RESPIRATORY DISEASES Flashcards
what is the main function of the lungs?
gas exchange - inhaling oxygen that we need to oxidize macromolecules and removing carbon dioxide from our systems
where is gas exchange done?
alveoli
describe the roles of type 1 and type 2 alveoli cells
type 1: responsible for gas exchange
type 2: alveoli cells produce surfactant decrease surface tension to avoid the alveoli to collapse after exhalation
what is pleural effusion
accumulation of fluids in the pleura (layer that allows the lungs to expand) - causing shortness of breath
what is atelectasis
when lungs collapse
describe how nutrition impacts pulmonary function
- strength and endurance of respiratory muscles
- lung parenchyma –> increased incidence of pulmonary infection
- antioxidant protection - inadequate intake of antioxidants could lead to increased oxidative injury of the lung tissues
how do pulmonary functions impact nutrition>
- energy expenditure
- dietary intake (early satiety, anorexia)
what is cystic fibrosis?
autosomal recessive disease
- disease caused by genetic mutation which will impair the function of the CFTR (cystic fibrosis transmembrane conductance)
- CTFR is the sodium and chloride transport and so there will be abnormal transport leading to viscous/thick mucus secretion from epithelial surfaces
what is progressive lung disease?
inability to clear mucus from the lungs - mucus prevents entrance of different particles which will increase the change that we are exposed to possible infections
- chronic inflammation can lead to losing the functions of our lungs
- increased risk of infection
what is pancreatic insufficiency
malabsorption of fats
- steatorrhea (excessive amounts of fat in poops) –> poor growth pattern
- main causes of malnutrition in patients with CF
how are cystic fibrosis and diabetes related
(10-15% of adults)
- inflammation and accumulation of fibrous tissues in the pancreas - interferes with normal insulin production
what are the CF diagnosis
- all newborns are screened with serum testing
- fecal elastase test (elastase is a digestive enzyme) - may have pancreatic insufficiency if cannot find elastase in stools or lower values
- sweat chloride test (considered gold standard)
what are CF nutrition implications
- pancreatic insufficiency - malabsorption of dietary fat, fat soluble vitamins, and other nutrients
- increased energy requirements
- malnutrition –> stunted growth and inadequate weight gain in children
- osteoporosis –> from fat malabsorption (unabsorbed FA can form soaps and increase secretion of calcium, zinc, and magnesium
- hyponatremia - loss of sodium in sweat
what are you looking for in the assessment portion of CF?
- anthropometric measurements
- labs: glucose, albumin, electrolytes, serum vit A, D, E, K, and calcium
intervention for individuals with CF?
- high energy, high protein
- no need to restrict on fat
- liberalize high salt diet
- routine supplementation of fat soluble vitamins A, D, E, K
- breast milk recommended for first year of life
describe asthma
chronic inflammatory disorder of the airway –> airflow obstruction often reversible either spontaneously or with treatment
- restricts airflow to the lungs
what is the association between obesity and asthma
both inflammatory conditions
what are nutrition therapies for asthma
- mediterranean dietary pattern (anti-inflammatory diet)
- olive oil, omega 3’s, intake of fruit and vegetables (increase antioxidants)
- long term use of corticosteroids –> increased glycemia and Na retention - watch out
what is COPD
chronic obstructive pulmonary disease
- generalized inflammatory response to pollutants repeated exposure to cigarette smoke and other pollutants
- progressive disease that limits airflow through inflammation of bronchial tubes (bronchitis) or destruction of alveoli (emphysema)
what is chronic bronchitis
- thickened airways
- decreased cilia function (inability to clean mucus from the airways)
- thickened mucus provides an environment prime for bacteria growth
what is cor puolmonale
complication of COPD
- right sided heart failure (helps remove CO2 - will overwork the right side of the heart)
what is emphysema
- destruction of lung tissue
- loss of connective tissue –> loss of surface area –> decreased surfactant
- bronchioles collapse during exhalation and cause hyperinflation of the lungs
a noticeable clinical manifestation of emphysema
barrel chest
COPD Treatment
- lifestyle changes (smoking, avoidance of other pollutants, exercise as tolerated)
- pharmacologic treatment
- pulmonary rehabilitation
- lung transplant
COPD Nutrition Implications
- increased REE secondary to the work of breathing
- reduced nutrient intake from:
- hyperinflation of the lungs with flattening of the diaphragm –> early satiety
- chronic mouth breathing –> taste perceptions and xerostomia
- change of breathing patterns and reduced oxygen uptake –> chewing and swallowing difficulties
- fatigue and reduced functional status
- weight loss and losses of lean body mass
- osteoporosis in advanced COPD
COPD Nutrition Therapy:
- SFM - alleviate the fullness and bloating
- nutrient and energy dense foods
- high kcal and high protein
what is respiratory failure
occurs when the respiratory system is no longer able to perform its normal functions
- can be caused by low oxygen or excess CO2 or both
what is pneumonia
infection of the lungs, usually caused by bacteria, viruses, or fungi
3 diff ways to acquire pneumonia
- community
- hospital
- ventilator
what is aspiration pneumonia
- aspirate material causes an inflammatory response in the lung
some risk factors of aspiration pneumonia
- head injuries, neurological impairments
- use of paralyzing agents
- improper positioning of a feeding tube
- placement of the head of the patient’s bed at a shallow angle
- hyperglycemia, gastroparesis
ways to prevent aspiration pneumonia
- patient’s head to be elevated higher than his or her stomach or at an angle of >30 degrees during feeding
what are tracheostomies
surgical opening made in the trachea to assist breathing
nutrition implications of tracheostomies
- risk of aspiration
- patients may require a feeding tube
- viscosity of food makes a difference once the patient is able to eat orally
- SLP should determine whether the patient can safely swallow food without aspiration
