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Year 1: LSS 1 > Respiratory System > Flashcards

Respiratory System Flashcards

1
Q

What type of epithelium lines alveoli?

A

Simple squamous

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2
Q

What do the upper airways consist of?

A

The nasal cavities
Larynx
Nasopharynx
Laryngopharynx

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3
Q

How is the upper respiratory tract protected from cold shock and drying?

A

Inspired air passes through warm plates of conchae where air is warmed and humidified

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4
Q

Why does open air breathing take over during exercise

A

Nasal passages are narrow and complex and have a high resistance to air flow and during exercise, respiratory muscles can’t propel air through the nose fast enough

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5
Q

Where are paranasal sinuses located?

A

On the lateral walls of the nasal cavities

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6
Q

What is the purpose of the paranasal sinuses?

A

Crumple zone in trauma
Reduce weight of face
Voice resonators
Protect sensitive dental roots and eyes from temperature fluctuations

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7
Q

What do the lower airways consist of?

A

Trachea, bronchi and bronchioles

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8
Q

What is the purpose of the pleura?

A

Allow lungs to slide smoothly within pleural cavity during breathing

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9
Q

What are the surfaces of the lung?

A

Costal
Inferior (diaphragmatic)
Mediastinal

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10
Q

What is the highest part of the lung?

A

Apex

Lying 2-3 cm above clavicle in the root of the neck

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11
Q

What is the costo-diaphragmatic recess?

A

Lowest part of pleural cavity which contains no lung during expiration

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12
Q

What is minute ventilation?

A

Volume of air expired in one minute

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13
Q

What is the respiratory rate?

A

Frequency of breathing per minute

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14
Q

Why may alveoli not be able to take place in gas exchange?

A

Hypoperfused

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15
Q

What is the approximate tidal volume?

A

600 ml

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16
Q

What is the approximate inspiratory reserve volume?

A

2.7 L

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17
Q

What is the approximate expiratory reserve volume?

A

1.3 L

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18
Q

What is the approximate residual capacity?

A

1.2 L

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19
Q

What is the approximate total lung capacity?

A

6 L

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20
Q

What are anatomical dead spaces?

A

Nasal cavity
Larynx
Pharynx

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21
Q

How would you increase alveolar ventilation?

A

Increase depth of breathing

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22
Q

Why are the lungs always under negative pressure?

A

Due to the natural recoil of the lungs away from the chest wall

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23
Q

What is the pleural pressure of the lungs?

A
  • 5cmH20
  • 3 at base
  • 7 at apex
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24
Q

What is a haemothorax?

A

Accumulation of blood in the pleural cavity

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25
Q

Why does a haemothorax pose a problem?

A

Blood gradually fills into the pleural cavity which gradually reduces the area in which the lungs can expand. This leads to gradually more effort required to inhale a certain volume.
The overall volume achievable is reduced

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26
Q

Why does a pneumothorax pose a problem?

A

The negative pressure caused by the inward recoil of the lungs and outward recoil of chest wall is compromised.
The resistance between the two forces will disappear

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27
Q

Why is the FVC in restrictive disorders decreased?

A

Air trapping due to emphysema

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28
Q

How can peak expiratory flow measurement distinguish between asthma and cold?

A

cold measurements are stable whereas asthma is variable

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29
Q

Where does a flow volume loop begin on the x axis?

A

The total lung capacity

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30
Q

What measurements are higher in obstructive lung disease?

A

Residual volume and Total lung capacity

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31
Q

What measurements change in restrictive lung disease?

A

Total lung capacity is lower

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32
Q

What can cause variable extra thoracic obstruction?

A

Obstruction in upper airways

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33
Q

What can cause variable inter thoracic obstruction?

A

Obstruction in trachea

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34
Q

Why does the base of the lung ventilate more readily?

A

The effect of gravity on transpulmonary pressure makes the base more compliant

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35
Q

What else does gravity effect?

A

The distribution of blood flow, blood will perfuse the base more as it has the route of least resistance

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36
Q

How are V/Q ratios interpreted?

A

High V/Q- poor perfusion

Low V/Q- poor ventilation

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37
Q

What is Henry’s law?

A

At a constant temperature, the volume of gas that dissolves in a certain volume and type of liquid is proportional the the partial pressure and solubility of the gas in equilibrium with the liquid

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38
Q

What is Dalton’s law?

