Bronchitis = Irreversible Bronchioconstriction
 .    Causes - Infection, Air polution, cigarette smoke

a.    Primary Defect = Enlargement & Over Activity of Mucous Glands, Secretions very viscous
b.    Hypertrophy & hyperplasia, Narrows & Blocks bronchi, Lumen of airway, significantly narrow
c.    Impaired Clearance by mucocillary elevator
d.    Microorganism retension in lower airways,Prone to Infectious Bronchitis, Pneumonia
e.    Permanent Inflamatory Changes IN epithelium, Narrows walls, Symptoms, Excessive sputum, coughing
f.    CAN CAUSE EMPHYSEMA

Surface Tension

1.    Maintains stability of alveolus, preventing collapse

2.    Surfactant (Type II pneumocytes) = dipalmityl lecithin

3.    Type II pneumocyte appears at 24 weeks of gestation;
    1.    Surfactant production, 28-32 weeks;
    2.    Surfactant in amniotic fluid, 35 weeks.
    3.    Laplace equation for thin walled spheres P = 2T
        a.    P = alveolar internal pressure r
        b.    T = tension in the walls r = radius of alveolus
        
4.    During normal tidal respiration

    1.    Some alveoli do collapse (Tidal pressure can't open)
    2.    Higher than normal pressure needed (Coughing)
    3.    Deep breaths & sighs promote re-expansion
    4.    After surgery/Other conditions, Coughing, deep breathing, sustained maximal respiration

Regulation of Blood Pressure by Hormones

The Kidney

One of the functions of the kidney is to monitor blood pressure and take corrective action if it should drop. The kidney does this by secreting the proteolytic enzyme renin.

• Renin acts on angiotensinogen, a plasma peptide, splitting off a fragment containing 10 amino acids called angiotensin I.
• angiotensin I is cleaved by a peptidase secreted by blood vessels called angiotensin converting enzyme (ACE) — producing  angiotensin II, which contains 8 amino acids.
• angiotensin II
  • constricts the walls of arterioles closing down capillary beds;
  • stimulates the proximal tubules in the kidney to reabsorb sodium ions;
  • stimulates the adrenal cortex to release aldosterone. Aldosterone causes the kidneys to reclaim still more sodium and thus water.
  • increases the strength of the heartbeat;
  • stimulates the pituitary to release the antidiuretic hormone (ADH, also known as arginine vasopressin).

All of these actions, which are mediated by its binding to G-protein-coupled receptors on the target cells, lead to an increase in blood pressure.

Each hormone in the body is unique.  Each one is different in it's chemical composition, structure, and action.  With respect to their chemical structure, hormones may be classified into three groups: amines, proteins, and steroids.

 Amines- these simple hormones are  structural variation of the amino acid tyrosine.  This group includes thyroxine from the thyroid gland and epinephrine and norepinephrine from the adrenal medulla.

Proteins- these hormones are chains of amino acids.  Insulin from the pancreas, growth hormone from the anterior pituitary gland, and calcitonin from the thyroid gland are all proteins.  Short chains of amino acids are called peptides.  Antidiuretic hormone and oxytocin, synthesized by the hypothalamus, are peptide hormones.

Steroids- cholesterol is the precursor for the steroid hormones, which include cortisol and aldosterone from the adrenal cortex, estrogen and progesterone from the ovaries, and testosterone from the testes.

Respiratory system plays important role in maintaining homeostasis . Other than its major function , which is supplying the cells with needed oxygen to produce energy and getting rid of carbon dioxide , it has other functions :

1 Vocalization , or sound production.
2 Participation in acid base balance .
3 Participation in fluid balance by insensible water elimination (vapors ).
4 Facilitating venous return .
5 Participation in blood pressure regulation : Lungs produce Angiotensin converting enzyme ( ACE ) .
6 Immune function : Lungs produce mucous that trap foreign particles , and have ciliae that move foreign particles away from the lung. They also produce alpha 1 antitrepsin that protect the lungs themselves from the effect of elastase and other proteolytic  enzymes

Bleeding Disorders

A deficiency of a clotting factor can lead to uncontrolled bleeding.

The deficiency may arise because

• not enough of the factor is produced or
• a mutant version of the factor fails to perform properly.

Examples:

• von Willebrand disease (the most common)
• hemophilia A for factor 8 deficiency
• hemophilia B for factor 9 deficiency.
• hemophilia C for factor 11 deficiency

In some cases of von Willebrand disease, either a deficient level or a mutant version of the factor eliminates its protective effect on factor 8. The resulting low level of factor 8 mimics hemophilia A.