Respiratory Disease |
Classification and external resources |
Micrograph of an emphysematous lung; emphysema is a common respiratory disease, strongly associated with smoking. H&E stain.
|
ICD-10 |
J00-J99 |
ICD-9 |
460-519 |
MeSH |
D012140 |
Respiratory disease is a medical term that encompasses pathological conditions affecting the organs and tissues that make gas exchange possible in higher organisms, and includes conditions of the upper respiratory tract, trachea, bronchi, bronchioles, alveoli, pleura and pleural cavity, and the nerves and muscles of breathing. Respiratory diseases range from mild and self-limiting, such as the common cold, to life-threatening entities like bacterial pneumonia, pulmonary embolism, and lung cancer.
The study of respiratory disease is known as pulmonology. A doctor who specializes in respiratory disease is known as a pulmonologist, a chest medicine specialist, a respiratory medicine specialist, a respirologist or a thoracic medicine specialist.
Contents
- 1 Classification
- 1.1 Inflammatory lung disease
- 1.2 Obstructive lung diseases
- 1.2.1 Chronic obstructive pulmonary disease (COPD)
- 1.3 Respiratory tract infections
- 1.3.1 Upper respiratory tract infection
- 1.3.2 Lower respiratory tract infection
- 1.3.3 Malignant tumors
- 1.3.4 Benign tumors
- 1.4 Pleural cavity diseases
- 1.5 Pulmonary vascular disease
- 1.6 Neonatal diseases
- 2 Diagnosis
- 3 Epidemiology
- 4 References
Classification[edit]
Respiratory diseases can be classified in many different ways, including by the organ or tissue involved, by the type and pattern of associated signs and symptoms, or by the cause (etiology) of the disease.
Inflammatory lung disease[edit]
Characterised by a high neutrophil count, e.g. asthma, cystic fibrosis, emphysema, chronic obstructive pulmonary disorder or acute respiratory distress syndrome.[1]
Obstructive lung diseases[edit]
Obstructive lung diseases are diseases of the lung where the airways (i.e. bronchi, bronchioles, alveoli) become reduced in volume or have free flow of gas impeded, making it more difficult to move air in and out of the lung.
Chronic obstructive pulmonary disease (COPD)[edit]
Chronic obstructive pulmonary disease (COPD), which includes emphysema an example of an obstructive lung disease, is where the alveolae rupture causing air to be retained in the lungs and limit the available space during inhalation.
Asthma is an example of an obstructive lung disease, (and of an inflammaory lung disease). It is a disease in which muscles of bronchi contract, making it difficult for air to reach the lungs. One treatment of asthma is to use an inhaler which contains a drug to relax muscles of bronchi. Asthma is a difficulty in breathing causing wheezing due to inflammation of bronchi and bronchioles, this causes a restriction in the airflow into the alveoli.
Asthma attacks can be brought on by triggers, such as air pollution, tobacco smoke, factory fumes, cleaning solvents, infections, pollens, Dust, foods, cold air, exercise, chemicals and medications. Triggers are highly individual and may not be related to allergens. Many asthmatics are not allergic to common allergens such as mol
Restrictive lung diseases (
also known as interstitial lung diseases) are a category of respiratory disease characterized by a loss of lung compliance,[2] causing incomplete lung expansion and increased lung stiffness, such as in infants with respiratory distress syndrome.
Respiratory tract infections[edit]
Infections can affect any part of the respiratory system. They are traditionally divided into upper respiratory tract infections and lower respiratory tract infections.
Upper respiratory tract infection[edit]
The most common upper respiratory tract infection is the common cold however, infections of specific organs of the upper respiratory tract such as sinusitis, tonsillitis, otitis media, pharyngitis and laryngitis are also considered upper respiratory tract infections.