A

The pressure of a mixture of gases is the sum of the partial pressures of all gases in the liquid?

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39
Q

What is Fick’s law?

A

Molecules diffuse from an area of high concentration to low concentration at a rate that is directly proportional to the surface area of gas exchange, the solubility of the gas, the concentration gradient and inversely proportional to the exchange surface

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40
Q

What is Boyle’s law?

A

The volume of a gas is inversely proportional to partial pressure

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41
Q

What is Charles’ law?

A

The volume of gas is directly proportional to temperature

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42
Q

What does inspired air consist of?

A
  1. 2 % Nitrogen
  2. 9 % Oxygen
  3. 9 % Argon
  4. 04 % Carbon dioxide
  5. 01 % inert gases
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43
Q

What are the inert gases?

A

Xenon, helium, hydrogen, neon

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44
Q

What is barometric pressure at sea level?

A

101.3 kPa

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45
Q

What is inspired air humidified to?

A

6.3 kPa

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46
Q

What are allosteric proteins?

A

Proteins that change their change depending on what ligands are bound or unbound

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47
Q

What are the different glob in chains?

A

Alpha
Beta
Delta
Gamma

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48
Q

Where is the harm group attached to the protein chain?

A

The proximal histamine residue

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49
Q

What are the different variations of haemoglobin?

A

HbA - 98 % 2 alpha 2 beta
HbA2 - 2% 2 alpha 2 delta
HbaF - (foetal) trace amounts 2 alpha 2 gamma

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50
Q

Why is haemoglobin toxic?

A

Can cause renal failure by attacking renal tubule epithelia

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51
Q

What is the phenomenon where oxygen binds to haemoglobin, changing the conformation and allowing more oxygen to bind?

A

Co-operativity

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52
Q

How does oxygen bind promote oxygen unloading?

A

It affects the active site between two beta subunits for the binding of 2,3-DPG which is a co-factor in red blood cell energy production.
This cofactor binds to the beta subunits and pushes haemoglobin into the tense state to promote oxygen unloading

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53
Q

What will cause the Bohr effect? (rightwards shift)

A

Acidosis
Hypercapnia
Increased temperature
Increased 2,3-DPG

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54
Q

What is normal P50?

A

3.3kPa

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55
Q

How much greater is the affinity of Hb for CO than oxygen?

A

250x

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56
Q

Why does Hb binding to CO cause problems?

A

Reduces number of sites on Hb that can bind to oxygen

CO pushes Hb into tense state so it is unable to unbind from oxygen

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57
Q

What effect does CO have on the oxygen dissociation curve?

A

Pushes it downwards and to the left

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58
Q

What is methaemoglobin?

A

When the Fe2+ ligand becomes oxidised to the Fe3+ state and cannot bind haem

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59
Q

What is familial methaemoglobinaemia?

A

A genetically recessive disease presenting with a blue tinge to the skin

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60
Q

What are the differences between myoglobin and haemoglobin?

A

Myoglobin is monomeric

Myoglobin is principally a storage molecule found in myocytes

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61
Q

What is the route of oxygen during oxygenation?

A

From alveolar space, pulmonary epithelial cells, interstitial space, vascular endothelial cells, into the plasma, into red blood cells where it binds to Hb that is not yet saturated

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62
Q

Why does aqueous carbon dioxide pose a problem?

A

Will bind to H20 to form weak carbonic acid which will dissociate into protons and bicarbonate ions

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63
Q

What prevents the intracellular decrease in pH?

A

Excess protons are buffered by globin molecules

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64
Q

How is carbaminohaemoglobin formed?

A

Carbon dioxide binds to the amine group at the N-terminal of the Hb molecule

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65
Q

What is the Halade effect?

A

Describes the relationship between the saturation of oxyhaemoglobin and the formation of carboaminohaemoglobin

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66
Q

What is hypoxia?

A

Low oxygen environment

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67
Q

What is hypoxaemia

A

Low blood oxygen level

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68
Q

What is the oxygen cascade?

A

Reduction in partial pressure of oxygen from atmospheric air to respiring tissues

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69
Q

What are the determinants the effects the oxygen cascade

A

Ventilation/perfusion matching
Alveolar ventilation
Cardiac output
Diffusion capacity

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70
Q

What are the adaptions to prevent the initial responses of hypobaric hypoxia?

