Cystic Fibrosis		Mucolytics
CF; Cystic Fibrosis Research Directions; Fibrocystic Disease of Pancreas; Mucoviscidosis

Pictures

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the transmural distending pressure in spherical alveoli is equal to T 2r where T is the total wall tension elastic recoil plus surface tension N m 1 and r is the radius Fig 8 9 Because the distending pressure is essentially the same in communicating alveoli the total wall tension changes with diameter During expiration the diameter decreases

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at the airway openings PB As flow resistance dissipates the driving energy along the bronchial tree the driving pressure of the cartilaginous bronchi falls towards zero at the mouth Fig 13 5 At a certain point the forces that expand the airway equal the forces that tend to collapse This is the equal pressure point Beyond the equal pressure point the driving

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pressure changes because the oesophagus traverses the intrapleural space The Pit is subatmospheric due to the opposing directions of the elastic recoil of lungs and thoracic cage Fig 14 5 Fig 13 3 Transmural static pressures and lung volumes in a healthy person The red compliance curve is for the total system see later The blue and green compliance

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is performed with all the expiratory and accessory muscles When we contract our strong expiratory accessory muscles we generate high airflows at lung volumes near total lung capacity Fig 13 6 Just following peak expiratory flow PEF the airflow velocity decreases linearly with volume no matter how hard the subject tries This is the effort independent airflow Fig

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by smoke dust cold air and irritants leads to airway constriction whereas sympathetic stimulation dilatates the airways 2 Lung volumes Lung volumes are measured by spirometry Fig 13 1 A spirometer consists of a counterbalanced bell which is connected to a pen writing on a rotating drum The air filled bell is inverted over a chamber of water so an

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when air moves into and out of the lungs and the condition is therefore called dynamic The driving pressure for inspiration is a negative alveolar pressure Palv relative to PB Fig 13 4 Respiratory volume is recorded graphically with a x y recorder The tidal volume is plotted against the driving pressure which is equal to the dynamic alveolar pressure

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resistance Chapter 14 The lung disease causes pulmonary hypertension increased work load of the right heart right ventricular hypertrophy and finally right heart failure Fig 13 9 Upper airways of a healthy person and of a patient with obesity and obstructive sleep apnoea This patient also suffers from the Pickwick syndrome The airway pressures are

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for oxygen is often reduced by 75 compared to normal Ch 15 Pulmonary compliance is reduced when alveoli collapse atelectasis or when left heart failure causes alveolar oedema Fig 10 10 B 2 Restrictive disorders of the chest wall These disorders comprise rib fractures damage of the trachea or major bronchi kyphoscoliosis hunchback ankylosing

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the total sum of partial pressures of the gases in the passing blood is lower than the atmospheric pressure prevailing in the pleural space or cavity Krogh s sliding equilibrium Fig 13 10 Drawing of the characteristic X ray findings in a large spontaneous left and a case of tension right pneumothorax Tension pneumothorax is fortunately quite rare but

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see later 3 Pneumotachography A pneumotachograph is a device for measuring airflow It consists of a respiratory tube with a small resistance typically a fine network to airflow Fig 13 2 The two chambers separated by the resistance connects to the differential transducer chambers by thin tubes A transducer consists of 2 chambers separated by a membrane

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in the alveoli is equal to the static mouth pressure when there is no airflow during apnoea with the glottis open The static mouth pressure = Palv depends upon the lung volume Fig 13 3 3 The intrathoracic pressure Pit The intrathoracic pressure is the pressure in the fluid filled pleural space between the parietal and visceral layers of pleura Fig

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The airways are protected by humidification all the way to the alveoli with a mucous layer which prevents dehydration of the epithelium and surrounds the epithelial cilia Fig 13 7 Fig 13 7 Bronchial wall during an attack of asthma The protective layer in the lumen is abundant and consists of a gel phase and a liquid phase surrounding the cilia of the epithelial

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reflex bronchoconstriction in asthmatics This probably explains the hypersensitivity to non specific stimuli eg exercise cold air or water pollution dust vapours and fumes Fig 13 8 Asthma is an acute obstructive lung disease with reduced lumen due to broncho constriction hypersecretion and oedema of the bronchial wall Emphysema is a chronic obstructive

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aerosol device jpg

has also been used to help patients with sinus infections related to cystic fibrosis allergies and mold spores Our aerosolizing device is much more dynamic than an inhaler Our Sinus Science� system creates a light fog

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