Mf1 Related Vocab

Front 1

acute mountain sickness and symptoms

Back 1

unacclimatized ascends to mod altitude

headache, dizziness, breathlessness at rest, weakness, malaise, nausea, anorexia, sweating, palpitations, dimness of vision, partial deafness, sleeplessness, fluid retention, dyspnea on exertion

result of hypoxia, hypocapnia, alkalosis and/or cerebral edema

Front 2

hypocapnia

Back 2

state of reduced carbon dioxide in the blood
eg during hyperventilation

can lead to alkalosis = low plasma Ca2+ = nerve and muscle excitability (pins and needles, cramps, tetany)

Front 3

Minute ventilation

Back 3

aka respiratory minute volume
volume of air inhaled from a person's lungs in one minute

tidal volume x respiratory rate

higher minute vent = more CO2 release

normal resting = 5-8L/min

Front 4

hypoxic ventilatory response

Back 4

in response to acute hypoxic exposure

minimizes the drop in alveolar PO2

interindividual variability

large increases not seen until PaO2 falls below 60mmHg

mediated mostly by carotid body chemoreceptors

Front 5

paroxysmal nocturnal dyspnea

Back 5

Episodes of breathlessness that wake persons from a sound sleep

usually denote left ventricular failure

may also occur in patients with chronic pulmonary diseases because of pooling of secretions, gravity-induced decreases in lung volumes, sleep-induced increases in airflow resistance, or nocturnal aspiration

Front 6

Orthopnea

Back 6

onset or worsening of dyspnea on assuming the supine position

found in patients with heart disease and chronic lung disease

Front 7

instant orthopnea

Back 7

inability to assume the supine position

characteristic of paralysis of both leaves of the diaphragm.

Dyspnea soon after assuming the supine position also may be associated with other conditions, such as arteriovenous malformation, bronchiectasis, and lung abscess

Front 8

Platypnea

Back 8

dyspnea that occurs in the upright position

Front 9

trepopnea

Back 9

rarer form of dyspnea that develops in either the right or the left lateral decubitus position

suggest lung vascular shunting

Front 10

hyperpnea

Back 10

increase in minute ventilation

Front 11

Sudden dyspnea without an obvious provocation

Back 11

pulmonary embolism or pneumothorax, although myocardial ischemia and asthma also may have a rapid onset

Front 12

nociceptive pain

Back 12

pain caused by stimulation of nociceptive receptors and transmitted over intact neural pathways

usually is responsive to opioid analgesics

Front 13

neuropathic pain

Back 13

pain that is caused by damage to neural structures, often involving neural supersensitivity

typically responds poorly to opioid analgesics and may require higher doses of drug

Front 14

pain as suffering

Back 14

the original sensation plus the reactions evoked by the sensation

generally is agreed that all types of painful experiences, whether produced experimentally or occurring clinically as a result of pathology, include the original sensation and the reaction to that sensation

Front 15

apnea

Back 15

Cessation of breathing lasting 10 seconds or longer.
Obstructive: continued respiratory effort with paradoxical motion of rib cage and abdomen;

central: absent respiratory effort.

Front 16

complex apnea

Back 16

used when an individual initially has obstructive apneas, but central apneas occur once the individual is treated with nasal continuous positive airway pressure (CPAP)

Front 17

central apnea

Back 17

occur as a result of temporary loss of neural output to the diaphragm

Front 18

hypopnea

Back 18

respiration declines but does not completely stop. This decline in ventilation can lead to the same consequences as from apneas

a number of different definitions

Front 19

apnea-hypopnea index (AHI)

Back 19

severity of sleep-disordered breathing

number of apneas plus hypopneas per hour of sleep

counting the number of apneas and hypopneas during sleep and then dividing by total sleep time

normal AHI < 5 episodes/hr;
mild sleep apnea AHI ≥ 5 and < 15 episodes/hr;
moderate sleep apnea AHI ≥ 15 and < 30 episodes/hr;
severe sleep apnea AHI ≥ 30 episodes/hr.

