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NR507 WEEK 4 MIDTERM STUDY GUIDE
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Pulmonary: review concepts related to treatment for asthma: acute- oxygen, inhaled beta agonist bronchodilators, inhaled corticosteriod
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Your text here 1NR-507 Mid-Term Study Guide
Hello Class,
This study guide is for the 50 question multiple choice Mid-Term exam that will be given
during Week 4. It will cover the following concepts:
Pulmonary: review concepts related to
treatment for asthma: acute- oxygen, inhaled beta agonist bronchodilators,
inhaled corticosteriod
bronchitis and associated pathogenesis: chronic- hypersecretion of mucus and
chronic production cough that continues for 3 months of the year, irritants
promote bronchial inflammation, causing bronchial edema, increases in the size
and buber of mucous glands and goblet cells in the eirway epithelium, smooth
muscle hypertrophy with birosis, and narrowing of airways. Mucous accumulates,
which cannot be cleared, causes a productive cough
Acute- bronchitis usually caused by viruses, cough, fever, chills, mailaise,
nonproductive cough
chronic bronchitis and related acid/base disturbances: hypoxemia, hypercapnia,
respiratory acidosis
perfusion, blood flow between the heart and lungs, The RIGHT side of the heart
receives deoxygenated systemic blood and returns it to the lungs. This is the
pulmonary circuit. The LEFT side of the heart receives oxygenated blood from
the lungs and returns it to systemic circulation. This is the systemic circuit.
asthma signs and symptoms,: beginning-chest constriction, expiraoty wheezing,
dyspnea, non-productive cough, prolonged expiration, tachycardia, tachypnea.
Severe- use of accessory muscles, inspiratory and expiratory wheezing.
Hypoxemia with resp alkalosis.
Bronchioles: smallest branches of the bronchi, carry oxygen to the alveoli. The
bronchioles are a three layer tube like structure surrounding the lumen or air
passageway.
The innermost layer, closest to the lumen, is composed of columnar epithelial
cells and mucus producing goblet cells.
The outermost layer is composed of smooth muscle cells, responsible for the
ability of the airways to constrict and dilate.
The middle layer, called the lamina propria, is embedded with connective tissue
cells, as well as immune cells. These immune cells include a number of different
kinds of white blood cells located here to help protect the airways. However, in
, the case of asthma, this protective feature goes into overdrive, causing an
inflammatory response that damages host tissue.
alveolar hyperinflation with asthma: Air trapping occurs because of the
destruction of the walls of the alveoli, which creates larger air spaces that no
longer effectively participate in gas exchange.
The plugs of mucus and pus from this inflammatory process can block alveolar
passageways,
leading to air-trapping and hyperinflation more signs and symptoms consistent
with the diagnosis of asthma
This process is illustrated in this image which shows the airway pathology in its
entirety mast cell degranulation triggered by the excessive amounts of IGE that
have airingly formed this individual that will bind that allergen as it enters the
airway that mast cell degranulation releases chemicals that releases mucus
production and accumulation as well as chemicals that contribute to smooth
muscle constriction that smooth muscle constriction along with mucus plugs that
form result in hyperinflation of the alveoli and eventual erosion of airway tissue
polycythemia vera: is a type of blood cancer. It causes your bone marrow to
make too many red blood cells. These excess cells thicken your blood, slowing
its flow, which may cause serious problems, such as blood clots.
mechanism of action of anticholinergic drugs to treat asthma: Anticholinergics
antagonise the parasympathetic effects of acetylcholine, thus providing
therapeutic benefit via a supplementary mechanism to ICS and LABA effects in
asthma. - Ipratropium bromide (Atrovent®) and Tiotrpium Bromide (Spiriva®) are
medications that prevent the muscle bands around the airways from
tightening. Atrovent® is available for use as a metered dose inhaler and in a
solution for a nebulizer. Spiriva® is available for use in a HandiHaler®.
Like short-acting beta agonists (e.g. albuterol), they are bronchodilators, relaxing
the muscle bands around the airways. However, short-acting beta agonists relax
the muscle bands after they are already tight. Ipratropium bromide (Atrovent®)
and Tiotropium bromide (Spiriva®) prevent the muscle bands from tightening.
Cardiovascular: review concepts related to
cardiac output: which is defined as the volume of blood ejected by each ventricle
per minute. CO = heart rate (HR; bpm) x stroke volume (SV)
cardiac contractility: Contractility can be increased by sympathetic stimulation
such as fever, anxiety, or ↑ thyroxine (TH). Contractility can be decreased by low
ATP levels such as brought on by ischemia, hypoxia, and/or acidosis. These
factors decrease the amount of energy available to the muscle cell, decreasing
its “strength” to contract.
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