Patho Exam 1 PrepU
Which situation would be most deserving of a pediatrician's attention?
A midwife notes that a newborn infant's chest is retracting on inspiration and that the child is grunting. Retraction and grunting indicate a significant increase in the work of breathing that can be indicative of respiratory distress syndrome, a situation that would require medical intervention. Periods of hyperventilation interspersed with reduced breathing rates are common during the transition to postpartum ventilation, and infants are commonly unable to mouth breathe. Nostril flaring could be a sign of dyspnea, but it can also be a compensatory mechanism that the infant uses to increase oxygen intake; this situation would not be considered as serious as an infant who has chest retractions and grunting.
The nurse is caring for a 67-year-old client who has been diagnosed with pneumonia. The vital signs are temperature 101.7°F (38.7°C), blood pressure 155/95, respiratory rate 26, and heart rate 88. Which interventions should the nurse incorporate into the client's plan of care? Select all that apply.
Administer antipyretics as ordered. Encourage deep breathing and coughing. Encourage fluid intake. The client has a fever, which will cause more water to be lost from the respiratory mucosa. Also, the client has an increased respiratory rate, which will increase these insensible losses. This will result in a thickening of respiratory secretions that will be more difficult to clear. For these reasons, the nurse should encourage fluids, treat fever, and encourage deep breathing and coughing to facilitate clearing secretions from the airway. The client with pneumonia should not routinely be given antitussives as this impedes the protective function of the mucociliary defense system when experiencing a productive cough. Elevating the legs periodically through the day is an intervention to prevent nocturia and paroxysmal nocturnal dyspnea in a client with pedal edema and/or left heart failure; it is not relevant in pneumonia.
Which long-term care resident is most likely to be exhibiting the signs and symptoms of chronic obstructive pulmonary disease (COPD)?
An 81-year-old male who has a productive cough and recurrent respiratory infections. Productive cough and recurrent respiratory infections are associated with COPD, while pain, fever and increased white cells are not common signs and symptoms. Acute shortness of breath and bronchoconstriction are associated with asthma.
An increase in venous return stimulates what mechanism within the heart?
An increase in heart rate An increase in venous return stimulates right atrial stretch receptors that initiate an increase in heart rate. The other assessments are not found with increased venous return. An increase in blood pressure and increase in cardiac output are found.
The circulatory system can be divided into two parts. What does the systemic circulation include? Select all that apply.
Aorta Capillaries The systemic circulation includes the aorta and capillaries. The pulmonary circulation includes the right heart and pulmonary artery.
Blood transports both oxygen and carbon dioxide in a physically dissolved form to the tissues and organs of the body. It is the measurements of the components of the gases in the blood that are used as indicators of the body's status by health care workers. Why is it more appropriate to measure the blood in the arteries rather than in the veins?
Arterial blood most adequately measures the gas exchange function of the lungs. In the clinical setting, blood gas measurements are used to determine the partial pressure of oxygen (PO2) and carbon dioxide (PCO2) in the blood. Arterial blood commonly is used for measuring blood gases. Venous blood is not used because venous levels of oxygen and carbon dioxide reflect the metabolic demands of the tissues rather than the gas exchange function of the lungs.
A nurse is evaluating clients at risk for developing dyspnea. Which diagnoses would place a client at risk? Select all that apply.
Asthma Heart disease Emphysema Pneumonia Dyspnea commonly occurs in persons with primary lung diseases such as pneumonia, asthma, and emphysema; heart disease that is characterized by pulmonary congestion; and neuromuscular disorders such as myasthenia gravis and muscular dystrophy that affect the respiratory muscles. Peripheral vascular disease and multiple myeloma would not interfere with respiration.
The microbiologist is explaining cell communication. Which statement is accurate?
Autocrine signaling occurs when a cell releases a chemical into the extracellular fluid that affects its own activity. Autocrine signaling occurs when a cell releases a chemical into the extracellular fluid that affects its own activity. Endocrine signaling relies on hormones carried in the bloodstream. With paracrine signaling, enzymes rapidly metabolize the chemical mediators, and therefore they act mainly on nearby cells. Synaptic signaling occurs in the nervous system.
A female older adult client has presented with a new onset of shortness of breath, and the client's physician has ordered measurement of her brain natriuretic peptide (BNP) levels along with other diagnostic tests. What is the most accurate rationale for the physician's choice of bloodwork?
