blue discoloration of the skin and mucous membranes -Late sign of hypoxia -Caused by the presence of desaturated hemoglobin in capillaries.

Croup

Broad classification of upper airway illness that result from swelling of the epiglottis and larynx. The swelling extends to the trachea and bronchi. The epiglottis swells and occludes the airway. The trachea swells against the cricoid cartilage, causing airway restriction. Risk factors Infectious Agents: -RSV - most infections Age: -<3months age - lower infection rate - protective moms antibodies -3-6 months - rate increases -Viral infection rate remains high during toddler, preschool, by age 5 viral respiratory infections less frequent Size: -diameter of the airway smaller in young children - subject to narrowing from edematous mucous membranes & increases production of secretions Resistance: -deficiencies of immune system -malnutrition, anemia, fatigue, chilling of the body Seasonal variations: -most common pathogens occurs as epidemics in winter & spring months Clinical manifestations: Inspiratory stridor Barking "seal" cough Hoarseness Fever Throat pain Onset Several days Hours

Types of pneumonia

Bronchopneumonia -Patchy fashion -Originated in 1 or more areas of bronchi and extending -More common Interstitial pneumonia - the inflammation and scarring - involves the interstitium (the alveolar walls and connective tissue supporting the bronchial tree) -situated between the cells of a structure or part: interstitial tissue Miliary pneumonia - spread of the pathogen to the lungs via the blood stream causes the development of numerous discrete inflammatory lesions -usually seen in immunocompromised people Lobar pneumonia -Portion of 1 or more lobes involved

What is gas exchange between the lungs and blood and between the blood and tissues? A. Diffusion B. Perfusion C. Respiration D. Ventilation

C. Respiration -Respiration is gas exchange between the lungs and blood and blood and tissues

Pathogenesis of pulmonary hypertension and cor pulmonale

COPD, interstitial fibrosis, hypoventilation --> chronic hypoxemia, chronic acidosis --> pulmonary artery vasoconstriction --> increased pulmonary artery pressure (progression at this point can be reversed w/ effective treatment of primary or underlying disease) --> intimal fibrosis and hypertrophy of medial smooth muscle layer of pulmonary arteries --> chronic pulmonary HTN --> cor pulmonale (hypertrophy and dilation of right ventricle --> Right sided heart failure

Function of hemoglobin

Carrier for oxygen and carbon dioxide, transports most oxygen (approximately 97%).

Surfactant

Chemical produced in the lungs to maintain the surface tension of the alveoli and keep them from collapsing.

Atelectasis

Collapse of the alveoli that prevents the normal exchange of oxygen and carbon dioxide.

Bronchiecstasis

Condition in which damage to the airways causes them to widen and become flabby and scarred. Airways slowly lose their ability to clear out mucus. The mucus builds up, and bacteria begin to grow. This leads to repeated, serious lung infections. Risk factors: Cystic fibrosis Immunodeficiency Disorders that affect ciliary function S/S: A daily cough that occurs over months or years Daily production of large amounts of sputum Shortness of breath and wheezing Chest pain Clubbing Abnormal lung sounds. Over time, you may have more serious symptoms. You may cough up blood or bloody mucus and feel very tired.

What is the primary clinical symptom of emphysema? A.Chest pain B. Productive cough C. Sputum D. Wheezing

D. The primary symptom of emphysema is wheezing. -Sputum and productive cough are the primary symptoms of chronic bronchitis

Cystic fibrosis

Decreased chloride secretion and increased sodium absorption results causing the body to produce unusually thick, sticky mucus that clogs the lungs leading to infections and obstructs the pancreas secretion of natural enzymes that enable the body to digest and absorb food.

IRDS aka Neonatal Respiratory Distress Syndrome

Develops when infants lungs are not fully developed Caused by the lack of surfactant, which helps the lungs fill with air and keeps the alveoli from deflating. Risk Factors: Mom who is diabetic Rapid labor Twins or more Premature less than 37 weeks S/S: cyanosis apnea Decreased urine output Grunting Nasal flaring Rapid breathing Shallow breathing Shortness of breath and grunting sounds while breathing Unusual breathing movement (such as drawing back of the chest muscles with breathing)

What is exchange of O2 and CO2 at the alveolar-capillary membrane?