Lower respiratory tract infection[edit]
The most common lower respiratory tract infetion is pneumonia, an infection of the lungs which is usually caused by bacteria, particularly Streptococcus pneumoniae in Western countries. Worldwide, tuberculosis is an important cause of pneumonia. Other pathogens such as viruses and fungi can cause pneumonia for example severe acute respiratory syndrome and pneumocystis pneumonia. A pneumonia may develop complications such as a lung abscess, a round cavity in the lung caused by the infection, or may spread to the pleural cavity.
Malignant tumors[edit]
Malignant tumors of the respiratory system, particularly primary carcinomas of the lung, are a major health problem responsible for 15% of all cancer diagnoses and 29% of all cancer deaths. The majority of respiratory system cancers are attributable to smoking tobacco.
The major histological types of respiratory system cancer are:
- Small cell lung cancer
- Non-small cell lung cancer
- Adenocarcinoma of the lung
- Squamous cell carcinoma of the lung
- Large cell lung carcinoma
- Other lung cancers (carcinoid, Kaposi’s sarcoma, melanoma)
- Lymphoma
- Head and neck cancer
- Pleural Mesothelioma, almost always caused by exposure to asbestos dust.
In addition, since many cancers spread via the bloodstream and the entire cardiac output passes through the lungs, it is common for cancer metastases to occur within the lung. Breast cancer may invade directly through local spread, and through lymph node metastases. After metastasis to the liver, colon cancer frequently metastasizes to the lung. Prostate cancer, germ cell cancer and renal cell carcinoma may also metastasize to the lung.
Treatment of respiratory system cancer depends on the type of cancer. Surgical removal of part of a lung (lobectomy, segmentectomy, or wedge resection) or of an entire lung pneumonectomy), along with chemotherapy and radiotherapy, are all used. The chance of surviving lung cancer depends on the cancer stage at the time the cancer is diagnosed, and to some extent on the histology, and is only about 14-17% overall. In the case of metastases to the lung, treatment can occasionally be curative but only in certain, rare circumstances.
Benign tumors[edit]
Benign tumors are relatively rare causes of respiratory disease. Examples of benign tumors are:
- Pulmonary hamartoma
- Congenital malformations such as pulmonary sequestration and congenital cystic adenomatoid malformation (CCAM).
Pleural cavity diseases[edit]
Pleural cavity diseases include pleural mesothelioma which are mentioned above.
A collection of fluid in the pleural cavity is known as a pleural effusion. This may be due to fluid shifting from the bloodstream into the pleural cavity due to conditions such as congestive heart failure and cirrhosis. It may also be due to inflammation of the pleura itself as can occur with infection, pulmonary embolus, tuberculosis, mesothelioma and other conditions.
A pneumothorax is a hole in the pleura covering the lung allowing air in the lung to escape into the pleural cavity. The affected lung “collapses” like a deflated balloon. A tension pneumothorax is a particularly severe form of this condition where the air in the pleural cavity cannot escape, so the pneumothorax keeps getting bigger until it compresses the heart and blood vessels, leading to a life threatening situation.
Pulmonary vascular disease[edit]
Pulmonary vascular diseases are conditions that affect the pulmonary circulation. Examples are:[citation needed]
- Pulmonary embolism, a blood clot that forms in a vein, breaks free, travels through the heart and lodges in the lungs (thromboembolism). Large pulmonary emboli are fatal, causing sudden death. A number of other substances can also embolise (travel through the blood stream) to the lungs but they are much more rare: fat embolism (particularly after bony injury), amniotic fluid embolism (with complications of labour and delivery), air embolism (iatrogenic - caused by invasive medical procedures).
- Pulmonary arterial hypertension, elevated pressure in the pulmonary arteries. Most commonly it is idiopathic (i.e. of unknown cause) but it can be due to the effects of another disease, particularly COPD. This can lead to strain on the right side of the heart, a condition known as cor pulmonale.
- Pulmonary edema, leakage of fluid from capillaries of the lung into the alveoli (or air spaces). It is usually due to congestive heart failure.
- Pulmonary hemorrhage, inflammation and damage to capillaries in the lung resulting in blood leaking into the alveoli. This may cause blood to be coughed up. Pulmonary hemorrhage can be due to auto-immune disorders such as Wegener's Granulomatosis and Goodpasture's syndrome.
