Respiration through the lifespan Flashcards
What are the signs and symptoms of asthma?
Breathlessness
Chest tightness
Coughing
Wheezing
What is asthma?
A chronic inflammatory condition affecting the airway
can be Extrinsic or Intrinsic
Define Intrinstic
Intrinsic factors include the genetic, physiological, and pathological characteristics of an individual; in other words, these are traits that are “intrinsic” to a person rather than being determined by that person’s environment
Define Extrinsic
originating from or on the outside
especially: originating outside a part and acting upon the part as a whole
PLEASE CHECK THIS DEFININTION
Explain the pathophysiology of asthma
Always some element of breathing obstruction
Airflow is normally limited but reversible
Airway always hyper-responsiveness to stimuli (or trigger factors) causes bronchospasm causes contraction of smooth muscle resulting in narrow airways
Bronchi are always in a state of chronic inflammation (-> eosinophils (WBC for allergies and infections -> release proteins which damage airway lining -> mucous gland hypertrophy and scar tissue allow wall to recover but is thicker
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Atopic (extrinsic)
Allergic disease in childhood -> hypersensitivity reaction that produes IgE antibodies -> over production of histamine produced
- Enviro allergens
Middle age- late onset
- Respiratory tract infection
- Exercise / cold air
- Emotional stress
- Cigarette smoke & perfume exposure
Ebunoluwa is an 8-year-old girl who attends the asthma clinic with the GP practice nurse. Although Ebunoluwa hasn’t had many acute asthma attacks; she often feels mild tightness in the chest and frequently coughs.
Using your knowledge of the pathophysiology of chronic asthma, explain why? (3 marks)
Airflow is normally limited but reversible
The asthmatics airway is always in a condition of being hyper-responsive to stimuli/triggers
Bronchospasm causes contraction of smooth muscle resulting in narrow airways
The bronchi are always in a state of chronic inflammation
There is always some element of obstruction of breathing
What is emphysema?
A chronic, irreversible inflammatory condition affecting the airway
Oxygen should ALWAYS be withheld from a patient with COPD?
False
Which test is used to aid the diagnosis of COPD?
Spirometry
At what point does bronchiolitis peak in it’s symptoms?
3-5 days
What is the most common cause of bronchiolitis?
Viral
What is the most common age group to experience bronchiolitis?
Up to 2 years
Bronchiolitis occurs as a result of the _______ of the lining of the ________ cells of the small airways in the lungs causing ______, inflammation and cellular ________ of those cells. It is the inflammation of these cells that can obstruct the airway and ultimately result in _________ .
Bronchiolitis occurs as a result of the INFLAMMATION of the lining of the EPITHIAL cells of the small airways in the lungs causing MUCUS PRODUCTION, inflammation and cellular NECROSIS of those cells. It is the inflammation of these cells that can obstruct the airway and ultimately result in WHEEZING.
Select the missing words that describe the three characteristics of Asthma:
- Airflow limitation which is normally __________ with treatment.
- Airway hyper-responsiveness from a number of triggers causes _______________. This results in
_________________ of the airways and _____________ of breathing. - __________ of the bronchi is always present and causes the long-term manifestations of asthma such as __________ inflammation leading to _________ of the smooth muscle and constant productions of ________
- Airflow limitation which is normally [REVERSIBLE] with treatment.
- Airway hyper-responsiveness from several triggers causes [BRONCHOSPASM]. This results in [NARROWING] of the airways and [OBSTRUCTION] of breathing
- [inflammation] of the bronchi is always present and causes the long-term manifestations of asthma such as [CHRONIC] inflammation leading to [constriction] of the smooth muscle and constant production of [MUSOUS]
Asthma is regarded as an allergic inflammatory response. Which type of inflammatory mediator cell releases histamine in asthma?
Mast Cells
What immunoglobulin (antibody type) attaches to mast cells causing them to release histamine which produces the symptoms of Asthma?
IgE
The NEWS2 describes a second oxygen scale for patients at risk of hypercapnic respiratory failure and therefore suggests (following clinician review) a target oxygen saturation of 88-92%.