A

Renal compensation- bicarbonate improves the pH and returns the oxygen dissociation curve to the correct place
Increase 2,3-DPG to increase oxygen unloading

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71
Q

What is a long term response to hypobaric hypoxia?

A

Secondary erythrocytosis. Hypoxia stimulates kidneys to release erythropiotein, leading the the bone marrow to produce red blood cells at a higher rate

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72
Q

What are the results of HAPE

A

Pulmonary artery vasoconstriction
Pulmonary artery hypertension
Capillary leakage

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73
Q

What treatment is available for HAPE?

A

Nifepidene

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74
Q

When do the lungs begin to develop from the tracheal bud?

A

4-5 weeks gestation

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75
Q

When is bronchial branching complete?

A

16 weeks gestation

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76
Q

When is alveolar development completed?

A

8-10 years of age

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77
Q

What is more important in malformation?

A

The timing of the insult rather than the nature

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78
Q

What supplies bronchial buds in utero?

A

Systemic vessels

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79
Q

What is agenesis?

A

When the developing lung does not develop

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80
Q

What are local lesions?

A

When the developing lung develops extra buds which present as lesions

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81
Q

What factors influence lung development?

A 
Hox genes
Maternal nutrition
Thoracic cage volume 
Paracrine and autocrine interactions
Growth factors 
Lung liquid positive pressure 
Amniotic fluid volume 
Transcription factors
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82
Q

Why is the lung inactive in the womb?

A

No air therefore no need

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83
Q

Why does maternal smoking result in reduced lung function for the baby at birth?

A

Affects the pacemaker which causes pulsation and respiratory movements. Inflammation has a greater effect and the baby will be more susceptible to disease

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84
Q

What is the umbilical vein?

A

Connects placenta to foetal circulation

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85
Q

What does the umbilical vein carry?

A

Blood to ductus venosus which takes blood to inferior vena cava
OR blood directly to the liver via the hepatic portal vein

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86
Q

What prevents blood from entering the pulmonary circulation in utero?

A

The foramen ovale is a whole that connects the right atrium to the left atrium which blood flows through
Blood is able to do this as the right atrium is at a higher pressure than the left

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87
Q

What does the ductus arteriosus connect?

A

The pulmonary artery to the arch of the aorta

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88
Q

What happens at birth?

A

There is massive CNS stimulation

Placental circulation is cut off and systemic pressure rises

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89
Q

Under the influence of prostaglandins, what do the ductus arteriosus and foramen ovale form?

A

Ligamentum arteriosum

Fossa Ovalis

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90
Q

What causes the fluid in lungs to recede?

A

Breathing
Expelled via mouth
Absorbed by lympatics

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91
Q

Where does superfactant come from?

A

Lamellar bodies in type II pneumocytes

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92
Q

What is trachoesophageal fistulae?

A

An opening between the oesophagus and trachea

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93
Q

What disease can occur in premature infants?

A

Respiratory distress syndrome (hyaline membrane disease)

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94
Q

Outline RDS

A

Deficient superfactant which decreases lung compliance and increases dead space.
Alveolar collapse leading to hypoventilation causing hypoxia and acidosis.
This leads to pulmonary vasoconstriction and pulmonary pressure increases. Right to left shunting.

95
Q

What is shunting?

A

Poor ventilation with normal perfusion

96
Q

What does mucus consist of?

A

Mucin proteins
proteoglycans
glycosaminoglycans

97
Q

What are the parts of mucus?

A 
Sol face (thin overlying the cells)
Gel phase (thick overlying the lumen)
98
Q

How does mucus protect lung tissue?

A

Contains alpha 1 anti trypsin. Which is a neutrophil protease inhibitor so any proteases in the lumen don’t affect lung tissue

99
Q

How does mucus combat oxidants?

A

Contain antioxidants including:-
Uric acid
ascorbic acid
Glutathione

100
Q

What is goblet cell hyperplasia?

A

Common in smoker
Number of goblet cells at least doubles and secretions increase
Mucous thickens
Can take cigarette smoke particles but becomes more habitable to micro-organisms

101
Q

How do cilia beat?

A

Metasynchronously

102
Q

Where are the tips of the cilia?

