Lung notes

Question 1

In the lung we have trachea, windpipes, we have upper respiratory system and lower respiratory system where we have smaller branches of the bronchi getting into the respiratory bronchioles…one of the more important spaces we find is the alveoli which is place the gas exchange occurs

Question 1

Respiratory system consists of the air passages and the lungs which is divided into our conducting airways which is how the air moves to get into the lungs and then the actual respiratory issues of the lungs where this gas exchange takes places….we need to be able to get air to the proper parts of the lungs for exchanges to take place and then we need the proper structures in order for that exchange to take place once its there and we will see that we have disorders of both types sometimes its difficulty getting there sometimes its not being able to exchange once it is there

Question 2

_____________is the movement of gases into and out of the lungs…its function is it moves air out of the lungs and into the lungs but it doesn’t participate in gas exchange

Answer 2

Ventilation

Question 3

Ventilation is not gas exchange

Question 4

The process of gas exchange involves ventilation,perfusion, and diffusion

Question 5

So perfusion is the flow of blood

Question 6

What is ventilation? The flow of _____ into the lungs

Answer 6

air

Question 7

The amount of oxygen in the blood…in the arteries in the blood is usually above _________

Answer 7

80mm Hg

Question 8

Large majority of our oxygen is going to be bound to hemoglobin traveling through the blood

Question 9

Carbon dioxide is around half of what we see oxygen primarily

Question 10

About 10% of this can be dissolved and we will see this in our gas exchange and our buffer exchange things…talking about diffusing carbon dioxide this is one of those things that helps our pH balance…it also can be attached hemoglobin

About 30% in the bicarbonate again

Bicarbonate…carbon dioxide will exchange back and forth but this is going to influence how much of bicarbonate is in the blood

Question 11

___________ is the most common upper respiratory tract infection

Answer 11

Common cold

Question 12

Major transmission of common cold is through ________…touching…these are things we get on our hands that why its important to wash hands

Answer 12

fingers

Question 13

Common cold is NOT an airborne illness

Question 14

Common cold

Major points of entry:picking nose or rubbing your eyes

Question 15

Frontal sinuses are above our eyes

Maxillary sinuses are on the side of your nose

Ethmoid sinuses which are between your eyes

Question 16

Most sinus infections last 5 to 7 days or even less

Question 17

What is halitosis? __________

Answer 17

Bad breath

Question 18

The most common port of entry for cold viruses? _________

Answer 18

Fingers

Question 19

Is fingers transmission less contagious or more contagious than something that is in the air? fingers transmission is less contagious…in the air is going to spread easily

Question 20

Influenza is RNA virus
There are 3 different divisions: Type A, Type B, and Type C

The one that we think about when we think about the flu is Type A

Type A influenza is the most common and the most severe for the flu

Question 21

Influenza can affect multiple species usually its different flus for different species and its further divided into subtypes by 2 antigens H and N.When you hear about flu subtypes its H1N1

H is hemagglutin
N is neuraminidase…this is an adhesion molecule this is peptidase and they are the different ways that the flu is going to attach and find its way into the body so there divided into those ways

Question 22

Type B influenza is less common and considered to be less severe

Type C influenza is the least severe and it feels like the common cold

Question 23

Influenza A can develop into new subtypes…there’s a new flu vaccine every year because of antigen shift and antigen drift…the types of flu that we get are not the same from year to year and that’s one of the main reasons its able to come back year and after because the vaccine is one year…the immunity you gained one year may not translate over to the next year so we can control this primarily by immunization and the formulation changes yearly and what they do is there’s a committee of experts at CDC who predict what strains and what variants they think might be the most common over the next year due to some complex pattern and they guess how well does it work not well what do we usually see vaccines usually what is anywhere from 30 to 60% successful in any given year so that’s good but it would be nicer if it was higher

Question 23

Types of vaccine for influenza we have is the________________–and this is administered by injection so the flu shot

Answer 23

Trivalent inactivated influenza vaccine (TIIV)

Question 24

_________vaccine is administered up the nose and it is found to be less effective

Answer 24

LAIV

Question 25

in general we are going to see the flu shot aka TIIV vaccine instead

Question 26

Common cold is a acute upper respiratory tract infection,its self limited

Question 27

What does self-limited mean? it is able to resolve on its own and doesn’t need treatment