Front 20

sleep apnea syndrome

Back 20

patients who not only have abnormal breathing events during sleep of required frequency but also complain of daytime sleepiness

most commonly used instrument to assess sleepiness is the Epworth Sleepiness Scale

Front 21

Epworth Sleepiness Scale

Back 21

Rank from 0-3 liklihood of falling asleep in these situations:
Sitting and reading
Watching TV
Sitting inactive in public place
Passenger in car
Lying down to rest in afternoon
Sitting talking to someone
Sitting after lunch without alcohol
In a car, stopped for minutes in traffic
0 = Never
1 = Slight chance
2 = Moderate chance
3 = High chance

Front 22

carboxyhaemoglobin

Back 22

Hb combined with CO

Front 23

carbaminohaemoglobin

Back 23

Hb carrying CO2

Front 24

Functional saturation

Back 24

[HbO2] x 100 / ( [HbO2] + [DeoxyHb]

May be misleading if 99% but a large proportion of Hb is COHb, so really oxygen content is low

*consider what saturation is reported on blood gas reports you are reading

Front 25

Fractional saturation

Back 25

[HbO2] x 100 / Total [Hb]

where Total [Hb] = [HbO2] + [DeoxyHb] + [MetHb] + [COHb]

May be more useful in clinical setting

*consider what saturation is reported on blood gas reports you are reading

Front 26

ODC causes of right shift

Back 26

increase in 4 factors:
• temperature
• [H+]
• pCO2
• red cell 2,3 DPG level

indicates decrease in O2 affinity

higher P50

Front 27

P50

Back 27

the partial pressure of oxygen at which the oxygen carrying protein is 50% saturated

used to specify the position of the oxygen dissociation curve

the most sensitive point for detecting a shift of the curve

P50 of normal adult haemoglobin is 26.6 mmHg

Front 28

ODC mixed venous point

Back 28

the point which represents mixed venous blood. The pO2 here is 40 mmHg and the
haemoglobin saturation is 75%

The increased pCO2 and decreased pH in mixed venous blood mean that the
mixed venous point must lie on a slightly right shifted ODC
= Bohr effect

Front 29

Main points to indicate on ODC

Back 29

Arterial point: pO2 100 mmHg with SaO2 = 97.5%

Mixed venous: pO2 40 mmHg with SaO2 = 75%

P50: pO2 26.6 mmHg with SaO2 = 50%

pO2 0 mmHg, SO2 0% - the origin

pO2 10 mmHg, S02 10% - just easy to remember & helps get the sigmoid shape.

pO2 60 mmHg, SO2 91% - the ‘ICU’ point

pO2 150 mmHg, SO2 98.8% - shows flat upper part of ODC

Front 30

atelectasis

Back 30

collapse of part of or, more rarely, all of a lung

Front 31

right-to-left shunt

Back 31

mixing of venous blood that has not been oxygenated (or not fully oxygenated) into the arterial blood

Front 32

physiologic shunt

Back 32

corresponds to the physiologic dead space,

consists of the anatomic shunts plus the intrapulmonary shunts

Front 33

intrapulmonary shunts

Back 33

absolute shunts
or
"shuntlike states" = areas of low ventilation-perfusion ratios in which alveoli are underventilated and/or overperfused

Front 34

Anatomic shunts

Back 34

systemic venous blood entering the left ventricle without having entered the pulmonary vasculature

normal healthy adult, about 2–5% of the cardiac output

venous blood from the bronchial veins, the thebesian veins, and the pleural veins

