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Respiratory System > Obstructive Airway Diseases > Flashcards

Obstructive Airway Diseases Flashcards

1
Q

Name 3 obstructive airway diseases

A

Chronic Bronchitis
Emphysema
Asthma

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2
Q

Chronic Obstructive Pulmonary Disease (COPD) is the name more commonly known for what diseases?

A

Chronic Bronchitis

Emphysema

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3
Q

What is FEV1?

A

The forced expiratory volume

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4
Q

What is the normal FEVE1 volume?

A

3.5 - 4 litres

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5
Q

What is the normal FVC volume?

A

About 5 litres

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6
Q

What is the normal ratio of FEV1 : FVC?

A

0.7 - 0.8

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7
Q

What is the normal peak expiratory flow rate (PEFR)?

A

400-600 litres/min

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8
Q

What is the normal range of PEFR (as a percentage of best value)?

A

80-100%

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9
Q

What effect do obstructive lung diseases have on:
PEFR
FEV1
FVC

A

PEFR - reduced
FEV1 - reduced
FVC - may be reduced, may be normal

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10
Q

What causes bronchial asthma?

A

Type I sensitivity in the airways

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11
Q

Bronchial asthma is driven by what?

A

Mast cell degranulation

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12
Q

What two groups of chemicals are released due to degranulation?

A

Chemotactic factors

Spasmogens

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13
Q

What does bronchial asthma cause the cross-sectional area of the lumen in small bronchioles to do?

A

Reduce

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14
Q

Is bronchial asthma generally considered to be reversible or irreversible?

A

Reversible

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15
Q

What effect does bronchial asthma have on bronchial smooth muscle?

A

Bronchial asthma causes contraction and inflammation of the bronchial smooth muscle

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16
Q

Give a cause of COPD?

A

Smoking
Atmospheric pollution
Occupational pollution (e.g. asbestos)
Ageing

(Alpha-1-antiprotease (antitrypsin) deficiency = very rare cause of emphysema)

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17
Q

What morphological changes occur in the large airways in chronic bronchitis?

A

Mucous gland hyperplasia
Goblet cell hyperplasia
inflammation and fibrosis (minor component)

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18
Q

What morphological changes occur in the small airways in chronic bronchitis?

A

Goblet cells appear

Inflammation and fibrosis in long standing disease

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19
Q

Emphysema is an increase beyond normal in the size of airspaces distal to the terminal bronchiole arising from

A

Dilatation
or
destruction of their walls

20
Q

What type of emphysema begins with bronchiolar dilatation followed by loss of alveolar tissue?

A

Centri-acinar Emphysema

21
Q

What is Panacinar Emphysema characterised by?

A

Permanent destruction of the entire acinus distal to the respiratory bronchioles
No obvious associated fibrosis

22
Q

What is Bullous Emphysema characterised by?

A

The presence of one or more abnormally large air spaces surrounded by relatively normal lung tissue

23
Q

What is a Bulla?

A

An emphysematous space greater than 1cm

24
Q

What is a “bleb”?

A

An emphysematous space greater than 1cm (a bulla) just underneath the pleura

25
Q

What components of small airways have been found to respond to pharmacological intervention?

A

Smooth muscle tone

Inflammation

26
Q

What value of PaO2 is seen in type I respiratory failure?

A

PaO2

27
Q

What is the value of PaCO2 in type I respiratory failure, compared to normal?

A

Normal or low

28
Q

What is the value of PaCO2 in type II respiratory failure?

A

PaCO2 > 6.5 kPa

29
Q

What is the value of PaO2 in type II respiratory failure compared to normal?

A

(usually) low

30
Q

What are the four abnormal states associated with Hypoxaemia?

A
  • Ventilation/Perusion imbalance (V/Q)
  • Diffusion Impairment
  • Alveolar Hypoventilation
  • Shunt
31
Q

What does a ventilation/perfusion mismatch cause which contributes to COPD?

A

Airway obstruction

32
Q

What does diffusion impairment cause which contributes to COPD?

A

Loss of alveolar surface area

33
Q

What does alveolar hypoventilation cause which contributes to COPD?

A

Reduced respiratory drive

34
Q

When does shunt occur in hypoxaemia?

A

Only during active ineffective exacerbation

35
Q

What is the normal ventilation/perfusion ratio?

A

4/5 (0.8)

36
Q

What ventilation/perfusion imbalance is the most common cause of hypoxaemia?

A

Low V/Q

37
Q

Local alveolar hypoventilation due to some focal disease may cause what to arise in some alveoli?

A

Low V/Q

38
Q

Hypoxaemia due to low V/Q responds well to small increases in what?

A

FIO2

39
Q

What effect does alveolar ventilation have on PACO2 and PaCO2?

A

PACO2 - increases

PaCO2 - increases

40
Q

What effect does increased PACO2 have on PAO2 and PaO2?

A

PAO2 - decreases

PaO2 - decreases

41
Q

A fall in PaO2 due to hypoventilation is corrected by raising what?

A

FIO2

42
Q

What is FIO2?

A

The fraction of inspired air which is oxygen

43
Q

What does hypoxia cause in the pulmonary arterioles?

A

Vasoconstriction

44
Q

Pulmonary arteriolar vasoconstriction can be a localised effect, what would cause all vessels will constrict?

A

Hypoxaemia

45
Q

Why is vasoconstriction a protective mechanism?

A

As it stops blood being sent to alveoli that are short of oxygen

46
Q

What is Chronic Cor Pulmonale?

A

Hypertrophy of the right ventricle resulting from disease affecting the function and/or structure of the lung

47
Q

What factors cause Pulmonary Hypertension to occur in Hypoxic Cor Pulmonale?

A
  • pulmonary vasoconstriction
  • muscle hypertrophy and intimal fibrosis in pulmonary arterioles
  • loss of capillary bed
  • secondary polycythaemia
  • bronchopulmonary arterial anastamoses

Respiratory System (17 decks)

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