A

Sol phase of the mucus

103
Q

What is the appearance of cilia in smokers?

A

The numbers are depleted
Appear in bronchioles
Beat asynchronously
Can’t transport thickens mucous

104
Q

What is the main function of phase 1 enzymes?

A

cytochrome p450 oxidase

Protect against foreign material

105
Q

What problems do phase 1 enzymes cause?

A

They convert pre-carcinogens into carcinogens

106
Q

What is the ratio of type 1 to type 2 epithelial cells?

A

1:2

107
Q

What are type 1 epithelial cells?

A

Cover 95% of the alveolar surface

Present for efficient gas exchange

108
Q

What are type 2 epithelial cells?

A

type II pneumocytes containing lamellar bodies

and precursors to the type 1 cell

109
Q

What cells are more present in alveolar fibrosis?

A

Type II cells

Fibroblasts

110
Q

What are alveolar macrophages?

A

They make up 90% of phagocytic cells in lung
Phagocytose debris and microorganisms in the lung
Send messages to the blood and lymphatic system to recruit other leukocytes during infection

111
Q

How many neutrophils in large airway normally and in a smoker?

A

30%

70%

112
Q

Where is the involuntary centre located?

A

Metabolic centre

Medulla

113
Q

Where is the voluntary centre located?

A

Behavioural centre

motor centre in the cerebral cortex

114
Q

What overrides the behavioural centre?

A

The metabolic centre

115
Q

What effects the metabolic centre

A

Limbic system
Frontal cortex
Sensory inputs

116
Q

How does the medulla sense increased carbon dioxide?

A

Proton receptors in carotid bodies

Directly from extracellular fluid it is bathed in

117
Q

What is the pre-Botzinger complex?

A

nucleus in the brain that determines the rhythm of the lung

118
Q

What is chemosensitivity?

A

A change in minute ventilation due to a change in PaCO2

119
Q

What causes acute respiratory acidosis?

A

Hypoventilation

120
Q

What causes chronic respiratory acidoses?

A

When the correction mechanisms for hypoventilation are not enough ie. minute ventilation being increased, to increase 02 and correct pH

121
Q

What is metabolic acidoses?

A

Excess production of protons by the metabolism

122
Q

What is renal compensation?

A

Excreting weak acids and retaining chloride ions in a bid to reduce the strong ion difference

123
Q

What is metabolic alkalosis?

A

Excess production of Hc03-, reducing the proton concentration

124
Q

How is alkalosis corrected?

A

Hypoventilation- increasing ventilation
Long term renal compensation where chloride ions are excreted and protons are retained so the strong ion difference is increased

125
Q

What are the acute and chronic causes of central hypoventilation?

A

Acute- metabolic centre poisoning due to drugs

Chronic- disease of the metabolic centre, mountain sickness

126
Q

What are the acute and chronic causes of peripheral hypoventilation?

A

Acute- muscle relaxants and myasthenia gravis

Chronic- neuromuscular disease, neuromuscular weakness

127
Q

What disease is a mix of both central and peripheral hypoventilation?

A

COPD

128
Q

What are examples of hyperventilation conditions?

A

Chronic anxiety
Pulmonary vascular disease
Chronic hypoxaemia
Excess protons

129
Q

What is the predominant supply of the respiratory system?

A

Parasympathetic nervous system via the vagus nerve?

130
Q

What does the sympathetic nervous system have an effect on?

A

The adrenal glands, secreted catecholamines

131
Q

What does parasympathetic activation cause?

A

Smooth muscle constriction

Mucus secretion

132
Q

What is airway remodelling?

A

Basement membrane will thicken
Epithelium will become more fragile
Increased mucus secretion
More congested airways

133
Q

What does activation of beta receptors cause?

A

Bronchoconstriction

134
Q

What is the precursor of squamous cell carcinoma?

A

Squamous cell metaplasia leads to dysplasia
Leads to carcinoma-in-situ
Leads to squamous cell carcinoma

135
Q

What is the precursor of adenoma?

A

Atypical adenomatous hyperplasia

136
Q

What are the clinical features of lung cancer?

A 
Hoarseness of voice
Chest pain
Cough 
Clubbing of nails 
May be asymptomatic 
Haemoptysis 
Dyspnoea
137
Q

What does smoking cause?