Front 35

Absolute Intrapulmonary Shunts

Back 35

Mixed venous blood perfusing pulmonary capillaries associated with totally unventilated or collapsed alveoli constitutes an absolute shunt

no gas exchange occurs as the blood passes through the lung

Front 36

Shuntlike States

Back 36

Alveolar-capillary units with low A/cs also act to lower the arterial oxygen content because blood draining these units has a lower PO2 than blood from units with well-matched ventilation and perfusion

adding low O2 blood into normal perfused blood = reduction in overall PaO2

Front 37

venous admixture

Back 37

resulting ratio of shunt flow to the cardiac output

the part of the cardiac output that would have to be perfusing absolutely unventilated alveoli to cause the systemic arterial oxygen content obtained from a patient

Front 38

Causes of Increased Alveolar-Arterial Oxygen Difference

Back 38

Increased right-to-left shunt
- Anatomic
- Intrapulmonary
Increased ventilation-perfusion mismatch
Impaired diffusion
Increased inspired PO2
Decreased mixed venous PO2
Shift of ODC

Front 39

eupnea

Back 39

normal, quiet breathing

VT = 500 mL / breath 70kg adult

Front 40

cor pulmonale

Back 40

failure of the right side of the heart brought on by long-term high blood pressure in the pulmonary arteries and right ventricle of the heart

Almost any chronic lung disease or condition causing prolonged low blood oxygen levels can lead to cor pulmonale, incl
•Chronic obstructive pulmonary disease (COPD)

•Chronic blood clots in the lungs

•Cystic fibrosis

•Scarring of the lung tissue (interstitial lung disease)

•Severe curving of the upper part of the spine (kyphoscoliosis)

•Obstructive sleep apnea, in which pauses occur during breathing because of airway inflammation

Front 41

ankylosis

Back 41

immobility and consolidation of a joint due to disease, injury, or surgical procedure

Front 42

hemiplegia

Back 42

paralysis on one vertical side of body

Front 43

electromyogram

Back 43

detects electrical activity of muscles

Front 44

fasciculation

Back 44

"muscle twitch", is a small, local, involuntary muscle contraction and relaxation visible under the skin arising from the spontaneous discharge of a bundle of skeletal muscle fibers

Front 45

areflexia

Back 45

absence of reflexes

Front 46

nadir

Back 46

the lowest point

Front 47

plasmapheresis

Back 47

blood purification procedure used to treat several autoimmune diseases

therapeutic plasma exchange

used to remove antibodies from the bloodstream, thereby preventing them from attacking their targets. It does not directly affect the immune system's ability to make more antibodies, and therefore may only offer temporary benefit. This procedure is most useful in acute, self-limited disorders such as Guillain-Barré syndrome

Front 48

venous thromboembolism

Back 48

disease that includes both deep vein thrombosis (DVT) and pulmonary embolism (PE)

third most common cardiovascular illness after acute coronary syndrome and stroke

Front 49

surfactant

Back 49

coats inside surfaces of alveoli

reduces surface tension (the tendency for fluid to reduce its surface area)

facilitates inspiration and prevents total collapse of alveoli during expiration

Front 50

glottis

Back 50

true vocal cords and space between them

Front 51

larynx

Back 51

consists of various cartilages and assoc muscles

thyroid cartilage: largest, "adams apple"

2 pairs of vocal cords:
upper = false
lower = true

epiglottis over opening of larynx

Front 52

pharynx

Back 52

nasopharynx (pharyngeal tonsils on posterior wall; 2 eustachian tubes open into)

oropharynx (palatine tonsils at posterior oral cavity; common passage of air and food)

laryngopharynx

Front 53

compliance

Back 53

ability of the lungs to expand

depends largely on elasticity of tissues
can be affected by other factors:
- surface tension
- shape, size, flexibility of thorax

Front 54

inspiratory centre of medulla

Back 54

controls basic rhythm by stimulating PHRENIC nerves to diaphragm and INTERCOSTAL nerves to external intercostal muscles

spontaneous, each lasting about 2 sec

Front 55

expiratory centre of medulla

Back 55

appears to fn primarily when forced expiration required

Front 56

breathing control centre in pons

Back 56

plays role in coordinating inspiration, expiration and intervals for each

Front 57

modifing factors of rate and depth of breathing

Back 57

- CNS depression (drugs)
- activity of hypothalamus (emotions?)
- stretch receptors in lungs
- Hering-Breuer reflex (prevents excessive lung expansion)
- voluntary (ie singing) (overridden by PCO2 levels in blood)

