Home > Uncategorized > Pulmonary Pathphysiology: Restrictive Diseases

Pulmonary Pathphysiology: Restrictive Diseases

Overview

We’ll spend 52 minutes on the restrictive diseases today, which are quite different from the obstructive diseases.  Next should be vascular diseases.  I found a bunch of GIT lectures.  We’ll cover those after we exhaust what Dr West has available. 

https://www.youtube.com/watch?v=61ITY06kO1U&feature=relmfu

Details

These are very different from obstructive diseases.  In restrictive diseases, the lung volumes are small and air flow is normal to increased. 

The parenchyma are the gas exchanging regions fo the lung; the alveoli.  The ECM is a critical part of the BGB or blood gas barrier. 

Gas – Alevolar Epithelium-ECM-Capillary Endothelium-Blood

Type 4 collagen is the lifeline of the BGB because it contains its contents. 

Fibroblasts make type 1 collagen which makes the fibrosis of the restrictive diseases; same tissue as the Achilles tendon.

Type 1 collagen cable supports the alveolar wall with a figure 8 like manner. 

type 2 alveolar epithelial cells emit surfactant, which needs to be released very often.  Very metabolically active. 

Alveolar macrophages eat foreign bodies.  It lurks. 

The thin side is gas exchange for passive diffusion.  The thick side has type 1 collagen cable, and is involved in fluid exchange. 

DIPF – Diffuse interstitial pulmonary fibrosis

Thickening of the interstitium.  Initial infiltration with lymphocytes and plasma cells.  Later fibroblasts lay down thick collagen bundles.  Architecture is destroyed with scarring, dilating air spaces and honey combing. 

Scarring is the end result of bacterial infection, trauma, or a burn.  It’s the laying down of type 1 collagen. 

The disease is uncommon and affects middle age adults.  Dyspnea with rapid hyperventilation.  Unproductive cough.

DIPS causes small lungs. 

Pulmonary Functions

Ventilary capacity – impaired.  Lower FEV and FVC.  FEV/FVC ratio is the same.  Normal values are FEV of 4, FVC or 5, ratio of 0.8    

FEV is forced expiratory volume

Ephysema reduces caliber, ISF increases caliber. 

Gas Exchange – reduction in arterial pO2 with normal to low pCO2.  pO2 falls on exercise. 

Pulmonary circulation – capillaries are obliterated.  resistance is higher, on exercise. 

Exercise – pulmonary hypertension

Ventilation Control – rapid shallow breathing.  Stimulation of J receptors.  increased dead space ventilation.  Juxtacapo receptors end in the alveolar wall.  Stimulated by the laying down of collagen. 

Sarcoidosis:

Characteristic granulomas, affects several organs, probably immunological basis, can cause interstitial pulmonary fibrosis. 

Hypersenssitiviety Pneumonitis

Hyperensititivity to inhaled organic dusts.  Farmer’s lung. 

DIF scleroderma, paraquat, oxygen toxicity, therapeutic radiaction

Causes of RD Outside of the Lung

Pleural disease – pneumothorax, tension pneumothorax, pleural effusion, pleural thickening

Chest wall diseases – scoliosis, anklyosis spondylitis

Neuromuscular Diseases – polio, myasthenia gravis, muscular dystrophy, Guillain Barre.

transradient see through it 

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
  1. Jaimie Stelling
    February 5, 2013 at 10:56 pm

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