Pulmonary Mechanics

Question 1

What is inspiratory reserve volume?

Answer 1

inspiration max minus max tidal volume

Question 2

What is expiratory reserve volume?

Answer 2

minimum tidal volume minus maximum expiration

Question 3

What is tidal volume?

Answer 3

The volume that happens in a each breath

Question 4

What is inspiratory capacity?

Answer 4

difference between maximum inspiration and minimum tidal volume

Question 5

What is functional residual capacity?

Answer 5

difference between minimum tidal volume and physical max emptiness

Question 6

What is residual volume?

Answer 6

difference between maximum expiration and physical maximum emptiness

Question 7

What is total lung capacity?

Answer 7

maximum physical differene between full lung and physically empty lung

Question 8

What is transpulmonary pressure?

Answer 8

Palv-Ppl

Question 9

What is the order of inspiration?

Answer 9

diaphragm and inspiratory intercostals contract
thorax expands
Ptp becomes more subatmospheric
increase tranpulmonary pressure
lungs expand
Palv becomes subatmospheric
air flows into alveoli

Question 10

What determines airflow?

Answer 10

Flow=(Palv-Patm)/airway resistance

Question 11

What are the simplle keys to spirometry interpretation?

Answer 11

look at FEV1/FBC ratio and the numbers

Question 12

What does a low ratio indicate on spirometry

Answer 12

an obstructive procss

Question 13

What si teh normal ratio for normal spirometry?

Answer 13

0.7 to 0.87 depending on demographic of patient

Question 14

What is bronchodilator responsivity?

Answer 14

a significant response to bronchodilator when FBC or FEV1 increases at least 12%

Question 15

What is the hallmark of a restrictive lung deficity?

Answer 15

reduced TLC

Question 16

What are the role of type 1 pneumocytes?

Answer 16

alveolar, cover 95% of alveolar surface

Question 17

What are the type II pneumocytes function?

Answer 17

produce surfacant

repair of alveolar epithelium

Question 18

What are the types of obstructive lung disease?

Answer 18

ephysema
chronic bornchitis
asthma
bronchiectasis

Question 19

What is forced vital capacity?

Answer 19

lungs are focibly emptied at maximal speed from full point of inspiration

Question 20

What is FEV1?

Answer 20

forced expiratory volume in 1 second

Question 21

What is FEV1:FVC ratio?

Answer 21

useful for detecting obstruction and differentiating form restrictvie lung disease

Question 22

What is obstructive lung disease?

Answer 22

airway disorder-trachea to terminal bronchiole
increased resistance to air flow and limited expiratory rates on forced expiration

reduced FEV1:FVC

Question 23

What is restrictive lung disease?

Answer 23

parenchymal disorder-respiratory bronchiole, alveoli and alveolar ducts

decreased expansion with reuced total lung capacity, O2 diffusing capacity, lung volumes and compliance

up FEV1:FVC ratio

Question 24

What is emphysema?

Answer 24

permanent enlargment of all or part of hte respiratory unit accompanies by wall destruction without obvious fibrosis

Question 25

What is the pathogensis behind emphysema?

Answer 25

increased number of macrophages, CD8 and neutrophils neutrophils and macrophages are activated by tissue damage from cigarette smoke elastase and free radicals derive from neutrophils and macrophages up elastase down antielastase -- portease-antiportease mechanism up oxidants and down antioxidants destruction of elastic tissue increased comliance and decreased elasticity

Question 26

What is centriacinar emphysema?

Answer 26

smokers emphsema, apical segment of upper lobe

Question 27

What is panacinar emphysema?

Answer 27

alpha-antitrypsin deficiency AD genetic lower lobes all parts of respiratory unit

Question 28

What is alpha-antitrypsin devciency?

Answer 28

total lack of antiproteases throughout acinus lower lung dustribution wherer perfusion and neutrophil numbers are graetest smoking greatly accelerates this process

Question 29

What are the clinical finidngs of emphysema?

Answer 29

``` severe and early onset of dyspnea pink puffers coexistaence with chronic bronchitis cor pulmonale diminished breath sounds due to hyperinflation ```

Question 30

What is CXR emphysema finidings?

Answer 30

increased AP diameter hyperlucent vertical heart depresed diaphragm

Question 31

What is paraseptal emphysema?

Answer 31

subpleural involvement spontaneous pneumothorax no COPD

Question 32

What is irregular emphysema?

Answer 32

localized scar associated | no COPD

Question 33

What is chronic bornchitis?

Answer 33

productive cough for at least 3 months for two consecutive years inhaled smoke is irritant leads to mucous hypersecretion airflow obstruction in terminal bronchioles, irreversible fibroiss of terminal bronchioles infection maintenaince of disease and acute exacerbations bronchospasm

Question 34

What are the clinical findings of chrnoic bronchitis?

Answer 34

``` productive cough cyansosis blue bloaters dyspnea expiratory wheezing and ronchi cor pulmonale ```

Question 35

What does a CXR show from chronic bronchitis?

Answer 35

enlarged heart, horizontally oriented | increased bronchial markings