Front 58

central chemorecptors

Back 58

in medulla

respond quickly to slight elevations in PCO2 (normal 40mmHG to 43mmHG)
OR to decrease in pH (increased H+) in CSF

Front 59

peripheral chemoreceptors

Back 59

1. carotid bodies at bifurcation of common carotid arteries
2. aortic body of aortic arch

sensitive to decreased O2 levels in arterial blood as well as to low pH
MARKED Decrease in O2
(from 105mmHg to 60mmHg)

Front 60

spirometry

Back 60

used to test pulmonar volumes, measuring volume and airflow time

Front 61

arterial blood gas determinations

Back 61

used to check O2, CO2 and bicarbonate levels and serum pH

Front 62

oximeters

Back 62

measure O2 saturation of Hb

Front 63

cough reflex

Back 63

controlled by centre in medulla

consists of coordinated actions that inspire air, then close glottis and vocal cords

forceful expiration, with glottis open

Front 64

hemoptysis

Back 64

blood-tinged (bright red) frothy sputum usually associated with pulmonary edema

Front 65

hematemesis

Back 65

vomitus containing blood, usually granular and dark in colour

Front 66

Kussmaul respirations

Back 66

deep rapid respirations
"air hunger"
typical of acidosis
may follow strenuous exercise

Front 67

wheezing

Back 67

indicate obstruction in small airways

Front 68

stridor

Back 68

high pitched crowing noise, usually indicates upper airway obstruction

need to indicate if inspiratory or expiratory or both

Front 69

rales

Back 69

light bubbly or crackling sounds,
associated with serous secretions in lungs

Front 70

rhonchi

Back 70

deeper harder sounds resulting from thicker mucus

Front 71

pleural pain

Back 71

results from inflammation or infection of the parietal pleura

cyclic pain, increases as inflammed membrane is stretched with inspiration or coughing

Front 72

clubbed fingers

Back 72

result of chronic hypoxia associated with resp or CV diseases

painless, firm, fibrotic enlargement of end of digit

Front 73

thoracentesis

Back 73

removal of excess fluid from pleural cavity

prevent atelectasis

Front 74

pulmonary edema

Back 74

fluid collection in the alveoli and interstitial area

reduces amt of O2 diffusing into blood
interferes with lung expansion

from:
-inflammation increasing capillary permeability
-low plasma protein levels, decreasing plasma osmotic pressure
-pulmonary HTN

Front 75

signs of pulmonary edema

Back 75

-cough
-orthopnea
-rales
-hemoptysis
-laboured breathing
-feeling of drowning
-hypoxemia
-cyanosis in advanced

Front 76

pulmonary embolus

Back 76

blood clot or other obstruction of pulmonary artery
- most are thrombi originiating from leg veins

Front 77

types of pulmonary emboli

Back 77

-deep veins
-fat emboli (from bone marrow, fracture of large bone)
- vegetations from endocarditis of R heart
- amniotic fluid emboli (placental tears in labour and delivery)
- tumor cell emboli
- air embolus (injected into vein)

Front 78

thrombophilia

Back 78

abnormality of blood coagulation that increases the risk of thrombosis

most common conditions associated with thrombophilia are deep vein thrombosis (DVT) and pulmonary embolism

Front 79

Factor V Leiden

Back 79

autosomal dominant single point
mutation (G→A) that brings about resistance to activated
protein C and an increased predisposition to VTE
(roughly three times)

Front 80

saddle embolus

Back 80

Extremely large emboli, lodge at the bifurcation of the pulmonary artery

Front 81

Thrombocytopenia

Back 81

any disorder in which there is an abnormally low amount of platelets

Front 82

Heparin-induced thrombocytopenia

Back 82

development of thrombocytopenia, HIT predisposes to thrombosis, the abnormal formation of blood clots inside a blood vessel, and when thrombosis is identified the condition is called heparin-induced thrombocytopenia and thrombosis (HITT)
immune system forms antibodies against heparin when it is bound to a protein called platelet factor 4 (PF4). These antibodies are usually of the IgG class and their development usually takes about five days

Front 83

Quadriparesis

Back 83

Weakness of all four limbs, both arms and both legs, as for example from muscular dystrophy.

