Respiratory

Question 1

Airways

Answer 1

• 23 generations of branches to alveoli
• Asymetrical
• Generations 1-6/8 - cartillage
• Generations 8-23 - soft tissue structure

Question 2

Airway Resistance

Answer 2

• Most resistance is in the first (up to 8) Generations of airways - Choke point of the respiratory system
• Low airway resistance in the lower aiwars

Question 3

Factors that influence airway flow

Answer 3

1. Airway
2. Lung Parenchyma
3. Chest wall/pleura
4. Neuromuscular (diaphragm, intercostals)

Question 4

Glymphatics

Answer 4

• Essentially drains CSF to lymphatics
• Activated during sleep
• Modulates fluid cortical volume
• Clearance of toxins (Amyloid, Tau Proteins etc)
• Restoration of function

Question 5

Upper airway muscles

Answer 5

• > 12 separate muscles - sequential contractions
  Issues:
• Surgically altering palate changes vectors of muscle function
• Pacing - which muscle
• Training - which muscle

Question 6

Collapsible airway influenced by

Answer 6

• Body weight (50%)
• Size of Airway (25%)
• Loss of airway muscle tone
• Dryness (less secretions = collapse)

Question 7

Concerns about Snoring

Answer 7

• Cardio-pulm-vasc risk
• Sleepiness
• Noise pollution (partner)
• Post-op risk

Question 8

OSA

Answer 8

Doubles CVD risk
# L Heart Failure
- hyperventilation - Decreases PCO2
- Cheyne Stokes respiration
# R Heart Failure
- Hypoventilation - Increases PCO2
- Cor Pulmonale

Question 9

OSA Treatment

Answer 9

Improves
- HTN
- Heart Failure
Unsure
- Diabetes
- IHD
- Mortality
- AF

Question 10

Cheyne Stokes Respiration

Answer 10

• Changes in rate and deepness of breathing

- 2ndary to CO2 levels

Question 11

OSA Treatment

Answer 11

1. Lifestyle
2. CPAP
3. Dentition

Question 12

Causes of a raised TLCO

Answer 12

asthma
pulmonary haemorrhage (Wegener's, Goodpasture's)
left-to-right cardiac shunts
polycythaemia
hyperkinetic states
male gender, exercise

Question 13

Causes of a lower TLCO

Answer 13

pulmonary fibrosis
pneumonia
pulmonary emboli
pulmonary oedema
emphysema
anaemia
low cardiac output