Pulmonary Phys theme 1 Flashcards
Name the vascular lung disorders
Pulmonary embolism
Pulmonary edema
Pulmonary hypertension
Congenital malformation
Name the restrictive-like lung disorders
Interstitial pulmonary fibrosis sacrcoidosis environmental factors hypersensitivity pneumonitis certain cancers pleural effusions & thickening Pneumothorax scoliosis ankylosing spondylitis obesity neuromuscular disorers pulmonary edema
Changes seen in a PFT for a person with obstructive lung disorder?
lower FEV1 leading to a lower FEV1/FVC (norm value 80%)
changes seen in a person with restrictive like lung disorder
dec FVC leading to and inc in FEV1/FVC ratio (norm value 80% you’ll see ~90% here)
what creates the subatmoshperic Ppl?
It is created by the tension between the chest wall expanding force, and the lungs collapsing force
How does the diaphragm contracting begin inspiration?
it inc the pleural space-> makes the pleural pressure more negative -> lungs expand-> cause negative alveolar pressure-> causing a gradient btw alveoli and atmosphere-> air flows in
be able to describe the respiratory cycle
1.06 slide 9-14
whats the biggest factor in Airway Resistance?
size of radius
the bigger the radius = less resistance
How does adding branches lower airway resistance?
the branches are added in a parallel circuit fashion, which lowers the resistance of the system
What does radial traction do for airways?
its mechianically tethered
it inc the diameter which will lower the resistance
What happens if you lower the radius of of airways?
you inc the airway resistance making it more difficult to push air out(dec FEV1), takes a higher press gradient. This is what you see in an obstructive lung disorder (like asthma)
Why do you get an occulsion in emphysema during forced expiration?
in emphysema you have a reduce alevolar elastic component so you have less recoil force. Has you go up the airway you lose some of your pressure due to airway resistance. You can get to a point that the pleural pressure is actually greater than the airway pressure which is what causes the occulsion
What/How do we overcome pulmonary surface tension?
surfactant, which is produce by type 2 pnemocytes, which only cover a small fraction of the alveolar surface area. This is why they have a greater effect on small alveoli from collapsing
what is surfactant?
mixture of lipids and proteins sim to phospholipids of the membrane. They interpose themselves between water molecules to reduce surface tension.
whats the importance of reducing surface tension with surfactant?
based on size pressure laws air would flow to just bigger alveoli bc of reduced surface tension. Surfactant reduces surface tension of smaller alveoli, kind of evening out the ball field, so air goes into both small and big alveoli
Why does a person with restricted lung disease inc their breath freq?
resistricted lung disease inc the work of breath during inspiration. People want to breath at the lowest work needed to breath, so to compensate the inc workload to do normal breath, someone will just inc their breath rate instead of working harder to inflate to normal capacity
How does obstructive lung disorder effect ones work of breathing?
it inc the work of breathing during expiration
What happens when Pulmonary Pressure goes up?
vascular resistance goes down-> pulmonary blood flow goes up
What can cause lace of function to ciliated epithelium in the Respiratory tract?
infection (big player) chemical (alcohol & smoking) congentital (situs inversus) increases pneumonias (Klebsiella pneumoniae) toxins from bacteria -> paralysis
Defects in immunity increases incidence of upper respiratory tract infections by what?
encapsulated organsisms, especially:
streptococcus pneumoniae
Neisseria meningitidis
Haemophilus influenzae
Defects impact oropharyngeal area causing increase in infection by?
Haemophilus meningitidis and Neisseria influenzae
Infection of the upper respiratory tract that cause inflammation?
sinusitis (bacterial), otitis media (fungal), pharyngitis (viral)
infection of the lower respiratory?
pneumonia
Describe the TLR signaling pathway?
TLRs recognize PAMPs -> MyD88 activates NFKappaB-> induces the transcription of cytokines
