- Contraction of diaphram & other muscles are controlled by neurons in_________ - spontaneous firing is ADDITIONALLY influenced by__________

- brain stem - sensory input by chemoreceptors

Module 9 Flashcards by Anson Lam

Trachea is made up of_________, which prevents_________

Cartilage, collapsing

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DO bronchioles have cartilage ?

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Right lung has____lobes, left lung has____lobes

3,2

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Gas xchange occurs in______of lung

alveoli

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Pressure in lung (rise/drops) during inhalation

drops

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parasympathetic innervation causes broncho________

constriction

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sympathetic innervation causes broncho_______

dilation

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What are the 3 key factors contributing to physiological properties of lung

Compliance, Elastic recoil, Surface tension

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Lipoprotein is produced by type____alveolar cells

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What are the 2 fxns of pulmonary surfactants

Reduce surface tension, immunoprotective

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(CO2/O2) is more soluble in blood

CO2

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Breathing pattern is controlled by_______

CNS

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Contraction of diaphram & other muscles are controlled by neurons in_________
- spontaneous firing is ADDITIONALLY influenced by__________

brain stem
- sensory input by chemoreceptors

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The__________contains the DRG (Dorsal Respiratory Group) which is the main region for neural control of breathing that sends output to respiratory muscles (i.e. diaphragm)

NTS (Nucleus Tractus Solitarius)

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_______provide tonic input to ensure a smooth rhythm ?

PRG (Pontine Respiratory Group)

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_______contains the pre-Botzinger complex that gives output to smaller muscles & may act as pace maker for rhythm ?

VRG (Ventral Respiratory Group)

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______is the number 1 factor that affects ventilation

pCO2

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What are the 3 key factors that influence ventilation

CO2, O2, plasma pH

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Periphery chemoreceptors are located in___________

Carotid bodies & aortic bodies

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T/F, peripheral chemoreceptors are sensitive to pO2 ?

F. It is sensitive to H+, only very low pO2 triggers it as an emergency mechanism

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What does central chemoreceptors detect ?

pH of CSF

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Respiratory sys. has a surface area of ~_____m2

140

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Which 2 viral determinants contribute to virus stability

Capsid structure, densely packaged internal proteins & viral genomes

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(Tb/Coronavirus) reach deeper in the lung

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(Innate/Adaptive) immunity could be reactive to self

Adaptive

Allergy is known as type____hypersensitivity

What are the four things involved in type I hypersensitivity

Helper T cells that produce cytokines, Mast cell, eosinophils, IgE antibody

Type II hypersensitivity is known as_______hypersensitivity

Antibody-mediated

What are the 2 things involved in type II hypersensitivity

IgM & G

Type III hypersensitivity is known as_______hypersensitivity

Immune complex-mediated

Type IV hypersensitivity is known as_______hypersensitivity

T-cell mediated

What is the 3 clin. definition of chronic bronchitis ?

1. daily sputum pdtion for more than 3 months in a year, lasting 2 or more consecutive years 2. xs mucous 3. cough

T/F, asthma involves the flattening of airway ?

F, it is found in emphysema instead

If you were to examine the airway of an individual with Chronic Obstructive Pulmonary Disease (COPD), occurrence of which of the following cell types would be elevated? Basophils Type 2 T cells Eosinophils Neutrophils Mast cells

Neutrophils

Cells that are responsible for the production of reactive dentin are most likely to be present in which of the following areas of pulp? Cell free zone Pulp core Pulp periphery Around blood vessels Cell rich zone

Pulp periphery

Define COPD

AIRFLOW OBSTRUCTION that is not fully reversible.

Inc. in PCO2 causes_______cross BBB

CO2

The nucleus tractus solitarius contains (PRG/DRG/VRG)

DRG

(Droplets/Aerosol) travel further

Aerosol

_________can grow inside macrophages & hide from immune sys.

_________is an important mechanism of airway narrowing in COPD ?

Loss of elastic recoil due to emphysema destruction of lung tissue

What is emphysema ?

Abnormal enlargement of air spaces & destruction of alveoli

What are the 3 muscles for inhalation ?

Diaphragm, External intercostal, Scalene

Agonist effect on muscarinic receptor of eye lead to pupil (constriction/dilation)

constriction

Anti-muscarinic lead to (inc./dec.) heart rate

inc.

ipratropium bromide belongs to what class of med ?

SAMA

Which med treating urinary urge incontinence has the lowest chance of causing dry mouth ?

