Week 6: Respiratory Flashcards
Obstructive Sleep Apnea
risk factors
Obesity
Male gender
Age (increased risk with older age)
Family history of sleep apnea
Anatomical abnormalities (e.g., enlarged tonsils, deviated septum)
Smoking
Alcohol consumption
Clinical features of OSA
- Daytime somnolence
- Nocturia
- Witnessed apneas
- Insomnia
- Monring headaches
- Dry mouth
- Cognitive impairment
- Croweded oropharynx
Mallampati score
- assess visibility of ora structures
- Class I is best, Class IIII is worst
Polysomnography
an investigation collecting multiple physiological parameters during sleep.
Includes:
* Pulse Oximetry
* Electroencephalogram (EEG)
* Electro-oculogra (EOG)
* Electromyogram (EMG)
* ECG
* Nasal Pressure Cannula
* Thermocouple
* Microphone
* Thoraco Admonial Bands
Electroencephalogram (EEG)
Records brain’s electrical activity.
Electro-oculogram (EOG)
Tracks eye movement during sleep.
Electromyogram (EMG)
Monitors muscle activity.
Nasal pressure cannula
Measures airflow through the nostrils
Thermocouple
Measures airflow by detecting temperature changes.
Microphone in Polysomnography
Records sounds like snoring during sleep.
Thoraco-abdominal bands
Monitor chest and abdominal movement to assess breathing.
Obstructive apnoea
Complete cessation of airflow due to upper airway resistance and obstruction, characterised by effort to breathe against resistance.
Central apnoea
Complete cessation of airflow due to lack of control from brainstem respiratory centres; caused by medications, cardiac failure, brainstem
disease, or idiopathic in nature.
Type 1 (A) Sensitivity
IgE mediated (Allergic) responses (e.g., anaphylaxis, atopic tetrad)
Type 2 (C) hypersensitivity reactions
Antibody-dependent Cellular Cytotoxicity
Type 3 (I) Hypersensitivity Reactions
Immune-mediated responses involving IgG and IgM
Type 4 (D) hypersensitivity reactions.
Delayed or cell-mediated response
Risk Factors for Atopic Disorders
- Maternal exposures
- Type of Birth
- Skin Epithelial dysfunction (eg vitmain d deffincey)
- Lung epithelium dysfunction
- Gut epithelium dysfunction
Management of Atopy
- Corticosteroids
- Anti-alarmin therapy (inhibits differntiation of naive T cells into Th2 Cells
- Anti-Th2 Therapy (blocks cytokine receptor signalling
- Immunosuppresants
- Anti-IgE (prevents binding of antibodies to mast cells)
Type 2 Asthma vs Non type 2
Type 2: is more common, More severe, has airway/systemic eosinophilla
and is responsive to corticosteriods
Asthma Pathophysiology
- Trigger
- Release of inflmmatory mediators with mast cell degranulation
- Promotion of tissuse inflammation
- Smooth muscle contraction
- Stimulation of nerves leads to airway narrowing
Clinical Features of Asthma
- Wheezing (mostly exhalation)
- Cough (especially at night)
- Dyspnoea
- Chest Tightness
Chronic Bronchitis
Chronic inflammation of the bronchi, resulting in mucus hypersecretion and goblet cell hypertrophy, chronic cough, and airway narrowing.
Emphysema
Destruction of alveolar walls, leading to loss of elastic recoil and impaired gas exchange.
