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1 PY1000 > Case study 2 (asthma) > Flashcards

Case study 2 (asthma) Flashcards

1
Q

Describe asthma

A

Chronic inflammatory airway disease

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2
Q

What happens to the airways of people who suffer from asthma

A

Hyperactive airways respond to various stimuli by widespread inflammation
Muscles around the airways tighten, making airways narrower
The airway lining also becomes inflamed, causing a build-up of sputum
Airways become even narrower
Airflow to lungs is restricted

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3
Q

Describe how an asthma airway would look during an attack

A

Tightened muscle around the airway

Inflammation and increased sputum leads to a narrowed passageway

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4
Q

Name some symptoms of asthma

A

Coughing
Dyspnoea (difficulty breathing)
Wheeze
Chest tightness

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5
Q

What are some triggers of asthma

A 
Pollen
Pollution
Cold weather
Smoking
Irritants (animal hair)
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6
Q

Name 2 types of asthma

A

Exercise-induced asthma

Allergy-induced asthma

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7
Q

Describe the structure of the airways

A 
Upper Respiratory Tract
•Nose (mouth)
•Pharynx
•Larynx
Lower Respiratory Tract
•Trachea
•Bronchi
•Bronchioles
•Alveoli
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8
Q

Name the role of the nose in the respiratory tract

A

Warms, humidifies and filters air (cilia)

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9
Q

Describe the role of the trachea in the lower respiratory tract

A
  • Trachea “windpipe” descends from the larynx into the thorax
  • Walls contains C-shaped rings of cartilage supporting the anterior and lateral aspects
  • Cartilage helps to prevent tracheal collapse during pressure changes
  • Trachea bifurcates (splits) at the carina
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10
Q

Where does the bronchi begin?

A

•Trachea bifurcates at the carina into the R and L main (primary) bronchi

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11
Q

Where does gaseous exchange occur?

A

Alveoli

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12
Q

How do the respiratory bronchioles join to the alveolar sac

A

Respiratory bronchioles joined to alveolar sac via alveolar duct

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13
Q

What is the thoracic cage comprised of?

A
  • Ribs
  • Sternum
  • Thoracic vertebra
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14
Q

Describe typical ribs

A
  • Pairs 2-9
  • Curved bone
  • Posterior end has a head which articulates with 2 vertebral bodies
  • Anterior end continuous with costal cartilage which articulates with sternum
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15
Q

Describe atypical ribs

A
  • Rib 1
  • Flat in the horizontal plane
  • Broad superior and inferior surfaces
  • Articulates with the body of T1 (thoracic vertebrae) only
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16
Q

What are the 3 elements of the sternum?

A

3 elements:
•Manubrium
•Body
•Xiphoid process

17
Q

What muscles work during inspiration?

A
  • Diaphragm

* External intercostals

18
Q

What muscles work during active expiration?

A
  • Internal intercostals
  • Rectus abdominis
  • Transversus abdominis
  • Internal and external obliques
19
Q

Are expiration and inspiration active or passive?

A

•Inspiration is an active process requiring energy •Expiration is largely a passive process, but we occasionally actively expire too

20
Q

Describe how inspiration occurs

A
  • Controlled by autonomic nerve impulses from the respiratory centre in the medulla oblongata in the brainstem
  • Nerve stimulation causes contraction of the diaphragm and the external intercostals this expands the thoracic cage and lungs
  • Expansion creates a lower pressure relative to the outside of the body
  • Air rushes in
21
Q

Describe how relaxed expiration occurs

A
  • Expiration is normally a passive process (i.e. requires no energy)
  • Brought about by relaxation of the diaphragm and external intercostal muscles
  • This allows for the elastic recoil of the lung tissue
22
Q

Describe how forced expiration occurs

A
  • Contraction of the abdominal muscles causes the abdominal contents to push up against the diaphragm – reduces the vertical diameter of the thorax
  • Contraction of the internal intercostals depress the ribs and decrease space in the thorax
23
Q

Where does the control of breathing occur?

A

respiratory control centres in the brainstem

24
Q

Name the movement of gas for the movement of air from the atmosphere to alveoli

A

Bulk flow

•Occurs due to a pressure difference during inspiration in alveoli (lower) compared to the atmosphere (higher)

25
Q

What is partial pressure measured in?

A

Partial pressures are measured in kilopascals (kPa) or millimetres of mercury (mmHg)

26
Q

Where does gaseous exchange occur at the lungs?

A

Occurs at the respiratory membrane

- the alveolar air space and the blood capillaries

27
Q

What characteristics of the respiratory membrane make it ideal for gaseous exchange

A
  • Large surface area provided by the large number of lung alveoli
  • Very thin membrane so small depth for diffusion (1-2000ths of a millimetre)
28
Q

Name the channels that can be used to bypass the normal route of airways to the alveoli

A 
Channels of Martin
 - Bronchiole-bronchiole
Canals of Lambert
 - Bronchiole-alveolar
Pores of Kohn
 - Alveolar-alveolar

Collateral ventilation

29
Q

What is the role of the mucociliary transport system?

A

provides the means for drainage of secretory products and particulate matter out of the sinuses.

30
Q

What type of muscle lines the airways

A

Airway smooth muscle spans from the trachea to bronchioles

31
Q

What nervous system is responsible for controlling the airways and how do the nerves act?

A

Parasympathetic nervous system

The parasympathetic nerves are autonomic (involunatry)

32
Q

What type of inhaler would you recommend, how does it help and when do you use it?

A

Reliever inhaler (blue)

  • relax the muscles around the airways
  • airways open wider and easier to breath
  • short-acting
  • use the inhaler as soon as you notice the symptoms
33
Q

What tips for breathing would a physio recommend and why?

A
  • breathe slowly through the nose, not the mouth
  • keeps the air warm and moist
  • less sensitive to airways
34
Q

What exercise would you recommend and what are the benefits?

A

Walking, yoga, and swimming. Low impact aerobic exercises, preferably inside to avoid cold air

  • raises HR, increases lung power and stamina, reducing breathlessness
  • supports the immune system, helping to fight cold and viruses
  • reduces stress by releasing endorphins.
35
Q

What are some risk factors that increase your chance of asthma?

A
  • family history
  • exposure to tobacco smoke as a child
  • mother smoking during pregnancy
  • bronchiolitis (childhood lung infection)
36
Q

What complications can asthma have on daily living?

A
  • feel tired all the time
  • stress, anxiety, depression
  • lung infections
  • delays in growth
  • severe asthma attacks can be life-threatening
37
Q

How can steroid tablets help asthma sufferers?

A

Taken either as:
- immediate treatment when you have an attack
OR
- used every day as a long-term treatment to prevent symptoms

38
Q

What surgery can be provided and for whom?

A

Bronchial thermoplasty

  • thin, flexible tube placed down throat, into the lungs
  • heat applied to airway walls, which reduces the excess smooth muscle tissue
  • allows airways to open wider
  • offered for severe asthma sufferers

1 PY1000 (17 decks)

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