Respiratory System Flashcards
What is otorhinolaryngology?
Otorhinolaryngology (ENT Surgery) refers to a very wide field, including. medical and surgical conditions of the ear, nose and throat. neurotology. skull-base surgery, head and neck surgery.
How much interstitial fluid is returned to blood and how much enters the lymphatic pathway?
Roughly 90% of interstitial fluid is returned to blood and 10% enters the lymphatic pathway
Where do lymph nodes drain?
They are organized in superficial and deep groups of nodes, and eventually drain via the right lymphatic duct and left thoracic duct into the subclavian or internal jugular veins
Name new places where we find lymph nodes besides old ones like submandibular or submental
Jugulodigastric (upper jugular)
Jugulo-omohyoid (mid-jugular)
Supraclavicular (lower jugular)
Upper accessory chain
Spinal accessory chain
Suboccipital
Transverse cervical supraclavicular
What is the shape of most lymph nodes?
Oval or bean shape with a depression at the hilar region (which is where nerves, arteries and veins enter the lymph node)
What is the size of a normal lymph n?
About 1cm
except the jugolodigastric nodes which can be up to 1.5cm in size
Besides filtration, what do lymph nodes do?
- They undergo lymphopoiesis and create an immune reactionLymphopoiesis—from lympha (Latin, water)—refers to the production of new lymphocytes, including B lymphocytes, T lymphocytes, and natural killer (NK) cells.
How does a lymph node work?
The lymph brings antigens to the node and carries out antibodies, T-cell and macrophage components of cellular immunity, and activated B lymphocytes of humoral immunity
In addition, the phagocytic apparatus of the sinuses filters the lymph, retaining foreign antigens and substances
The passage of the lymph and cells from one chain of lymph nodes to the next is a means by which the immune response is conveyed from the peripheral to the more central lymph nodes
When a lymph node recirculates, usually how long does it take?
12 days except when it is antigenically challenged
What is lymphoma?
What is lymphoma? Lymphoma is a type of blood cancer that affects the immune system. It specifically affects white blood cells called lymphocytes, which are an important part of your immune system. Lymphoma is also called a cancer of the lymphatic system, or lymphatic cancer.
Describe sarcomas
Sarcomas are rare cancers that develop in the bones and soft tissues, including fat, muscles, blood vessels, nerves, deep skin tissues and fibrous tissues
Glomus tumour
Glomus tumors, or paragangliomas, are slow-growing, benign tumors of the neuroendocrine tissues in the body. They are rare but most commonly occur in the head, neck, and adrenal gland. In very rare situations, they are malignant.
Haemangioma
A hemangioma (hee-man-jee-oh-muh) is a common, benign (not-cancer) growth made of extra blood vessels in the skin. The cause of hemangiomas isn’t known, but they’re not hereditary
Lymphangioma
Lymphangiomas are uncommon, benign malformations of the lymphatic system that can occur anywhere on the skin and mucous membranes. Lymphangiomas can be categorized as deep or superficial based on the depth and size of the abnormal lymphatic vessels or as congenital or acquired.
Laryngopharynx
The laryngopharynx, also referred to as the hypopharynx, is the most caudal portion of the pharynx and is a crucial connection point through which food, water, and air pass. Specifically, it refers to the point at which the pharynx divides anteriorly into the larynx and posteriorly into the esophagus.
Name the order of the pharynx
Nasopharynx
Oropharynx - incl tongue and soft palate
Hypopharynx/laryngopharynx - splits into larynx and oesophagus
Name the order from top to bottom of cavities in the head
Nasal cavity
Oral cavity
then comes tongue, epiglottis
and vocal chords
Name the parts of the larynx
Your larynx is divided into three parts:
The upper part (supraglottis).
The middle part (glottis) - only one containing vocal chords
The lower part (subglottis).
What are the functions of the larynx (voicebox)
Basically breathe and talk!
Your larynx is part of your respiratory system. It’s a hollow tube that’s about 4 to 5 centimeters (cm) in length and width. It lets air pass from your throat (pharynx) to your trachea on the way to your lungs. Your larynx is also the reason you’re able to make sounds, so it’s often called your voice box.
Interesting one: betel nut
Betel nut chewing, also called betel quid chewing or areca nut chewing, is a practice in which areca nuts (also called “betel nuts”) are chewed together with slaked lime and betel leaves for their stimulant and narcotic effects, the primary psychoactive compound being arecoline.
Barbiturate
Barbiturates are a category of sedative-hypnotic medications used for treating seizure disorders, neonatal withdrawal, insomnia, preoperative anxiety, and the induction of coma to address increased intracranial pressure (ICP). In addition, these medications are also helpful for inducing anesthesia.
Croup
Croup is a common infection in children. It causes swelling in the upper part of the airway in the neck. It causes a barking cough, with or without fever. And it may cause problems with breathing. The illness is seen more often in the winter.
Difference between croup and pertussis
Whooping cough is a bacterial infection whereas a viral infection usually causes croup. Therefore, no vaccines can prevent croup and antibiotics can’t treat it
Myasthenia gravis (MG)
Myasthenia gravis (MG) is a chronic autoimmune disorder in which antibodies destroy the communication between nerves and muscle, resulting in weakness of the skeletal muscles. Myasthenia gravis affects the voluntary muscles of the body, especially those that control the eyes, mouth, throat and limbs
Papillomatosis
Papillomatosis is skin surface elevations caused by hyperplasia and solid outgrowths of skin and connective tissue.