Front 84

staccato speech

Back 84

Abrupt speech in which each syllable is produced separately, associated with multiple sclerosis

Front 85

the single breath count

Back 85

Assess Ventilatory reserve

patient is asked to count as many numbers as possible
after taking a single deep inspiration. A count of 50 is
normal and one of < 15 signifies severely decreased ventilatory capacity

Front 86

dysphagia

Back 86

difficulty swallowing

Front 87

MIP

Back 87

maximum inspiratory pressure

normally < -70 cm H2O, measures the strength of the
diaphragm and other muscles of inspiration, and gener-
ally reflects the ability to maintain normal lung expansion and avoid atelectasis

> -30 cmH2O = criteria for intubation

Front 88

MEP

Back 88

max expiratory pressure

normally > 100 cmH2O, measures the strength of the expiratory muscles
and correlates with strength of cough and the ability to
clear secretions from the airway.

< 40 cm H2O = criteria for intubation

Front 89

dysutonomia

Back 89

(autonomic dysfunction) is a broad term that describes any disease or malfunction of the autonomic nervous system

Front 90

pulmonary toilet

Back 90

attempts to clear mucus and secretions from the trachea and bronchial tree by deep breathing, incentive spiratomy, postural drainage, and percussion.

Front 91

advantages of tracheostomy vs long term intubation

Back 91

decreased risk of larnygotra-
cheal injury, which can be as high as 10% for endotracheal
intubation beyond 2 to 3 weeks,

decreased dead space,

increased ease of weaning,

improved pulmonary toilet

by freeing the mouth and nose of tubes, enhanced patient
comfort.

Front 92

risks of tracheostomy

Back 92

local hemorrhage or infection

tracheal stenosis, usually in the re-
gion of the tracheal incision or tracheostomy tube cuff

Front 93

large-bore catheter placement complications

Back 93

-pneumothorax,
-hematomas at the catheter insertion site
-line infection

Front 94

Trendelenburg position

Back 94

patient is placed head down on a table inclined at about 45 degrees from the floor with the knees uppermost and the legs hanging over the end of the table OR head below feet

Front 95

Wernickes syndrome

Back 95

Opthalmoparesis, ataxia, Encephalopathy, rarely seen in chronic alcoholics, (1 in 500)

Front 96

Korsakoff's syndrome

Back 96

Retrograde and anterograde amnesia

rarely seen in chronic alcoholics, (1 in 500)

Front 97

Cogeners

Back 97

Compounds in alcohol that affect drink's taste

Might contribute to adverse effects

Methanol, bugaboo, acetaldehyde, histamine, tannins, iron, lead

Front 98

Acquired tolerance

Back 98

1) metabolic/pharmacokinetic
2) cellular/pharmacodynamic
3) learned/behavioral

Front 99

Blood alcohol level 1 STD drink

Back 99

0.02 g/dL

12oz beer
6 oz wine
1.5 oz 80proof

Front 100

Stridor

Back 100

harsh, high-pitched respiratory sound, which is usually inspiratory but can be biphasic and is produced by turbulent airflow

sign of upper airway obstruction

Front 101

coryza

Back 101

describing the symptoms of a head cold.[1] It describes the inflammation of the mucous membranes lining the nasal cavity which usually gives rise to the symptoms of nasal congestion and loss of smell

Front 102

obtunded

Back 102

Describing someone who is far from alert or oriented to time and space

exhibits other signs being confused, a state just short of frank delirium.

