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Exam 1 Respiration And Immunology Y2 > Intro To Respiration W1 > Flashcards

Intro To Respiration W1 Flashcards

1
Q

Neural control of respiration involves 3 components. What are they?

A
  1. Generation of alternating inspiration/expiration rhythm
  2. Regulation of the magnitude of ventilation
  3. Modified respiratory movements (voluntary and involuntary)
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2
Q

What is Regulation of the magnitude of ventilation?

A

How much we breath in and out

ie hold breath or slow down breathing. If not getting enough oxygen the brain will take back control and wont be voluntary

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3
Q

What does breathing depend on?

A

Cyclical respiratory muscle contraction

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4
Q

What is the pre-botzinger complex?

A

In the brain and sets respiratory rhythm

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5
Q

What is inspiration indicated by ?

A

Burst of action potentials in spinal motor nerves :
- phrenic nerve innervates the diaphragm
- intercostal nerves innervate the external intercostal

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6
Q

When these motor neurons are activated, what do they stimulate?

A

They stimulate muscle contraction leading to inspiration and when action potentials in these neurons cease the muscles relax leading to expiration

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7
Q

What determines how deep and quickly we breathe

A

This is determined by the oxygen and carbon dioxide in our system. More carbon dioxide needs more deeper breathing and more rapidly.

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8
Q

Our respiratory rate and tidal volume isn’t ……

A

Fixed

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9
Q

The Mac sheet of ventilation is adjusted in response to …..

A

Three chemical factors:
- PO2
- PCO2
- H+`

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10
Q

What do the three chemical factors respond to?

A

Changes in blood pH and gas content

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11
Q

Changes in blood pH and gas content detected by?

A

Peripheral chemo receptors in carotid and aortic bodies

Central chemo receptors stimulated by increased hydrogen in brain extra cell cellular fluid

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12
Q

Which part of the spiritually anatomy of medicines used to treat asthma/COPD?

A

The bronchi

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13
Q

What does bronchial smooth muscle depend on?

A

The balance between the parasympathetic input, circulating adrenaline/non-noradrenergic and non-cholinergic nerves

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14
Q

Cartilage and smooth muscle as you move from bronchi to bronchioles

A

There is less cartilage and more smooth muscle

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15
Q

Is bronchodilation agonist or antagonist?

A

Agonist

Relaxation/sympathetic

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16
Q

Is bronchoconstriction agonist or antagonist?

A

Antagonist

Contraction

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17
Q

Which types of muscarinic receptors and adrenergic receptors are most prominent in airway smooth muscles?

A

Muscarinic subtype = m1 and m3 (antagonist)

Adrenergic subtype = a1, a1 and b2 (agonists)

Both are GPCR’s

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18
Q

Where do we use agonists?

A

At adrenergic to encourage broncho dilation

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19
Q

Where do we use antagonists?

A

At muscarinic to encourage bronchoconstriction

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20
Q

What do bronchodilators do and what are the different types?

A

They open up the airways

Type one = beta adrenergic agonist
- SABA - salbutamol
- LABA - serovent

Type two = muscarinic antagonist
- SAMA - atrovent
- LAMA - incruse

Type three = xanthines

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21
Q

What do anti-inflammatories do and what are the different types?

A

They target the causes of bronchi dilation

One = corticosteroids
Two = leukotriene modifiers (LTRA) - motelukast
Three = anti IgE antibody
Four = biologics

22
Q

What is asthma?

A

An inflammatory disease of the airway categorised by recurrent attacks of breathlessness and wheezing, which vary in severity and frequency from person to person. The airway obstruction is mostly reversible with treatment or spontaneously.

23
Q

Classification of asthma

A

Extrinsic
- atopic
- Indoor triggers and outdoor triggers

Intrinsic
- non-atopic
- Obesity, stress, food additives, exercise, infections, occupation, exposure, cold air, drugs

24
Q

Asthma aetiology

A

Environmental
- allergens
- pollutants
- Tobacco smoke
- infections
- Diet
- Drugs
- Object

Host
- Genetic predisposition
- Age
- atrophy
- Airway hypersensitivity
- Biological sex
- ethnicity

25
Q

Asthma signs and symptoms

A

Shortness of breath, difficulty breathing, dry cough, cough, wheezing, chest pain

26
Q

What is COPD?

