Home > Uncategorized > Pulmonary Pathophysiology: Lecture 2

Pulmonary Pathophysiology: Lecture 2

Overview

We’ll finish up obstructive lung diseases with asthma.

https://www.youtube.com/watch?v=qZgjLN0Npak&feature=relmfu

Details

Asthma occurs in all ages, especially in the young.  Increased responsiveness, inflammation, narrowing of the airways.  It’s occurring quite often in Western nations..

Can be tested with methacholine.  Cold air, smoke, and exercise can set it off.  Status asthmaticus may last for many hours up to several days.  Attacks cause anxiety.

The airways constrict, the smooth muscle hypertrophies and contracts.  Mucus in the airway, increased number of mucus glands.  Mucosal edema. 

Reduce the caliber to half, resistance increases 16x. 

Reticular remodeling occurs in asthma. 

Pathogenesis

hyperresonsiveness, inflammation, allergic basis, hygiene hypothesis, pollutants, genetics

Antigen-Lymphoid Tissuie-Mast Cells – Mediators-Capillary (increased permeability) or Contractions (cAMP down)

Mediators

Cytokines, interleukin, arachidonic acid, leukotrienes, prostagandins, histamine, platelet activators

Bronchoactive Drugs

Beta adrenergic agonists/inhaled corticosteroidds

Beta 1 receptors in the heart, beta 2 receptors in the bronchi, blood vessels and uterus.  Increase activity of cAMP to raise [cAMP] in smooth muscle, reduce airway inflammation. 

BAA have different durations of action.  ICs inhibit inflammatory and immune response.  Good for patients who need BAs more than twice per week. 

Ventilary capacity and gas exchange are the two main effects of asthma.  Uneven ventilation distribution and ventilation perfusion inequality are two changes in gas exchange. 

Arterial pO2 is reduced, arterial pCO2 is usually normal.  This is the ventilation perfusion inequality. 

Uneven ventilation mechanisms

Parallel, series, collateral

Localized Airway Obstruction- Trachea/Bronchi

Tracheal from inhaling a foreign body, compression of the trachea, stenosis, enlargement of lymph/thyroid glands.  Hypoxemia and CO2 retention.  Stridor is a loud wheeze. 

Broncheal obstruction from inhaling a foreign body, compression of the tube, retained secretions, aspiration following surgery/inability to cough.  Complete obstruction can cause absorption atelectasis.

AA depends upon the composition of the gas.   

Review

  • Stay relaxed
  • Weapon moves first
  • Accelerate the weapon
  • Move towards the target
  • Penetrate

Acetyl COCH3

Thionyl chloride SOCl2

Barchan Dune 35 degrees down, 15 up

R-N=N-R Azo

Ambush – linear, L, V

C=S Thioketone

H2N(C=O)NH2 Urea

cash-futures = basis

+ basis negative carry

– basis positive carry

4 carbons overwhelm hydrogen bonding

Atmosphere: troposphere, stratosphere, mesosphere, thermosphere, ionosphere, exosphere

CTLSC 7 12 554

Sextuple Bond: Mo2, W2

Intermolecular Bonding: electrostatic, h bonding, dipole dipole, van der Waals

Hydrogen Bonding: FON Cl

Mandatory Refusal – when communications are lost, no one is trusted. A breach is assumed.

Gain Band Width Product = Gain x Bandwidth

CARVER is an acronym that stands for Criticality, Accessibility, Recuperability, Vulnerability, Effect and Recognizability.

Wind Speed Beaufort Category How to Judge the Wind
1-3 mph Light Air Smoke drifts. Wind cannot be felt.
4-7 mph Light Breeze Wind felt on face. Leaves rustle. Weather vanes move.
8-12 mph Gentle Breeze Leaves and twigs in motion. Light flags are extended.
13-18 mph Moderate Breeze Wind raises dust and loose papers. Small branches move. Flags flap.
19-24 mph Fresh Breeze Small trees in leaf sway slightly. Wavelets form on ponds and lakes.
25-31 mph Strong Breeze Large branches move. Telephone lines sing.

Visible Light – 400 to 700 nm

adam boy charles david edward frank george henry ida john kevin lincoln mary nora ocean paul queen robert sam tom union victor william xray young zebra
bull spread buy near, sell far
bear spread sell near, buy farcash – futures = basis

spreads are differences between futures contract months
cashpostive carry
cash>futures negative carry (inverted)
Basis: time space quality

Aromatic: planar, cyclic, Huckels Rule – 4n+2 electrons

Fibrous – sclera, cornea

Sensory – retina

Vascular – choroid, iris, pupil, ciliary body

Kingdoms – monera, protista, fungi, plant, animal

HSbF6 pKa = 25

Electrophiles are positive, nucleophiles are negative

EDTA is a tetraprotic acid.

C-C=O-C Ketone

Ketones containing alkene and alkyne units are often called unsaturated ketones.

Ph2CO Benzophenone

Sunflower 8 benzenes fused together

(H3C)(CO)(CO)(CH3) Diacetyl

Butanone MEK

Acetoin (H3C)(CO)(COH)CH3

Tissue: nervous muscular epithelial connective

Epithelial: simple stratified pseudostratifed/ cuboidal columnar

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Categories: Uncategorized
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