Lecture 4

Question 1

Some most important disease that interfere with movement of air is called

Answer 1

Chronic obstructive pulmonary disease

Question 2

What 3 conditions make up the COPD circle

Answer 2

Chronic bronchitis
Asthma
Emphysema

Question 3

What is asthma

Answer 3

Reduction in airway diameter due to inflammation or contraction of smooth muscle

Question 4

What is chronic bronchitis

Answer 4

Secretions blocking the airway

Question 5

What is emphysema

Answer 5

Collapse of airways due to disruption of parenchyma

Question 6

Intrapleural pressure is split into two sections

Answer 6

Static component

Dynamic component

Question 7

What does the static component do

Answer 7

Holds the lungs open

Question 8

What does the dynamic component do

Answer 8

Moves air in and out

Question 9

Airflow happens in what direction

Answer 9

High to low

Question 10

Where and when is the pressure the same when we breathe

Answer 10

When we pause to exhale or inhale

The pressure is the same at the lips to the alveoli

Question 11

What does recoil of the lungs resist and assist

Answer 11

Resists inspiration

Assists expiration

Question 12

Laminar flow has what pressure gradient

Answer 12

Small

Question 13

Turbulent flow has what type of pressure

Answer 13

Large

Question 14

In regards to radius what does it do to resistance and velocity

Answer 14

Resistance increases 16th

Velocity reduced 16th

Question 15

In a tube where is the most air (new) travelling through

Answer 15

The middle of the tube

Question 16

What sort of low volume are we talking about in chest trauma

Answer 16

50Hz

Question 17

What do we need to measure airway resistance

Answer 17

Driving pressure and the airflow of the tube

Question 18

Airways resistance is said to only be

Answer 18

Dynamic

Question 19

What instrument is used to test airway resistance

Answer 19

Pneumotachograph

Question 20

How do we measure intrapleural pressure

Answer 20

Insertion of a small balloon in oesophagus

Question 21

How do we work out alveoli pressure

Answer 21

Subtracting changes in recoil pressure from changes in intrapleural pressure

Question 22

What is a whole body plethysmograph

Answer 22

Airtight box where a patient pants against a closed shutter or Pneumotachograph while pressure change in the mouth and box

Question 23

Distribution of airway resistance in an Open mouth

Mouth to trachea

Trachea to alveolar duct

Answer 23

Mouth to trachea 35-40%

Trachea to alveolar duct 60-65%

Question 24

Distribution of airway resistance in nasal breathing

Mouth to trachea

Trache to alveolar duct

Answer 24

Mouth to trachea 40-50%

Trachea to alveolar duct 50-60%

Question 25

Of the amount residing below the larynx how much resides in the trachea and bronchi

Answer 25

80%

Question 26

What cells release cytokines in response to allergens

Answer 26

NKT cells

Question 27

What do the cytokines do when released

Answer 27

Trigger inflammation and this causes the air passage to become inflamed and mucus filled

Question 28

What does NANC mean

Answer 28

Non adrenergenic non cholinergic nerve

Question 29

What does VIP mean

Answer 29

Vasoactive intestinal peptide

Question 30

What does RAR mean

Answer 30

Rapidly adapting pulmonary sensory receptor

Question 31

What does PSR mean

Answer 31

Slowly adapting

Question 32

Name 7 factors of the bronchomotor tone

Answer 32

1. Parasympathetic innervation (contracts) 2. Circulating catecholamines 3. Autonomic nerve supply (relaxes) 4. Mast cell degranulation 5. Neutrophils and eosinophils 6. RAR contracts an PSR relaxes 7. CO2 directly relaxes muscle

Question 33

Inflammation during asthma does what

Answer 33

Irritates the lining of bronchial tubes so tey become swollen and inflamed an excess mucus makes breathing difficult

Question 34

Bronchoconstriction of asthma does what

Answer 34

Bands of muscle surround the bronchial tubes contract causing the airway to narrow

Question 35

What are the 2 stages of asthma

Answer 35

Immediate phase - spasm of bronchial muscle Late phase - acute inflammation reaction

Question 36

Treatment of asthma

Answer 36

Early stage - relax smooth muscle eg xanthines Late stage - reduce inflammation eg glucocorticoids

Question 37

What is bronchitis

Answer 37

Excessive production of lung mucus

Question 38

What is radial traction

Answer 38

Parenchyma forms a | Scaffolding aroun airways

Question 39

If parenchyma was rigid what would doubling linear dimensions increase too

Answer 39

Increase volume 8x | Increase conductance 2 power 4

Question 40

What happens when low lung volume appears

Answer 40

Airways collapse and radial support disappears and airway pressure increases

Question 41

In emphysema is radial traction is lost what happens to the alveoli

Answer 41

They collapse

Question 42

What is the best measurement of obstructive diseases

Answer 42

Flow / volume curve

Question 43

What % is work of breathing at rest

Question 44

What is work

Answer 44

Intrapleural pressure X change in volume

Question 45

Work of breathing is made up of

Answer 45

Elastic resistance of tissues Airflow resistance

Question 46

Some work done by inspiration is recovered by what

Answer 46

Elastic recoil

Question 47

What is total work of breathing

Answer 47

Work done against recoil and work to produce airflow

Question 48

What 4 categories are clinical presentation

Answer 48

At risk Symptomatic Exacerbations Respiratory failure