A

Chromosal translocation
Formation of a fusion gene which inhibits the natural arrest of G1 causing a cell to unto mitosis uncontrollably
Also atopsis is halted

138
Q

How many lung cancers does non-cell carcinoma account for ?

A

75%

139
Q

Give examples of non cell carcinoma

A 
Adenocarcima
Large cell carcinoma
Squamous cell carcinoma
Broncho-alveolar carcinoma
Anaplastic carcinoma
140
Q

Which type of lung cancer is more responsive to chemotherapy?

A

Small cell carcinoma

141
Q

Which type of lung cancer is prevalent in non smokers?

A

Non small cell carcinoma - adenocarcinoma

142
Q

What organs should have a CT scan for staging?

A

Thorax, liver, adrenals

143
Q

What is stage TX

A

The primary tumour can not be assessed

144
Q

What stage is T0

A

No evidence of primary tumour

145
Q

What stage is Tis

A

Carcinoma in situ

146
Q

What stage is T1

A

Tumour is 3cm or less in dimension and is surrounded by the lungs or visceral pleura

147
Q

What stage is T2

A

Tumour is more than 3cm and invades the pleura, involves main bronchus, is 2 cm or more distal to the carina, involves atelectasis

148
Q

What stage is T3

A

Tumour of any size invades, parietal pericardium, diaphragm, chest wall, Is less than 2cm distal to carina but does not invade it

149
Q

What stage is T4

A

Tumour invades, heart, medistinum, great vessels, trachea, oesophagus, vertebral body

150
Q

Describe NX

A

Regional lymph nodes cannot be assessed

151
Q

Describe N0

A

No regional lymph node metastasis

152
Q

Describe N1

A

Involves ipsilateral hilar node

153
Q

Describe N2

A

Ipsilateral, mediastinal lymph node

154
Q

What are risk factors of lung cancer?

A

Smoking
Asbestos exposure
Radiation

155
Q

What is paraneoplastic syndrome?

A

What is caused by the effects of the tumour

Secondary effects due to the presence of the tumour itself

156
Q

Give examples of paraneoplastic syndrome

A

Cushings- ACTH release due to ectopic lung
Hypoatronaemia -adh release
Hypocalcaemia - parathormone

157
Q

What is mesothelioma?

A

Malignant tumour of the pleura due to asbestos exposure

158
Q

Why is mesothelioma usually fatal?

A

Has a long lag phase so symptoms take a long time to present?

159
Q

Which gender is mesothelioma more common in?

A

Males

160
Q

Which centre controls breathing during sleep?

A

Metabolic centre via the medulla

161
Q

What are the two main stages of sleep?

A

Rapid eye movement sleep

Non REM

162
Q

What causes the eyes to move during REM sleep?

A

The body is paralysed and relaxed due tot he release of neurotransmitters that render motor neurones immobile.
The only things that can move are the eyes and diaphragm

163
Q

What is the purpose of REM sleep

A

To consolidate memory

164
Q

What are the changes observed between wakefulness and sleep?

A

Reduced tidal volume
Reduced ventilatory rate
Reduce oxygen saturation
Reduced alveolar ventilation

165
Q

What is the apnoeic threshold?

A

The level of PC02 that must be exceeded to stimulate respiratory centres during sleep. If the levels are below the threshold apnoea will occur

166
Q

What is central sleep apnoea?

A

When one continuously stops breathing during sleep because impulses stop being sent to the brain because of hypocapnia.
If hypocapnia occurs, it will not be corrected and the CO2 reserve will decrease leading to apnoea
The p02 will decrease and pC02 increases leading a person to wake up as a result of discomfort

167
Q

What causes central sleep apnoea?

A

Lesion in the brain where breathing is controlled or can be congenital

168
Q

Which muscles cause stiffening of the pharynx and prevention of its collapse?

A

Tongue
Levator palitini
Tensor palatine

169
Q

Why is there difficulty in breathing whilst sleeping in COPD patients?

A

Accessory muscles will be paralysed

P02 is already low

170
Q

How is heart failure associated with central sleep apnoea?

A

Causes pulmonary congestion which irritates the J-receptors leading to chronic hyperventilation causing a patient to get closer to the apnoeic threshold

171
Q

What is the purpose of a cough?