BNP is released as a compensatory mechanism during heart failure and measuring it can help differentiate the client's dyspnea from a respiratory pathology. BNP is released to compensate for heart failure and elevated levels help confirm the diagnosis of heart failure as opposed to respiratory etiologies. It does not measure the effectiveness of the RAA system, the risk of cognitive deficits, or the specific severity of pulmonary symptoms of heart failure.
The nurse has just completed a respiratory assessment on a postoperative client who has undergone repair of a large abdominal aneurysm. Which conditions may impair the client's cough reflex? Select all that apply.
Bed rest Muscle weakness Surgery Paralysis The cough reflex is impaired in persons whose abdominal or respiratory muscles are weak. This problem can be caused by disease conditions that lead to muscle weakness or paralysis, by prolonged inactivity, or as an outcome of surgery involving these muscles. Bed rest interferes with expansion of the chest and limits the amount of air that can be taken into the lungs in preparation for coughing, making the cough weak and ineffective. Increased activity would help facilitate the movement of secretions.
Which breathing-related actions are affected by voluntary respiratory control? Select all that apply.
Blowing Speaking Singing Voluntary respiratory control is needed for integrating breathing and actions such as speaking, blowing, and singing. Neither hiccupping nor swallowing is related to voluntary respiratory control.
A client in the emergency department is experiencing a massive stroke with extremely low blood flow to the brain exhibited by a BP <60 mm Hg. The nurse suddenly notes there is a sharp rise in the BP to 250 mm Hg. This high BP lasts about 5 minutes and then the BP drops sharply again. The pathophysiologic principle behind this is likely due to the:
CNS ischemic response. When blood flow to the brain has been sufficiently interrupted to cause ischemia of the vasomotor center, these vasomotor neurons become strongly excited. This causes massive vasoconstriction as a means of raising the blood pressure to levels as high as the heart can pump against. This response is called the CNS ischemic response and can raise BP to levels as high as 270 mm Hg for as long as 10 minutes.
An adult's documented blood pressure (BP) readings over the past 2 years include: 140/82 mm Hg, 144/82 mm Hg, 150/82 mm Hg, 160/82 mm Hg, and 162/82 mm Hg. Which interpretation(s) of these BP trend will the provider discuss with this client? Select all that apply.
Client's systolic BP is hypertensive. Client has increased risk for future cardiovascular events. The provider's interpretation of the results should include that the client's systolic BP is hypertensive and that the diastolic BP is stage 1 hypertension. This leads to increased pulse pressure, placing the client at increased risk for future cardiovascular events.
Clients with unstable angina/non-ST-segment elevation myocardial infarction (UA/NSTEMI) are classified as low or high risk for acute myocardial infarction and sudden death based on the severity of which characteristic?
ECG changes Risk stratification of people presenting with UA/NSTEMI is important because the outcome can range from excellent, with little change in treatment, to NSTEMI or death, requiring aggressive treatment. UA/NSTEMI is classified by severity based on clinical history, ECG pattern, and serum biomarkers. Chronic pulmonary disease increases pulmonary vascular resistance, leading to right-sided or left-sided heart failure. Pericardial effusion increases intracardiac pressure and venous pressure. Heart murmurs result from turbulent blood flow through a diseased valve.
Which statement provides blood work results and rationale that would be most closely associated with acute coronary syndrome?
Elevated creatine kinase and troponin, both of which normally exist intracellularly rather than in circulation Myocardial necrosis releases creatine kinase and troponins that normally exist intracellularly. Serum creatinine and potassium are not core markers of heart damage and myoglobin and creatine kinase levels rise, not fall, with cardiac events.
The client's ultrasound shows a true aneurysm that involves the entire circumference of the vessel and has a gradual and progressive dilation of the vessel. The provider tells the client the aneurysm is which of the following forms?
Fusiform A fusiform aneurysm is a true aneurysm that involves the entire circumference of the vessel and is characterized by a gradual and progressive dilation of the vessel. A saccular aneurysm is a true aneurysm that appears saclike; a dissecting aneurysm is a false aneurysm and a berry aneurysm is a true aneurysm that consists of a small, spherical dilation of the vessel at a bifurcation.
During assessment of a 66-year-old woman, the nurse practitioner notes a pulsating abdominal mass and refers the woman for further treatment. Which aspects of the pathophysiology of aneurysms would the health care provider explain to this client?
Hypertension is a frequent modifiable contributor to aneurysms. Hypertension is associated with over half of aneurysms. They are not consequences of diabetes, and while some are asymptomatic in early stages, this is not necessarily the norm and does not necessarily culminate in a rupture. Aneurysms normally require surgical repair.
