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Flashcards in Final Deck (85):
1

How many L of air a day?

about 10,000

2

passageways of respiratory tract serve what purpose?

warm, clean, and humidify air

3

Alveoli epithelia

Type 1, type 2, alveolar macrophages

4

compliance

volume change of lung per unit pressure change; stretch-ability

5

Poiseuille's Law

resistance = pressure/ flow

6

sympathetic innervation

B2 adrenergic receptors induce:
smooth muscle relaxation
bronchodilation
decreased resistance to airflow

7

parasympathetic innervation

muscarinic cholinergic receptors induce:
smooth muscle contraction
bronchoconstriction
increased resistance to airflow

8

muscarinic receptor blockers

atropine & Atrovent
promote bronchodilation

9

obstructive lung diseases

disrupt airflow (increase resistance)
ex. asthma, chronic bronchitis, emphysema

10

factors decreasing airflow

bronchospasm, intraluminal secretions, irregularities of bronchial walls, decreased recoil, airway collapse

11

restrictive lung diseases

decreased expansion of lung tissue and decrease total lung capacity

12

asthma

chronic (symptoms come and go)
characteristics: narrowed airways, bronchospasms, mucosal edema, hypersecrections of viscous mucous
symptoms: wheezing, cough, sputum, status asthmaticus

13

where does asthma occur in the lungs?

bronchioles

14

status asthmaticus

repetitive asthma attacks with no pause

15

brochodilators

B2 beta adrenergic receptor agonists
-stimulate sympathetic system to RELAX
-used to treat asthma

16

muscarinic cholinergic receptor antagonist

drugs: Atrovent; Spiriva
-inhibit parasympathetic system
-used to treat asthma

17

What does cAMP do?

inhibits contractions

18

methyl-xanthines

drugs: aminophylline; theophylline
-break down cAMP (increase cAMP)
-prolong smooth muscle relaxation and bronchodilation
-used to treat asthma

19

Mast cell stabilizers

drugs: Intal; cromolyn sodium
-used to treat asthma

20

steroids

drugs: Flovent; Beclovent
-decrease inflammation and immune response
-used to treat asthma

21

leaukotriene modifiers

drugs: Singular, Accolate, Zyflo
-blocks leukotrienes
-used to treat asthma

22

immunotheraphy

drugs: Xolair
-used to treat asthma

23

Which medication to treat asthma has been replaced by leukotriene modifiers?

mast cell stabilizers

24

How does cigarette smoke lead to heart failure?

smoke --> chronic irratation/ elastin breakdown --> chronic bronchitis/ emphysema --> airway obstruction --> hypoxemia, hypoventilation --> heart failure

25

Can someone has chronic bronchitis without having emphysema?

yes, but they are mostly found together

26

shunted blood

blood that passed through the pulmonary circuit without becoming oxygenated

27

what does "V" stand for in V/Q ratio?

ventilation

28

what does "Q" stand for in V/Q ratio?

perfusion; cardiac output

29

what is a normal V/Q ratio value?

.8

30

what is a normal V rate? (P/Q ratio)

4.2 liters air/ min

31

what is a normal Q rate? (P/Q ratio)

5.0 liters of blood/ min

32

Low V/Q indicates what?

inadequate ventilation
-asthma
-chronic bronchitis
-pneumonia
-commonly seen with obstruction

33

High V/Q indicates what?

decreased perfusion
-primary embolism
-commonly seen with blood clots

34

Chronic bronchitis

chronic inflammation of bronchial tissue with chronic cough for at least 3 months per year for 2 consecutive years

35

Changes in bronchial tissue during chronic bronchitis

-hypertrophy of mucus glands
-increase number of goblet cells
-impaired ciliary function

36

Symptoms of chronic bronchitis

-cough
-cyanosis
-hypoxemia (turns tissue blue)
-right sided heart failure (causes bloating)

37

cor pulmonale

Blue bloater

38

where does chronic bronchitis occur?

primary and secondary bronchus

39

what is the functional unit of the lungs?

alveoli

40

Emphysema

abnormal permanent enlargement of gas exchange airways accompanied by destruction of alveolar walls

41

pathology of emphysema

-elastin breakdown
-large air pockets in lung
-increased protease activity
-deficiency of protease inhibitor