Diffusion

Pulmonary fibrosis

Disease marked by scarring of the tissue inside and between the air sacs in the lungs. When the scar forms, the tissue becomes stiff and thicker. This makes it harder for oxygen to pass through the walls of the air sac into the bloodstream. Once the lung tissue becomes scarred, the damage cannot be reversed. S/S: Shortness of breath, particularly during exercise Dry, hacking cough Fast, shallow breathing Gradual unintended weight loss Tiredness Aching joints and muscles Clubbing (widening and rounding of the tips of the fingers or toes) Causes: -In most cases, there is no known cause for the disease -Things that may increase the risk of pulmonary fibrosis include: Cigarette smoking Certain viral infections Exposure to environmental pollutants, including silica and hard metal dusts, bacteria and animal proteins, and gases and fumes The use of certain medicines Genetics. Some families have at least two members who have pulmonary fibrosis. Gastroesophageal reflux disease (GERD).

Kyphoscoliosis

Disorder characterized by posterior curvature (kyphosis) and lateral curvature (scoliosis) of the spine. These processes alone and in combination decrease the volume and mobility of the lung and chest wall.

What can cause dead alveolar space?

Emboli, pulmonary infarction, cardiogenic shock -the alveoli do not have adequate blood supply for gas exchange -High V/Q ratio

Diffusion

Exchange of respiratory gases in the alveoli and capillaries (Diffuse gases into and out of the blood)

Prevention of PE

Exercises to avoid venous stasis -Early ambulation -Sequential compression devices (SCDs

True or false: For patients with chronic bronchitis, the nurse expects to see the major clinical symptoms of tachypnea and tachycardia.

False; For patients with chronic bronchitis, the nurse expects to see the major clinical symptoms of sputum and productive cough.

True or false: Bradypnea is the most common sign for a possible pulmonary embolism.

False; Tachypnea is the most common sign for a possible pulmonary embolism.

Hypoxia

Inadequate tissue oxygenation at the cellular level -Life threatening -Causes may include: anemia, carbon monoxide poisoning, septic shock, cyanide poisoning, pneumonia atelectasis, cardiomyopathy, spinal cord injury, and head trauma.

Pneumonia

Inflammation of the lung parenchyma caused my microbial agent -Parenchyma: (Cells in the tissue of the lungs) part of the lung which is responsible for its main function (ventilation and perfusion) -Affects both ventilation and perfusion

Atelectasis

Is an incomplete expansion of lobules (clusters of alveoli) or lung segments may result in partial or complete lung collapse. Causes: Asthma Chronic bronchitis Emphysemia Bronchietasis CF (cystic fibrois) Heavy smoking Occlusion of foreign body Carcinoma Idopathic respiratory distress syndrome in infants CNS depression Pulmonary edema Pneumonia Prolonged immobility Clinical manifestations: Symptoms varies with the degree of hypoxia Dyspnea Anxiety Cyanosis (central) Diaphoresis Diminshed or absent breath sounds Coughing Sputum production Peripheral circulatory collapse Tachycardia Substernal or intercostal retraction Mediastinal shift to the affected side Compensatory hyperinflation of unaffected areas of the lung Development usually is insidious (progressive)

Vital capacity

Max volume of air exhaled -found in COPD, atelectasis, pulmonary edema, obesity

Pulmonary emboli

Obstruction of pulmonary artery or branch by blood clot, air, fat, amniotic fluid, or septic thrombus. -Inflammatory process obstructs area, results in diminished or absent blood flow -Bronchioles constrict, further increasing pulmonary vascular resistance, pulmonary arterial pressure, and right ventricular workload

What can cause a total blockage?