Front 103

Fulminant

Back 103

any event or process that occurs suddenly and quickly, and is intense and severe to the point of lethality, i.e., it has an explosive character. The word comes from Latin fulmināre, to strike with lightning. It is most frequently used in medicine, and there are several diseases described by this adjective:

Fulminant liver failure
Fulminant colitis
Fulminant pre-eclampsia
Fulminant meningitis

Front 104

angioedema

Back 104

swelling, similar to hives, but the swelling is beneath the skin rather than on the surface

may be caused by an allergic reaction

usually occurs around the eyes and lips. It may also be found on the hands, feet, and throat

Front 105

status asthmaticus

Back 105

severe attack that is refractory to treatment with bronchodilators

may require assisted ventilation or may even die

Front 106

triad asthma

Back 106

aka Samter's syndrome

triad with asthma
aspirin sensitivity
nasal polyposis

Front 107

major symptoms during an asthma attack

Back 107

cough
dyspnea
wheezing
chest tightness

Front 108

common pulmonary function test results in patients with asthma

Back 108

decreased:
FEV1
FVC (<than FEV1 decrease)
FEV1/FVC

increased:
RV
FRC
TLC

Front 109

dynamic hyperinflation

Back 109

because more time is required for expiration when airways are obstructed, pts may not have sufficient time before the next breath to fully exhale the volume from the previous breath

Front 110

arterial blood gases during asthma attack

Back 110

low PO2
low PCO2
from ventilation/perfusion mismatch

if see norm - high PCO2 = warning! pt tiring or airway obstruction worsening

Front 111

Classes of asthma drugs

Back 111

Bronchodilators
- sympathemimetics
- xanthines
- anticholinergics
Antiinflammatory
- corticosteroids
- cromolyn, nedocromil
LTD4 R antagonists
5-Lipoxygenase inhib
Anti-IgE antibody

Front 112

alert patient

Back 112

vigilantly attentive and keen

Front 113

lethargic patient

Back 113

dull, sluggish and appears half asleep

Front 114

obtunded patient

Back 114

opens their eyes, responds slowly to questions, is somewhat confused, and has a decreased interest in their environment

Front 115

A stuporous patient

Back 115

near unconscious with apparent mental inactivity and reduced ability to respond to stimulation

Front 116

Comatose patients

Back 116

are unconscious and unresponsive

Front 117

Heliox

Back 117

21%+ O2
79%- He
or other combos

generates less airway resistance since He is less dense than N
therefore require less mechanical energy to ventilate lungs

Front 118

Vocal Cord Dysfunction

Back 118

vocal cords involuntarily close inappropriately during inspiration and sometimes exhalation, producing shortness of breath, coughing, throat tightness, and often audible laryngeal wheezing and/or stridor

manifest as intermittent daytime wheezing

Front 119

denudation

Back 119

the act or process of removing surface layers (as of skin) or an outer covering (as of myelin) ; also : the condition that results from this

ie airway epithelium denudation from eosinophil products in asthma, leading to access of inhaled material to deeper layers

Front 120

cytokine vs chemokine

Back 120

any of a class of immunoregulatory proteins (as interleukin, tumor necrosis factor, and interferon) that are secreted by cells especially of the immune system

any of a group of chemotactic cytokines that are produced by various cells (as at sites of inflammation), that are thought to provide directional cues for the movement of white blood cells

Front 121

allergic rhinitis

Back 121

rhinitis caused by exposure to an allergen

rhinitis = inflammation of the mucous membrane of the nose marked especially by rhinorrhea, nasal congestion and itching, and sneezing

Front 122

rhinitis

Back 122

inflammation of the mucous membrane of the nose marked especially by rhinorrhea, nasal congestion and itching, and sneezing

Front 123

rhinorrhea

Back 123

excessive mucous secretion from the nose

Front 124

eczema

Back 124

an inflammatory condition of the skin characterized by redness, itching, and oozing vesicular lesions which become scaly, crusted, or hardened

Front 125

asthma control

Back 125

degree to which symptoms, ongoing functional impairments, and risk of adverse events are minimized and goals of therapy are met.

