5.1.3 Pulmonary Flashcards
restrictive lung disease means?
restriction of lung inflation
*so much ER that is is hard to inflat
two most common ways to get restrictive disease?
1) increase connective tissue
2) lack of pulmonary surfactant
once of most common cause of death for hospitalizaed adults?
ARDS (adult respiratory distress syndrome)
causes of ARDS?
tons of causes
- either utilize pulmonary surfactant too fast OR not making enough
- must constantly replace
causes of decreased surfactant?
shock, severe blood loss, bone fracture, lung infections, drowning, transfusion, poilo
examples of restrictive lung diseases due to CT?
fibrosis and asbestosis
examples of restrictive lung diseases due to minimal surfactant?
IRDS and ARDS
are there any diseases where the body makes too much surfactant?
not that we know of
restrictive lung diseases are partially diagnosed via? using?
lung inflation tests!
*using a spirometry
how does spirometer work in detecting restrictive lung disease?
struggle to fully inflate lungs, but is world champ at exhaling due to so much ER indicates restrictive lung disease
what is wrong with airways in restirctive lung diseases?
NOTHING- they are fine
* don’t get restrictive and resistance confused! restrictive lung diseases does NOT mean they are resistant
typically a healthy person exhales how much vital capacity in the 1st second? how much with restrictive disease?
80%
*but about 86% with restrictive (bc exhaling champs)
when you take a deep breath, the alveolar septal walls pull?
the airway open
* called radial traction
radial traction does what?
increases radius of airway which greatly decreases resistance to airflow
*by the septal walls pulls the airways open
law of poiseuille tells us?
the resistance to flow for a fluid through a tube
resistance to airflow is closely associated with the ____ of the airway
radius
in the law of poiseuille, why is r^4 iportant?
bc a small increase in the radius cause HUGE decreases in resistance
what alters airway resistance?
1) auto stimulation
- -sympathetic
- -para
2) irritant reflexes
3) allergic
is there para neurons innervating airways?
Yes. they activate a signal transduction pathway that causes an increase in IP3, causing constriction
on (review this!)
is there any sym innervation of bronchial smooth muscle?
NO! No sym neurons, but there are beta 2 adronergic receptorson it
epi does what on bronchial smooth muscle?
released by adrenal medulla into blood, bind to beta 2 adronergic receptors on bronchial smooth muscle, activate cAMP, causing bronchial relaxation and bronchial dilation
define obstructive lung disease?
obstruction of airflow
*hard to move air thru airways
what is used to stop asthma attacks?
**
1) glucocorticoids = decrease inflammation
2) leukotriene inhibitors= decrease inflam
3) theophyline= smooth muscle relax
4) beta 2-sym agonists
what is typically in rescue inhalers for asthma?
beta 2 sym agonists
most common way to manage asthma?
glucocorticoids
glucocorticoids inhibit?
PLAs therefore you can’t make arachidonates, therefore you can’t make leukotriences
**from biochem! part 1 slide 24
common theme for all obstructive lung
diseases?
*****
a high resistance to air flow
how does inhalers/meds work for obstructive?
1) decrease resistance so air gets in by INCREASING dialation
2) decreases inflammation
large # of asthmatics is from?
production of leukotriences 4
problem with bronchitis?
thick layers of mucus decrease radius of airway and increase resistance
productive vs dry cough?
productive = mucus generated
whenever you hear productive cough, think?
possible chronic bronchitus
chronic bronchitis caused by?
leukotriences or another inflammatory agent
triggers of asthma?
physical, exercise, or emotional
obstructive vs restictive
- *O= disorders of airflow; diagnosed by maximal airflow tests (FEV1/FVC test); high resistance
- R= disorders of lung inflation; diagnosed by lung inflation tests (TLC, volumes and capacities); low resistance
how do you test for obstructive?
- do a FEV1/FVC ratio test (check max airflow)
- –FEV1= forced expired in first second
- –FVC= entire volume expired aka forced vital capacity
FEV1= ___% in healthy person
80%
FEV1= ___% in person with restrictive disease
- person with obstructive disease can breath out this much but RV and TLC is low
- if above 86% actually support restrictive disease
spirameters measure?
***test question
velocity and volume
*so you CAN complete FEV1/FVC test to check for obstructive disease
when airflow improves following beta 2 agonist inhaler medication, it indicates?
asthma
***the more severe the asthma, the greater the improvement after bronchodilator
a patient with obstructive lung disease has resistance to airflow and CANNOT ___ rapidly; note elevated RV and TLC
exhale
a
eu
pnea
dys
a= no eu= good pnea= breath dys= labor or faculty
define eupnea
normal breathing
define apnea
cessation of breathing
define hyperpnea
rapid breathing
define dyspnea
labored or faulty breathing
define hypoxia
condition of low oxygen
define hypoxemia
condition of low oxygen in blood
define hypercapnia/ hypercarbia
condition of elevated CO2 (cap and ar mean same thing)
define anoxia
absence of oxygen
define hyperventilation
increased breathing rate and/or depth
**beyond metabolic needs
define hypoventilation
decreased breathing rate and/or depth
** not ventilating as fast as body needs to bring in or remove metabolic gases
