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- - - - An increase in volume increases compliance
        
        For example in emphysema
    - - Compliance of the lungs
      - Compliance of the chest wall
      - Surface tension
        
        The tension that happens in the air-water interaction
        
        Leads to
        
        Increased tendency of alveoli shrinkage
        
        For example in infant respiratory distress syndrome where there is alveolar shrinkage due to insufficient surfactant production
  - - - A decrease in volume increases elasticity
        
        For example in fibrosis there is more scar tissue that is not stretchable increasing compliance
  - - - Tube length (directly proportional)
      - Tube radius (inversely proportional)
      - Viscosity (directly proportional)
    - - Physical factors
      - Chemical factors
        
        Sympathetic stimulation increases airway radius and thus decreases resistance
      - Neural factors
- - - - the production of speech sounds by the vibration of the vocal cords in the larynx
    - - 2- elongation and increased tension of vocal ligaments
      - 3- Airflow through the glottis causing vibration of vocal cords
      - 1-Adduction as the the arytenoid cartilages move toward the the midline 
    - - phonatory system
        
        include
        
        larynx and vocal cords
      - respiratory system
        
        include
        
        lungs, ribcage, chest muscles, diaphragm, and trachea
      - resonance system
        
        include
        
        throat , nasal passages, sinuses and mouth
  - - - warm, moist air helps to to relax the vocal cords
    - - produces bronchodilation
      - reduces mucosal edema by vasoconstriction
    - - reduces production of inflammatory mediators
      - immunosuppressant effect
      - Causes gluconeogenesis, lipolysis, and proteolysis
      - nducing sodium and water retention.
- - - - Meaning
        
        Tendency for Th2 Stimulation / Hyper response of person to the products
    - - Meaning
        
        Worst Allergic reaction. Prostaglandins cause vasodilation, lowering B.P.
  - - - Allergen reaches mucosal surface
        
        Dendritic Cells Engulf the Allergen becoming an APC
        
        Present it to Naïve CD4 T Cells via MHCII receptors
    - - T cells become Th1 via IL- 4,6 &10
        
        Th2 produce IL-4 & 13 And interconnect with B cells via CD40-CD40L receptors, stimulating B cells to produce IgE
    - - IgE cause Mast cell degranulation
        
        Releasing products such as Histamine causing the allergic reaction
- - - - Type of
        
        Stridor
        
        what is it?
        
        Types
        
        Inspiratory stridor
        
        Occurs when the child breathes in
        
        indicates a collapse of tissue above the vocal cords.
        
        Expiratory stridor
        
        occurs when the child breathes out
        
        indicates a problem further down the windpipe.
        
        Biphasic stridor
        
        occurs when the child breathes in and out
        
        indicates a narrowing of the cartilage right below the vocal cords.
        
        Harsh, High pitched, musical sound produced by turbulent airflow through a partially obstructed airway
- - - - Nose
        
        Includes external nose and nasal cavity
        
        Functions
        
        Respiration
        
        Humidification
        
        Filtration
        
        Elimination of secretions
        
        Superior, middle & inferior nasal conchae subdivide nasal cavity, create turbulence in inspired air
      - Paranasal sinuses
        
        air-filled spaces lined by mucous membrane
        
        Superior one-third is the olfactory area
        
        Inferior two-thirds is the respiratory area
      - Pharynx
        
        A funnel shaped muscular tube
        
        Nasopharynx
        
        Oropharynx
        
        Laryngopharynx
      - Larynx
        
        Larynx is lined a hollow musculoligamentous structure
        
        Cartilages
        
        Thyroid cartilage
        
        Cricoid cartilage
        
        Arytenoid cartilages
        
        Membranes and ligaments
        
        Thyrohyoid membrane
        
        Cricothyroid ligament
        
        Muscles: Extrinsic and intrinsic
        
        Extrinsic Laryngeal Muscles
        
        Suprahyoid muscles
        
        Stylohyoid
        
        Mylohyoid
        
        Digastric
        
        Geniohyoid
        
        Infrahyoid muscles
        
        Sternohyoid
        
        Sternothyroid
        
        Thyrohyoid
        
        Omohyoid
        
        Intrinsic Laryngeal Muscles
        
        Posterior cricoarytenoid
        
        Lateral cricoarytenoid
        
        Oblique arytenoids
        
        Transverse arytenoids
        
        Thyroarytenoid
        
        Vocalis
        
        Cricothyroid
    - - Trachea
      - Bronchi
      - Bronchioles
      - Lungs
  - - - The prevalence rate of asthma (19.8%) in Qatari schoolchildren
    - - Around 300 million people
- - - - Directly relax the bronchial smooth muscle bronchodilation
    - - Short-acting β2 agonists (SABAs)
        
        e.g. Albuterol, Levalbuterol
        
        it has
        
        Rapid onset of action (5–30 min; 4–6 hour duration)
        
        Quick relief from acute bronchoconstriction
        
        No anti-inflammatory effects
        
        Adverse effects
        
        tachycardia
        
        hyperglycemia
        
        hypokalemia
      - Long-acting β2 agonists (LABAs)
        
        e.g. Formoterol, Salmeterol
        
        it is
        
        Long duration of action (~12 hour)
        
        Quick relief from acute bronchoconstriction
        
        Use only in combination with an asthma ‘control’ medication (ICS)
        
        Continuous treatment often leads to tolerance (may be due to downregulation of the receptor)
  - - - Inhibit release of arachidonic acid
      - Anti-inflammatory effects
      - inhibit phospholipase A2
    - - Fewer adverse effects with ICS;
      - when used with spacer Oropharyngeal candidiasis and hoarseness.
- - - - Examine face (plethora? conjunctival pallor?)
      - Chest: Palpation + Percussion + Auscultation
        
        by using
        
        Smart digital stethoscope
      - Examine hands (clubbing? flapping tremor?)
      - Chest inspection (symmetry? shape? scares?)
      - BMI & vital signs
      - 1.general inspection (awake? respiratory distress signs?
  - - - Peak flow meter
        
        measures how fast air comes out of lungs when exhaling forcefully
        
        findings
        
        Green Zone: asthma is in good control
        
        Yellow Zone: airways are narrowing
        
        Red zone: severe airway narrowing
      - Spirometry
        
        measures
        
        lung volumes & capacities
        
        findings
        
        normal
        
        Obstructive lung disease
        
        Restrictive lung disease
        
        mixed defect
        
        1 more item...
        
        FEV1/FVC ratio increases or remains the same (low TLC)
        
        FEV1/FVC ratio reduced < 80%
        
        FEV1/FVC ratio = 80%
- - - - Includes
        
        Intrapleural Pressure
        
        be equal to alveolar pressure because the lung will collapse
        
        Transpulmonary Pressure
        
        Equals
        
        Alveolar pressure - Intrapleural Pressure
        
        Alveolar Pressure
        
        Determines
        
        The direction of air flow
    - - Includes
        
        Inspiration
        
        includes
        
        external intercostal muscles
        
        sternocleidomastodi and scalene group
        
        Diaphragm
        
        Pectoralis Minor
        
        Expiration
        
        Includes
        
        internal intercostal muscles
        
        Recoil of abdominal organs, diaghragm and ribs
        
        abdominal wall muscles