Neonatal diseases[edit]
Pulmonary diseases may also impact newborns, such as pulmonary hyperplasia.
Diagnosis[edit]
Respiratory diseases may be investigated by performing one or more of the following tests
- Chest x-ray
- Pulmonary function test
- Computed tomography scan
- Culture of microorganisms from secretions such as sputum
- Bronchoscopy
- Biopsy of the lung or pleura
- Ventilation - perfusion scan
- blood investigation
- Ultrasound scanning can be useful to detect fluid such as pleural effusion
Epidemiology[edit]
Respiratory disease is a common and significant cause of illness and death around the world. In the US, approximately 1 billion "common colds" occur each year.[3] A study found that in 2010, there were approximately 6.8 million emergency department visits for respiratory disorders in the U.S. for patients under the age of 18.[4]
In the UK, approximately 1 in 7 individuals are affected by some form of chronic lung disease, most commonly chronic obstructive pulmonary disease, which includes asthma, chronic bronchitis and emphysema.[5]
Respiratory diseases (including lung cancer) are responsible for over 10% of hospitalizations and over 16% of deaths in Canada.[6]
References[edit]
- ^ http://www.irishscientist.ie/2004/contents.asp?contentxml=04p104.xml&contentxsl=is04pages.xsl
- ^ Sharma, Sat. "Restrictive Lung Disease". Retrieved 2008-04-19.
- ^ "National Institutes of Health – common cold". Retrieved 2008-05-07.
- ^ Wier LM, Hao Y, Owens P, Washington R. Overview of Children in the Emergency Department, 2010. HCUP Statistical Brief #157. Agency for Healthcare Research and Quality, Rockville, MD. May 2013. [1]
- ^ "British Lung Foundation - Facts about ukinnam respiratory disease". Retrieved 2008-04-19.
- ^ "Public Health Agency of Canada - Centre for Chronic Disease Prevention and Control Chronic Respiratory Diseases". Retrieved 2008-05-06.
Pathology: Medical conditions and ICD code
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(Disease / Disorder / Syndrome / Sequence, Symptom / Sign, Injury, etc.)
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(A/B, 001–139) |
Infectious disease/Infection: Bacterial disease (G+, G-) · Virus disease · Parasitic disease (Protozoan infection, Helminthiasis, Ectoparasitic infestation) · Mycosis · Zoonosis
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(C/D,
140–239 &
279–289) |
Cancer (C00–D48, 140–239)
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Tumor
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Myeloid hematologic (D50–D77, 280–289)
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Anemia · Coagulopathy
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Lymphoid immune (D80–D89, 279)
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Immunodeficiency · Immunoproliferative disorder · Hypersensitivity
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(E, 240–278) |
Endocrine disease · Nutrition disorder · Inborn error of metabolism
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(F, 290–319) |
Mental disorder
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(G, 320–359) |
Nervous system disease (CNS, PNS) · Neuromuscular disease
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(H, 360–389) |
Eye disease · Ear disease
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(I, 390–459) |
Cardiovascular disease (Heart disease, Vascular disease)
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(J, 460–519) |
Respiratory disease (Obstructive lung disease, Restrictive lung disease, Pneumonia)
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(K, 520–579) |
Stomatognathic disease (Tooth disease) · Digestive disease (Esophageal, Stomach, Enteropathy, Liver, Pancreatic)
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(L, 680–709) |
Skin disease · skin appendages (Nail disease, Hair disease, Sweat gland disease)
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(M, 710–739) |
Musculoskeletal disorders: Myopathy · Arthropathy · Osteochondropathy (Osteopathy, Chondropathy)
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(N, 580–629) |
Urologic disease (Nephropathy, Urinary bladder disease) · Male genital disease · Breast disease · Female genital disease
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(O, 630–679) |
Complications of pregnancy · Obstetric labor complication · Puerperal disorder
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(P, 760–779) |
Fetal disease
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(Q, 740–759) |
Congenital disorder (Congenital abnormality)
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(R, 780–799) |
Syndromes · Medical signs (Eponymous)