Which statements regarding hypertension are correct? Select all that apply.
Hypertension is more frequent among younger men than in younger women. Hypertension is a major risk factor for cardiovascular disease. Hypertension is one of the most common health problems for adults. Hypertension is a frequent health disorder in adults, and is a major risk factor for cardiovascular disease. It is more frequent among younger men, older adults, and black people. Postmenopausal women are at greater risk for hypertension than premenopausal women.
The nurse is caring for a client admitted with carbon monoxide (CO) poisoning who is extremely agitated, dyspneic, and confused. The nurse understands that treatment with a hyperbaric chamber with 100% oxygen administration would result in which physiologic response?
Increase the amount of oxygen that can be carried in the dissolved state. Hemoglobin carries most of the oxygen in the blood (98% to 99%) and is essential in the transport and release of oxygen at the tissue level. Dissolved oxygen in the blood accounts for approximately 1% to 2% and it is only the dissolved oxygen that can participate in cellular metabolism. The oxygen carried by the hemoglobin is reversibly bound and is released at the tissue level. If carbon monoxide molecules, which have approximately a 200% greater affinity for hemoglobin compared to oxygen, are attached to the binding sites on hemoglobin, oxygen cannot bind and therefore only a small portion is available for cellular metabolism without treatment. Treatment with a hyperbaric chamber and 100% oxygen administration will increase the amount of oxygen dissolved and available in the blood.
A client diagnosed with septic shock who is experiencing tissue hypoxia likely will activate which pathophysiologic process?
Inflammatory mediators In sepsis and septic shock, tissue hypoxia produces continued production and activation of inflammatory mediators, resulting in further increases in vascular permeability, impaired vascular regulation, and altered hemostasis. Anaerobic metabolism is caused by tissue hypoxia, not aerobic. The other options do not facilitate the process.
A nurse is providing care for a number of older clients on a restorative care unit of a hospital. Many of the clients have diagnoses or histories of hypertension and the nurse is responsible for administering a number of medications relevant to blood pressure control. Which assessment would the nurse be most justified in eliminating during a busy morning on the unit?
Measuring the pulse of a client taking an ACE inhibitor. ACE inhibitors act on the renin-angiotensin-aldosterone system and are thus not significant influences on heart rate. They can, however, induce hyperkalemia and it would be prudent for the nurse to check potassium levels. β-adrenergic blockers affect a client's heart rate, and diuretics can affect electrolyte levels.
A client has developed left-sided heart failure. Which symptom might have precipitated this condition?
Myocardial infarction Myocardial infarction causing damage to the left ventricular wall can decrease ventricular efficiency and result in left-sided failure. Pulmonary edema, hypotension, and stroke are not causes of left-sided heart failure.
A client diagnosed with rhinosinusitis asks the nurse what type of nonpharmacologic measures can be used to reduce the nasal stuffiness that occurs with the disorder. What suggestion can the nurse give to the client? Select all that apply.
Nasal irrigation Saline nasal spray Mist humidification Nonpharmacologic measures include saline nasal sprays, nasal irrigation, and mist humidification. Antihistamines, topical corticosteroids, and mucolytic agents are all pharmacologic measures.
The nursing instructor is explaining pressure changes that occur during inspiration. During inspiration, which would be the most appropriate information to include about changes in intrapleural pressure?
Negative in relation to alveolar pressure During inspiration, the intrapleural pressure is negative to alveolar pressure. Intrapleural pressure is negative to intrapulmonary pressure, positive to atmospheric pressure, and equal to intrathoracic pressure.
A nurse is conducting a staff development program on the Healthy People 2030 determinants of health. The nurse notes that the participants need additional education based on which statement?
Nursing practice should focus solely on the management of chronic disease. The U.S. Department of Health and Human Services in Healthy People 2030 describes determinants of health as: 1) Attaining lives free of preventable disease, disability, injury, and premature death; 2) Achieving health equity and eliminate disparities; 3) Promoting good health for all; 4) Promoting healthy behaviors across the lifespan. With this in mind, the nurse determines that additional education is needed when participants state that nursing practice should focus solely on chronic disease management.
A nurse caring for a client on complete bed rest will focus her assessment on which area of this client's lungs most affected by immobility?
Posterior portions of the lungs In the supine position, ventilation in the lowermost (posterior) parts of the lung exceeds that in the uppermost (anterior) parts. In the seated or standing position, gravity exerts a downward pull on the lung, causing intrapleural pressure at the apex of the lung to become more negative. As a result, the alveoli at the apex of the lung are more fully expanded. In the lateral position (i.e., lying on the side), the dependent lung is better ventilated.
