Lecture 4 Flashcards

1
Q

Some most important disease that interfere with movement of air is called

A

Chronic obstructive pulmonary disease

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2
Q

What 3 conditions make up the COPD circle

A

Chronic bronchitis
Asthma
Emphysema

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3
Q

What is asthma

A

Reduction in airway diameter due to inflammation or contraction of smooth muscle

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4
Q

What is chronic bronchitis

A

Secretions blocking the airway

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5
Q

What is emphysema

A

Collapse of airways due to disruption of parenchyma

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6
Q

Intrapleural pressure is split into two sections

A

Static component

Dynamic component

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7
Q

What does the static component do

A

Holds the lungs open

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8
Q

What does the dynamic component do

A

Moves air in and out

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9
Q

Airflow happens in what direction

A

High to low

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10
Q

Where and when is the pressure the same when we breathe

A

When we pause to exhale or inhale

The pressure is the same at the lips to the alveoli

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11
Q

What does recoil of the lungs resist and assist

A

Resists inspiration

Assists expiration

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12
Q

Laminar flow has what pressure gradient

A

Small

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13
Q

Turbulent flow has what type of pressure

A

Large

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14
Q

In regards to radius what does it do to resistance and velocity

A

Resistance increases 16th

Velocity reduced 16th

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15
Q

In a tube where is the most air (new) travelling through

A

The middle of the tube

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16
Q

What sort of low volume are we talking about in chest trauma

A

50Hz

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17
Q

What do we need to measure airway resistance

A

Driving pressure and the airflow of the tube

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18
Q

Airways resistance is said to only be

A

Dynamic

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19
Q

What instrument is used to test airway resistance

A

Pneumotachograph

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20
Q

How do we measure intrapleural pressure

A

Insertion of a small balloon in oesophagus

21
Q

How do we work out alveoli pressure

A

Subtracting changes in recoil pressure from changes in intrapleural pressure

22
Q

What is a whole body plethysmograph

A

Airtight box where a patient pants against a closed shutter or Pneumotachograph while pressure change in the mouth and box

23
Q

Distribution of airway resistance in an Open mouth

Mouth to trachea

Trachea to alveolar duct

A

Mouth to trachea 35-40%

Trachea to alveolar duct 60-65%

24
Q

Distribution of airway resistance in nasal breathing

Mouth to trachea

Trache to alveolar duct

A

Mouth to trachea 40-50%

Trachea to alveolar duct 50-60%

25
Q

Of the amount residing below the larynx how much resides in the trachea and bronchi

A

80%

26
Q

What cells release cytokines in response to allergens

A

NKT cells

27
Q

What do the cytokines do when released

A

Trigger inflammation and this causes the air passage to become inflamed and mucus filled

28
Q

What does NANC mean

A

Non adrenergenic non cholinergic nerve

29
Q

What does VIP mean

A

Vasoactive intestinal peptide

30
Q

What does RAR mean

A

Rapidly adapting pulmonary sensory receptor

31
Q

What does PSR mean

A

Slowly adapting

32
Q

Name 7 factors of the bronchomotor tone

A
  1. Parasympathetic innervation (contracts)
  2. Circulating catecholamines
  3. Autonomic nerve supply (relaxes)
  4. Mast cell degranulation
  5. Neutrophils and eosinophils
  6. RAR contracts an PSR relaxes
  7. CO2 directly relaxes muscle
33
Q

Inflammation during asthma does what

A

Irritates the lining of bronchial tubes so tey become swollen and inflamed an excess mucus makes breathing difficult

34
Q

Bronchoconstriction of asthma does what

A

Bands of muscle surround the bronchial tubes contract causing the airway to narrow

35
Q

What are the 2 stages of asthma

A

Immediate phase - spasm of bronchial muscle

Late phase - acute inflammation reaction

36
Q

Treatment of asthma

A

Early stage - relax smooth muscle eg xanthines

Late stage - reduce inflammation eg glucocorticoids

37
Q

What is bronchitis

A

Excessive production of lung mucus

38
Q

What is radial traction

A

Parenchyma forms a

Scaffolding aroun airways

39
Q

If parenchyma was rigid what would doubling linear dimensions increase too

A

Increase volume 8x

Increase conductance 2 power 4

40
Q

What happens when low lung volume appears

A

Airways collapse and radial support disappears and airway pressure increases

41
Q

In emphysema is radial traction is lost what happens to the alveoli

A

They collapse

42
Q

What is the best measurement of obstructive diseases

A

Flow / volume curve

43
Q

What % is work of breathing at rest

A
44
Q

What is work

A

Intrapleural pressure X change in volume

45
Q

Work of breathing is made up of

A

Elastic resistance of tissues

Airflow resistance

46
Q

Some work done by inspiration is recovered by what

A

Elastic recoil

47
Q

What is total work of breathing

A

Work done against recoil and work to produce airflow

48
Q

What 4 categories are clinical presentation

A

At risk
Symptomatic
Exacerbations
Respiratory failure