Question 28

Common cold is spread by contact like through the fingers

Question 29

Both the flu and common cold are acute URTIs(upper respiratory tract infections),

Question 30

Flu can be severe, rapid onset, still be a pandemic, spreads by inhalation

Question 31

Flu is spread by inhalation so more easily than a cold

Question 32

_________: a disease prevalent worldwide (on multiple continents)

Answer 32

pandemic

Question 33

_____:an increased prevalence of a disease in a specific geographic area

Answer 33

endemic

Question 34

Flu is found in other animals but generally it doesn’t jump from species to species when it does that’s when we start to see concerns

Question 35

Avian (Bird flu) is commonly carried by wild birds and are unaffected and seems to infect and kill domestic birds like chicken

Question 36

COVID 19 is an RNA virus and this is related to SARS which is severe acute respiratory syndrome covid-1 and then mers-cov which is middle eastern respiratory syndrome

Question 37

Covid presents as a respiratory infection although some will argue its also a cardiovascular infection due to the increase risk of blood clots that occur with it

Question 38

COVID risk factors: age
People most likely to die from covid are elderly and also male. Males have a higher chance of getting covid over women

Question 39

_________=low oxygen in the blood

Answer 39

Hypoxia

Question 40

Covid-19
Pulmonary phase
Can’t move oxygen in the blood when alveoli are inflamed

The third stage is the marked systemic inflammation and this tends to have severe inflammation and this tends to have severe symptoms including a cytokine storm

Question 41

COVID-19

Cytokine storm is overwhelming response of the immune system releasing a whole bunch of cytokines and it can be quite severe and problematic…anyone who goes into cytokine storm has a high fatality rate and cytokine storm is not just due to COVID….its due to a number of different diseases

Question 42

COVID19
Hyperinflammation
Dilation of vascular bed (allows blood pressure to drop sometimes severely
Thickening of alveolar wall
Thrombus formation

Question 43

Pneumonia can be caused by COVID,flu, a number of our upper respiratory disorders that turn into a lower respiratory disorder.
Pneumonia is where the alveoli have a hard time with gas exchange often precluded by another respiratory tract infection
Factors facilitating development of pneumonia, virulence in the organism(how infectious is it, how aggressive is it, how much did you get, inoculum size…if you have somebody who is sick you were taking care of them all day long and you have a brief exposure
The higher the inoculum size the worse off you are…what are your host defenses are you impaired in anyway or do you have normal host defenses

Question 44

Pneumonia can occur because of flu or COVID

Pneumonia can be a bacterial in origin

Question 44

COVID is the leading cause of death now

Question 45

Why does it matter if someone has typical or atypical pneumona?

Answer 45

determines treatment

Question 46

If it’s a pnemonia that is bacterial in origin we use antibiotic

Pneumonia can spread through a hospital…these pneumonia tend to be drug resistant
Hospital acquired pneumonia are harder to treat than community acquired pneumonia

Question 47

Pt has a cough, achy part, the rapid onset and how badly the pt was tends to be more influenza (flu) than cold

Common cold isn’t usually that rapid and you don’t generally feel as bad…doesn’t worsen as quickly and you don’t tend to feel as bad and your usually talking about a really runny nose

Question 48

Tuberculosis is a bacterial infection…certain bacteria have a few different ways of protecting themselves or is notorious for being difficult to kill by the immune system.

Tuberculosis has outer waxy capsule on it and makes it difficult for any antibiotic to get through and makes it difficult for the immune system to get through so it makes the organism more resistant to destruction.

Tuberculosis is often thought of as a lung infection
However it can really effect any organ in the body even though the lungs are most frequently involved and we saw this already when we talk about the bone…

TB infections if you inhale bacteria.

Primary tuberculosis you have a cell mediated hypersensitivity response and you develop immunity…you end up getting an inflammatory response and you get a huge dormant lesion
The tuberculosis never really goes away it just kind of stays in the body and its dormant its very hard to get rid of totally so what happens is that dormant TB may exacerbate again and it will go through remission and it may come back so it may reactivate itself and may turn progressive and it may turn progressive and may try disseminate and whats most problematic for these infections if you start to become disseminated in all sorts of different parts of the body

One of the things we see with tuberculosis is the skin test and it’s a test where they shoot something under your arm to see if it goes away quickly or if it doesn’t