A client experiencing increasing fatigue in recent months has an echocardiogram that reveals the client's end-diastolic volume is insufficient. Which other parameter of cardiac performance will directly decrease as a result?
Preload Preload is the volume of blood stretching the heart muscle at the end of diastole and is normally determined by the venous return to the heart. Within limits, as end-diastolic volume or preload increases, the stroke volume increases in accord with Frank-Starling mechanism. Afterload represents the force that the contracting heart muscle must generate to eject blood from the filled heart. Cardiac contractility, or inotropy, is the contractile performance of the heart.
An older male client has fallen at home and sustained a bruised left hip. Assessment reveals shortness of breath and shallow respirations with a respiratory rate of 40 breaths/min. If the client develops a tension pneumothorax, what additional assessment finding would the nurse observe?
Presence of a mediastinal shift Physical assessment findings of a mediastinal shift and neck vein distention would indicate a tension pneumothorax. Asymmetry of the chest during inspiration would suggest a spontaneous pneumothorax. Decreased blood pressure is present with tension pneumothorax, and a friction rub is present with pleural effusion.
How do free radicals damage cells?
Reacting with proteins and lipids thereby damaging cell membranes Free radicals are highly reactive chemical species that can damage cells in several ways. In cells and tissues, free radicals react with proteins, lipids, and carbohydrates, thereby damaging cell membranes. Free radicals modify proteins but do not affect the immune function, calcium storage, or intracellular enzymes of cells.
Which diagnosis puts a client at risk for developing an immunologic form of interstitial lung disease?
Rheumatoid arthritis Rheumatoid arthritis is a risk factor for the development of immunologic lung disease. Cancer is a risk for therapeutic agent-related interstitial lung disease when certain chemo drugs are used as treatment. Asbestosis is a risk for occupational /environmental inhalant interstitial lung disease. Septicemia increases the risk of acute respiratory distress syndrome.
Cystic fibrosis (CF), the major cause of severe chronic respiratory disease in children, is characterized by which diagnostic finding?
Salt depletion CF is manifested by pancreatic exocrine deficiency and elevation of sodium chloride in sweat. Excessive loss of sodium in sweat predisposes young children to salt depletion episodes. Respiratory manifestations are caused by an accumulation of viscid mucus in the bronchi, impaired mucociliary clearance, lung infections, bronchiectasis, and dilatation. Steatorrhea, diarrhea, and abdominal pain and discomfort are common.
Which disease results from a nutritional deficiency?
Scurvy Dietary deficiencies can occur because of a selective deficiency of a single nutrient. Iron deficiency anemia, scurvy, beriberi, and pellagra are examples of injury caused by a lack of specific vitamins or minerals. Anorexia nervosa, sickle cell anemia, and atherosclerosis are not caused by lack of a vitamin/mineral.
Clients with chronic diseases such as chronic obstructive pulmonary disease (COPD), when given oxygen at a level that increases PO2 above 60 mm Hg (7.98 kPa) would experience:
Severely depressed ventilation A client with chronic respiratory disease receiving increased levels of PO2 would tend to experience depressed hypoxic stimulus for ventilation and hypoventilation and carbon dioxide retention. It would not cure the disease process.
The plaques in a client's coronary arteries are plentiful, and most have small- to moderate-sized lipid cores with thick fibrous caps. This form of atherosclerosis is most closely associated with which diagnosis?
Stable angina The fixed or stable plaque is commonly associated with stable angina, and the unstable plaque is implicated in unstable angina and myocardial infarction (MI).
A nurse is providing care for a client who has been admitted with a newly diagnosed bilateral pleural effusion. Which finding from the nurse's initial assessment of the client is incongruent with the client's diagnosis and would require further investigation?
The client reports sharp pain exacerbated by deep inspiration. Pleural effusion is not normally associated with pain, and intense pain that is worsened by deep breathing would necessitate further investigation. Diminished breath sounds, hypoxemia, and dyspnea are common findings associated with pleural effusion.
In infective endocarditis, vegetative lesions grow on the valves of the heart. These vegetative lesions consist of a collection of infectious organisms and cellular debris enmeshed in the fibrin strands of clotted blood. What are the possible systemic effects of these vegetative lesions?
