Respiratory System Overview
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Respiratory System Overview

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Questions and Answers

What characterizes asthma?

  • Irreversible airway obstruction
  • Reversible bronchospasm and inflammation (correct)
  • Thick secretions in the lungs
  • Chronic inflammation unrelated to cytokines

    • Which disorder is primarily linked to chronic, irreversible obstruction of the airways?

  • Cystic fibrosis
  • Respiratory distress syndrome
  • Asthma
  • Chronic obstructive pulmonary disease (COPD) (correct)

    • What is a primary cause of the respiratory distress seen in premature infants?

  • Accumulation of thick secretions
  • Chronic bronchitis
  • Inadequate lung development and low surfactant levels (correct)
  • Cigarette smoking exposure

    • Which condition is a hereditary disease causing thick secretions in multiple systems?

    <p>Cystic fibrosis</p> Signup and view all the answers

    What symptom is NOT typically associated with COPD?

    <p>Pneumonia</p> Signup and view all the answers

    What triggers the expiration of air during breathing?

    <p>Stretch and irritant receptors</p> Signup and view all the answers

    Which respiratory infection results from viral invasion of the upper respiratory tract and causes symptoms like nasal congestion and headache?

    <p>Common cold</p> Signup and view all the answers

    What is a potential consequence of untreated sinusitis?

    <p>Spread of microorganisms to the brain</p> Signup and view all the answers

    Which type of infection is bronchitis most often associated with?

    <p>Viral infection</p> Signup and view all the answers

    What condition is primarily characterized by the incomplete expansion of alveoli?

    <p>Atelectasis</p> Signup and view all the answers

    What is a common symptom of pneumonia?

    <p>Difficulty breathing</p> Signup and view all the answers

    Which condition involves dilation of the bronchial tree and is chronic in nature?

    <p>Bronchiectasis</p> Signup and view all the answers

    What symptoms are indicative of tuberculosis?

    <p>Coughing up blood, fatigue, and weight loss</p> Signup and view all the answers

    What is the primary function of the respiratory system?

    <p>To facilitate the exchange of gases like oxygen and carbon dioxide</p> Signup and view all the answers

    Which structure is primarily responsible for trapping foreign substances in the respiratory tract?

    <p>Goblet cells</p> Signup and view all the answers

    What initiates the cough reflex in the respiratory system?

    <p>Stimulation of receptors in the trachea and conducting bronchi</p> Signup and view all the answers

    What is the main pathway for air to travel from the nasal cavity to the lungs?

    <p>Nasal cavity → Trachea → Bronchi → Alveoli</p> Signup and view all the answers

    How many lobes does the left lung have compared to the right lung?

    <p>Left lung has two lobes; right lung has three lobes</p> Signup and view all the answers

    What role do cilia play in the respiratory system?

    <p>They move mucus and trapped substances toward the throat</p> Signup and view all the answers

    Which part of the brain primarily regulates ventilation?

    <p>Pons and medulla</p> Signup and view all the answers

    What is the primary structural unit where gas exchange occurs in the lungs?

    <p>Alveoli</p> Signup and view all the answers

    What is a common adverse effect associated with both topical and oral decongestants?

    <p>Rebound congestion</p> Signup and view all the answers

    Which decongestant is known for its topical application and potential for causing rebound congestion?

    <p>Oxymetazoline</p> Signup and view all the answers

    What mechanism is primarily responsible for the therapeutic actions of steroid nasal decongestants?

    <p>Direct local anti-inflammatory effects</p> Signup and view all the answers

    How long may steroid nasal decongestants require to show noticeable changes in symptoms?

    <p>1 week</p> Signup and view all the answers

    Which of the following conditions is NOT a contraindication for the use of steroid nasal decongestants?

    <p>Nasal polyps</p> Signup and view all the answers

    What potential side effect can occur from using topical nasal decongestants with lesions in the mucous membranes?

    <p>Local stinging and burning</p> Signup and view all the answers

    Which of the following is NOT classified as a steroid nasal decongestant?

    <p>Oxymetazoline</p> Signup and view all the answers

    Which decongestant is generally not absorbed systemically after administration?

    <p>Fluticasone</p> Signup and view all the answers

    What are common adverse effects associated with inhaled medications for asthma?

    <p>Sore throat and dry mouth</p> Signup and view all the answers

    Which of the following is true regarding leukotriene receptor antagonists?

    <p>They include Montelukast as a primary drug.</p> Signup and view all the answers

    What serious side effect has been reported with leukotriene receptor antagonists?

    <p>Neurological events</p> Signup and view all the answers

    What is a primary action of anticholinergic medications in treating COPD?

    <p>Relax bronchial smooth muscle</p> Signup and view all the answers

    During long-term use of inhaled medications, which potential adverse effect should be monitored?