TRANSDERMAL PATCH of oxybutynin

- What is the indication for hyoscine butylbromide ? - What drug class is hyoscine butylbromide

- irritable bowel syndrome - Anticholinergic/Antimuscarinic

List 3 indications for SABA

1. asthma/copd 2. Prevention of exercise-induced bronchoconstriction 3. Mangement of pre-term labour

List 2 SABA drugs

Salbutamol, Terbutaline

- Adrenergic receptors are divided into which types ? - Which type is commonly found in lungs

- a(a1,a2) & b(b1,b2,b3) - b2

T/F, the use of SABA alone is sufficient tx if patients experience asthma symptoms 4 times a month

F, if symptoms > 2 times a month, use anti-inflammatory inhalers ON TOP OF SABA

- Using ____or more canisters of SABA per year is considered overuse - Overuse SABA inc. the risk of____________

- 3 - asthma flare ups

SABA can generally be used up to______times a day

What receptor does SABA work on

b2 adrenergic receptor

Which of the following approaches would NOT help resolve a delayed-type hypersensitivity reaction to nickel? A T cell depleting therapeutic monoclonal antibody A cytokine depleting therapeutic monoclonal antibody Cease contact with nickel Anti-histamines Corticosteroids

Anti-histamines

Mycobacterium tuberculosis primarily infects the respiratory system through aerosol transmission. The aerosol transmission is important because the aerosol particles: Allow the deposition of M. tuberculosis to the upper respiratory tract Protect M. tuberculosis from UV exposure Enable dissemination of M. tuberculosis far from the index case Allow the deposition of M. tuberculosis to the lower respiratory tract Protect M. tuberculosis from drying out

Allow the deposition of M. tuberculosis to the lower respiratory tract

What best describes the pulmonary ligament? A suspensory ligament of the pleura, attaching to the first rib A projection of pleura below the lung root, to allow for expansion of the vessels in the lung root A remnant of ductus arteriosus A ligament which helps suspend the trachea to the first rib A projection of pleura below the lung root, to allow for expansion of the lung during inspiration

A projection of pleura below the lung root, to allow for expansion of the vessels in the lung root

Which of the following statements regarding asthma is CORRECT? Asthmatic children may have a higher risk of caries The aetiology of asthma involves a mutation in the gene for the FCFTR chloride channel NSAIDs are not known to cause acute exacerbation of asthma Asthma is less prevalent in Indigenous Australian populations Asthma is characterised by irreversible bronchoconstrictio

Asthmatic children may have a higher risk of caries

What is the primary pathophysiological change in pneumonia that leads to hypoxia? Collapse of the entire lung tissue Increased airway resistance due to bronchoconstriction Overproduction of mucus in the bronchi Increased fluid and pus in the alveoli impair air exchange Swelling of the upper respiratory tract

Increased fluid and pus in the alveoli impair air exchange

Which of the following drug classes is NOT associated with bruxism? Caffeine Amphetamines Antipsychotics Benzodiazepines Antidepressants

Benzodiazepines

Immune complex-mediated hypersensitivity requires: Binding of cytokines to cytokine receptors Binding of T cell receptors to dendritic cell MHC molecules Binding of antibodies to antigen in circulation Binding of autoantibodies to tissue self-antigens Binding of T cells to B cells

Binding of antibodies to antigen in circulation

What is the most correct definition of aerosol? A liquid mist of 100 μm formed by the condensation of water vapor in the air A suspension of solid particles, with a size of <500 μm A suspension of liquid and solid particles in air, with a particle size >100 μm A mixture of gases released into the atmosphere, containing no particles A suspension of liquid and solid particles in air, with a particle size <100 μm

A suspension of liquid and solid particles in air, with a particle size <100 μm

What aerosol particle size is more likely to reach the lower respiratory tract? It depends on the individual's breathing pattern Ultrafine particles (<0.1 μm) Smaller particles (1-5 μm) Larger particles (>10 μm) All particle sizes have an equal chance

Which of the following statements regarding the sympathetic trunk in the thorax is TRUE? The sympathetic trunk lies posterior to the parietal pleura The sympathetic trunk lies anterior to the vertebral bodies in the thorax. The sympathetic trunk in the thorax does not have any connections to other sympathetic trunks. The sympathetic trunk innervates the skeletal muscles of the thoracic wall. The sympathetic trunk receives preganglionic fibers from the parasympathetic nervous system.

The sympathetic trunk lies posterior to the parietal pleura

What macronutrient will produce more CO2 during digestion? Alcohol Carbohydrate Protein Exogenous ketone Fat

Carbohydrate

Suggested integrated question- Upon giving an IAN block with a local anesthetic containing adrenaline, the patient notes an accelerated heart rate. Based on your understanding of the pterygomandibular space, which vessel is the likely route for this effect? Pterygoid venous plexus Internal Carotid Lingual artery Retromandibular vein Inferior alveolar artery

Pterygoid venous plexus

(too much/too little) water inc. the lung's tendency to collapse

too much

Partial pressure gradient is maintained by_______

ventilation

Gas diffusion rate is dependent on which 3 factors

Surface area, membrane thickness, gas diffusion constant

The most important factor that determines haemoglobin saturation is the pO2 of_______

blood

~25 % of CO2 is transported via binding to the_______portion of Haemoglobin

Globin

~_____% of CO2 is transported via HCO3- ion

T/F, medulla contains chemoreceptors for ventilation

An avg. adult has a surface area of_______m2 for respiratory sys.

