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1

Types of respiratory diseases:

-Obstructive
-restrictive
-Infection and inflammation

2

What happens in obstructive diseases?

-Airway resistance is increased
-due to narrowing of the airways
-outflow pressure is reduced
-due to loss of elastic recoil?

3

What is airway resistance

the ease with which air can flow into and out of the lungs

4

What is outflow pressure?

The rate at which we can exhale

5

What effects do restrictive diseases have?

Reduced compliance
- loss of elasticity
-reduced vital capacity

6

What is compliance

The extent to which our lungs increase in volume in response to a given pressure change

7

How do we measure airway resistance?

Using FEV1 (the forced expiratory volume in the 1st second) - taken as a percentage of the total vital capacity

8

What is a normal FEV1

80% of vital capacity

9

What do we use FEV1 for?

-measuring airway resistance
-diagnosing airway resistance
-monitoring it

10

Name the obstructive pulmonary diseases:

-Bronchitis (acute and chronic)
-emphysaema
-asthma

11

what happens in chronic obstructive pulmonary disease:

-covers emphysaema and chronic bronchitis
-narrowing of the airways --> increased airway resistance
-mucus build up
-loss of elastic recoil --> reduced outflow pressure and gas exchange
-over inflation of the chest coz of increased residual volume

12

What kind of respiratory tract diseases can you get?

upper and lower
-upper is more common and easier to treat
-lower is more severe so more intense treatment

13

How many people die annually from COPD?

3 million
-3rd leading cause of death in the world

14

Acute Bronchitis:

-your standard phlegmy cough
-caused by bacteria or virus
-lasts for days or weeks

15

Chronic bronchitis: what happens

-irritants cause inflammation of the bronchi
-bronchi narrow
-over production of mucus
-airways become plugged
-airways become more prone to infection causing inflammation

16

Chronic bronchitis: causes

80% smoking, sometimes environmental irritants

17

Chronic bronchitis: treatments

-stop smoking
-bronchodilators (can be preventative) open up airways to aid airflow
-antibiotics to treat underlying infection

18

Chronic bronchitis: symptoms

-shortness of breath
-airway obstruction
-wheezing due to turbulent airflow
-chest pain - over exertion of muscles in breathing (not quiet breathing anymore, accessory muscles used)
-productive cough - can look for bacteria present in mucus of cough

19

Chronic bronchitis: lasts for

3 consecutive months in 2 years

20

Emphysaema: causes

smoking or an alpha1 trypsin deficiency (2% of COPD patients)
20% of smokers will develop emphyseama

21

Emphysaema: treatments

-stop smoking
-alpha1 antitrypsin supplements
-O2 supplement
-lung transplant

22

Emphysaema: what happens

-irritants in smoke cause neutrophils and macrophages to release elastase
-elastase breaks down alveolar walls reducing surface area
-significantly high compliance
-increased residual volume and FRC because damaged alveoli retain air
-chronically over inflated lung
-reduced vital capacity
-inefficient gas exchange
-Hyperventilation because of excess CO2 in lungs (to get rid)
(-alpha1 antitrypsin inhibits elastase action)

23

Emphysaema: symptoms

-hyperventilation
-inflated chest
-shortness of breath
-muscle wastage due to inefficient gas exchange and hyperventilation

24

what does high compliance indicate?

loss of elastic recoil

25

Asthma: Symptoms

-bronchoconstriction
-over production of mucus
-oedema (collection of mucus in cavities)
both cause increased airway resistance

26

Asthma: Treatments

Bronchodilators:
-relievers
-act immediately e.g. salbutamol
-preventors
-take two weeks to effect
-contain steroids
-dull down mast cell response
Anti-inflammatories:
Given in an asthma attack to re-inflate the airways

27

Asthma: Mechanisms

-mast cells stimulated by allergen
-release histamine and other cytokines
-bronchoconstriction
-mucus production
-oedema
-smooth muscle contraction narrowing airways

28

Asthma: Causes

-hypersensitive reaction to allergens
-exercise and cold air
-genetics
-stress
-air pollution

29

Name the restrictive diseases:

-fibrosis
-respiratory distress syndrome (IRDS, ARDS, SARS)

30

Acute Fibrosis: causes

-severe trauma or infection