Lecture 2 Flashcards
What is rhinitis
Inflammation of the nose
What is rhinosinusitis
Inflammation of the paranasal sinuses
How much are made up of rhino viruses that start rhinosinusitis
50%
Corona viruses how much
25%
Transient vasoconstriction of the mucous membrane is followed by
Vasodilatation
Mucus production
Oedema
Secondary infection
How is allergic rhinitis classified
Into two groups
Seasonal - pollen
Perennial - dust mite faeces
What is the nasal cross sectional area measurement
30mm2
Turbinates has an area of
150cm2
The nose is covered in what tissue
Vascular tissue
How do we get a blocked nose
The mucosa tissue swells restricting air flow
How is CSA categorised
Into two areas
Cheyne stokes respiration
Periodic breathing
How is the tongue held forward
High tone of genioglossus
What are the symptoms of OSA
Sleep interruption Daytime drowsiness Snoring Morning headaches Night sweating Nocturia
If someone is obese how does this affect OSA
Pressure is exerted by fat in the neck and causes the airway to collapse
Name some factors that could contribute to OSA
Enlarged tonsils Tumours Abnormalities of the mandible Alcohol Sedative drugs
Most common treatment of OSA
Nasal continuous positive airway pressure
NCPAP
Other treatments of OSA
Removal of uvula and part of the soft palate but it can cause fluid going into the nose during drinking
What does OSA stand for
Obstructive sleep apnoea
What is laryngospasm
When the vocal folds of the larynx close
What is bronchoscopy
Used to inspect below the larynx where they can pass medical equipment down to take a sample of tissue or biopsy
What is the Reid index
It’s a measurement of the ratio between the thickness of the submucosal mucus secreting glands and the thickness between the epithelium and cartilage that covers the bronchi
What is the normal reading of the Reid index
40%
What occurs in the gland cells in chronic bronchitis
Hyperplasia
Is pulmonary circulation high or low pressure
Low pressure system
Where do the veins trVel if they don’t travel along the airways
Travel along the septa that seperate lung compartments
The airways at the bronchiole recieved nutrients from which circulation bronchial or pulmonary
Bronchial
Where does part of the bronchial circulation return to
Systemic venous system
What is a broncho pulmonary shunt
Some of the blood is shunted by draining back into the pulmonary veins instead of flowing in the systemic venous system
Normal pulmonary reading
15mmHg
What does hypertension cause
Extra pulmonary - narrowing, left ventricular failure that prevents blood moving away from the heart
Intra pulmonary - changes pulmonary vessels by blocking them by fat, amniotic fluid, cancer.
Main result of pulmonary hypertension
Increased pressure producing a pumping load on the right heart.
Resulting in oedema, chest pain, fatigue, modified heart sounds
If someone had a pulmonary oedema what will the xray look like
Butterfly shadow
What is pleurisy
Inflammation of the pleura
What is dry pleurisy
No effusion
Pain caused by the raw pleura moving across the other
What is wet pleurisy
Significant effusion
If wet enough it can cause collapse of the lung
If effusions contain too much protein what is it called.
If they contain less protein what is it
Lots - transudates
Little - exudates
Rate of air transit through the nose
Air temperature in the nose is raised from 20C to what
20C - 31C
Temperature of the air by the time it reaches the trachea
35C
How many times more heat is used to vapour use water than to heat the air
5x
How much gets recovered in expiration
40%
What is counter current heat exchange
Mucosa of the nose is much colder than the exhales air from deep in the lungs forming condensation drops
Do smaller or larger droplets fall faster
Large drops fall faster
For particles to travel deep into the lungs what size will they need to be
Very small
What was stokes law
Terminal velocity of a falling sphere - radius 2
What is MMAD
Mass mean aerodynamic diameter
What size are 95% of particles
> 5um
How do particles get trapped in the mucous of the nose and pharynx
Turbulence throws particles out of the airstream, particles are swept in mucous via cilia
How are small particles removed
Sedimentation
Particles get trapped in mucous and travel up what
Mucosillary escalator
How thick is the mucus blanket
5-10um
How fast do cilia beat
20Hz
Size of the smallest particles
How do particles stick to the wall if there is no mucus
Surface tension
What do particles get ingested by
Amoeboid macrophages
What is used in detoxification
Cytochrome P450
Name some proteins that dilate some blood vessels
ATP ADP AMP Noradrenaline Bradykinin
Name a serotonin
5HT
Name an inflammatory response
Leukotrienes
Name some prostaglandins
PGE1, 2
PGF2a
What do lungs activate and by what
Activate ANGI and ANGII
By ACE
How much of ACE plasma is converted in a single pass through the lungs
80%
Name 5 non respiratory functions
- Blood filtration
- Blood fluidity
- Blood capacity
- Cooling
- Behaviour