lec 17 - lung and heart

Question 1

what structures are part of the upper resp tract

Answer 1

nasal cavity, pharnyx, larynx

Question 2

what structures are part of the lower resp tract

Answer 2

trachea, primary bronchi, lungs

Question 3

what are examples of lung infections

Answer 3

bronchitis and pneumonia

Question 4

what are the two types of bronchitis

Answer 4

acute - viral and bacterial
chronic - airway changes associated with COPD (chronic obstructive pulmonary disease) - smoking/genetic

Question 5

what is the treatment for bronchitis

Answer 5

inhalers and antibiotics (for bacterial infection only)

Question 6

what is pneumonia

Answer 6

lobe infection in distal bronchioles and alveoli
can get multilobar infection from virus or bacteria

Question 7

what is the treatment for pneumonia

Answer 7

anitbiotics or antivirals depending on type of infection

Question 8

what is a pneumothorax

Answer 8

punctured lung
commonly spontaneous (small and heals by itself)
can be from trauma such as broken rib puncture

Question 9

what are the symptoms of a pneumothorax

Answer 9

short of breath, possible pain

Question 10

what is the treatment for a pneumothorax

Answer 10

small = watch and monitor
large = chest tube

Question 11

what is a tension pneumothorax and why is it an emergency

Answer 11

air gets out of the lungs and expands the space outside the lungs
- shifts the mediastinum causing a vena cava kink
- decreases oxygenation and venous return
- emergency!!

Question 12

what is a hemothorax

Answer 12

blood in the chest cavity
- from broken rib, bleeding vessels, sharp trauma
- marfan syndrome = from aortic aneurysm

Question 13

what are the signs and symptoms of a hemothorax

Answer 13

short of breath and pain
decreased oxygenation
blood loss

Question 14

what is the treatment for a hemothorax

Answer 14

chest tube at the hospital

Question 15

what is asthma

Answer 15

reversible airway disease characterised by airway narrowing and inflammation
- provoked by allergens, exercise, fog, cold air, infection, etc

Question 16

what are the symptoms of asthma

Answer 16

all symptoms are expiratory!
- wheezing
- coughing
- both of the above adn chest tightness with exercise

Question 17

what is the net effect of the inflammation caused in asthma

Answer 17

expiratory resistance and air trapping

Question 18

what is the number 1 issue in asthma that drives the treatment

Answer 18

inflammation

Question 19

what are the long term results of asthma

Answer 19

denudation of epithelium
collagen deposition
airway remodelling

Question 20

what is the progression/pathology of asthma

Answer 20

1. inflammation causes disruption to ciliated epitheilum
2. irritation causes increased mucous production
3. mucus can’t get up the bronchioles normally because the cilia is damaged
4. causes smooth muscle hypertrophy
5. lumen is decreased in diameter

Question 21

what are the different types of treatment for asthma

Answer 21

anti inflammatories
- corticosteroid puffers = main
smooth muscle relaxants
- B2 agonists (need therapeutic use exemption)
— terubutaline - short acting (SABA)
— clenubterol - long acting (LABA)

Question 22

what are the recommendations for asthma treatment

Answer 22

combined inhaler with corticosteroids and LABA (clenbuterol)
- good short term control and prevents exacerbation of asthma

(traditionally treated with SABA before exercise)

Question 23

what is a PFT test (pulmonary lung function test) used for

Answer 23

usually the standard for asthma diagnosis

Question 24

what are the thresholds for tachycardia and bradycardia

Answer 24

tachy = >100 bpm
brady = <60 bpm (commonly seen in athletes)

Question 25

what is sudden cardiac death in sport

Answer 25

exercise stimulated fatal dysrhythmia
tragic - receives disproportionate degree of public scrutiny
rare event
commonly death is the first indication of problem

Question 26

what is the prevalence of sudden cardiac death in sport

Answer 26

male to female = 2:1
usually around high school and early college age
0.75 in 100 000 athletes per year (3x higher than no athletes)

Question 27

what is hypertrophic cardiomyopathy (HOCM)

Answer 27

when the heart muscle gets too big
- usually genetically transmitted
- mutations may have malignant / benign cause
- death may occur without other symptoms during moderate to severe exertion

Question 28

what does HOCM cause within the heart

Answer 28

left ventricle wall thickening
- asymmetric
- distorted cellular architecture
- abnormal coronary arteries

Question 29

what are the mechanisms of sudden death from HOCM

Answer 29

ventricular dysrhythmias
sudden hemodynamic instability
- exercise induced hypotension
- increased LV outflow obstruction
- brady dysrhythmias

Question 30

what is commotio cordis

Answer 30

blunt chest trauma over heart (sternum)
hits just before T wave (repolarisation) causing the heart to go into ventricular fibrillation (v fib)

Question 31

what is the only immediate treatment for commotio cordis

Answer 31

AED - need to shock out of v fib

Question 32

what is the greatest cause of morbidity and mortality in gen pop

Answer 32

heart disease

Question 33

what is atherosclerosis

Answer 33

decreased diameter of vessels
- increased fat, scarring, and plaques in the vessel wall

Question 34

what causes atherosclerosis

Answer 34

genetics, LDL cholesterol, triglycerides, tobacco, lack of exercise and obesity, diabetes, hypertension, old age

Question 35

what are options for screening for heart conditions

Answer 35

PAR-Q+ for those wanting to be active
- not very helpful for younger people usually
heart tests not normally required in screening
- cost implications for ECG and ECHO
history and physical exam

Question 36

what occurs during the parts of the ECG
- P wave, QRS complex, T wave

Answer 36

P wave = depolarisation of L/R atrium (SA node)
QRS complex = ventricular depolarisation
- atrial repolarisation hidden in here
T wave = ventricular repolarisation