Respirology

• Upon completion of this problem, students should be able to explain the role of the neuromusculature in respiratory pump function.
• Upon completion of this problem, students should be able to describe the mechanism of hypoxia in alveolar inflammation.
• Upon completion of this problem, students should be able to describe the factors that influence airway luminal diameter, and the key aspects of allergic mediated inflammation.
• Upon completion of this problem, students should be able to explain the impact of chronic hypoxia on the cardiopulmonary circulation.
• Upon completion of this problem, students should be able to explain the mechanics of lower airway obstruction.
• Upon completion of this problem, students should be able to explain how disruption of the alveolar capillary membrane affects gas transfer in the lung.
• Upon completion of this problem, students should be able to explain the role of the alveolar-capillary membrane in gas exchange.
• Upon completion of this problem, students will be able to describe the concept of V/Q mismatch and shunting and how it causes hypoxia.
• Describe the role of the respiratory muscles in ventilation.
• Describe the clinical features of a patient with neuromuscular “pump failure”.
• Explain the role of mechanical ventilation in the treatment of respiratory failure.
• Describe the vascular supply to lungs, in particular the anatomy of the pulmonary vascular supply.
• Identify factors that control the pressure in the pulmonary vascular supply.
• Describe the relationship between Ventilation and Perfusion and how this affects oxygenation.
• Describe the clinical features of V/Q mismatch.
• Recognize methods available to measure Ventilation/Perfusion relationships.
• Describe how the lungs protect themselves against foreign materials.
• Review the response of lungs to infection.
• Review the role of cells of the immune system -- epithelia, neutrophils, alveolar macrophages.
• Describe the normal microscopic architecture of the airways.
• Explain the physiologic role of the epithelium, mucus secreting cells, inflammatory cells, and smooth muscle cells in the airway of normal patients.
• Identify the role of cellular and immunologic process by which allergic asthma develops.
• Describe the physiologic changes that occur in asthma and how they can be assessed with pulmonary function tests.
• Develop a mechanism-based approach to the management of asthma.
• Explain the concepts of gas transfer, dead space and venous admixture and how these can be impaired in pulmonary disease.
• Explain how pulmonary function tests can be used to diagnose lower airway obstruction.
• Discuss smoking history as a social determinant of health.
• Review control of ventilation and drive to breathe in the setting of chronic hypoxia.
• Describe the pathophysiology of pulmonary hypertension secondary to obstructive lung disease.
• Explain the mechanisms behind chronic inflammation and how this leads to tissue damage/fibrosis.
• Describe how interstitial lung disease affects the mechanics of breathing.
• Explain the impact of ventilation perfusion mismatch on blood gases.
• Describe the structural components that make up the alveolar-capillary unit.
• Explain the mechanisms which keep the alveolus open and free of fluid for gas exchange.
• Explain how the disruption of the factors that keep the alveolus open leads to impairment in gas exchange.
• Explain the importance of including occupation in a respiratory history.
• Describe how diagnostic testing would confirm respiratory failure.
• Describe the atopic triad and its associated conditions (asthma, atopic dermatitis, allergic rhinitis).
• Explain how oxygen saturation is measured and describe racial bias in pulse oximetry measurements.
• Discuss the impact of stigmatizing language and transmission of bias through medical records.