    <p>Glaucoma</p> Signup and view all the answers

    When evaluating a patient for anticholinergic use, what should be considered as a contraindication?

    <p>Known allergy to the drug</p> Signup and view all the answers

    What happens to most inhaled anticholinergics once administered?

    <p>Most are excreted unchanged in the urine.</p> Signup and view all the answers

    Which of the following drugs is NOT classified as a leukotriene receptor antagonist?

    <p>Ipratropium</p> Signup and view all the answers

    Study Notes

    Respiratory System

    • The respiratory system brings oxygen into the body, allows for the exchange of gases, and expels carbon dioxide and other waste products.
    • The respiratory system is primarily involved in ventilation, changing the quality of atmospheric air.
    • Conducting Airways
      • Nasal hairs catch and filter foreign substances.
      • Goblet cells produce mucus that traps foreign substances.
      • Cilia move the mucus and trapped substances towards the throat for swallowing.
      • Pairs of sinuses open into the nasal cavity and mucus produced in the sinuses drains into the nasal cavity and into the throat.
      • Air moves from the nasal cavity into the pharynx and larynx.
      • Air proceeds to the trachea, the main conducting airway into the lungs.
      • The trachea divides into bronchi.
    • Cough and Sneeze Reflexes:
      • The walls of the trachea and conducting bronchi are highly sensitive to irritation.
      • When receptors in the walls are stimulated, the central nervous system (CNS) triggers a reflex.
      • A cough causes air to be pushed through the bronchial tree under tremendous pressure to clean out any foreign irritant.
      • The sneeze reflex is similar, initiated by receptors in the nasal cavity.

    Respiratory Airways Layers, Alveoli, and Lungs

    • Layers of Bronchial Tubes:
      • Alveoli, the smallest units of the lungs, are respiratory sacs at the end of bronchioles, and are the functional units where gas exchange occurs.
      • Bronchial tree consists of all airways from the trachea to the alveoli.
      • Blood supply is provided by the pulmonary perfusion.
      • Elastic tissue in the lungs provides flexibility and resilience for breathing movements.
      • The left lung has two lobes, while the right lung has three lobes.

    Ventilation

    • Ventilation is controlled by the CNS, specifically neurons in the pons and medulla which stimulate inspiratory muscles.
    • The rate and depth of breathing can increase rapidly in response to higher acid or carbon dioxide levels, detected by chemoreceptors.
    • Stretch and irritant receptors trigger expiration.
    • Breathing can be voluntarily controlled.
    • The vagus nerve stimulates diaphragm contraction and inspiration.
    • Sympathetic stimulation allows for freer airflow.

    Respiratory Tract Infections

    • Common Cold:
      • Caused by a variety of viruses that invade upper respiratory tract tissues.
      • The invasion triggers the release of histamine and prostaglandins, causing an inflammatory response.
      • Symptoms include sinus pain, nasal congestion, runny nose, sneezing, watery eyes, scratchy throat, and headache.
    • Seasonal Rhinitis:
      • Inflammation of the nasal cavity.
      • The upper airways respond to specific antigens, triggering a vigorous inflammatory response.
      • Symptoms include nasal congestion, sneezing, stuffiness, and watery eyes.
    • Sinusitis:
      • Inflammation of the epithelial lining of the sinus cavities.
      • Causes severe pain due to pressure against bone.
      • If untreated, microorganisms can travel to brain tissue or affect eyesight.
    • Pharyngitis, Laryngitis, and Bronchitis:
      • Inflammation of the respective structures.
      • Caused by either viral or bacterial infection.
      • Pharyngitis and laryngitis are frequently seen with influenza.
      • Bronchitis can be acute (mostly viral) or chronic (irritation from noxious stimuli + recurrent infections).
    • Pneumonia:
      • Inflammation of the lungs.
      • Caused by bacterial or viral invasion or aspiration of foreign substances.
      • Leads to localized swelling, engorgement, and exudation of protective sera.
      • Symptoms include difficulty breathing, fatigue, fever, noisy breath sounds, and poor oxygenation.
    • Tuberculosis:
      • Discussed in Chapter 9.
      • Symptoms include cough (often with bloody tinge), fatigue, shortness of breath, fever, chills, weight loss, and night sweats.

