Now, here's what happens when you have some alveolar conditions
that really threatens someone's respiratory status.
The first one is one of the parts of COPD,
emphysema, acute respiratory distress syndrome, and neonatal respiratory distress syndrome.
Whoa, how did we just go from surfactant to talking about
emphysema, ARDS, and neonatal respiratory distress syndrome?
There really is a connection, it's all about the alveolar wall staying intact.
Have you seen emphysema? Look at that picture.
Those walls are all blown up, that's no longer an efficient way
to exchange CO2 for O2 and air gets trapped in there.
You've taken care of an emphysema patient, you know they are, bless their hearts,
it is miserable for them because they always feel like they can't really get a good breath.
Now, ARDS we've talked about before but you're looking at that membrane,
hey, look, what goes on in there?
You've got some white cells break in through that capillary wall, infiltrating the alveoli,
now it's filling up with fluid, hey, that can't be good, right?
So, if that alveolar wall is not intact,
you're gonna have real problems with CO2 and O2 exchange.
Now, the next one makes me really sad.
See, in utero, babies start making surfactant in about 26 weeks.
Now, if the baby's born before 37 weeks gestation, they may not have enough,
so that's why you've probably seen an emphasis of trying to get that baby to at least 37 weeks.
It's because we're worried about the baby having enough surfactant in their little lungs
to make sure that it's sufficient.
If they don't, it will start making it really until 26 weeks
and if they're born too long before 37-week mark,
then they're gonna be at risk for neonatal respiratory distress syndrome.
Now, when you see these babies, it is heartbreaking.
So the purpose of this slide, why do I care about an intact wall?
Why do I care about structural integrity?
Well, surfactant is why I care about it because without it, if --
it's what keeps my wall intact, and keeps the alveoli open.
Ready for a quick challenge? Let me ask you some questions that will quiz your knowledge.
This is one of the best ways to check where you are and see where you need to brush up.
Okay, so one wall has endothelial cells, one has epithelial cells, which place are they?
The alveoli has epithelial cells, the capillary wall is endothelial cells.
Ready for another?
The PaO2 in this picture is 90. Is that normal?
Yes, the PaO2, a normal range is 80-100.
What lipoprotein helps keep the alveoli open especially in low volumes? Right, surfactant.
You did great. Now, if you didn't get all of them, don't worry.
You just haven't got it yet.
Hang on to your notes, keep reviewing with our spaced-repetition tools and you will get there.