They can fragment and cause cerebral emboli. The intracardiac vegetative lesions also have local and distant systemic effects. The loose organization of these lesions permits the organisms and fragments of the lesions to form emboli and travel in the bloodstream, causing cerebral, systemic, or pulmonary emboli. Preventing the valves of the heart from either opening or closing completely is not a systemic effect of the lesions. Fragmentation of the lesions does not make them larger.
Which most important complication of atherosclerosis can result in occlusion of small heart vessels?
Thrombosis Thrombus formations on complicated atherosclerotic lesions are the result of sluggish blood flow and turbulence in the ulcerated plaque region. Fatty streaks are preatherosclerotic plaque changes in vessels. Fibrous plaque is part of the atherosclerosis formation, not a complication of it.
Although the basic structure of the cell plasma membrane is formed by a lipid bilayer, most of the specific membrane functions are carried out by which substance?
Transmembrane proteins Although the lipid bilayer provides the basic structure of the cell membrane, proteins carry out most of the functions. The integral proteins cross the entire lipid bilayer and are also called transmembrane proteins, which can function on both sides of the membrane or transport molecules across it. The functions of the plasma membrane depend on the presence of proteins that are bound in the lipid bilayer and some that have the ability to pass freely into and out of the cell. Carbohydrate chains form a cell coat that surrounds the membrane and that contain surface antigens and surface hormone receptors. Some ion channels are gated and open only when the membrane potential changes significantly.
A client has developed atelectasis postoperatively. Which physiologic response to the atelectasis is expected?
Vasoconstriction of pulmonary vessels surrounding alveoli that are hypoxic. Regional hypoxia, such as with a diagnosis of atelectasis, is associated with vasoconstriction and redirection of blood away from, not toward, the affected alveoli. This helps maintain arterial oxygen levels by essentially bypassing the oxygen-poor alveoli in favor of alveoli with better oxygen content. This pulmonary vessel vasoconstriction can contribute to an increased workload for the right side of the heart if enough areas of the lung are affected. However, constriction of vessels at the alveoli will not affect the ability for blood to return to the left side of the heart and, therefore, will not cause increased capillary pressures that would result in pulmonary edema.
A 44-year-old woman has developed calf pain during a transatlantic flight. She is extremely short of breath upon arrival at her destination. She was subsequently diagnosed with a pulmonary embolism (PE) that resolved with anticoagulant therapy. Which statement best characterizes the underlying problem of her PE?
Ventilation was occurring but perfusion was inadequate, causing shortness of breath. Impaired blood flow to a portion of the lung, such as with a PE, is associated with ventilation without perfusion, rather than perfusion without ventilation. The situation is not related to an anatomic shunt or impaired diffusion across alveolar membranes.
What is a function of the bronchial circulation?
Warms and humidifies incoming air The bronchial circulation warms and humidifies incoming air, while the pulmonary circulation carries oxygenated blood in the veins and deoxygenated blood in the arteries. The bronchial blood vessels are the only ones that can undergo angiogenesis (formation of new vessels) and develop collateral circulation when vessels in the pulmonary circulation are obstructed, as in pulmonary embolism.
The nurse evaluates a client for manifestations of a disease. Which assessment data are considered signs? Select all that apply.
dilated pupils tachycardia skin rash Diseases produce clinical manifestations. Signs are manifestations that can be observed objectively such as changes in vital signs, exudate, rash, and changes in pupil size. Symptoms are subjective manifestations that cannot be measured objectively and include pain, dizziness, itching, and difficulty breathing (dyspnea). Although a nurse may observe a client scratching or having an increased work of breathing, being itchy or feeling short of breath are subjective and, therefore, these data must be collected from the client's perspective as symptoms.
The cardiologist examines a client's echocardiogram and determines that the client has aortic stenosis. The cardiologist explains that a frequent cause of this valve disease is:
dystrophic calcification. Dystrophic calcification is commonly seen in atheromatous lesions of advanced atherosclerosis, areas of injury in the aorta and large blood vessels, and damaged heart valves. Calcification of the aortic valve is a frequent cause of aortic stenosis in older adults. Metastatic calcification occurs in normal tissues as a result of increased serum calcium levels. Hyperplasia refers to an increase in the number of cells in an organ or tissue. Apoptosis is a process that eliminates injured and aged cells.
Which cellular component is a key regulator of apoptosis (programmed cell death)?
mitochondria Mitochondria function as key regulators of apoptosis or programmed cell death. Golgi apparatus, protoplasm, and phospholipids exist within the cell. They are not key in the process of programmed cell death.
