The Respiratory System Flashcards
What is Cystic Fibrosis?
Inherited condition that causes sticky mucus to build up in the Lungs and Digestive System.
If both Parents are carriers there is a 1 in 4 chance their Child will inherit the faulty gene from both Parents and have CF.
Significantly Impact on Life Expectancy and Quality of Life.
Lung Infections are a cause of Significant Morbidity in CF.
CF is one of the leading causes of Bronchiectasis, a Chronic lung condition with Abnormal Widening, Thickening and Scarring of the Bronchi. This results in repeated Respiratory Infections.
What are Respiratory Infections?
The Lungs have an exposed surface area of approximately 500m2, so Respiratory infections are relatively common.
According to WHO (World Health Organisation) one of the leading causes of death and disability globally.
Although the lungs are protected by Defence Mechanisms, many abnormalities may predispose to Respiratory Infections:
Loss of Cough Reflex - Coma, Anaesthesia, Neuromuscular disorders, Surgery, Stroke.
Ciliary defects - Loss of Cilia in Smoking, Bronchitis
Mucus Disorders - Cystic Fibrosis, Chronic Bronchitis
Immunosuppression - HIV/AIDS, Loss of B and/or T Lymphocytes
Pulmonary Oedema - Flooding of Alveoli due to Heart Failure.
What is Bronchitis?
Inflammation of the Airways in the Lungs that is usually caused by an infection (usually viral). It often gets better without treatment in around 3 weeks.
Characterised by Cough, Dyspnoea, Tachypnoea and Excessive production of Sputum.
Bronchitis often affects Trachea, Larynx and Lungs.
Infants and Young Children can suffer from acute ‘Laryngotracheobronchitis’ or ‘Croup’.
What is Bronchitis?
Viruses are usually the Cause of Bronchitis, but Haemophilus influenza and Streptococcus pneumoniae are frequent bacterial causes.
Exacerbations of Acute Bronchitis are common in Chronic Obstructive Pulmonary Disease (COPD) and cause a sudden deterioration in Pulmonary Function with cough and purulent sputum.
What is Bronchopneumonia?
Inflamed Bronchioles and Bronchi spreads to alveoli. Occurs mostly in Old age, Infants and in patients with debilitating diseases such as cancer, heart failure, stroke. Affected area of lung can be identified by Crackles (Crepitations) on Auscultation. Patients often become Septicaemic.
What is Pneumonia?
Alveolar Inflammation.
Polymorphs and later Lymphocytes and macrophages appear in greater numbers in Bloodstream.
Lobar or Bronchopneumonia
Usually due to infection affecting distal airways, especially Alveoli, with formation of Inflammatory exudate.
What is Tuberculosis?
Caused by Bacteria (Mycobacterium Tuberculosis).
Often affects the Lungs.
Spread through air when people with Lung TB cough, Sneeze of Spit.
Immunocompromised Patients, those with Malnutrition or Diabetes, or people who use Tobacco, have a higher risk of falling ill.
13th Leading cause of Death and 2nd Leading Infectious killer after COVID-19.
Treatable and Curable. Treated with a standard 4-month or 6-month course of 4 Antimicrobial drugs,
BCG Vaccination is recommended in Countries or Setting with a high incidence of TB and for healthcare workers.
What is a Pulmonary Embolism?
One or more Emboli, usually arising from a blood clot formed in the Veins are lodged in and obstruct the Pulmonary Arterial system, causing severe respiratory dysfunction.
Most common sources of PE is deep vein thrombosis (DVT) in the lower limbs.
Major Risk Factors for PE include:
- Current/Previous DVT or PE
- Active Cancer
- Recent Surgery
- Lower Limb Trauma
- Pregnancy
- Use of Combined oral contraceptive pill
- Obesity
What is COPD?
COPD describes a group of Chronic Respiratory Disorders characterised by irreversible, progressive and deliberating airflow obstruction and persistent respiratory systems.
Tobacco smoking is a major risk factor for the development of COPD.
Reduced Quality of life and Increased Morbidity and Mortality.
Diagnosis is based on the presence of typical clinical features supported by spitometry.
Should be suspected in people aged over 35yrs who have a risk factor and symptoms including exertional breathlessness, chronic/recurrent cough or regular sputum production.
What is the Pathophysiology of COPD?
Chronic Inflammation, Exudate and Swelling caused damage to connective tissue that supports the structure of the Alveoli of the Lungs.
Increased numbers of Inflammatory Cells
Airways and Alveoli lose Elasticity
Alveolar Walls are destroyed
Walls between airways become thick and inflamed
Increased overproduction of Mucus Blocks the Airflow.
Severe Hypoxia (Low Tissue O2 Supply) and Hypercapnia (CO2 too High) can lead to Respiratory Failure.
Chronic Hypercapnia shifts normal breathing drive from need to expel CO2 to the need to Raise O2.
What is Chronic Bronchitis?
Mucus Hypertension with Bronchial Mucous Gland Hypertrophy.
Typically middle aged men who are heavy smokers.
Clinical Episodes associated with recurrent, low grade bronchial infections caused by Bacteria such as Haemophilius Influenza or Streptococcus Pneumoniae.
Treatment is with Antibiotics and Chest Physiotherapy and sometimes short term use of Oxygen Therapy. Bronchodilators such as Salbutamol can also be used.
Over time obstructive airway disease becomes progressively more severe and is accompanied by Hypercapnia, Hypoxaemia and Cyanosis.
These patients hyperventilate, using accessory respiratory muscles, to produce a relatively normal blood gas profile.
Eventually right Heart Failure (Cor Pulmonale) or Respiratory Failure will occur.
What is Emphysema?
Enlargement and Dilation of Alveolar Airspaces with destruction of elastin in their walls, resulting in an inability to take part in Gaseous Exchange.
Frequently associated with Chronic Bronchitis.
Progressive Dyspnoea, Weight Loss and Right Heart Failure.
Cough and Sputum, recurrent infections with Dyspnoea and Purulent Sputum (Contains Pus, Dead Cells and Mucus, usually Green/Yellow).
What is Asthma?
Chronic Pulmonary Disease that produces intermittent reversible airway obstruction.
Characterised by Acute Airway inflammation, Bronchoconstriction, Bronchospasm, Brinchiole Oedema and Mucus Production which combined, cause airway narrowing.
Genetics and Environmental Factors increase susceptibility to asthma. Exacerbation can occur as a result of exercise, occupational exposure (Paint, Animals), Drug induced (E.g. Aspirin, NSAIDs cause Bronchoconstriction), Changes in weather, viral respiratory infections.
Asthma is often the result of a strong immune reaction to an allergen.
Episodic Asthma in childhood tends to resolve in adolescence and early adulthood.
