5.1.3 Pulmonary

Question 1

restrictive lung disease means?

Answer 1

restriction of lung inflation

*so much ER that is is hard to inflat

Question 2

two most common ways to get restrictive disease?

Answer 2

1) increase connective tissue

2) lack of pulmonary surfactant

Question 3

once of most common cause of death for hospitalizaed adults?

Answer 3

ARDS (adult respiratory distress syndrome)

Question 4

causes of ARDS?

Answer 4

tons of causes

• either utilize pulmonary surfactant too fast OR not making enough
• must constantly replace

Question 5

causes of decreased surfactant?

Answer 5

shock, severe blood loss, bone fracture, lung infections, drowning, transfusion, poilo

Question 6

examples of restrictive lung diseases due to CT?

Answer 6

fibrosis and asbestosis

Question 7

examples of restrictive lung diseases due to minimal surfactant?

Answer 7

IRDS and ARDS

Question 8

are there any diseases where the body makes too much surfactant?

Answer 8

not that we know of

Question 9

restrictive lung diseases are partially diagnosed via? using?

Answer 9

lung inflation tests!

*using a spirometry

Question 10

how does spirometer work in detecting restrictive lung disease?

Answer 10

struggle to fully inflate lungs, but is world champ at exhaling due to so much ER indicates restrictive lung disease

Question 11

what is wrong with airways in restirctive lung diseases?

Answer 11

NOTHING- they are fine

* don’t get restrictive and resistance confused! restrictive lung diseases does NOT mean they are resistant

Question 12

typically a healthy person exhales how much vital capacity in the 1st second? how much with restrictive disease?

Answer 12

80%

*but about 86% with restrictive (bc exhaling champs)

Question 13

when you take a deep breath, the alveolar septal walls pull?

Answer 13

the airway open

* called radial traction

Question 14

radial traction does what?

Answer 14

increases radius of airway which greatly decreases resistance to airflow
*by the septal walls pulls the airways open

Question 15

law of poiseuille tells us?

Answer 15

the resistance to flow for a fluid through a tube

Question 16

resistance to airflow is closely associated with the ____ of the airway

Answer 16

radius

Question 17

in the law of poiseuille, why is r^4 iportant?

Answer 17

bc a small increase in the radius cause HUGE decreases in resistance

Question 18

what alters airway resistance?

Answer 18

1) auto stimulation
- -sympathetic
- -para
2) irritant reflexes
3) allergic

Question 19

is there para neurons innervating airways?

Answer 19

Yes. they activate a signal transduction pathway that causes an increase in IP3, causing constriction
on (review this!)

Question 20

is there any sym innervation of bronchial smooth muscle?

Answer 20

NO! No sym neurons, but there are beta 2 adronergic receptorson it

Question 21

epi does what on bronchial smooth muscle?

Answer 21

released by adrenal medulla into blood, bind to beta 2 adronergic receptors on bronchial smooth muscle, activate cAMP, causing bronchial relaxation and bronchial dilation

Question 22

define obstructive lung disease?

Answer 22

obstruction of airflow

*hard to move air thru airways

Question 23

what is used to stop asthma attacks?

**

Answer 23

1) glucocorticoids = decrease inflammation
2) leukotriene inhibitors= decrease inflam
3) theophyline= smooth muscle relax
4) beta 2-sym agonists

Question 24

what is typically in rescue inhalers for asthma?

Answer 24

beta 2 sym agonists

Question 25

most common way to manage asthma?

Answer 25

glucocorticoids

Question 26

glucocorticoids inhibit?

Answer 26

PLAs therefore you can't make arachidonates, therefore you can't make leukotriences **from biochem! part 1 slide 24

Question 27

common theme for all obstructive lung diseases? *****

Answer 27

a high resistance to air flow

Question 28

how does inhalers/meds work for obstructive?

Answer 28

1) decrease resistance so air gets in by INCREASING dialation 2) decreases inflammation

Question 29

large # of asthmatics is from?

Answer 29

production of leukotriences 4

Question 30

problem with bronchitis?

Answer 30

thick layers of mucus decrease radius of airway and increase resistance

Question 31

productive vs dry cough?

Answer 31

productive = mucus generated

Question 32

whenever you hear productive cough, think?

Answer 32

possible chronic bronchitus

Question 33

chronic bronchitis caused by?

Answer 33

leukotriences or another inflammatory agent

Question 34

triggers of asthma?

Answer 34

physical, exercise, or emotional

Question 35

obstructive vs restictive

Answer 35

* *O= disorders of airflow; diagnosed by maximal airflow tests (FEV1/FVC test); high resistance * * R= disorders of lung inflation; diagnosed by lung inflation tests (TLC, volumes and capacities); low resistance

Question 36

how do you test for obstructive?

Answer 36

* do a FEV1/FVC ratio test (check max airflow) - --FEV1= forced expired in first second - --FVC= entire volume expired aka forced vital capacity

Question 37

FEV1= ___% in healthy person

Answer 37

80%

Question 38

FEV1= ___% in person with restrictive disease

Answer 38

* person with obstructive disease can breath out this much but RV and TLC is low * if above 86% actually support restrictive disease

Question 39

spirameters measure? | ***test question

Answer 39

velocity and volume | *so you CAN complete FEV1/FVC test to check for obstructive disease

Question 40

when airflow improves following beta 2 agonist inhaler medication, it indicates?

Answer 40

asthma | ***the more severe the asthma, the greater the improvement after bronchodilator

Question 41

a patient with obstructive lung disease has resistance to airflow and CANNOT ___ rapidly; note elevated RV and TLC

Answer 41

exhale

Question 42

a eu pnea dys

Answer 42

``` a= no eu= good pnea= breath dys= labor or faculty ```

Question 43

define eupnea

Answer 43

normal breathing

Question 44

define apnea

Answer 44

cessation of breathing

Question 45

define hyperpnea

Answer 45

rapid breathing

Question 46

define dyspnea

Answer 46

labored or faulty breathing

Question 47

define hypoxia

Answer 47

condition of low oxygen

Question 48

define hypoxemia

Answer 48

condition of low oxygen in blood

Question 49

define hypercapnia/ hypercarbia

Answer 49

condition of elevated CO2 (cap and ar mean same thing)

Question 50

define anoxia

Answer 50

absence of oxygen

Question 51

define hyperventilation

Answer 51

increased breathing rate and/or depth | **beyond metabolic needs

Question 52

define hypoventilation

Answer 52

decreased breathing rate and/or depth | ** not ventilating as fast as body needs to bring in or remove metabolic gases