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(S/T, 800–999) |
Bone fracture · Joint dislocation · Sprain · Strain · Subluxation · Head injury · Chest trauma · Poisoning
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Pathology of respiratory system (J, 460–519), respiratory diseases
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Upper RT
(including URTIs,
Common cold) |
Head
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- sinuses
- Sinusitis
- nose
- Rhinitis
- Vasomotor rhinitis
- Atrophic rhinitis
- Hay fever
- Nasal polyp
- Rhinorrhea
- nasal septum
- Nasal septum deviation
- Nasal septum perforation
- Nasal septal hematoma
- tonsil
- Tonsillitis
- Adenoid hypertrophy
- Peritonsillar abscess
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Neck
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- pharynx
- Pharyngitis
- Strep throat
- Laryngopharyngeal reflux (LPR)
- Retropharyngeal abscess
- larynx
- Croup
- Laryngitis
- Laryngopharyngeal reflux (LPR)
- Laryngospasm
- vocal folds
- Laryngopharyngeal reflux (LPR)
- Vocal fold nodule
- Vocal cord paresis
- Vocal cord dysfunction
- epiglottis
- Epiglottitis
- trachea
- Tracheitis
- Tracheal stenosis
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Lower RT/lung disease
(including LRTIs) |
Bronchial/
obstructive
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- acute
- Acute bronchitis
- chronic
- COPD
- Chronic bronchitis
- Acute exacerbations of chronic bronchitis
- Acute exacerbation of COPD
- Emphysema)
- Asthma (Status asthmaticus
- Aspirin-induced
- Exercise-induced
- Bronchiectasis
- unspecified
- Bronchitis
- Bronchiolitis
- Bronchiolitis obliterans
- Diffuse panbronchiolitis
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Interstitial/
restrictive
(fibrosis)
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External agents/
occupational
lung disease
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- Pneumoconiosis
- Asbestosis
- Baritosis
- Bauxite fibrosis
- Berylliosis
- Caplan's syndrome
- Chalicosis
- Coalworker's pneumoconiosis
- Siderosis
- Silicosis
- Talcosis
- Byssinosis
- Hypersensitivity pneumonitis
- Bagassosis
- Bird fancier's lung
- Farmer's lung
- Lycoperdonosis
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Other
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- ARDS
- Pulmonary edema
- Löffler's syndrome/Eosinophilic pneumonia
- Respiratory hypersensitivity
- Allergic bronchopulmonary aspergillosis
- Hamman-Rich syndrome
- Idiopathic pulmonary fibrosis
- Sarcoidosis
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Obstructive or
restrictive
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Pneumonia/
pneumonitis
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By pathogen
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- Viral
- Bacterial
- Atypical bacterial
- Mycoplasma
- Legionnaires' disease
- Chlamydiae
- Fungal
- Parasitic
- noninfectious
- Chemical/Mendelson's syndrome
- Aspiration/Lipid
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By vector/route
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- Community-acquired
- Healthcare-associated
- Hospital-acquired
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By distribution
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IIP
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Other
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- Atelectasis
- circulatory
- Pulmonary hypertension
- Pulmonary embolism
- Lung abscess
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Pleural cavity/
mediastinum |
Pleural disease
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- Pneumothorax/Hemopneumothorax
- Pleural effusion
- Hemothorax
- Hydrothorax
- Chylothorax
- Empyema/pyothorax
- Malignant
- Fibrothorax
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Mediastinal disease
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- Mediastinitis
- Mediastinal emphysema
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Other/general |
- Respiratory failure
- Influenza
- SARS
- Idiopathic pulmonary haemosiderosis
- Pulmonary alveolar proteinosis
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anat (n, x, l, c)/phys/devp
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noco (c, p)/cong/tumr, sysi/epon, injr
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proc, drug (R1/2/3/5/6/7)
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Certain conditions originating in the perinatal period / fetal disease (P, 760–779)
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Maternal factors and
complications of pregnancy,
labour and delivery |
