Respiratory System and Asthma Overview

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Questions and Answers

What is the primary role of the cartilaginous rings in the airway?

To allow for the passage of air without obstruction

To keep the esophagus flexible while ensuring airway patency (correct)

To aid in the immune response during an infection

To maintain the airway's rigidity and prevent collapse

What substance do mast cells release that contributes to inflammation?

Cytokines

Histamine (correct)

Prostaglandin

Serotonin

Which of the following statements best describes mast cells?

They are critical components of the immune response. (correct)

They play a minor role in the immune response.

They are primarily responsible for oxygen transport.

They primarily release enzymes for digestion.

What potential risk is associated with cuff pressures of a tracheostomy tube?

Impingement on the innominate artery and esophagus Signup and view all the answers

How do histamines affect the respiratory system?

They increase vascular permeability and cause inflammation. Signup and view all the answers

What is a primary function of the upper airway?

To aid in the coordination of ventilation and swallowing Signup and view all the answers

What type of epithelium lines the nasal cavity?

Pseudostratified ciliated columnar epithelium Signup and view all the answers

Which structure houses the vocal cords in the respiratory system?

Larynx Signup and view all the answers

At what temperature does inhaled air reach by the time it reaches the carina?

37 degrees Celsius Signup and view all the answers

What is the role of the epiglottis in the respiratory system?

To prevent food from entering the trachea Signup and view all the answers

What does the volume of distribution (Vd) indicate about a drug?

The total amount of drug in the body relative to plasma concentration Signup and view all the answers

Which of the following is NOT a mechanism of drug absorption?

Tissue perfusion Signup and view all the answers

What is the primary function of the absorption phase in pharmacokinetics?

Facilitating the transfer of drugs from the GI tract to the bloodstream Signup and view all the answers

What factors can affect the bioavailability of a drug?

Route of administration and first-pass metabolism Signup and view all the answers

Which body compartment has the largest volume in the context of pharmacokinetics?

Intracellular fluid Signup and view all the answers

What is the primary focus of pharmacology?

The nature, effects, and actions of medications Signup and view all the answers

Which branch of pharmacology deals with the study of toxins and poisonous substances?

Toxicology Signup and view all the answers

Which of the following best describes pharmacognosy?

The study of drugs obtained from natural sources Signup and view all the answers

What does pharmacy primarily involve?

Compounding and dispensing medical drugs Signup and view all the answers

What is the purpose of toxicology reports in medical contexts?

To determine the presence of intoxicating substances Signup and view all the answers

Which of the following is NOT considered a source of drugs?

Synthetic textiles Signup and view all the answers

What is the correct sequence in the drug approval process in the United States?

Chemical isolation and identification, Animal studies, Investigational New Drug approval Signup and view all the answers

Which of the following is a primary document typically used for drug information?

Physician's Desk Reference Signup and view all the answers

What type of name is given to a drug for marketing purposes?

Trade name Signup and view all the answers

Which of the following sources is the most common for drug preparation?

Chemical synthesis Signup and view all the answers

What is the effect of blocking muscarinic receptors in the respiratory system?

Bronchodilation Signup and view all the answers

Which of the following describes the sympathetic nervous system's primary function?

Stimulates adrenal gland release Signup and view all the answers

What happens when beta-2 receptors are blocked?

Increased airway resistance Signup and view all the answers

Which receptors are responsible for closing the airways under parasympathetic stimulation?

Muscarinic receptors Signup and view all the answers

What neurotransmitter is primarily involved in the parasympathetic nervous system?

Acetylcholine Signup and view all the answers

Study Notes

Cartilaginous Rings

Provide structural support to maintain open airways, preventing collapse during breathing.
Allow the esophagus to remain flexible for the passage of food, facilitating digestion.

The Asthmatic Airway

Mast cells play a crucial role in the immune response, particularly in allergic reactions and asthma.
Activation of mast cells contributes to airway inflammation, leading to symptoms such as wheezing and shortness of breath.