140

- Can droplets be inhaled ? - Droplets can travel <___meter

- No - 1

(a2,3 gal/ a2,6 gal) receptors are mainly found in human upper respiratory tract

a2,6 gal

Tb is resistant to antibiotics because of thick_________

cell wall

Which of the following is considered THE GREATEST source of aerosol contamination ? Air polishing Air water syringe Ultrasonic & sonic scalers Tooth prep w/ air turbine handpiece Tooth prep w/ air abrasion

Ultrasonic & sonic scalers

_______means the genetic tendency to dvlp allergic diseases

Atopy

________is an important virus in causing pneumonia

human rhinovirus

- Adrenergic receptors are mostly part of__________nervous sys. - Muscarinic receptors are part of_________nervous sys.

- Sympathetic - Parasympathetic

Adults with asthma who have symptoms > 2 a month is recommended to use a preventer. What are the 2 main types of preventer ?

Inhaled Corticosteroid (ICS) or combination of ICS & LABAs

- What is the main indication for SABA - What is the main indication for LAMA

- Asthma & COPD - COPD

(SAMA/SABA) can be used prior to exercise to prevent symptoms

SABA

Allergic rhinitis is also known as_________

hay fever

T/F, asthma patients should have their relievers on hand even though they are using preventer therapy regularly

T, it is helpful in case of flare ups

LABA should not be used in children <____y.o.

Should LABA be used as monotherapy

List 2 common oral adverse effects of inhaled preventers

Dysphonia, oral candidiasis

- Oxygen therapy may be prescribed to patients of what condition - Oxygen therapy indicated for patients w/ oximetry readings <____%

- severe asthma or COPD - 92 (<88 if @ risk of hypercapnia)

Allergic rhinitis is very common for ppl w/ what condition ?

asthma

What are the 2 tx for allergic rhinitis

Anti histamines, INCS (INtranasal CorticoSteroids)

What is usually the first drug to be given to COPD patients in a stepped approach

LAMA

T/F, ICS is always added for COPD patients in conjunction w/ LAMA & LABA

F, it is usually not added unless LAMA & LABA are not sufficient (unlike management of asthma)

T/F, SABAs are usually prescribed as monotherapy for patients w/ asthma

F, SABA + ICS(preventer) is considered the bare minumum

The increased risk of oral candidiasis that accompanies the use of some asthma inhalers indicates that: The ingredients in the inhalers can suppress the immune system in the oral mucosa The inhalers increase the risk of bacterial infection The inhalers are probably being used incorrectly These inhalers can be susceptible to fungal contamination The inhibition of mast cell degranulation

The ingredients in the inhalers can suppress the immune system in the oral mucosa

Which of the following drugs used for incontinence is MOST LIKELY to cause dry mouth when taken orally? Mirabegron Solifenacin Oxybutynin Tamsulosin Tolterodine

Oxybutynin

If you were to examine the airway of an individual with Chronic Obstructive Pulmonary Disease (COPD), occurrence of which of the following cell types would be elevated? Eosinophils Neutrophils Mast cells Basophils Type 2 T cells

Neutrophils

The binding of_____will activate mast cell in type 1 sensitivity

igE

In the tx of (Asthma/COPD), mono therapy w/out ICS cannot be indicated

Asthma

Regarding inflammatory changes in chronic bronchitis, which of the following statements is TRUE? They are associated with decreased mucus production in the bronchi They are associated with thickening of the basement membrane of the bronchial epithelium They are associated with a decrease in the thickness of the mucous glands in the submucosa of the bronchus (Reid Index) They are not associated with recurrent infections of the respiratory tract They are associated with a non-productive cough

They are associated with thickening of the basement membrane of the bronchial epithelium

Where is NTS (Nucleus Tractus Solitarius) located in brain

Medulla oblongata

Where is VRG (Ventral Respiratory Group) located in brain

Medulla oblonata

Choose all the correct statements as they relate to the trachea: Lies in front of the oesophagus The tracheal "rings" are open anteriorly Sensory to the mucous membrane is supplied by the vagus and recurrent laryngeal nerves Is lined with pseudostratified columnar ciliated epithelium Bifurcates into left and right primary bronchi at the sternal angle

Lies in front of the oesophagus Sensory to the mucous membrane is supplied by the vagus and recurrent laryngeal nerves Is lined with pseudostratified columnar ciliated epithelium Bifurcates into left and right primary bronchi at the sternal angle

Module 9 Flashcards

(105 cards)