At 4 AM the hemodynamic monitoring for a critically ill client in the intensive care unit indicates that the client's mean arterial pressure (MAP) is at the low end of the normal range; at 5 AM the client's MAP has fallen definitively below normal. The nurses should prioritize assessments for:
organ damage and hypovolemic shock. The mean arterial pressure, which represents the average blood pressure in the systemic circulation, is a good indicator of tissue perfusion. The fact that this client's MAP is falling at a time when it should be at its daily peak is cause for grave concern; blood volume is likely low, and vital organs, which depend on adequate perfusion, are at risk. Low blood pressure does not normally result in aneurysms, edema, or ischemic stroke.
Which respiratory neurons function to turn off inspiration and assists in the control of the respiratory rate and inspiratory volume?
pneumotaxic center The pacemaker properties of the respiratory center in the medulla result from the cycling of two groups of neurons: the pneumotaxic center in the upper pons and the apneustic center in the lower pons. The pneumotaxic center switches inspiration off and assists in the control of respiratory rate and inspiratory volume. The apneustic center has an excitatory effect on inspiration, tending to prolong inspiration. There is no respiratory neurons referred to as the expiratory center.
A client with rheumatoid arthritis is being started on immunosuppressive therapy. It would be most important for the nurse to inform the health care provider about the client's history of:
tuberculosis. While all aspects of a client's medical history should be disclosed, the most important aspect related to a client starting on immunosuppressive therapy is the history of tuberculosis. None of the other conditions have a direct risk related to this new therapy. Mycobacterium tuberculosis can be encapsulated and be held in a dormant state inside the client's lung in a tubercle. The infective bacilli in the tubercle are more likely to become active when the client has a compromise to the immune system, such as with immunosuppressive therapy.
Severe shock can be followed by acute lung injury/acute respiratory distress syndrome (ALI/ARDS) characterized by:
ventilation-perfusion mismatch. Despite the delivery of high levels of oxygen using high-pressure mechanical ventilatory support and positive end-expiratory pressure, many persons with ALI/ARDS remain hypoxic, often with a fatal outcome. Arterial blood gas analysis establishes the presence of profound hypoxemia with hypercapnia, resulting from impaired matching of ventilation and perfusion and from the greatly reduced diffusion of blood gases across the thickened alveolar membranes. Abnormalities in the production, composition, and function of surfactant may contribute to alveolar collapse and gas exchange abnormalities.
A toddler seems to have a little "cold" and runny nose. During the night, the parents awaken hearing a "tight" coughing sound. On arrival to the emergency department, the nurses suspect bronchial asthma based on which assessment data? Select all that apply.
Audible wheezing Respiratory rate—44 with prolonged exhalation Sitting upright, leaning forward, and using accessory muscles to breathe Bronchial asthma represents a reversible form of obstructive airway disease caused by narrowing of airways due to bronchospasms, inflammation, and increased airway secretions. Healthy children develop what may seem to be a cold with rhinorrhea, rapidly followed by irritability, a tight and nonproductive cough, wheezing, tachypnea (respiratory rate—44), dyspnea with prolonged expiration, and use of accessory muscles of respiration. Cyanosis, hyperinflation of the chest, and tachycardia indicate increasing severity of the asthma attack. Croup is characterized by inspiratory stridor or a barking cough. The British use the term croup to describe the cry of the crow or raven, and this is undoubtedly how the term originated. Hemoptysis (blood in the sputum) is usually associated with pulmonary emboli or lung cancers to name a few.
When intracranial pressure (ICP) equals intra-arterial pressure, the central nervous system ischemic response is initiated. This response is directed at raising arterial pressure above ICP, thereby reestablishing blood flow to the vasomotor center of the brain. What is this response called?
Cushing reflex The Cushing reflex is a special type of central nervous system (CNS) reflex resulting from an increase in intracranial pressure (ICP). When the ICP rises to levels that equal intra-arterial pressure, blood vessels to the vasomotor center become compressed, initiating the CNS ischemic response. The purpose of this reflex is to produce a rise in arterial pressure to levels above ICP so that the blood flow to the vasomotor center can be reestablished. If the ICP rises to the point that the blood supply to the vasomotor center becomes inadequate, the vasoconstrictor tone is lost, and the blood pressure begins to fall. The elevation in blood pressure associated with the Cushing reflex is usually of short duration and should be considered a protective homeostatic mechanism. The brain and other cerebral structures are located within the rigid confines of the skull, with no room for expansion, and any increase in ICP tends to compress the blood vessels that supply the brain.