Mast Cell Function

Release histamine, a chemical that induces inflammation and increases airway reactivity.
Histamine release causes swelling and mucus production, exacerbating respiratory difficulties in asthmatic individuals.

Cuff Pressures in Tracheostomy

Tracheostomy tube cuffs must be monitored due to their close anatomical proximity to vital structures, including the innominate artery and esophagus.
Excessive cuff pressure can lead to complications, such as tissue ischemia or erosion, emphasizing the importance of careful management.

Functions of the Upper Airway

Facilitates phonation, allows for smell detection, and helps coordinate ventilation and swallowing.
Acts as a defense mechanism against foreign particles and microbes, protecting the lower respiratory tract.
Warms and humidifies inhaled air to a temperature of 37 degrees Celsius and to a humidity level of 44 mg/dl before reaching the carina.

Upper Respiratory System Components

Comprises the nasal cavity, pharynx, and larynx.
Nasal cavity features pseudostratified ciliated columnar epithelium, aiding in mucus production and trapped particle clearance.
Pharynx serves as a muscular conduit connecting the nasal cavity and larynx to the esophagus, facilitating both respiratory and digestive functions.
The larynx, a cartilaginous structure, houses vocal cords essential for sound production.

Instrumentation in Upper Airway Management

The Miller laryngoscope is used to lift the epiglottis for visualization during intubation.
The Macintosh laryngoscope is designed to lift the vallecula, enabling direct view access to the vocal cords.

Thermal Regulation of Inhaled Air

By the time air reaches the carina, it is adjusted to body temperature, optimizing conditions for gas exchange.

Epithelial Profile of the Upper Airway

The upper airway is lined with pseudostratified ciliated columnar epithelium, which plays a critical role in mucociliary clearance and maintaining airway patency.

Pharmacokinetic Phases

Comprises four main phases: absorption, distribution, metabolism (primarily in the liver), and elimination (primarily through the kidneys).

Pharmacokinetic Phase: Distribution

Distribution involves transporting the drug to action sites, elimination locations, or storage areas within the body.
Volume of distribution (Vd) is a key concept linking drug quantity in the body to its plasma concentration, influencing dosing and effectiveness.
The formula for Vd is expressed as ( Vd = \frac{drug \ amount}{plasma \ concentration} ), providing insight into how a drug disperses in bodily compartments.

Pharmacokinetic Phase: Absorption

Absorption mechanisms include:
- Aqueous diffusion, allowing movement through water-filled channels.
- Lipid diffusion, enabling passage across cell membranes due to lipid solubility.
- Carrier-mediated transport, where specific proteins assist in moving substances across membranes.
- Pinocytosis, a process where cells engulf fluid and small particles.
Bioavailability measures the extent and rate at which the active ingredient or active moiety is absorbed and becomes available at the site of action.

Volumes of Major Body Compartments

Major body compartment volumes are vital for understanding drug distribution:
- Vascular (blood) compartment has a volume of approximately 5 liters.
- Interstitial fluid compartment contains about 10 liters.
- Intracellular fluid compartment is about 20 liters.
- Fat (adipose tissue) varies between 14 to 25 liters, highlighting significant variability in distribution based on body composition.

Pharmacology Overview

Pharmacology is the study of drugs, including their nature, effects, and actions.
It encompasses various fields such as pharmacy, pharmacognosy, pharmacogenetics, therapeutics, and toxicology.

Key Components of Pharmacology

Pharmacy: Involves preparing, preserving, compounding, and dispensing medical drugs.
Pharmacognosy: Focuses on drugs derived from natural sources, such as plants.
Pharmacogenetics: Studies how an individual's genetic makeup affects their response to drugs.
Therapeutics: Relates to the treatment of diseases through medication.
Toxicology: Examines the effects and measurements of potential toxins and intoxicating substances in the body.

