PHYSIOLOGY CASE DISCUSSION AND REPORTING

November 7, 2019

Each group will be given 30-45 minutes to discuss the following:

CASE 1:

A 30 year old woman presents to the emergency department due to difficulty of breathing. She has a
3 day history of nonproductive distressing cough with night awakening and colds. She denies fever,
abdominal pain, and vomiting. She is awake, speaks in phrases, with increase in respiratory rate,
oxygen saturation of 90% (low) at room air. She has intercostal and subcostal retractions with
crackles, wheezes, and prolonged expiratory phase. Other physical exam was unremarkable.

1. Describe the anatomy of the pulmonary tree

2. Enumerate and discuss the relative roles of the muscles involved in breathing (inspiration
and expiration).

On the 2nd hospital day, patient improved. Her physician requested for a spirometry.

1. Explain the lung volumes and capacities

CASE 2:

A 24-year-old pregnant woman presented to the hospital in preterm labor and subsequently
delivered a premature infant at only 27 weeks gestation (normal term pregnancy is 37-42 weeks).
After the delivery, the infant cried, but it subsequently began to grunt and showed signs of hypoxia
despite oxygen supplementation. The baby immediately was intubated by endotracheal tube and
given surfactant down the endotracheal tube. The baby’s hypoxia resolved, and he was transferred
to the neonatal intensive care unit for further stabilization.

1. What is surfactant and what is its role in the lungs?

2. Discuss the roles of compliance of the lung and compliance of the chest wall in determining
lung volumes and capacities.

3. Define surface tension and discuss its role in the mechanics of breathing.