A

A defence mechanism which protects the lower respiratory tract from foreign material and mucus build up

172
Q

What initiates a cough?

A

Irritant receptors sense irritants such as mucus and dust and the cough reflex is initiates via the superior laryngeal nerve to the vagus of the brain

173
Q

Where are irritant receptors most numerous

A

Posterior wall of trachea and present on airway epithelium
Pharynx
Stomach
Diaphragm

174
Q

What neurotransmitters are involved in relaying information to the cough centre?

A

GABA

Serotonin

175
Q

What can be used to suppress a cough?

A

Opiates

176
Q

Describe the mechanics of a cough

A

Begins with the inspiratory phase and then the closure of the glottis. This causes pressure to increase and the glottis opens after a certain point which forces air out during the expiratory phase

177
Q

What are causes of acute cough?

A 
Common cold
Post nasal drip
Throat clearance
Nasal blockage 
Nasale discharge
178
Q

How can gastric reflux cause cough?

A

Protons can travel into oesophagus to pharynx and enter respiratory system where they will act on cough receptors

179
Q

How is the cough for gastric reflux treated?

A

Proton pump inhibitors to cease the release of protons

180
Q

What are the different ways to treat cough?

A

Narcotic and non-narcotic cough medicine

Removing inflammation through use of corticosteroids

181
Q

What are the neural pathways for sensory input for lungs, airway and chest wall?

A

Vagus nerve

Spinal nerve

182
Q

What is the neural pathway for the sensory input of the nose?

A

Trigeminal nerve

183
Q

What are the neural pathways for the sensory input of the pharynx?

A

Glossoparyngeal nerve

Vagus nerve

184
Q

How does pain reach its target site?

A

Goes through the thalamus, spino-thalamic tract, to the dorsal horn of the spinal nerve

185
Q

Where are the dermatomes of the diaphragm situated?

A

Shoulder

186
Q

What may cause pleural pain?

A

Pulmonary infarction and pneumonia

187
Q

What may cause chest pain in non respiratory disease?

A

Cardiovascular disorder
Musculoskeletal
Gastrointestinal
Psychiatric

188
Q

Which two circulations does the lung have?

A

Bronchial and pulmonary

189
Q

Where do bronchial arteries arise from?

A

Thoracic aorta

190
Q

Where do bronchial arteries converge?

A

Pulmonary vein

191
Q

Describe the pulmonary circulation

A

It is a low resistance, high capacity circuit

192
Q

What are the purposes of pulmonary circulation?

A

Gas exchange
Metabolism of vasoactive substances
Filtration of the blood

193
Q

What compounds are cleared due to the action of enzymes on the pulmonary epithelium?

A

Serotonin
Leukotreines
Prostaglandins
Noradrenaline

194
Q

What acts as a filter of harmful emboli

A

Pulmonary microcirculation

195
Q

How are air emboli, fat emboli and cancerous cells removed?

A

Air- diffuse out and removed via alveolar air spaces
Fat- broken down by the vascular endothelium
Cancer- removed via secondary metastasis

196
Q

Give examples of shunts

A

Bronchial circulation
Formaen ovale
Ductus arteriosus
Atrial septum disease

197
Q

How does the pulmonary circulation prevent a great increase in resistance during exercise?

A

Greater recruitment of capillary beds

Distension of the vessels

198
Q

How do the adaptions of the pulmonary circulation to prevent an increase in resistance help?

A

Prevents oedema
Prevents an increase pressure on right ventricle
Slows velocity to ensure efficient gas exchange

199
Q

What are the differences between systemic vessels and pulmonary vessels in the event of hypoxaemia?

A

Systemic vessels dilate

Pulmonary vessels constrict

200
Q

What is more porous, systemic or pulmonary capillaries?

A

Pulmonary

201
Q

What can cause oedema?

A

Increasing hydrostatic press
Reducing interstitial oncotic pressure
Increasing interstitial protein
Reducing lymphatic drainage

202
Q

What are the consequences of oedema

A

Lungs become less compliant and therefor require more energy to be ventilated which can present with oedema.
Lead to bronchioles becoming swollen which increases resistance
Furthermore, if excessive oedema is present in the interstitial space then increases diffusion distance and impedes gas exchange

203
Q

Outline resting respiration

A

Diaphragm contracts, compressing the abdominal cavity and decompressing the thoracic cavity.
Interpleural pressure decreases from -5cmH20 to -8cmH20.
Lungs expand to prevent a further decrease in inter pleural pressure
Alveoli expand to return to normal pressure

204
Q

What allows the lungs to stretch?