Front 126

pneumoconiosis

Back 126

general term for lung disease caused by inhalation of mineral dust

ie silicosis

Front 127

silicosis

Back 127

fibronodular lung disease
inhalation of dust containing crystalline silica or its polymorphs (tridymite or cristobalite)
quartz, found in granite, slate and sandstone

increased prevalence due to mechanized mining

Front 128

body habitus

Back 128

physique or body build

endomorphic (overweight), ectomorphic (underweight) or mesomorphic (normal weight)

Front 129

Normal ABG

Back 129

- pH: 7.40 (7.35-7.45)
- pCO2: 40 (35-45)
- pO2: 80 (80-100)
- HCO3: 24 (23-25)

Front 130

pulmonary parenchyma

Back 130

region of lung directly involved in gas exchange

alveolar walls and spaces
alveolar-capillary interface

at level of alveolar sacs and resp bronchioles

normal lung= capillaries closely apposed to alveolar lumen and little extraneous tissue

Front 131

epithelial cells of lung parenchyma

Back 131

surface alveolar walls at lumen is lined with continous layer epithelial cells

type I - less numerous, long cytoplasmic extensions lining 95% surface, function as barrier, regulate ion and fluid balance

type II: cuboidal shape, bulge into epi; produce surfactant, repair alveolar epithelium, ion and fluid transport

Front 132

surfactant proteins

Back 132

SP-B and SP-C: hydrophobic; creates low surface tension

SP-A and SP-D: also play role in surface tension, but important role in innate immunity of lung

Front 133

components of interstitial space of lung parenchyma

Back 133

collagen
elastin
proteoglycans
macromolecules involved with cell-cell and cell-matrix interactions
nerve endings
fibroblastlike cells
lymphocytes in state bw blood monocytes and alveolar macrophages

Front 134

normal barrier to diffusion in lung parenchyma

Back 134

thin cytoplasmic extensions of type I cell

basement membrane of type I and capillary endothelial cells

capillary endothelial cell

extremly thin 0.5 micrometers

diffusion preferentially at thinest areas, not areas where interstitium present

Front 135

compliance curves

Back 135

y axis volume
x axis transpulmonary pressure

normal lung: as increase transpulm P, increase volume up to maximum = plateau

stiffer, less compliant (most diffuse parenchymal lung diseases) = right shift of curve, lower plateau

more compliant (eg emphysema) = left shift of curve (easier to increase V, need less P)

Front 136

diffuse parenchymal lung disease

Back 136

aka interstitial ling disease (misnomer)

disorders causing inflammation and fibrosis of alveolar structures, occuring simultaneously

>150 diseases, w or w/o known etiology (35% w known)

beaware of mimicking disorders: can produce diffuse parenchymal abnorm on xray

Front 137

alveolitis

Back 137

inflammation in alveolar wall and alveolar spaces

one of 2 major componenets of diffuse parencymal lung disease

variety of inflam cells infiltrate, with diff diseases having prominence in one cell type

Front 138

idiopathic pulmonary fibrosis

Back 138

a type of diffuse parenchymal lung disease

only one not associated primarily with inflammation/alveolitis

mainly function of dysfuntion in in epithelial cell injury repair = fibrosis

Front 139

granuloma

Back 139

pathologic feature of some lung diseases

localized collection of epithelioid histiocytes (tissue cells of phagocytic or macrophage series)
generally accompanied by T lymphocytes (within and around granuloma)

caseating= cellular necrosis in centre (Tb)

noncaseating= central area not necrotic (most of diffuse parenchymal lung diseases ie sarcoidosis)

also multinucleated giant cells = fused phagocytic cells

Front 140

alveolitis

Back 140

accumulation of
inflammatory and immune effector cells within the
interstitium and on the epithelial surface of the al-
veolar structures