Body Systems L22 Notes Flashcards by Jade Benita McLaughlin

Name the types of respiratory diseases

Obstruction
Restriction
Infection & inflammation

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Describe the conditions of obstruction in pulmonary disease

 Conditions -> Impede rate of flow into & out of lungs.

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What are the two ways in which lung obstruction in pulmonary disease can be caused?

 Incr airway resistance

 Decr. outflow pressure

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What would cause incr. airway resistance?

 Incr. airway resistance

|&raquo_space; Narrowed airways

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What would cause decreased outflow pressure?

 Decr. outflow pressure

|&raquo_space; Loss of elastic recoil -> Lung tissue

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What conditions would cause restriction of the lungs in pulmonary disease?

 Conditions -> Decr. lung volume

 » Reduced compliance

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What would cause reduced compliance of the lungs?

 Reduced compliance

|&raquo_space; Decr. Vital Capacity (VC)

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How is airway resistance measured?

Forced Expiratory Volume per second (FEV1)

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What tool can be used to measure airway resistance?

> > Spirometry/ spirometer

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What is the normal % for vital capacity?

Usually 80% -> Vital Capacity

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Give examples of obstructive lung diseases

 Chronic Obstructive Pulmonary Disease (COPD)

 Athsma

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What are the characteristics of Chronic Obstructive Pulmonary Disease?

-	Narrowed airways 
>> Incr. airway resistance
-	Loss -> elastic recoil of lung tissue
>> Decr. Outflow pressure
               Decr. Forced Expiratory Volume
-	Incr. Residual Volume (RV) 
>> Appearance -> Chest over-inflation

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What are the main forms of chronic obstructive pulmonary disease?

 Chronic bronchitis -> Narrowing

 Emphysema -> Recoil

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What are the characteristics / symptoms of chronic bronchitis?

	Inflammation of Bronchi
 Irritants -> inflammation of bronchi
 Abnormal mucus secretion 
 Blocks airways
 Incr. susceptibility -> infection 
 Further incr. inflammation

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What is caused by chronic bronchitis?

Results: > Airway obstruction  > Shortness of breath / wheezing
 >> Chest pain ; chronic productive cough

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Describe the treatment for chronic bronchitis

 Treatment:
 >> Stop smoking
 >> Bronchodilators
 >> Antibiotics

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What are the two types of bronchitis?

Acute

Chronic

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What causes acute bronchitis & how long do symptoms last?

> > Bacteria / virus

|&raquo_space; Lasts days / weeks

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What causes chronic bronchitis & how long do symptoms last?

> > Smoking (80%) / Environmentla irritants

|&raquo_space; Lasts at least 3 consecutive months -> 2 yrs.

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What are the characteristics of emphysema?

 Emphysema -> Recoil
 Compliance significantly above normal
 Incr. Residual Volume

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How is increased residual volume of the lung caused in emphysema?

 Incr. Residual Volume
&raquo_space; Increased Functional Residual Capacity
-» Chronic over-inflation -> lung

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What are the symptoms of emphysema?

 Symptoms:
&raquo_space; Shortness of breath -> Exertion
&raquo_space; Hyperventilation
&raquo_space; Exapnded chest

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Describe the mechanism by which emphysema is caused.

 Mechanism:
> Smoking
> Neutrophils & macrophages release elastase
> Genetic alpha-1 antitrypsin deficiency
(2% COPD patients)
&raquo_space; Insufficient alpha-1 antitrypsin -> Inactivate elastase.
> Elastase destroys alveolar walls
&raquo_space; Emphysema.

Describe the treatment of Emphysema

 20% smokers inherit COPD
      >> Lifelong smokers
 Treatment:
    >> Loss of alveoli -> permenant &amp; irreversible 
    >> Enzyme supplement -> Alpha-1 antitrypsin deficiency
    >> Stop smoking
    >> Supplemental O2
      >> Lung Transplant

What are the symptoms of asthma?

``` - Symptoms: >> Incr. airway resistance  Bronchoconstriction  Oedema -> Airway mucosa  Mucus – secretion ```

What are the causes of asthma?