Describe why a patient who has chronic obstructive pulmonary disease (COPD) may require a lower target oxygen saturation. (8 marks)
Patients with advanced COPD may have chronic obstruction and collapse of their airways in the lungs (1 mark)
This creates a constant increase/retention of carbon dioxide in the blood - the carbon dioxide cannot be expelled (1 mark)
In normal physiology high carbon dioxide level provides the stimulus to breathing /controls respiration – central chemoreceptors in medulla oblongata (1 mark)
As the disease progresses, central chemoreceptors become unresponsive to the constant stimulus of carbon dioxide (1 mark)
Low oxygen level becomes the main stimulus/control for breathing (1 mark)-
peripheral receptors situated in aortic arch and carotid bodies become essential for driving respiration (the hypoxic drive) (1 mark)
Administration of oxygen to normal levels (higher than the COPD patient is used to) may in some patients stop the stimulation to breathe/control of breathing (1 mark)
Carbon dioxide levels then further increase as breathing becomes ineffective (1 mark)
In a child with Bronchiolitis, what is the most common cause of the condition?
a) COVID-19 Infection
b) StreptococcalInfection
c) Respiratory Syncytial Virus Infection (RSV)
d) Escherichia Coli Infection (E.Coli)
c) Respiratory Syncytial Virus Infection (RSV)
- Which of the following would you expect to see in a patient with type 1 respiratory failure?
(1 Mark)
a) High carbon dioxide, low oxygen
b) Normal carbon dioxide, high oxygen
c) Normal carbon dioxide, low oxygen
d) Low carbon dioxide, normal oxygen
c) Normal carbon dioxide, low oxygen
Bronchiolitis progression: at what point does bronchiolitis peak in its symptoms?
a) 3-5 days
b) 1-2 weeks
c) 3 weeks
d) 1-2 days
a) 3-5 days
Chronic Obstructive Pulmonary Disease is a combination of which two diseases?
a) Emphysema and Bronchiolitis
b) Emphysema and Bronchitis
c) Asthma and Bronchiolitis
d) Asthma and Bronchitis
b) Emphysema and Bronchitis
. Why might a patient with Type 2 Respiratory Failure require very close monitoring when administering high-flow oxygen?
a) Increasing carbon dioxide levels stop the stimulus to breathe
b) Decreasing carbon dioxide levels stop the stimulus to breathe
c) Increasing oxygen levels stop the stimulus to breathe
4. d) Decreasing oxygen levels stop the stimulus to breathe
c) Increasing oxygen levels stop the stimulus to breathe
18.What are main characteristics of Asthma?
(3 Marks)
- coughing
- wheezing
- shortness of breath
18.What are main characteristics of Asthma?
(3 Marks)
- coughing
- wheezing
- shortness of breath
An ‘asthma attack’ is a common term of ‘exacerbation of chronic asthma’. What are the symptoms of ‘exacerbation of asthma’ and what changes occur in the airway that produce these symptoms? (3 Marks)
Use of assessor muscles, shortness of breath and low o2 levels
The smooth muscle in the airway is tightened, as well as the airway is inflamed, narrowed and swollen. Extra mucus in the airway. Therefore, less o2 is inhaled. Symptoms are low 02 saturations, audible wheeze, high respiration rate, shortness of breath and use of assessory muscles
Bronchiolitis
Bronchiol- bronchioles
itis- `inflammation
what are some risks of COPD?
- Smokers
- Asthma
- Air pollution
What are the signs and symptoms of Bronchiolitis?
- Initial: Upper resp. symptoms (Nasal congestion, runny nose, cough, sneezing) + fever
- Continued: Lower respiratory tract infections (cough, wheezing, high RR)
- Emergency: Grunting, nasal flaring, cyanosis, hypoxia, resp failure
what is the cause of Bronchiolitis how and where does it start and progress to?
Very contagious viral illness caused by RSV. Starts as an upper resp infection and moves to the chest
What’s the difference between extrinsic and intrinsic asthma?
A chronic inflammatory condition affecting the airway
- Extrinsic asthma occurs when the immune system overreacts to a harmless substance, such as pollen or dust
- Intrinsic asthma, as you might’ve guessed already, is triggered by various non-allergic factors like stress, cold or dry air, smoke, anxiety, viruses or infections, and more.
Where do LRTI and URTI occur
LRTI Lower aka below the neck. URTI Upper aka above the neck