    Ventilation and Gas Exchange Disorders

    • Atelectasis:
      • Incomplete expansion of alveoli.
      • Can result from outside pressure against the alveoli or pleural effusion.
      • Commonly caused by airway blockage.
      • Symptoms include crackles, dyspnea, fever, cough, hypoxia, and changes in chest wall movement.
    • Bronchiectasis:
      • Chronic disease characterized by dilation of the bronchial tree, chronic infection, and inflammation of the bronchial passages.
      • Often associated with an underlying medical condition that increases susceptibility to infections.
      • Symptoms include fever, malaise, myalgia, arthralgia, and purulent, productive cough.
    • Asthma:
      • Characterized by reversible bronchospasm, inflammation, and hyperactive airways.
      • It is a chronic inflammatory response mediated by cytokines.
      • Inflammation, mucous production, and edema contribute to airway obstruction.
      • Symptoms include wheezing, shortness of breath, chest tightness, and cough.
    • COPD (Chronic Obstructive Pulmonary Disease):
      • Progressive, not completely reversible chronic obstruction of airways.
      • Often related to cigarette smoking.
      • Includes emphysema and chronic bronchitis.
      • Airflow obstruction on expiration, increased inflation of lungs, and poor gas exchange.
    • Cystic Fibrosis:
      • Hereditary disease affecting epithelial linings of the respiratory, gastrointestinal, and reproductive tracts.
      • Accumulation of thick secretions in the lungs obstructs airways, leading to recurrent infections and potential destruction of lung tissue.
    • Respiratory Distress Syndrome:
      • Causes obstruction at the alveolar level.
      • Frequently seen in premature infants, as their lungs may not have fully developed and surfactant levels are still low.
      • Symptoms include decreased gas exchange, low oxygen levels, and generalized distress throughout the body.
    • Acute Respiratory Distress Syndrome:
      • Relieves discomfort of nasal congestion associated with the common cold, sinusitis, and allergic rhinitis.

    Decongestants (Topical and Oral)

    • Mechanism of Action: Reduce swelling in nasal passages and improve airflow.
    • Key Drugs:
      • Pseudoephedrine and phenylephrine: Commonly found in oral decongestants.
      • Oxymetazoline: Topical nasal decongestant that quickly relieves congestion, but may cause rebound congestion with prolonged use.
    • Pharmacokinetics: Onset of action is almost immediate (topical), not generally absorbed systemically, any portion absorbed is metabolized in the liver and excreted in the urine.
    • Contraindications: Lesions or erosion in the mucous membranes (topical), any condition exacerbated by sympathetic activity, pregnancy, or lactation.
    • Cautions: Pregnancy or lactation.
    • Adverse Effects: Local stinging and burning, rebound congestion, sympathomimetic effects.
    • Drug-Drug Interactions: Other drugs that affect the sympathetic nervous system.

    Steroid Nasal Decongestants

    • Therapeutic Actions: Exact mechanism unknown, antiinflammatory action blocks reactions responsible for inflammatory response.
    • Indications: Allergic rhinitis, relief of inflammation after removal of nasal polyps, first-line medication for nasal congestion.
    • Pharmacokinetics: May require 1 week to cause changes, not generally absorbed systemically.
    • Contraindications: Acute infection.
    • Cautions: Active infection, avoid exposure to airborne infections, pregnancy, or lactation.
    • Adverse Effects: Usually fewer adverse effects when inhaled, sore throat, hoarseness, coughing, dry mouth, pharyngeal and laryngeal fungal infections, long-term use: glaucoma, cataracts, decreased bone mineral density.
    • Drug-Drug Interactions: None known.

    Leukotriene Receptor Antagonists

    • Key Drug: Montelukast (Singulair).
    • Therapeutic Actions: Add-on therapy for asthma and allergy management when inhaled steroids are insufficient.
    • Contraindications: Not indicated for treatment of acute asthma attacks.
    • Cautions: Pregnancy or lactation.
    • Adverse Effects: Upper respiratory infection, pharyngitis, cough, headache, dizziness, nausea, diarrhea, abdominal pain, elevated liver enzyme concentrations, vomiting, generalized pain, fever, myalgia. Serious neuropsychiatric events have been reported.
    • Drug-Drug Interactions: Warfarin, theophylline, phenytoin, aspirin, and others. Check for interactions before administering.

    Anticholinergics

    • Key Drugs: Ipratropium (Atrovent), Tiotropium (Spiriva).
    • Therapeutic Actions: Block or antagonize the action of acetylcholine at vagal-mediated receptor sites, relaxing smooth muscle in bronchi.
    • Indications: Treatment of bronchospasm in patients with COPD.
    • Pharmacokinetics: When inhaled, most is not absorbed, metabolism, excretion, and half-lives vary, most are partially excreted unchanged in urine.
    • Contraindications: Known allergy.
    • Cautions: Any condition aggravated by anticholinergic effects, pregnancy, or lactation.
    • Adverse Effects: Dry mouth, constipation, blurred vision, urinary retention.
    • Drug-Drug Interactions: None known.

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    Description

    This quiz explores the key functions and structures of the respiratory system, including the conducting airways and reflexes such as coughing and sneezing. Understand how oxygen is brought into the body and the significance of mucus and cilia in keeping the airways clear. Test your knowledge on the intricate processes involved in respiration.

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