``` - Causes:  Hypersensitivity -> allergens  Air pollution  Exercise -> Cold air  Emotional stress  Possibly genetics ```

Describe the mechanism by which asthma occurs.

``` - Mechanics:  Mast cell activation >> Release Histamine & cytokine  Odeoma & mucus  Contraction -> smooth muscles. ```

Describe treatment of asthma.

- Treatment:  Bronchodilators Eg. salbutamol (beta-2-adrenoceptor agonist)  Anti-inflammatories  Approx. 5.4 mill -> UK receiving treatment. >> Incl. 1.1 mill children ->> 1 in 11 children --> Many receiving treatment do not actually have disease

What causes restrictive lung disorders?

• Restrictive Lung Disorders: |  Development -> Rigid Alveolar Walls

Name the types of restrictive lung disorder?

Acute | Chronic

What are acute restrictive lung disorders caused by?

 Sepsis / severe trauma

What do acute restrictive lung disorders cause?

>> Protein exudation | > Oedema

What are chronic restrictive lung disorders caused by?

 Industrial dusts, drugs / rheumatism

What do chronic restrictive lung disorders cause?

>> Inflammation | > Fibrosis

Give a examples of a restrictive lung disorder disease

Fibrosis | - Respiratory Distress Syndrome (IRDS, ADRS, SARS)

What is fibrosis?

Development -> Extra lung tissue

What is fibrosis caused by?

 Causes: >> Inhaled environmental & occupational pollutants >> Cigarette smoke >> Autoimmune disease

What does fibrosis cause?

>> Stiffening -> Lungs -> ‘Honeycomb lung’ >> Decr. lung compliance

What is the treatment for fibrosis?

 Treatment: | >> No effective treatments.

What are the types of respiratory tract infections?

- Upper Respiratory Tract infections: | - Lower Respiratory Tract infections:

Describe the characteristics of upper respiratory tract disease

- Upper Respiratory Tract infections:  Common but minor  Average adult -> 2-4 per year

Describe the characteristics of lower respiratory tract disease

- Lower Respiratory Tract Infections:  Less common but serious Eg. Bronchitis, Pneumonia, Tuberculosis

Name some examples of respiratory tract infections

 Pneumonia: |  Tuberculosis:

How is pneumonia caused?

 Bacteria | >> Streptococcus pneumonidae / Staphylococcus aureus / Klebsiella Pneumonidae

What does pneumonia effect?

 Affects bronchi & alveoli -> Become filled -> inflammatory exudate >> Consolidation -> Lung tissue becomes firm & airless.

How is tuberculosis caused?

 Inhalation -> Mycobacterium tuberculosis >> Highly contaigious  Affects approx. 8-9 million >> 1.2-1.5 mill deaths

Name the phases of tuberculosis

Latent | Active

Describe the latent stage of tuberculosis

1. Latent: >> Asymptomatic >> Non-infectious >> Granuloma -> Lung tissue

Describe the active stage of tuberculosis

2. Active: >> (~10%) >> Spreads -> Bronchioles & circulation

Describe the mechanism by which tuberculosis occurs

 Mechanism: >> Enter alveoli > Replicate -> Alveolar macrophage >> Initial infection stimulates immune response >> Bacteria move -> Lymph Nodes > Surrounded -> deposited collagen >> Lymph Node erodes > Bacteria drains into bronchioles >> Alveolar Destruction > Bacteria drains -> Blood vessels

What is the treatment of tuberculosis?

 Treatment: | >> Difficulties -> Antibiotic Resistance

Describe the Right Bronchial Tree & associated illness recorded

• Right Bronchial Tree: - Patient admitted -> Heart Failure >> Extreme Coughing >> Spontaneously coughed up intact right bronchial tree.

Name the major components of the right bronchial tree

Upper, middle & lower lobe

How many segmental branches does the upper lobe of the right bronchial tree have?

 3 segmental branches -> Upper lobe

How many segmental branches does the middle lobe of the right bronchial tree have?

 2 segmental branches -> Middle lobe

How many segmental branches does the lower lobe of the right bronchial tree have?

 5 segmental branches -> Lower lobe