A

A disease characterised by airflow obstruction which is usually progressive, not fully reversible and does not change over several months. Airflow obstruction is due to airway and parenchymal damage on the result of chronic inflammation that differs from asthma.

It is an umbrella term for what used to be diagnosed as emphysema and bronchitis

27
Q

COPD aetiology

A

Smoking
- Occupational dust exposure and biomass in cooking an air pollution
- More than 90% associated with smoking but only 10% of smokers developed the disease

Alpha antitrypsin deficiency
- Autosomal recessive condition
- Auntie Alphatrypsin is an anti-protease enzyme which inhibits neutrophile elastase
- elastase breakdown extra cellular matrix leading to lung damage and Alviola collapse

28
Q

Symptoms of COPD depend on whether it is…

A

Bronchitis or emphysema is predominant

In reality, the underlying pathophysiology may be a mixture between the two extremes

29
Q

Bronchitis symptoms

A

• Patients often have a productive cough, are overweight, dyspnea on physical exertion.
• Retain CO2 and lose ability to increase the rate and depth of ventilation.
• Bronchospasm
• Wheeze and dyspnoea
• Hypoxia and hypercapnia
• Blue tinge on skin, lips and palms

30
Q

emphysema symptoms

A

• Patients tend to hyperventilate to compensate for hypoxia, appearing pink with little CO2 retention.
• They are often thin with pursed lips in an effort to compensate for lack of elastic recoil.
• Breathe more but not getting enough oxygen
• Increasing dyspnea even at rest
• Bronchial infection less common
• Minimal cough

31
Q

It could be hard to distinguish between COPD and asthma based on the symptoms alone.

Clinical features of COPD

A

• Smoker or ex-smoker - nearly all

• Symptoms under age of 35 - rare

• Chronic productive cough - Common

• Breathlessness - persistent and progressive

• Night time waking with breathlessness and/or wheeze - uncommon

• Significant diurnal or day to day variability of symptoms - uncommon

32
Q

It could be hard to distinguish between COPD and asthma based on the symptoms alone.

Clinical features of asthma

A

• Smoker or ex-smoker - possibly

• Symptoms under age of 35 - often

• Chronic productive cough - uncommon

• Breathlessness - variable

• Night time waking with breathlessness and/or wheeze - common

• Significant diurnal or day to day variability of symptoms - common

33
Q

What is the pre-botzinger complex?

A

small but crucial group of neurons in the brain stem specifically in the Medella that is critical for generating the rhythmic breathing pattern. It is considered the main pacemaker a breathing.

34
Q

What is the phrenic nerve ?

A

originates from the cervical spinal cord and controls the diaphragm contraction leading to inhalation

35
Q

What is the intercostal nerves?

A

group of nerves from the spinal cord that run between the ribs and are responsible for innovating intercostal muscles which expand and contract the rib cage

36
Q

Carotid

A

refers to the carotid arteries which are major blood vessels in the neck. There are two main carotid arteries the internal and external.

37
Q

Spirometry

A

test to help diagnose/monitor lung conditions.measures how much air you can breathe in and out.

38
Q

Atopic

A

refers to a genetic tendency to develop allergic conditions

39
Q

Non-atopic

A

refers to conditions that reserve but allergic responses but are not caused by allergens or an overreactive immune system. There is no genetic predisposition.

40
Q

Extrinsic

A

something that originates from what has caused by external factors

41
Q

Intrinsic

A

refers to something that originates from or is caused by internal factors

42
Q

Tidal volume

A

quantity of air in millilitres that we breath in an out in a normal breath

43
Q

Tidal volume

A

quantity of air in millilitres that we breath in an out in a normal breath

44
Q

Respiratory rate

A

rate at which we reach in breaths per minute

45
Q

Hypocapnia

A

below normal CO2 in arterial blood

46
Q

Dyspnea

A

difficulty breathing/shortness in breath

47
Q

Exacerbations

A

a sustained worsening of the patient’s symptoms from their usual stable state that is beyond normal day-to-day variations, and is acut in onset.

48
Q

Cyanosis

A

blueness of skin

49
Q

Hypercapnia

A

excess CO2 in arterial blood

50
Q

Hypoxia

A

insufficient O2 at cellular level

Exam 1 Respiration And Immunology Y2 (40 decks)

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