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67 Cards in this Set

  • Front
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Obstructive Pulmonary Disease =
*interference* of air flow *through airways*
things that influence air flow:

(3)
1. diameter of airways

2. turbulence (usually at bifurcation)

3. weakness of muscles
Q =
dPpi R / 8nl

check
problems with expiration after many years =>

(2)
1. **inc. Residual Volume**

2. barrel chest as lungs don't deflate as much
FEV1: should be able to expire:
80% of air that you hold (after max Inspiration) in one second
obstruction =>
dec. FEV1
Asthma =
chronic inflammation of airways
asthma =>
swelling/constriction of airways
in first 5 minutes of asthma attack, mast cells degranulate, releasing:
histamine, cytokines

cytokines attract leukocytes, including eosinophils => inflammation
histamine =
bronchoconstrictor
aspirin inactivates cox2, =>
dec. inflammation
after 5 minutes of asthma attack, granules release:
LAM's
LAM's attract:

(2)
1. eosinophils

2. WBC's
long-term after asthma attack: eosinophil-derived cytokines cause:
inflammation
5 signs of inflammation:
1. dolor

2. chalor

3. rubor

4. turgor

5. loss of function
dolor =
pain
chalor =
heat
rubor =
redness
turgor =
swelling/tightness
asthma causes:

(5)
1. broncho-constriction

2. mucus plug formation

3. H/H of SM of bronchi

4. loss of bronchi epithilium

5. inc. vascular permeability/edema
result of H/H of SM of bronchi =
dec. diameter of airways
result of loss of epithelium =

(2)
1. bleeding

2.exposure of CT => inc. infections
hemoptysis =
coughing of blood, due to loss of epethilium

(found in severe asthma cases)
2 kinds of asthma:
1. Allergic/Extrinsic (high antiB's)

2. Non-allergic - occurs in the morning, regularly
symptoms of asthma:

(6)
1. cough

2. wheezing

3. dyspnea

4. tachycardia

5. inc. RR, not able to carry on speech

6. pulsus paradoxis
pulsus paradoxis =
inc. of >10 mm HG in *BP* between insp. and expiration
how can you tell it's asthma?

(2)
1. spirometry

2. give bronchodilator inhalant
how can you tell it's asthma by giving the inhaler?
if it's asthma, you see an inc. in FEV1 of 15%
management of asthma:

(3)
1. inhaler

2. anti-inflammatories

3. strong anti-inflammatories daily, + inhaler
the bronchodilator of inhalers =
**B-receptor agonist**

- mimics EPI
Chronic Bronchitis =
***cough w/ sputum***
sputem =
thick spit from mucus secretion
purulent sputem =
sputem with pus

~ severe infection
90% of Chronic Bronchitis is caused by
smoking
characteristics of CB:

(3)
1. ***enlargements of seromucus glands***

2. H/H of SM

3. loss of epithelium
loss of epithelium => replaced with scar tissue =>
dec. compliance
symptoms of CB:

(4)
1. coughing

2. wheezing

3. dyspnea

4. low FEV1 (<70)
treatments for CB:

(2)
1. stop smoking

2. AB's
CB can come and go in
cycles
Chronic Obstructive Pulmonary Disease =
**airflow obstruction** due to Chronic Bronchitis OR emphysema OR both
emphysema =
wholesale destruction of groups of alveoli and the lung tissue associated with it
loss of alveoli =>

(2)
1. loss of caps

2. dec. SA for air exchange
emphysema doesn't affect the bronchioles, b/c
the lung is **very compliant** in emphysema,

due to lots of space due to loss of alveoli

(but recoil not as good => problem expiring)
loss of elastic tissue =>
loss of recoil => trouble breathing
one cannot _____ COPD;
cure;

can only treat it
symptoms of COPD:

(3)
1. coughing with sputem

2. dyspnea

3. pain in chest
treatment for COPD:

(1)
O2 tank
Bronchiectasis =
**inflammation** of medium-size airways;

genetic or from infection
what happens in Bronchiectasis?

(2)
1. medium-sized airways **lose elasticity**

2. loss of cilia, epi => bacterial infection
treatment of BEX:

(2)
1. aggressive AB's, cycled

2. postural PT
bronchoectasis results in _______, which inhibits _________, leading to ___________
***dyskinesia***

the cilia;

infection
what is the MAP of the pulmonary side?
14
what is the MAP of the systemic side?
92
CO of pulm =
CO of sys
LA pressure = 8
RA pressure = 2
perfusion pressure = PLA - PRA =
pressure available to drive blood through the pulmonary system
perfusion pressure of the pulmonary side =
6 mm HG
perfusion pressure of the systemic side =
90
characteristics of the pulmonary system:

(2)
1. lower Pressure

2. lower Resistance
because the pressure of pulmonary is 10% of systemic, the Resistance is
*also* 10%
what causes lower R of pulmonary system?

(3)
1. much less musculature/much more compliant

2. distention (relaxation when blood enters)

3. recruitment/accommodation of blood flow when you lie down
when pulm. MAP is >25 mm HG, ________ occurs
PHTN
if pulm. *capillary* pressure is > 25, ______________ occurs
pulm edema
if Q of pulm > Q of sys, ________ occurs
*PHTN*

(when Qpulm = 1.5Q sys)
left to right shunting of blood occurs as a result of: ________________;

__________________________________
septal defects;

septal defects cause shunts
e.g. PDA:
ductus arteriosis fails to close after bith
DA connects
aorta to pulm arteries