Obstruction of the distal airways, such as with pneumonia, atelectasis, tumors or a mucus plug -Very low V/Q ratio (shunt)

Obstructive disorders

Obstructive lung disease have shortness of breath due to difficulty exhaling all the air from the lungs. Because of damage to the lungs or narrowing of the airways inside the lungs, exhaled air comes out more slowly than normal. At the end of a full exhalation, an abnormally high amount of air may still linger in the lungs. Ex: COPD, asthma, bronchiectasis, cystic fibrosis

ARDS(acute respiratory distress syndrome)

Occurs when fluid builds up in the tiny, elastic air sacs (alveoli) in your lungs. More fluid in your lungs means less oxygen can reach your bloodstream. This deprives your organs of the oxygen they need to function. Severe shortness of breath — the main symptom of ARDS — usually develops within a few hours to a few days after the original disease or trauma. The most common underlying causes of ARDS include: -Sepsis, a serious and widespread infection of the bloodstream. -Inhalation of harmful substances. Breathing high concentrations of smoke or chemical fumes can result in ARDS, as can inhaling (aspirating) vomit. -Severe pneumonia. Severe cases of pneumonia usually affect all five lobes of the lungs. -Head, chest or other major injury. Accidents, such as falls or car crashes, can directly damage the lungs or the portion of the brain that controls breathing. Medical management: Intubation, mechanical ventilation with PEEP to keep alveoli open Hypovolemia Prone positioning is best for oxygenation, frequent repositioning to safeguard integumentary Nutritional support, enteral feedings preferred Reduce anxiety

Pulmonary diffusion

Oxygen and carbon dioxide are exchanged from areas of higher concentration to areas of lower concentration at the air-blood interface

Pneumothorax

Partial lung collapse resulting from air or gas collecting in the lungs or the pleural space that surrounds the lungs - respiratory emergency. No known cause (spontaneous). Risk factors: COPD, Cystic fibrosis, TB Tension Pneumothorax - from an injury - broken rib or a progressive lung disease such as asthma or emphysema

What is arterial/venous circulation filling pulmonary capillaries with blood called?

Perfusion

Conditions affecting chest wall movement

Pregnancy, obesity, neuromuscular disease, musculoskeletal abnormalities, trauma, CNS alterations

Carbon dioxide

Product of cellular metabolism, diffuses into red blood cells and is rapidly hydrated into carbonic acid (H2CO3). The carbonic acid then dissociates into hydrogen (H) and bicarbonate (HCO3−) ions. Hemoglobin buffers the hydrogen ion, and HCO3− diffuses into the plasma. Reduced hemoglobin (deoxyhemoglobin) combines with carbon dioxide, and venous blood transports most of the carbon dioxide back to the lungs to be exhaled

Function of right ventricle

Pumps deoxygenated blood through the pulmonary circulation.

Function of left ventricle

Pumps oxygenated blood through the systemic circulation.

Hypoxemia

Reduced oxygenation of arterial blood. In order to function properly, your body needs a certain level of oxygen circulating in the blood to cells and tissues. Results from problems w/ one or more of the major mechanisms of oxygenation: -oxygen delivery to the alveoli -diffusion of oxygen from the alveoli to the blood -perfusion of pulmonary capillaries Hypoxemia can cause hypoxia, when your blood doesn't carry enough oxygen to your tissues to meet your body's needs.

Restrictive disorders

Restrict lung expansion, resulting in a decreased lung volume, an increased work of breathing, and inadequate ventilation and/or oxygenation.People with restrictive lung disease cannot fully fill their lungs with air. Their lungs are restricted from fully expanding. Restrictive lung disease most often results from a condition causing stiffness in the lungs themselves. In other cases, stiffness of the chest wall, weak muscles, or damaged nerves may cause the restriction in lung expansion. Ex: Interstitial lung disease, sarcoidosis (autoimmune disease), obesity, scoliosis, neuromuscular disease

Perfusion

The ability of the cardiovascular system to pump oxygenated blood to the tissues and return deoxygenated blood to the lungs. (Perfuse the lungs so the body receives oxygen)

Ventilation

The process of moving gases into and out the lungs. (Ventilate the alveoli)

RSV - Respiratory Syncytial Virus

The virus invades the cells of bronchial mucosa, causing the cells to rupture. Cell debris irritates the airway causing an increase in secretions that obstruct bronchioles. -Most common cause of lower respiratory tract infections in children world wide -Spreads easily from person to person through contact with respiratory secretions At risk: Infants aged 2 to 6 months Premature infants and infants less than 6 weeks of age Lower socioeconomic status; crowded living conditions Exposure to passive cigarette smoke Attendance in day care setting Children of any age with any underlying cardiac or pulmonary disease or who are immunocompromised Presence of older siblings in the home Infants who were not breastfed Initial: oxygen saturation <93% RA Rhinorrhea pharyngitis coughing/sneezing wheezing ear/eye drainage (possible) fever (intermittent) Progression of illiness: increased coughing and wheezing air hunger tachypnea/retractions cyanosis Severe Illness: tachypnea/greater than 70 a min. listlessness apneic spells poor air exchange, poor breath sounds

True or false: An initial characteristic symptom of a simple pneumothorax is sudden onset of chest pain.