placenta: Placenta praevia · Placental insufficiency · Twin-to-twin transfusion syndrome
chorion/amnion: Chorioamnionitis
umbilical cord: Umbilical cord prolapse · Nuchal cord · Single umbilical artery
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Length of gestation
and fetal growth |
Small for gestational age/Large for gestational age · Preterm birth/Postmature birth · Intrauterine growth restriction
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Birth trauma |
scalp (Cephalhematoma, Chignon, Caput succedaneum, Subgaleal hemorrhage) · Brachial plexus lesion (Erb's palsy, Klumpke paralysis)
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By system |
Respiratory
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Intrauterine hypoxia · Infant respiratory distress syndrome · Transient tachypnea of the newborn · Meconium aspiration syndrome · pleural disease (Pneumothorax, Pneumomediastinum) · Wilson-Mikity syndrome · Bronchopulmonary dysplasia
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Cardiovascular
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Pneumopericardium · Persistent fetal circulation
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Haemorrhagic and
hematologic disease
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Vitamin K deficiency (Haemorrhagic disease of the newborn)
HDN (ABO • Anti-Kell • Rh c • Rh D • Rh E) · Hydrops fetalis · Hyperbilirubinemia (Kernicterus, Neonatal jaundice)
Velamentous cord insertion
Intraventricular hemorrhage (Germinal matrix hemorrhage)
Anemia of prematurity
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Digestive
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Ileus · Necrotizing enterocolitis · Meconium peritonitis
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Integument and
temperature regulation
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Erythema toxicum · Sclerema neonatorum
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Nervous system
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Periventricular leukomalacia
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Musculoskeletal
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Gray baby syndrome · muscle tone (Congenital hypertonia, Congenital hypotonia)
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Infectious |
Vertically transmitted infection (Congenital rubella syndrome, Neonatal herpes simplex) · Omphalitis · Neonatal sepsis (Group B streptococcal infection) · Neonatal conjunctivitis
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Other |
Perinatal mortality (Stillbirth, Infant mortality) · Neonatal withdrawal
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Respiratory system, physiology: respiratory physiology
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Lung volumes |
- VC
- FRC
- Vt
- dead space
- CC
- PEF
- calculations
- respiratory minute volume
- FEV1/FVC ratio
- methods of lung testing
- spirometry
- body plethysmography
- peak flow meter
- nitrogen washout
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Airways/ventilation (V) |
- positive pressure ventilation
- breath (inhalation
- exhalation)
- respiratory rate
- respirometer
- pulmonary surfactant
- compliance
- elastic recoil
- hysteresivity
- airway resistance
- bronchial hyperresponsiveness
- bronchoconstriction/bronchodilation
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Blood/perfusion (Q) |
- pulmonary circulation
- hypoxic pulmonary vasoconstriction
- pulmonary shunt
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Interactions/
ventilation/perfusion ratio (V/Q) |
- ventilation/perfusion scan
- zones of the lung
- gas exchange
- pulmonary gas pressures
- alveolar gas equation
- alveolar–arterial gradient
- hemoglobin
- oxygen–haemoglobin dissociation curve (Oxygen saturation
- 2,3-DPG
- Bohr effect
- Haldane effect)
- carbonic anhydrase (chloride shift)
- oxyhemoglobin
- respiratory quotient
- arterial blood gas
- diffusion capacity (DLCO)
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Control of respiration |
- pons
- pneumotaxic center
- apneustic center
- medulla
- dorsal respiratory group
- ventral respiratory group
- chemoreceptors
- pulmonary stretch receptors
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Insufficiency |
- high altitude
- oxygen toxicity
- hypoxia
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anat (n, x, l, c)/phys/devp
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noco (c, p)/cong/tumr, sysi/epon, injr
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proc, drug (R1/2/3/5/6/7)
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