Differences between aspiration and choking
Choking occurs when the airway is obstructed by food, drink, or foreign objects. Aspiration occurs when food, drink, or foreign objects are breathed into the lungs (going down the wrong tube). It might happen during choking, but aspiration can also be silent, meaning that there is no outward sign.
Aspiration pneumonia
Aspiration pneumonia occurs when oral or gastric contents are aspirated into the lungs, leading to infection. It often results from impaired swallowing or protective airway reflexes
GORD
Gastro-oesophageal reflux disease (GORD) is a common condition, where acid from the stomach leaks up into the oesophagus (gullet). GORD causes symptoms such as heartburn and an unpleasant taste in the back of the mouth.
LPR
Laryngopharyngeal reflux (LPR), also known as silent reflux, occurs when a muscle at the end of the esophagus does not close properly.
Difference between GORD and LPR
When acid repeatedly “refluxes” from the stomach into the esophagus alone, it is known as gastroesophageal reflux disease (GERD). However, if the stomach acid travels up the esophagus and spills into the throat or voice box (called the pharynx/larynx), it is known as laryngopharyngeal reflux (LPR).
3 things that cause Interstitial lung disease?
Particles that cause localized airway obstruction.
Foreign objects
Foreign substances – molecules/antigens and fibers
Asbestos, coal, animal antigens, smoke
Infective
Viruses, bacteria, fungi
What can a foreign object do that causes issues downstream?
Collapse
Obstruction with mucous build-up
Pneumonia
Lung abscess
Bronchiectasis
Define pneumonia
Pneumonia is an infection that inflames the air sacs in one or both lungs.
The air sacs may fill with fluid or pus (purulent material), causing cough with phlegm or pus, fever, chills, and difficulty breathing. A variety of organisms, including bacteria, viruses and fungi, can cause pneumonia.
Define bronchioectasis
Disease characterized by permanent dilation of bronchi and bronchioles caused b destruction of the muscle and elastic tissue, resulting from or associated with chronic necrotizing infections.
To be bronchiectasis- the dilatation must be permanent.
Intralobar sequestration
An intralobar sequestration is located within a normal lobe (almost always in the lower lobe) and lacks its own visceral pleura. An extralobar sequestration is located outside the normal lung and has its own visceral pleura.A pulmonary sequestration is a medical condition wherein a piece of tissue that ultimately develops into lung tissue is not attached to the pulmonary arterial blood supply, as is the case in normally developing lung
What are the two types of pulmonary sequestration?
Intralobar, in which the mass forms inside the lungs. These lesions account for about 75% of cases of BPS, affect males and females equally, and are generally isolated birth defects. …
Extralobar, in which the abnormal mass forms outside — but nearby — the lungs.
Primary ciliary dyskinesia
Primary ciliary dyskinesia is caused by genetic mutations that affect the tiny hairline cilia in the lungs, nose and ears, impairing their ability to remove germs and pollutants, and allowing mucus buildup and infection.
Cystic fibrosis
Cystic fibrosis (CF) is a genetic (inherited) disease that causes sticky, thick mucus to build up in organs, including the lungs and the pancreas. In people who have CF, thick mucus clogs the airways and makes it difficult to breathe. Management includes ways of clearing lungs and a nutrition plan.
4 causes of bronchiectasis is congenital, post-infectious and bronchial obstruction. Name some examples:
Bronchiectasis
Causes:
Congenital – Cystic fibrosis, intralobar sequaestration, immundeficiency states and primary ciliary dyskinesia.
Post-infectious conditions – necrotizing penumonia
Bacteria : M. tuberculsis, Staphylococcus auresu, Haemophilus influenzae, Pseudomonas .
Virus: adenovirus, influenza virus, HIV
Fungi – aspergillus species.
Bronchial obstruction – tumour, foreign bodies, mucous plugs.
Other: Rheumatoid arthritis, SLE, IBD, post-transplantation.
Bronchioectasis Pathogenesis
Bronchiectasis Pathogenesis:
Develop obstruction and infection – either order.
Obsturction – normal clearing mechanism impaired, pooling of secretions and subsequent infection, with necrosis.
Wall destruction with dilatation of the bronchus.Lower lobes bilateral – especially vertical air passages.
Inflammation varies with activity – acute and chronic inflammation in the all of the bronchiole, fibrosis of the bronchial wall with peribronchiolar fibrosis.
How much will the bronchi dilate?
2-3times in normal size
Summary of bronchioectasis
Bronchiectasis
Permanent dilatation of bronchi & bronchioles.
Results from pulmonary inflammation and scarring due to infection, bronchial obstruction or lung fibrosis.
Airways dilate as surrounding fibrous tissue contracts.
Diffuse or restricted to a lung lob
Secondary inflammation lead to further damage.
Symptoms: chr cough with dyspnoea with ++ sputum.
What is the problem with having extra mucus in the bronchi walls?
Susceptible to infection
Abscess
An abscess is a pocket of pus.
Abscesses can form almost anywhere in or on your body. When you get an infection, your body’s immune system kicks into action to try to fight it. White blood cells travel to the infected area and build up within the damaged tissue.