True

True or false: Any condition that affects cardiopulmonary functioning directly affects the body's ability to meet oxygen demands.

True

True or false: CO2 diffuses more easily than O2 across the alveolar-capillary membrane

True

True or false: The thickness of the alveolar capillary membrane affects the rate of diffusion.

True -Patients with pulmonary edema, pulmonary infiltrates, or pulmonary effusion have a thickened membrane, resulting in slow diffusion, slow exchange of respiratory gases, and decreased delivery of oxygen to tissues. Chronic diseases (e.g., emphysema), acute diseases (e.g., pneumothorax), and surgical processes (e.g., lobectomy) often alter the amount of alveolar capillary membrane surface area.

HCO3 (Bicarbonate) normal range

24-28 mEq/l

CO2 (Carbon dioxide) normal range

35-45 mm Hg

Normal pH?

7.35-7.45

O2 (Oxygen) normal range

75-100 mm Hg PaCO2 amount of oxygen dissolved in blood serum

Physiologic shunting

A unit with adequate perfusion but inadequate ventilation -Gas exchange is impaired

Dead space

A unit with adequate ventilation but inadequate perfusion. -Gas exchange is impaired.

What is flow of air in and out of the lungs?

Ventilation

Hyperventilation

Ventilation in excess of that required to eliminate carbon dioxide produced by cellular metabolism The lungs remove CO2 faster than it is produced by cellular metabolism, resulting in decreased PaCO2, or hypocapnia, resulting in respiratory alkalosis. -Can be caused by anxiety, infection, drugs, acid-base imbalance, fever, aspirin poisoning, or amphetamine use.

What are the three steps are involved in the process of oxygenation?

Ventilation, perfusion, diffusion

Total lung capacity

Volume of air in the lungs after max inspiration -decreased w/ restrictive disease such as atelectasis and pneumonia and increased in COPD

Tidal volume

Volume of air inhaled and exhaled with each breath -may not vary w/ severe disease

Residual volume

Volume of air remaining in the lungs after max exhalation -will be increased w/ obstructive disease

Functional residual capacity

Volume of air remaining in the lungs after normal expiration -increased w/ COPD and decreased in ARDS and obesity

Alveoli

Where gas exchange takes place (diffusion of O2 and CO2)

Clinical manifestations of PE

dyspnea chest pain anxiety cough tachycardia or tachypnea crackles low grade fever diaphoresis hemoptysis syncope cyanosis

Risk factors for PE

stasis of venous blood flow vessel wall damage blood coagulation prolonged immobility trauma surgery MI/heart failure obesity age smoking oral contraceptive use Previous history of thrombophlebitis Diabetes COPD

The primary function of the lungs

to transfer oxygen from the atmosphere into the alveoli and carbon dioxide out of the body as a waste product.

Emphysema

-Abnormal permanent enlargement of the gas-exchange airways accompanied by destruction of alveolar walls without obvious fibrosis -Loss of elastic recoil -Inflammatory cells that collect in distal airways tissues appear to lead to the destruction of elastic fibers in the respiratory bronchioles and alveolar ducts. Alveolar wall destruction cause alveoli and air spaces to enlarge, with loss of corresponding portions of the pulmonary capillary bed. Thus the surface area for alveolar capillary diffusion is reduced, affecting gas exchange. , elastic recoil is lost, reducing the volume of air that is passively expired. Risk factors: Smoking Passive tobacco smoke Occupational exposure Air pollution, coal, gas, asbestos exposure Genetic abnormalities - serum alpha antitrypsin levels Older adults - loss of elastic, alveolar collapse Clinical manifestations: Wheezing Dyspnea Barrel chest - air trapping and hyperventilation increases the anteroposterior chest diameter Posturing Pursed lip breathing - prolong the expiratory phase in an effort to promote more alveolar emptying while maintaining open alveoli Tachycardia