Toxicology Insights

Toxicology plays a crucial role in determining the presence of substances like prescription medications and alcohol within an individual’s system.
Example: Toxicology reports help assess contributing factors, such as alcohol, in incidents like crashes.

Complementary and Alternative Medicine

Recognizes the integration of traditional and non-traditional medical practices in treatment approaches.

Naming Drugs

Chemical name: Reflects the specific chemical structure of the drug.
Code name: Temporary name assigned during the development process.
Generic name: Official name not protected by trademark, used universally.
Official name: Designated name based on regulatory approval; may differ from the trade name.
Trade name: Brand name under which the drug is sold, protected by trademark.

Sources of Drug Information

United States Pharmacopeia-National Formulary (U.S.P.): Comprehensive source for drug standards and formulations.
Physician's Desk Reference: Reference tool for medication information, including side effects and dosages.
Goodman & Gilman's The Pharmacological Basis of Therapeutics, edition 11: Authoritative textbook on pharmacology and drug actions.
Basic & Clinical Pharmacology, edition 11: Text focused on principles of pharmacology as they apply to clinical practice.
Drug Facts and Comparisons: Resource for detailed drug information, comparisons, and clinical considerations.

Sources of Drugs

Animal sources: Include hormones from animals such as thyroid hormone and insulin.
Plant sources: Derived from botanicals, e.g., khellin, atropine, digitalis, and reserpine.
Mineral sources: Include naturally occurring minerals like copper sulfate and magnesium sulfate (Epsom salts).
Chemical synthesis: Predominant method for drug preparation, utilizing synthetic methodologies alongside natural sources.

Process of Drug Approval in the United States

Chemical isolation and identification: Initial step identifying the active compounds.
Animal studies: Conducted to assess safety and biological activity before human trials.
Investigational New Drug approval: Required permission to begin human clinical trials.
New Drug Application: Detailed application submitted to the FDA for drug approval.
Food and Drug Administration (FDA) new drug classification system: Categorization for new drugs based on their characteristics and uses.
Orphan drugs: Special designation for drugs developed for rare diseases, incentivized to encourage research and development.

Parts of a Prescription

Over-the-counter (OTC) medications do not require a doctor's prescription for purchase.
OTC medications can pose risks, including potential side effects or interactions with other medications.

Smooth Muscle

Smooth muscle contraction is influenced by neurotransmitters like muscarinic and nicotinic receptors.
Muscarinic receptors M1, M2, and M3 are specifically involved in airway constriction, affecting respiratory function.

Sympathetic Nervous System

The sympathetic nervous system is responsible for the "Fight or Flight" response, preparing the body for action.
Key neurotransmitters include adrenaline and epinephrine, which enhance the body's readiness for stress.
Receptors involved in this response are classified into Alpha and Beta categories, each with distinct physiological effects.

Parasympathetic Nervous System

The parasympathetic nervous system is known as "Rest & Digest," promoting relaxation and digestion.
Acetylcholine primarily mediates signals in this system, facilitating bodily functions at rest.
Receptors include various muscarinic types (M1, M2, M3, M4, M5) and nicotinic receptors, playing roles in different organ systems.

Blocking Muscarinic Receptors

Blocking muscarinic receptors can serve as a test for parasympathetic activation.
This leads to bronchodilation, resulting in the widening of airways and improving airflow in the lungs.

Blocking Beta 2 Receptors

The phenomenon of blocking Beta 2 receptors is referred to as Sympatholytic.
This action can increase heart rate and enhance the force of cardiac contractions.
Beta 2 receptors are primarily responsible for bronchodilation, and their blockade can lead to airway constriction.

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Description

This quiz covers key concepts related to the respiratory system, including the structure and function of cartilaginous rings, the role of mast cells in asthma, and the importance of monitoring cuff pressures in tracheostomy procedures. Test your knowledge on how these elements interact in respiratory health and disease.