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22 When airways go wrong Flashcards

1
Q

Types of respiratory diseases:

A
  • Obstructive
  • restrictive
  • Infection and inflammation
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2
Q

What happens in obstructive diseases?

A
  • Airway resistance is increased
    • due to narrowing of the airways
  • outflow pressure is reduced
    • due to loss of elastic recoil?
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3
Q

What is airway resistance

A

the ease with which air can flow into and out of the lungs

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4
Q

What is outflow pressure?

A

The rate at which we can exhale

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5
Q

What effects do restrictive diseases have?

A

Reduced compliance

  • loss of elasticity
  • reduced vital capacity
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6
Q

What is compliance

A

The extent to which our lungs increase in volume in response to a given pressure change

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7
Q

How do we measure airway resistance?

A

Using FEV1 (the forced expiratory volume in the 1st second) - taken as a percentage of the total vital capacity

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8
Q

What is a normal FEV1

A

80% of vital capacity

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9
Q

What do we use FEV1 for?

A
  • measuring airway resistance
  • diagnosing airway resistance
  • monitoring it
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10
Q

Name the obstructive pulmonary diseases:

A
  • Bronchitis (acute and chronic)
  • emphysaema
  • asthma
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11
Q

what happens in chronic obstructive pulmonary disease:

A
  • covers emphysaema and chronic bronchitis
  • narrowing of the airways –> increased airway resistance
  • mucus build up
  • loss of elastic recoil –> reduced outflow pressure and gas exchange
  • over inflation of the chest coz of increased residual volume
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12
Q

What kind of respiratory tract diseases can you get?

A

upper and lower

  • upper is more common and easier to treat
  • lower is more severe so more intense treatment
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13
Q

How many people die annually from COPD?

A

3 million

-3rd leading cause of death in the world

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14
Q

Acute Bronchitis:

A
  • your standard phlegmy cough
  • caused by bacteria or virus
  • lasts for days or weeks
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15
Q

Chronic bronchitis: what happens

A
  • irritants cause inflammation of the bronchi
  • bronchi narrow
  • over production of mucus
  • airways become plugged
  • airways become more prone to infection causing inflammation
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16
Q

Chronic bronchitis: causes

A

80% smoking, sometimes environmental irritants

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17
Q

Chronic bronchitis: treatments

A
  • stop smoking
  • bronchodilators (can be preventative) open up airways to aid airflow
  • antibiotics to treat underlying infection
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18
Q

Chronic bronchitis: symptoms

A
  • shortness of breath
  • airway obstruction
  • wheezing due to turbulent airflow
  • chest pain - over exertion of muscles in breathing (not quiet breathing anymore, accessory muscles used)
  • productive cough - can look for bacteria present in mucus of cough
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19
Q

Chronic bronchitis: lasts for

A

3 consecutive months in 2 years

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20
Q

Emphysaema: causes

A

smoking or an alpha1 trypsin deficiency (2% of COPD patients)
20% of smokers will develop emphyseama

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21
Q

Emphysaema: treatments

A
  • stop smoking
  • alpha1 antitrypsin supplements
  • O2 supplement
  • lung transplant
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22
Q

Emphysaema: what happens

A

-irritants in smoke cause neutrophils and macrophages to release elastase
-elastase breaks down alveolar walls reducing surface area
-significantly high compliance
-increased residual volume and FRC because damaged alveoli retain air
-chronically over inflated lung
-reduced vital capacity
-inefficient gas exchange
-Hyperventilation because of excess CO2 in lungs (to get rid)
(-alpha1 antitrypsin inhibits elastase action)

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23
Q

Emphysaema: symptoms

A
  • hyperventilation
  • inflated chest
  • shortness of breath
  • muscle wastage due to inefficient gas exchange and hyperventilation
24
Q

what does high compliance indicate?

A

loss of elastic recoil

25
Asthma: Symptoms
-bronchoconstriction -over production of mucus -oedema (collection of mucus in cavities) both cause increased airway resistance
26
Asthma: Treatments
``` Bronchodilators: -relievers -act immediately e.g. salbutamol -preventors -take two weeks to effect -contain steroids -dull down mast cell response Anti-inflammatories: Given in an asthma attack to re-inflate the airways ```
27
Asthma: Mechanisms
- mast cells stimulated by allergen - release histamine and other cytokines - bronchoconstriction - mucus production - oedema - smooth muscle contraction narrowing airways
28
Asthma: Causes
- hypersensitive reaction to allergens - exercise and cold air - genetics - stress - air pollution
29
Name the restrictive diseases:
- fibrosis | - respiratory distress syndrome (IRDS, ARDS, SARS)
30
Acute Fibrosis: causes
-severe trauma or infection
31
Chronic fibrosis: causes
- industrial or environmental pollutants - prescription drug taken over a long period of time - disease process
32
Acute fibrosis causes
protein exudation - causes fluid build up (oedema) in the alveoli
33
Chronic fibrosis causes:
inflammatory processes which cause fibrosis
34
What is fibrosis
- replacement of lung tissue with connective tissue (collagen) and fibrotic tissue - reduces gas exchange - reduces compliance, makes lungs stiffer
35
Fibrosis: treatments
There are no treatments
36
Fibrosis: causes
- environmental or industrial pollutant inhalation - cigarette smoke - auto immune disease
37
Upper respiratory infections effect the
nasal cavity, pharynx and larynx
38
Lower respiratory tract infections include
-tuberculosis pneumonia and chronic bronchitis
39
Lower respiratory tract infections effect the
lungs, trachea and bronchi
40
how often does an adult get a upper respiratory tract infection?
2-4 times a year
41
How long does a normal cough last
15-18 days
42
How long does a productive cough last?
13-17 days
43
More women than men get productive coughs. T or F?
T
44
More men than women get productive coughs. T or F?
F
45
Pneumonia caused by:
bacteria - usually streptococcus - can be staphylococcus aureus or klebsiella - effects the alveoli and bronchioles but can effect the lung
46
What happens in pneumonia?
Protein exudate fluid fills the alveoli, inhibiting gas exchange and this causes them to become airless and firm (consolidation)
47
consolidation
Protein exudate fluid fills the alveoli, inhibiting gas exchange and this causes them to become airless and firm
48
two types on pneumonia?
- bronchopneumonia - alveoli in some of the bronchioles are affected - lobar pneumonia - alveoli in a certain lobe all become fluid filled
49
Tuberculosis stats: new cases 2012: active chronic cases 2012: deaths:
8.8 million new 8 million active 1.2-1.5 millon deaths
50
TB is caused by
mycobacterium inhaled, extremely infectious, shows up red in sputum
51
How many phases are there in TB? Name them.
2 Latent Active
52
Describe the Latent phase of TB
- mycobacterium innitiate response which causes the formulation of a granuloma in lung tissue - isolated (only effect this lung tissue) - not infectious
53
Describe the active phase of TB
- only occurs in 10% of people - spreads to the bronchioles and into the circulation - breaks down lymphnodes in order to enter the lymph - spreads systematically
54
How does TB spread around the body
- Initially it replicates on the macrophages - thought to spread due to inefficient immune response - spreads to bronchioles - moves to lymph and collagen gets deposited around the bacterium destroying lymph nodes and alveoli - moves into the lymph and spreads systematically
55
Treatments for TB
Very difficult to treat due to antibiotic resistance
56
What percentage of people move from the latent phase to the active phase of TB?
10%
57
Why does Tb transition phases?
Due to an inefficient immune response

Body Systems (21 decks)

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