Ventilation-Perfusion (V/Q Ratio)

-Adequate gas exchange depends upon balanced V/Q ratio -Imbalanced V/Q ratio causes shunting of blood and results in hypoxia

Risk factors of pneumonia

-Age - young (immature, anatomy structure) and old (diminished cough reflex and immune response) -Immuniocompromised people -smoking -underlying lung, cardiac, or liver disease -alcoholism -altered consciousness -impaired swallowing (aspiration) -endotracheal intubation -malnutrition -immobilization -residence in a nursing home

Chronic bronchitis and emphysema both lead to:

-Airway obstruction, air trapping, loss of surface area for gas exchange, frequent exacerbations -Dyspnea, cough, hypoxemia, hypercapnia, cor pulmonae

Treatment of PE

-Anticoagulation, thrombolytic therapy -Surgery

Neural regulation of respiration

-CNS controls the respiratory rate, depth, and rhythm. -Cerebral cortex regulates the voluntary control of respiration.

Perfusion: Carbon dioxide transport

-Carbon dioxide is the end-product of metabolic combustion -CO2 crosses the alveolar-capillary membrane into venous blood by diffusion, perfusion carries deoxygenated blood back to the lungs

Asthma

-Chronic inflammatory disorder of the airways -Inflammation results from hyperresponsiveness of the airways -Inflammatory mediators such as histamines, prostaglandins, and leukotrienes cause the symptoms of asthma -Can lead to obstruction and status asthmaticus - is a severe prolonged form of asthma that is difficult to treat -Symptoms include expiratory wheezing, dyspnea, and tachypnea -Peak flow meters, oral corticosteroids, inhaled beta-agonists, and anti-inflammatories used to treat Clinical manifestations: coughing, wheezing, SOB, chest tightness, tachypnea and tachycardia, anxiety and apprehension Diagnosis is supported by Hx of allergies and recurrent episodes of wheezing, dyspnea, and cough or exercise intolerance. Further evaluation includes spirometry.

Physiological factors affecting oxygenation

-Decreased oxygen-carrying capacity -Hypovolemia -Decreased inspired oxygen concentration -Increased metabolic rate

Cardiopulmonary physiology involves:

-Delivery of deoxygenated blood (blood high in carbon dioxide and low in oxygen) to the right side of the heart and then to the lungs, where it is oxygenated. -Oxygenated blood (blood high in oxygen and low in carbon dioxide) then travels from the lungs to the left side of the heart and the tissues

Chronic bronchitis

-Hypersecretion of mucus and chronic productive cough that lasts for at least 3 months of the year and for at least 2 consecutive years -Ciliary function is reduced, bronchial walls thicken, bronchial airways narrow, and mucous may plug airways -Alveoli become damaged, fibrosed, and alveolar macrophage function diminishes -The patient is more susceptible to respiratory infections -Inspired irritants increase mucus production and the size and number of mucous glands, the mucus is thicker than normal -Bronchodilators, expectorants, and chest physical therapy used to treat

Pulmonary hypertension

-Increased pressure in the pulmonary arteries -Begins w/ inflammation and change in the cells that line your pulmonary arteries -The inflammation makes it hard for your heart to pump blood through your pulmonary arteries and into your lungs -The condition may develop if: The walls of the arteries tighten. The walls of the arteries are stiff at birth or become stiff from an overgrowth of cells. Blood clots form in the arteries S/S: Shortness of breath during routine activity, such as climbing two flights of stairs Tiredness Chest pain A racing heartbeat Pain on the upper right side of the abdomen Decreased appetite As PH worsens, you may find it hard to do any physical activities. At this point, other signs and symptoms may include: Feeling light-headed, especially during physical activity Fainting at times Swelling in your legs and ankles A bluish color on your lips and skin

Classifications of pneumonia

-Infectious: caused by bacteria, viruses, fungi, protozoa -Community Acquired; in the community or within the first 48 hours of hospitalization -Hospital Acquired: Nosicomial - onset after 48 hours in the hospital. Occurs when at least 1 of 3 conditions exists: host defenses are impaired, inoculum of organisms reaches the lower respiratory tract and overwhelms the host's defenses, or a highly virulent organism is present. Associated with high mortality because of the virulence of the organism, their resistance to antibiotics and the patients underlying disorder Example of a virulent organism: MRSA VRSA -Immuno; such as AIDS, CHEMO, Cancer, etc (chronically ill) -Aspiration; also known as Noninfectious pneumonia

What happens during ventilation?

