lec 17 - lung and heart Flashcards by Sara Frostad

what structures are part of the upper resp tract

nasal cavity, pharnyx, larynx

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what structures are part of the lower resp tract

trachea, primary bronchi, lungs

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what are examples of lung infections

bronchitis and pneumonia

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what are the two types of bronchitis

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

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what is the treatment for bronchitis

inhalers and antibiotics (for bacterial infection only)

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what is pneumonia

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

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what is the treatment for pneumonia

anitbiotics or antivirals depending on type of infection

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what is a pneumothorax

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

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what are the symptoms of a pneumothorax

short of breath, possible pain

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what is the treatment for a pneumothorax

small = watch and monitor
large = chest tube

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what is a tension pneumothorax and why is it an emergency

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!!

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what is a hemothorax

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

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what are the signs and symptoms of a hemothorax

short of breath and pain
decreased oxygenation
blood loss

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what is the treatment for a hemothorax

chest tube at the hospital

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what is asthma

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

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what are the symptoms of asthma

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

what is the net effect of the inflammation caused in asthma

expiratory resistance and air trapping

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

inflammation

what are the long term results of asthma

denudation of epithelium
collagen deposition
airway remodelling

what is the progression/pathology of asthma

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

what are the different types of treatment for asthma

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

what are the recommendations for asthma treatment

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

(traditionally treated with SABA before exercise)

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

usually the standard for asthma diagnosis

what are the thresholds for tachycardia and bradycardia

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

what is sudden cardiac death in sport

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

what is the prevalence of sudden cardiac death in sport

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)

what is hypertrophic cardiomyopathy (HOCM)

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

what does HOCM cause within the heart

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

what are the mechanisms of sudden death from HOCM

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

what is commotio cordis

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

what is the only immediate treatment for commotio cordis

AED - need to shock out of v fib

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

heart disease

what is atherosclerosis

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

what causes atherosclerosis

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

what are options for screening for heart conditions

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

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

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