4 Lung Mechanics and Ventilation - Clinical Applications Flashcards

1
Q

What is interstitial lung disease?

A

Disorder characterised by ‘stiffer lungs’

Group of diseases

Diffuse lung/pulmonary fibrosis

(Cause example: Inorganic dusts- asbestos)

(Airways not narrowed like in emphysema)

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2
Q

What is the ‘interstitial space’ in the lungs?

A

Potential space between alveolar cells and capillary basement membrane

Only in disease states

(May contain fibrous tissue, cells or fluid)

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3
Q

What effects does the deposition of fibrous tissue in the interstitium have?

A
  • Lungs= stiffer, harder to expand
    • reduced Lung Compliance
  • Elastic recoil of lungs= increased
  • Lungs shrunken
  • Thickened alveolar walls- increased diffusion distance
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4
Q

What are the signs and symtoms of interstitial lung disease?

A

SIGNS:

chest expansion reduced (bilaterally)

inspiratory capacity and vital capacity (spirometry) = reduced

tachypnoea

tachycardia

Coarse crackles

SYMPTOMS:

Shortness of breath

reduced exercise tolerance

dry cough

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5
Q

Give an example of a cause of interstitial lung fibrosis

A
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6
Q

What are the signs of respiratory distress syndrome?

A

cyanosis

grunting

intercostal and subcostal recession

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7
Q

Respiratory distress syndrome is caused by a deficiency in surfactant production in (premature) new borns <30weeks. What effects does this have?

A

Surface tension= high

Reduced compliance

Lung expansion incomplete

Increased effort required to breathe

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8
Q

How is respiratory distress syndrome treated?

A

Surfactant replacement via endotracheal tube

Supportive treatment:

  • Oxygen
  • Assisted ventilation
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9
Q

What is emphysema?

A

Irreversible loss of elastin and breakdown of alveolar walls- causing increased lung compliance and narrowing of small airways

(feature of COPD)

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10
Q

Explain the effects of the loss of elastin fibres:

A
  • Lungs easier to expand
    • Increased lung compliancw
  • Reduced elastic recoil of lungs
  • Lungs= hyperinflated at rest (Barrel chest)
  • Small airways narrowed
    • Loss of radial traction on small bronchioles

SYMPTOMS

Shortness of breath

Reduced exercise tolerance

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11
Q

Apart from smoking, what is another cause of emphysema?

A

Alpha-1 antitrypsin deficiency (INHERITED)

Imbalance in proteinases and antiproteinases

Early age:

Destruction of elastin

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12
Q

What is asthma? Describe its effects in the lungs.

A

Reversible airway obstruction

Chronic inflammatory process

May be triggered by allergic stimuli

Effects:

  • Airway narrowing
    • Bronchial smooth muscle contraction
    • Thickening of airway walls by muscosal oedema
    • Excess mucus production (partially block lumen)
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13
Q

What is a pneumothorax?

A

Disorder- air enters pleural space

Loss of pleural seal and lung collapse

(Lung pulled in towards hilum)

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14
Q

What is atelectasis?

A

Lung collapse

Incomplete expansion of lungs (neonatal)

Collapse of previously inflated lung

—> producing areas of airless pulmonary tissue

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15
Q

What are the 2 main types of atelectasis?

A
  • Compression atelectasis
    • Siginificant volume of air or fluid in pleural cavity
      • Pneumothorax
      • Pleural efusion
  • Resorption atelectasis
    • complete obstruction of an airway
    • eventually air reabsorbed from alveoli which collapse
    • eg due to bronchial carcinoma
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16
Q

Where should a tube be inserted to release the air from a pneumothorax to avoid damage to blood vessels?

A

Just above rib

17
Q

How are inhaled particles and dust removed from the respiratory tract?

A

Mucocilliary escalator

Mucus traps dust

Cilia move it along–> swallowedf

Macrophages ingest small particles

18
Q

Why is physiological dead space increased by a pulmonary embolism?

A

No gas exchange occuring in alveoli

Since Physiological dead space= alveolar dead space + anatomical dead space

–> physiological dead space increased as alveolar dead space has been increased

19
Q

What will be the effect on resistance if there is inhalation of a B2 adrenoreceptor agonist?

A

Bronchodilation and reduction in resistance