-Inspiration: contraction of the diaphragm (movement of chamber floor downward) and contraction of external intercostal muscles increases space in thoracic chamber, lowering intrathoracic pressure (negative pressure); air enters the airways and inflates the lungs -Expiration: relaxation of the diaphragm (movement of chamber floor upward) relaxation of external intercostal muscles, increasing intrathoracic pressure (positive pressure), air exits the airways, deflation and elastic recoil of the lungs

Chemical regulation of respiration

-Maintains the rate and depth of respirations based on changes in the blood concentrations of CO2 and O2, and in hydrogen ion concentration (pH) -Chemoreceptors sense changes in the chemical content and stimulate neural regulators to adjust.

TB

-Mycobacterium enter the lungs - causing local inflammatory response -Spread by droplets--airborne. Spread by talking, coughing sneezing, laughing, singing. Risk Factors: Close contact with someone with active TB Immunocompromised patient Substance abuse Any person without adequate healthcare Chronic medical conditions Immigration Institutionalization Over crowed housing Health care worker Clinical manifestations: -Cough that will not go away May be productive or non productive, usually starts out as a dry cough which then becomes productive or purulent or be blood tinged (hemoptysis) -Pnuemothorax - causing air to enter the pleural space -Partial lung collapse caused by air or gas collecting in the lung or pleural space that surrounds the lung Feeling tired all the time Weight loss Low grade fever Coughing up blood Night sweats Altered mentation--elderly

Perfusion: oxygen transport

-Oxygen crosses the alveolar-capillary membrane into arterial blood by diffusion, perfusion carries oxygenated blood to all body tissues. -O2 is transported to the cells of the body by combining with Hemoglobin (plasma protein in RBC, Hgb), this combining is called oxyhemoglobin, HgbO2

TB disease (active)

-Sick and can spread the disease to other people -See a doctor as soon as possible. -Patient ordinarily quickly becomes noninfectious after the start of medical treatment

Clinical manifestations of pneumonia

-Sudden onset of chills -Rapid rising fever -Pleuritic chest pain -Tachycardia/tachypnea -Shortness of breath (orthopnea) -Headache -Purulent/rust colored sputum

TB (latent)

-TB germs, or bacteria, in their body -body's defenses are protecting them from the germs and they are not sick. -Most people who become infected do not develop TB disease because their body's defenses protect them -will have no symptoms -Cannot spread -Will have a positive skin test

Three things influence the capacity of the blood to carry oxygen:

-The amount of dissolved oxygen in the plasma -The amount of hemoglobin -And the tendency of hemoglobin to bind with oxygen.

Clinical manifestations of CF

-The mucous glands -produce thick mucoprotein that accumulates and dilates - mechanical obstruction increased viscosity of the mucous gland secretions -Chronic moist productive cough and frequent respiratory infections. -Child often wheezes and has SOB, frontal headaches, facial tenderness and purulent nasal discharge.

Arterial blood gases

-Used to assess the adequacy of alveolar ventilation and the ability of the lungs to provide oxygen and remove carbon dioxide. -Assesses acid-base balance -Provide a direct indication of oxygen and carbon dioxide exchange and the acid-base balance within the blood.

Virchow triad (factors contributing to thrombosis)

-Venous stasis, -Hypercoagulability -Injuries to the endothelial cells that line the vessels

Cor pulmonale (hypertrophy and dilation of right ventricle)

-is a maladaptive response to pulmonary hypertension. -Defined as an alteration in the structure and function of the right ventricle caused by a primary disorder of the respiratory system. Pulmonary hypertension is the common link between lung dysfunction and the heart in cor pulmonale.