A

Collagen

Elastin

205
Q

What is elastance?

A

Tendency of lungs to return to their original volume after the removal of inspiratory forces

206
Q

What is surface tension?

A

Tendency of water molecules to attract each other

207
Q

What does pulmonary surfactant consist of?

A 
Polar phospholipids (80%)
Neutral lipids (10%)
Protein (10%)
208
Q

How does pulmonary surfactant prevent oedema?

A

During expiration, the alveoli decrease in size which causes a reduction in pressure in the interstitial space which will draw fluid out of the pulmonary circulation.
Surfactant limits the change in size of the alveoli

209
Q

What are the causes of hypersensitivity?

A

Intolerance of food
Enzyme deficiency
Pharcological hypersensitivity

210
Q

What causes the acute symptoms of ally?

A

IgE mediated immunological reactions cause mast cell degranulation which results in histamine release

211
Q

What is atopy?

A

The heredity predisposition to produce IgE antibodies to common environmental allergens

212
Q

Give examples of atopic diseases

A

Allergic rhinitis
Atopic Eczema
Asthma
Anaphylaxis

213
Q

How are allergic tissue reactions characterised?

A

By the infiltration of Type 2 T helper cells and eosinophils

214
Q

What is the allergic march

A

The progression from atopic dermatitis to allergic asthma

215
Q

What mediates non atopic allergic diseases?

A

T cells

IgG

216
Q

Give examples of non atopic diseases

A

Coeliac disease
Contact dermatitis
Extrinsic allergic alveolitis

217
Q

Give examples of non-allergic hypersensitivity

A

Migraines
Bloating due to wheat intolerance
Enzyme deficiency
Irritable bowel syndrome

218
Q

What can anaphylaxis cause?

A

Oedema

Uticaria

219
Q

How would you treat anaphylaxis

A

With an epipen as is contain adrenaline to combat the histamine

220
Q

What drugs are used to treat rhinitis?

A

Antihistamines

Topical corticosteroids

221
Q

Give examples of histamine H1 receptor antagonists

A

Loratedine
Cetirizine
Fexofenadine

222
Q

What is specific immunotherapy?

A

Administering increasing extracts of allergens of a long period of time

223
Q

What are the pros and cons of specific immunotherapy?

A

Very effective in seasonal allergic rhinitis and lasts for a long time when administered over many years
However patients are at risk of developing general and possibly fatal anaphylaxis

224
Q

What is the arrangement in cilia?

A

9 pairs of dyenin arms on the outside and two in the middle

225
Q

What consists of cilia

A

Line the nose, middle ear, eustachian tube, line the bronchi as far as respiratory bronchioles
Form the tail of spermatozoa

226
Q

What is dextrocardia?

A

When the heart is on the right hand side

227
Q

What is Kartegeners syndrome?

A

When primary ciliary dyskinesia presents with bronchectasis, dextrocardia and chronic sinitus

228
Q

How do viral infections affect mucociliary clearance?

A

Destroy ciliary cells

Produce more water mucus which are not easily cleared by cilia as they are not sticky

229
Q

How does smoking effect ciliary epithelium cells?

A

Kills of cilia, causing ciliary dyskinesia, absent dyenin arms and compound cilia

230
Q

Why is H influenza chronically present in smokers?

A

They have fimbriae, allow them to anchor themselves to epithelium and resist being swept away by cilia

231
Q

What are present in the alveoli during pneumonia?

A

Cell debris
Fibrin
Bacterial invasion
Imflammatory cells

232
Q

What is the shape of streptococcus pneumoniae?

A

Diplococcus

233
Q

How does streptococcus pneumoniae cause harm?

A

Produces the toxin pneumolysin which punches holes into the alveolar cells which cannot regenerate therefore gas exchange is impaired

234
Q

What is broncthetasis?

A

Localised and irreversible dilation of part of the bronchial tree which is due to the muscle and elastic tissue being destroyed

Year 1: LSS 1 (3 decks)

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