42

types of emphysema

~centrilobular emphysema
- respiratory bronchioles initially effected and developes due to cig smoke
~panlobular emphysema
-uniform involvement from bronchiole to alveoli and deficient in protease inhibitor
-thin, flimsy, non-elastic walls

43

symptoms with emphysema

-dyspnea
-barrel chest
-pink puffer (airway collapse)
-less elastic recoil

44

spirometry

pulmonary function test that measures airflow rates
-results indicate airway resistance

45

treatment for COPD

-prevention (stop smoking)
-bronchodilators
-postural drainage
-supplemental O2

46

hypoxic drive

body uses O2 chemoreceptors instead of CO2

47

signs of indequate gas exchange

-cyanosis
-hypoxemia (low O2 in arteries)
-hypoxia (low O2 in tissues)
-hypercapnia (high CO2 in arteries)
-hypocapnia (low CO2 in arteries)

48

Adult Respiratory Distress Syndrome

ARDS or shock lung
acute, interstitial restrictive pulmonary disorder

49

Hyaline Membrane Disease of the Newborn

may arise in premature infants
type 2 pneumocytes (produce surfactant) have not matured

50

Clinical manifestations of Hyaline Membrane Disease of the Newborn

accelerate respiratory rate, flaring nostrils, harsh breath sounds, cyanosis, retraction, pooling of circulation, peripheral edema

51

treatment for ARDS

oxygen therapy and inhaled nitric oxide therapy

52

what are hyaline membranes composed of?

fibrin, cellular debris, RBC, neutrophils, and macrophages

53

pneumoconiosis

interstitial fibrosis of lung tissue due to chronic exposure to certain dusts
-injury, inflammation, scarring --> repeats every day building up collagen --> lungs don't expand

54

asbestosis

asbestos

55

beryllosis

beryllium

56

silicosis

silica (quartz)

57

anthracosis

black lung
coal

58

what other dust is often found in coal?

silica --> leads to both anthracosis and silicosis

59

pneumonia

consolidated areas of acute suppurative inflammation

60

what does pneumonia arise due to?

loss of cough reflex, mucociliary elevator impairment, alveolar macrophage impairment, pulmonary congestion and edema, accumulation of secretions

61

steps in pneumonia leading to healing/ death

streptococcus pneumonia --> inflammatory response congestion w/in 24 hr --> red hepatization --> gray hepatozation, fibrin, empyema --> resolution/ death

62

hepatization

lung tissue turning dense like liver tissue

63

what does bronchopneumonia progress to?

lobular pneumonia

64

reflexive pulmonary arteriole vasoconstriction

arteries in lungs constrict to minimize flow to poor aveoli

65

reflexive pulmonary arteriole vasoconstriction in smokers

-no better aveoli, but still have reflex
-increases workload on right side of heart --> right sided heart failure

66

What is the most vascularized organ?

kidneys

67

How much do the kidneys filter a day?

100L of filtrate is produced per day

68

What is the functional unit of the kidney?

nephron

69

What is the biggest arterial branch off of the abdominal aorta?

renal artery

70

How much of the cardiac out put are the kidneys receiving?

about 20%

71

What are the two leading causes of renal failure?

1. Diabetes Mellitus
2. HTN

72

nephrotic syndrome

kidney disorder that causes massive proteinuria

73

glomerulonephritis

injury/ inflammation of the glomerulus

74

What organ produces a majority of the plasma proteins?

liver

75

diffuse

relatively uniform involovement of most or all of the glomeruli; most common

76

focal

changes in only some of the glomeruli; others remain normal

77

mesangial

deposits of immune complexes in mesangial matrix

78

membranous

thickening of the glomerular capillary wall

79

proliferative

increase in number of glomerular cells

80

sclerotic

glomerular scarring form previous glomular injury

81

crescentic

accumulation of proliferation cells w/in Bowmans making appearance of crescent

82

Acute proliferative glomerulonephritis

immune mediated
type 3 hypersensitivity
large amounts of immune complexes over short amount of time
patchy deposition
leaking proteins --> no net charge
*most commonly seen in children*

83

Acute proliferative glomerulonephritis symptoms

hematuria, HTN, proteinuria, edema, oliguria to anuria, reduced filtration rate

84

Acute proliferative glomerulonephritis latent period

1-3 weeks

85

Acute proliferative glomerulonephritis outcomes

80-85% children cured
2-5% death acute stage
4% death in 3-18 months
10-20% develope chronic latent gromerulonephritis