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Lecture

respiratory disorders 1.docx

6 Pages
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School
UOIT
Department
Health Science
Course Code
HLSC 2461U
Professor
Otto Sanchez

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Respiratory Disorders 1 Clinical Manifestations of Respiratory Disorders 1. Cough (Dry or Productive) Hemoptysis: coughing up blood, related with cancer, angiogenic response, also caused by chronic inflammation (TB), caused by increased angiogenesis 2. Dyspnea: shortness of breath, constricted airways, anemia (nothing to do with airways), gas exchange Orthopnea: positional dyspnea, worse when you lay down (right heart failure) 3. Cyanosis: central & peripheral central: caused by something central such as the heart, blue everywhere peripheral: tips of fingers are blue (vascular reactions) Clubbing: tips of fingers are round, happens with chronic hypercapnia (smoking, CO2) 4. Pain: pleuritic pain, lungs don’t have pain receptors but pleuritic cavity has nociciceptors, worse pain as you breathe because the visceral and pleura are rubbing together 5. Cheyne-Stokes: altering of rhythm and pattern of breathing, neuro problem of the brain stem Upper Airway Sinusitis  inflammation of the paranasal sinuses  paranasal sinuses are connected with the nose  2 maxillary, 2 frontal, 1 sphenoid, 2 ethemoid  sinuses are covered with respiratory epithelium (cilia)  sinuses communicate with the nose through ducts  these ducts can become blocked with mucus and this alters communication  inflamed sinuses causes mucus to increase and accumulate (chronic or acute)  breeding ground for bacteria  commonly viral and when it doesn’t resolve quickly it becomes bacterial Upper Airway Alterations in Children * all 3 result in dyspnea 1. Epiglottitis: inflammation of the epiglottis, can block larynx when we eatneed for intubation 2. Croup: acute inflammation of the airways (larynx and trachea), complication of viral infections, acute obstruction  treat fast! 3. Bronchiolitis: inflammation of the bronchioles, inflammation causes constriction/contraction of the smooth muscle, closing because there is no cartilage to prevent the closing of the lumen, looks like asthma (wheezing and cyanosis)  act quickly as it affects all bronchioles  RSV produces severe bronchiolitis  all upper airway disorders, inflammation and edema produce obstruction  increased resistance to airflow  increased intrathoracic negative pressure  expiration is more passive because the air is stuck in the lungs  upper airway collapse = respiratory failure! Airway Disorders Bronchiectasis  ectasis: increase in the diameter of something  this is dilation of the bronchi which is permanent and is due to something structural/anatomical  happens in some segments of the bronchiole  results in turbulent airflow  mucus gets formed there and serves as a place for bacterial growth  makes the person more prone to frequent infections of the lungs/airways  productive cough  lung parenchyma is fine but the airways are dilated Bronchial Asthma  type 1 hypersensitivity reaction  airways in asthma look like this: increased production of mucus, asthma starts when a child is exposed to an allergen, mast cells and eosinophils are involved because of the iGE infection, mast cells in the airway degranulate releasing histamine and other cytokines, now the mucus is worse!!  mucus can cause obstruction  obstruction can also be caused by smooth muscle constriction because of mediators released from the mast cells  air will get trapped in the alveoli causing hyperinflation Sequence of Reaction  pollen in  binds to igE  mast cells degranulate  release histamine and other cytokines  induce mucus secretion  vasodilation (edema)  smooth muscle constriction causing wheezing  dramatic!!!  MAST cells release not only histamine but inflammatory cells (mediators) as well  Bronchospasm = inflammation Cystic Fibrosis  not as common as asthma  alteration in the lungs  congenital  lungs have cysts and look fibrotic (white) Why Do Cysts Form?  CFTR gene  gene normally encodes for chloride channels  gene mutation prevents the adequate functioning of chloride channels What Do Chloride Channels Do?  every exocrine gland needs a chloride channel  all glands in the airways of the lungs have CL channels (normally)  without them, the lungs CL would not be transported  CL binds to NA and attracts water 
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