Respiratory Disorders 1 Flashcards
Chronic Obstructive Airways Disease
Chronic Obstructive Airway Disease is the result of INSPIRATORY/EXPIRATORY airflow obstruction?
What are 2 causes of this?
Expiratory
- Reduced functional airway diameter e.g. asthma, chronic bronchitis, bronchiectasis
- Reduced elasticity of parenchyma e.g. emphysema
Atopic asthma is a type ____ hypersensitivity response.
Atopic asthma elicits a type ____ immune response. This involves what 2 things?
Type 1 hypersensitivity.
Type 2 immune - local anaphylaxis, mast cell activation (IgE via FcR - mast cells have a specialised Fc receptor).
The body’s acute response to atopic asthma involves mast cell activation. What is the first thing in regard to the mast cells that occurs? What does this word mean? What 4 things are released?
DEGRANULATION - the release of a variety of proinflammatory markers within the cell. This includes:
- Amines - histamine and adenosine
- Chemotactic mediators - eosinophils and neutrophils
- Enzymes - proteases
- Proteogylcans - heparin
After mast cell degranulation, what is the 2nd step that the mast cells do in response to atopic asthma?
They make and then release 2nd degree mediators - lipid mediatory, cytokines (TNF) , chemokines
The body’s acute response to atopic asthma has 4 local effects and 1 remote effect. What are they?
Local:
- Bronchospasm (resulting in narrowing of bronchioles)
- Vasodilation (due to histamine)
- Endothelial permeability —> oedema
- Mucous secretion
Remote:
- Leuocytes (neutrophils, eosinophils, monocytes, lymphocytes) are recruited. This recruitment works as part as a positive feedback loop and therefore this response is amplified and continues over many hours-days.
What are the 2 things that happen in the lungs with emphysema?
- Abnormal enlargement of air spaces - NOTE: the air spaces are not individually getting bigger (hyperexpansion). Instead say you have 5 small air spaces. The walls in between them get destroyed so instead you are left with 1 large air space.
- Destruction of bronchiole/alveolar walls. Therefore overall we are left with fewer no. of alveoli
What are 2 consequences of destruction of the alveolar walls in emphysema?
- Decreased SA means decreased oxygen exchange
- Pulmonary hypertension - e.g. image one hose running into 5 smaller tubes. Take 2 tubes away (due to destruction) and the pressure going into the remaining 3 will increase
A decrease in the enzyme _______ results in an increase in the activity of the ____ enzymes, specifically ______ + _______
Good diagram on slide 15 of Respiration 1 notes
α1 anti-trypsin
protease enzymes: collagenase + elastase
What are of the body does emphysema manifest in?
Distal bronchioles —> The alveoli!!
Emphysema results in:
- Critical loss of air exchange surface area which results in __________.
- Critical loss of elastic recoil which results in _________.
- Reduced air exchange
- Obstructive outflow
Do be diagnosed with CHRONIC BRONCHITIS a person needs to have a _____ cough for ___ months, for ____ consecutive years.
Productive, >3 months, 2 years
What are 3 symptoms characteristic of chronic bronchitis?
- Productive cough
- Excessive mucous
- Infection
EMPHYSEMA: critical loss of _____ = obstructive airflow
CHRONIC BRONCHITIS: critical loss of _____ = obstructive outflow
E: elastic recoil
CB: airway diameter (due to airway being filled up with mucous)
Can you get emphysema and chronic bronchitis occurring at the same time? What 3 shared symptoms will occur as a result?
Yes.
Loss of elastic recoil –> obstructive outflow
Loss of airway diameter –> obstructive outflow
+
Loss of SA –> reduced air exchange
Emphysema occurs in the _____. NO infection.
Bronchitis occurs in the _____. Infection
E: alveoli
B: bronchioles
