Chapter 8. Respiratory System Flashcards
The volume inspired or expired with each normal breathing and what measuring device?
Lung volume/ Tidal volume.
Spirometer
- The volume that remains in the lung after a maximal expiration, cannot measured by spirometer.
- vol. of air expired in 1s after max inspiration. Measured by spirometer.
- Residual volume
- Forced expiratory volume (FEV1)
Lung capacities:
The sum of all four lung volumes. The volume in the lungs after maximal inspiration.
Total lung capacity: (tidal volume, inspiratory lung volume, expiratory lung volume, residual volume)
- Measure vol. that has been exhaled at the end of the first second (FEV1). Diagnosis of obstructive lung diseases such as asthma and COPD.
- test to determine asthma severity for patient at home. This test measures the highest forced expiratory flow.
- Spirometer
- Peak flow meter
Sites and cause for asthma and COPD
A: -Bronchus or bronchial tube
-Inflammation in bronchus
C: Alveoli (enlarged, over-stretched, loss of long elasticity) Air trapped in lung.
-Permanent (irreversible) enlargement alveoli (emphysema) and /or Chronic bronchitis
Symptoms and tx for asthma
- Wheezing(main), cough, sputum, and SOB, cheat tightness, tachy♥️, tachypnea and pulses paradoxus
- Bronchodilators, Steroids (ICS, PO, IV), Eosinophilic, Obstruction of airflow is reversible
Immunization and prevention for asthma and COPD
A: -Flu vaccine annually Pneumococcal vaccine
-Avoid triggers (allergens, exercise, emotional stress, cold air, (NO trigger is warm air)
C: -Flu vaccine annually and Pneumococcal vaccine Q5- 10y in high risk.
-Causes of COPD, smoking, alpha1-antitripsine deficiency, air pollution, secondary smoke.
Symptoms and tx for COPD,
-DOC, cholinergic antagonist by blocking the brochoconstriction caused by activation of the PSNS
-Shortness of breath (SOB) (dyspnea), fatigue, cough, sputum
-Bronchodilators (SABD, LABD)
acute COPD oral steroids (not used? inhaled corticosteroids) Antibiotics (pneumonia) Neutrophil due to bacterial infections. Obstruction of airflow is irreversible
-Ipratropium DOC
Physiology of Lower Respiratory Tract: -Ventilation:
-What and where is the gaseous exchange?
- Ventilation: Air moves from Atmosphere ➡️URT➡️LRT➡️alveoli
- Respiration: alveoli capillary membrane
Factors that decrease the respiration
- Increased in resistance to air flow
- Decrease ventilation
- Decrease diffusion
- Mucosal edema
- Increased bronchial secretion
- Bronchospasm
- Arrangement of Bronchiole smooth muscles
- Diseases
• Tracheobronchial tubes have smooth muscle fibers arranged on a spiral around the tube
-Asthma, COPD is Emphysema and Bronchitis
Anatomy of Upper respiratory tract. Give Disorders:
Sinus (prenasal cavity in & around the nasal cavity)
Nasal cavity
Pharynx
Larynx
Trachea (past outside thoracic cavity)
Acute rhinitis Acute pharyngitis Acute tonsillitis Acute laryngitis Common cold (most prevalent of URI, and NOT life threatening but causes severe discomfort).
Tx for Upper respiratory tract
Antihistamine ➡️ Runny nose Decongestants (Sympathomimetics) ➡️ nasal congestion Antitussive ➡️ Cough
Antibiotics ➡️ Infections
Expectorants ➡️ Bring up mucus
Advantages of nasal route over oral route absorption of drugs
may include:
Nasal route has more blood vessels, higher onset of absorption.
Although smaller surface area than intestine, this has faster onset of action due to large quantity of blood vessels in the nasal route.
Which reaction can ozone cause in the lungs?
Ozone is a gas that may cause irritation and toxicity of pulmonary system. The main reaction of ozone in the body is oxidation.
Inflammation of the tongue, presence of pinkish-red central lesions on the dorsal surface of the tongue III- It can be a chronic condition of the tongue seen in?
Glossitis— pernicious anemia
This is an anti-inflammatory, nonsteroid inhaler, mast cell stabilizer used in asthma prophylaxis and as antiallergic agent.
Sodium cromoglycanate
Causes for asthma and COPD
- Avoid triggers (allergens, exercise, emotional stress, cold air, (NO trigger is warm air)
- Causes of COPD, smoking, alpha1-antitripsine deficiency, air pollution, secondary smoke.
Examples of drug(s) that may precipitate asthma:
Aspirin, β-Blockers, NSAIDs, Cholinergic drugs
Pathophysiologic characteristics of asthma:
Airway obstruction and inflammation
Thickened smooth muscle of airway
Mucosal edema
Narrowed lumen of airway
DOC for specific asthma emergency tx
Albuterol- fastest acting B-agonist
Precursor of leukotriene
-Give product of this precursor metabolism and MOA
- Arac. acid
- Cysteinyl leukotrienes. Leukotriene modifiers drugs inhibit leukotriene synthesis by inhibiting 5-lipoxygenase that catalyzes the conversion of arachidonic acid to leukotriene.
- Leukotriene modifiers drugs indications in the tx of asthma
- Montelukast a Leukotriene antagonist therapeutic use include?
-For prophylaxis and chronic treatment only.
NOT FOR ACUTE
-Asthma maintenance and ASA induced asthma
NOT: Acute asthma exacerbations
This is the new relative cromolyn like drug acting in a very similar way as sodium cromoglycanate does?
Nedocromil sodium
This is referred as steroid sparing agents, thus it is indicated to reduce corticosteroid doses
-Leukotriene antagonist
Patient has a relevant increase in his asthma symptoms due to environmental allergies. He is currently having salbutamol and fluticasone inhalers. What would you advise as an adjunct medication to treat his symptoms? Explain.
Sodium cromoglycate would be the best choice because it is a safe anti-inflammatory inhaler for children and very useful in treating environmental allergy and asthma prophylaxis.
