Home > Uncategorized > Pulmonary Pathophysiology: Vascular Diseases

Pulmonary Pathophysiology: Vascular Diseases

Overview

Today, we’ll cover some disease affecting the blood vessels of the lungs. 

https://www.youtube.com/watch?v=4CsqSov41MI&feature=relmfu

Details

Pulmonary Edema

It accompanies many diseases.  An accumulation of fluid that should be in the capillaries. 

Starling Equilibrum

Interstitium – Capillary

Fluid Out = Pc-Pi

Fluid In = a(osmotic pressure cap – osmotic pressure i)

Two Stages: Normal a small amount moves out and ends up in the perivascular and peribronchial areas, moving out the lungs as lymph

Interstitial Edema = cuffs of fluid around the small veins. 

The interstitium shows the spaces

alveolar vessles /extra alveolar vessesls pulled open by radial traction, closed by smooth muscle and elastic tissue.

Q = K [ Pc-Pi – a(pc-pi)]

Pink frothy sputum.

Increased Pc

hpertensive left ventricular failure, myocardial infarctation

increased capillary permeability

inhaled or circulating toxings, radiation, o2 toxicity,

Decreased Interstitial Hydrostatic Pressure Pi

Hyperinflation of the lung,

Decreased Colloid Osmotic Pressure

Hypoproteinemia, saline overtransfusion

Uncertain Etiology

High altitutde pulmonary edema

strong association with high pulmonary artery pressure but normal wedge pressure, no L ventricular failure

High permeability edema with high concentration of proteins/albumin

epithelium-ECM-endothelium

Clinical Features of Pulmonary Edema

dyspnea, cough, criptations on auscultation,

Pink from RBCs, frothy from surfactact

Alveolar Edema

Lung compliance is reduced and becomes stiff.  Higher airway resistance.  No CO2 retention.  Hypoxemia. 

Alveolar Edema

Pulmonary Embolism

Detached venous thrombi from legs.  Stasis of blood by immobilization, heart failure, dehydration, venous obstruction. 

Increased coagulability of blood, polycythemia, oral contraceptives. 

Abnormality of vessel wall, trauma, inflammation. 

Swelling, local tenderness, pain with ankle flexion, infarction is rare. 

Medium Emboli is common.  You must be suspicious.  Bloody sputum and cough.  Mild fever.  Abnormal lung scan.  Inhalation of radioactive xenon or albumin.

Small Emboli is often unrecognized.  Pulmonary hypertension.  Loud pulmonary second sound. 

Massic Emboli neck veins engorged. High fatality rate. 

Cor Pulmonale right heart disease secondary to lung disease

Arteriovenous Malformation

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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