Common Respiratory Conditions Flashcards
Define dyspnoea
difficulty breathing
define ventilation
the amount of air entering or leaving the lungs
define perfusion
the amount of blood perfusing a capillary bed
define hyper or hypoventilation
hyper = excessive ventilation, hypo = decreased ventilation
define trachypnoea
increased respiratory rate
define bradypnoea
decreased respiratory rate
define hypoxia
reduced oxygen in tissues
define hypoxaemia
reduced levels of oxygen in the blood
define hypercapina
increased carbon dioxide levels in the blood
define cyanosis
blue discolouration of the skin
define acidosis
blood Ph lower than 7.35
define alkalosis
high blood Ph above 7.45
define parenchyma
tissue in the lungs
What is a restrictive respiratory disease?
restrictive is where there is a small volume of air flowing in, meaning the total lung capacity is low and there is a decreased lung compliance. There is restriction to airflow, which means it is harder to fill and inflate the lungs
What is an obstructive respiratory disease?
Obstructive is where there is a small volume of air flowing out, meaning vital capacity is low and there is increased lung compliance. There is an obstruction to airflow, which means it is easier to fill and difficult to expel air.
What is cystic fibrosis?
A monogenetic disorder, which has mutation in the CFTR gene. it is an obstructive disorder but has some restrictive elements.
Which variant is cystic fibrosis?
The most common variant is delta F508 deletion mutation. The amino acid phenylaniline is deleted, and one AA deletion from a 1480 amino acid protein.
What is CFTR?
A chloride ion transporter. Chloride ions are being pumped out from the epithelial cells onto the epithelial surface.
What are the main cellular defects caused by CFTR variants?
Defects in protein production, defects in function of the pump, defects in regulation of the pump, defects in protein processing.
Explain detlaF508 variant defective processing.
Defective protein folding, which means it doesn’t fold properly. It doesn’t reach the plasma membrane, which means they don’t pump the chloride ions onto the epithelial surface.
What systems in the body does cystic fibrosis affect?
secondary biliary cirrhosis - blockage in tubules in the liver chronic pancreatis abnormal sweat electrolytes obstruction of vas defernes meconium ileus - plugging of the valve in new borns malabsorption lung abscess chronic bronchitis bronchiectasis honeycomb lung
what are the pathophysiological features in the lung due to cystic fibrosis?
dysregulated/reduced chloride secretion
increased sodium resorption into epithelial cells
water follows the sodium and is reabsorbed into the epithelium
mucus thickening
mucus adherent
Ph is lowered in bronchial epithelia
Ph is changed
What are the pathophysiological features in respiratory system due to cystic fibrosis?
airway obstruction chronic sinusitis hyperinflation of the lungs bronchiectasis peribranchial cuffing chronic pulmonary inflammation atelectasis lung abscess
what is bronchiectasis?
the widening of airways, scarred and thickened airway wall, loss of smooth muscle in the airway, and loss of mucus production.
What are the pathophysiological complication of cystic fibrosis in the lung?
chronic airway infection in occluded areas
pneumothorax
fragile, distended blood vessels - often bursting
widespread tissue destruction
pulmonary fibrosis (restrictive) and pulmonary hypertension
ventilation - perfusion mismatching occurs
chronic respiratory failure - hypercapnia, hypoxia or both
What is COPD?
Chronic obstructive pulmonary disease, which causes airway obstruction, hyperinflation of the lungs, and causes the chest to be full of lungs tissue. It is a mix of emphysema and chronic bronchitis together
What is emphysema?
it causes less alveoli, less surface area and less respiratory surface, vast pockets of alveoli, larger air spaces and less elastin in the tissues
what is chronic bronchitis?
it causes thickened mucosa in the bronchiole walls, much more mucus being produced, and the loss of ciliated cells that keep everything clean
How does COPD cause obstruction?
it causes blockage and plugging in the lumen, bronchoconstriction and inflammation in the walls, and parenchyma loss. It also causes an increased resistance of airflow and a reduction of expiratory flow rate
What are the adult COPD risk factors?
tobacco smoking
indoor air pollution
outdoor air pollution
occupational dusts and chemicals
What are the child COPD risk factors?
Maternal/paternal asthma
childhood asthma
severe respiratory infections before age of 5
maternal smoking
What is FEV and FVC, and their normal ranges?
FEV = forced expiratory volume in one second
FVC = forced vital capacity
Normal ranges = FEV - 4.0L and FVC - 5.0L so in one second, they’ve emptied 80% of their lungs.
What are the etiologic factors of atshma?
Asthma is obstructive character of air breathed out - smoking, cold air, pollutants acid reflux post nasal drip stress and anxiety genetic linkage drug induced
What is diffuse pulmonary fibrosis?
A restrictive respiratory disease, which raises the diaphragm, which makes it spacious and not as easy to inflate, which also makes it difficult to speak. It increases the interstitial space between the capillaries and alveoli which compromises the elasticity of the tissue
What are the features of pulmonary fibrosis?
dyspnoea, dry cough, shallow breathing, reduced chest movements, clubbing of finger tips and nails
Explain the interstitial lung disease pathology
reactive interstitial inflammation
amputation of distal airway and ingrowth of bronchiolar epithelium
causes dense fibrosis and collapsed distal airway
can cause honeycomb lung
Explain the role of the lung is acid base balance
The lungs keeps the homeostatic control working for the pH of blood. carbon dioxide production is respiring tissues is constant, lungs expel 240ml/min. the buffering system can donate or accept protons but elimination of excess is important
what happens to the respiratory system as we age?
the respiratory surface area decreases, alveolar size increases, bronchiole diameter increases, elasticity of lung tissues decreases, dysregulation of fibroblast function and thoracic compliance decreases.
Outline the effects of viral pneumonia and parenchyma on the lungs.
Viral pneumonia causes the lungs air sacs to become inflamed, and fill up with fluid or pus.
