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LSS: respiratory > sensory aspects of resp disease > Flashcards

sensory aspects of resp disease Flashcards

1
Q

what is a symptom?

A
  • an abnormal or worrying sensation that leads a person to seek medical attention
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2
Q

what is the difference between sensory stimulation and sensory impression?

A

sensory stimulus –> transducer –> excitation of sensory nerve –> integration CNS –>sensory impression

( this is neurophysiology )

sensory impression –> perception –> evoked sensation
( this is behavioural psychology)

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3
Q

what is the function of a cough?

A
  • crucial defense mechanism
  • protecting the lower resp tract
  • inhaled foreign material
  • excessive mucus production
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4
Q

what does a cough come after?

A
  • mucociliary clearance
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5
Q

what happens in the expulsive phase of a cough?

A
  • once the mucus gets to the large airways it stimulates he cough
  • it generates a high-velocity airflow
  • expels the mucus or foreign material
  • this is facilitated by mucus secretion
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6
Q

where are cough receptors normally found?

A
  • they are most numerous on the posterior wall of the trachea
  • they are found at the main carina
  • they are less numerous in the more distal airways
  • they are absent beyond the bronchioles
  • normally found on the proximal airways
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7
Q

what are the three types of sensory receptor in the lungs and the airways?

A
  • slow adapting stretch receptors
  • rapidly adapting stretch receptors
  • C- fibre receptors
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8
Q

what cranial nerve is the vagus nerve?

A

the 10th cranial nerve

through which all the sensory nerves from the airways pass through to the brain

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9
Q

what is caspaicin?

A
  • this is a stimulus to the sensory nerve
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10
Q

what is the stimulus for C fibres?

A
  • stimulated by chemicals
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11
Q

what is the stimulus for the rapidly and slow adapting stretch receptors?

A
  • inflation

- caspaicin has no effect

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12
Q

what happens to the stretch receptors after an INCREASE in tracheal pressure?

A
  • the rapidly adapting stretch receptors stop firing and he slows adapting stretch receptors are stimulated to fire

these receptors are involved in coughing

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13
Q

what are features of C fibre receptors

A
  • they have free nerve endings
  • they are present in the upper airways
  • they are small and unmyelinated fibres
  • the conduction is slow
  • releases neuropeptide, inflammatory mediators
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14
Q

what are features of rapidly adapting stretch receptors?

A
  • they are myelinated
  • conduct very fast
  • present in nasopharynx, larynx trachea and bronchi
  • stimulated with hyperinflation causes a rapid response
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15
Q

features of the slowly adapting stretch receptors?

A
  • located in smooth muscle airway
  • myelinated
  • therefore also conduct very quickly
  • mechanoreceptors
    they also respond to lung inflation
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16
Q

what types of receptors lead to coughing?

A
  • mechanoreceptors

- nociceptors

17
Q

what are the mechanoreceptors stimulated by?

A
  • mechanical displacement

- citric acid

18
Q

what are nociceptors activated by?

A
  • caspaicin
  • bradykinin
  • citric acid
19
Q

what is the complete cough pathway?

A
  • sensory information goes via the vagus nerve and through the brainstem to the cough center
  • this cough center consists of nucleus tractus solitarius
  • the nucleus tractus solitarius is a collection of neurones that are connected to the medullary cough pattern generator
  • from the medullary cough pattern generator, you can stimulation of various muscles to produce the cough
  • the complete cough pathway also includes the cerebral cortex
20
Q

what are the afferent neural pathways for a cough?

A
  • stimulation of the mechanical or chemical receptors leading to impulses going up the vagus nerve
  • travels through the brainstem to the cough center
  • some of the signals goes to the cerebral cortex
21
Q

what are the efferent neural pathways for a cough?

A
  • involves the stimulation of various muscles

- which leads to the closure of the glottis and the production of the cough sound

22
Q

what are the 3 phases of a cough?

A
  • inspiratory phase (opens trachea)
  • glottic closure
  • expiratory phase
23
Q

what happens to the intrapulmonary pressure during the act of coughing?

A
  • increase in intrapulmonary pressure
  • this compresses the posterior membrane of the trachea
  • which pushes and narrows the trachea into a crescent shape
  • this increases the flow and emphasizes the sound that is produced
24
Q

what is an acute cough?

what is it normally caused by?

A

lasts less than 3 weeks

- caused by a rhinovirus

25
Q

what is a chronic cough?

A 
- lasts more than 3 weeks 
most common causes are : 
- asthma 
- gastroesophageal reflux 
(when protons coming up from stomach activate the cough receptors)  
- rhinosinusitis
26
Q

what happens to the mucus when there is an infection?

A
  • the mucus may change color and become yellow
27
Q

what is an increased cough reflex?

A
  • cough hypersensitivity syndrome
  • this is like a cough that is hard to control
  • triggers might be deep breath, laughing, talking ect. temp change, lying flat
28
Q

how to identify an increased cough reflex?

A
  • giving the patient a range of doses of caspaicin
  • give diluted amounts and keep increasing the concentration
  • chronic coughers are particularly sensitive to this
29
Q

what is the mechanism of getting cough hypersensitivity?

A
  • increased excitability of the afferent nerves
    by chemical mediators
  • results in an increase in the number of receptors
  • this also increases the neurotransmitter
  • there might also be an increase in inflammatory mediators
30
Q

what are current suppressants for coughing?

A
  • using opiates

however they do come with side effects

31
Q 
what are the sensory nerves coming from each of these places?
nose 
pharynx 
larynx 
lungs 
chest wall
A 
nose = trigeminal 
pharynx = glossopharyngeal + vagus 
larynx = vagus
lungs = vagus
chest wall = spinal nerves
32
Q

what is the difference between the anatomical pathways of touch and pain?

A
  • the level at which the pathways cross over to the contralateral side
  • touch goes to the contralateral side at level of CAUDAL MEDULLLA
  • pain goes to the contralateral side at the level of the same anatomical level - direct
33
Q

what are the two types of pain?

A
  • somatic pain

- visceral pain

34
Q

what is the nature of somatic pain?

A

very localised pain

- there are lots of somatic afferents

35
Q

what is the nature of visceral pain?

A

very generalized pain difficult to identify

the number of visceral afferents are fewer

36
Q

where might chest pain from respiratory disorders be coming from?

A
  • pleuropulmonary disorder
  • tracheobronchitus
  • inflammation
  • referred pain
37
Q

where might the pain come from if not the resp system?

A
  • cardiovascular disease
  • gastrointestinal
  • referred pain
38
Q

what is dyspnoea?

A
  • shortness of breath

- occurs at low levels of exertion

LSS: respiratory (17 decks)

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