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Respiratory Clinical Asthma – inflammatory disorder that produces narrowing of the airways. Attacks are a result of smooth muscle spasms on the bronchi or bronchioles causing them to narrow or close. Triggers: (hyperactive response to): allergen ie dust, pollen, mold, foods. Emotions, aspirin, sulfites (in wine, beer,), exercise, cold air, smoke. Symptoms: Coughing, difficulty breathing, wheezing, trouble inhaling or exhaling. Acute: (Early) – smooth muscle spasms, excessive mucus secretion that clogs airways. Chronic: (late) – inflammation, fibrosis, edema, and necrosis of epithelium Meds: Prostagladins and histamines ie corticosteroids or epinephrine Emphysema –(Blow Up or Full of Air) alveolar walls disintegrate producing abnormally large air spaces that remain filled during expiration. Creates less surface area for oxygen diffusion, blood oxygen level lowers, exercise leaves the patient breathless. Patient has reduced volume during forced expiration. They have to work voluntarily to exhale! Extra work gives patient a “barrel Chest” over the years. Causes: Long term irritation – smoke, air pollution, industrial dust Bronchogenic Carcinoma: (lung Cancer) – Very common. Starts in the walls of the bronchi due to the constant irritation of smoke and pollutants causes the goblet cells to enlarge. The response is excess secretion of mucus. The basal cells response by increasing cellular division pushing the new cells into the spaces of the goblet cells. Mucus is further increases and no longer is carried to the throat clogging the bronchial tubes. The person develops a smoker’s cough. Still smoke – Slowly destroys the alveoli and the replacement of inelastic connective tissue. Mucus now gets trapped in the air sac. Millions of sacs rupture reducing the diffusion and the person now has emphysema. Still Smoke: Basal cells continue to divide. Columnar cells and goblet cells disappear and are replaced by stratified squamous epithelia Cancer cells. Rapid growth spreads throughout the lungs. Treatment – removal of the diseased lung. However, metastasis (spreading) through the lymphatic and circulatory system may result causing new growth in other parts of the body like the brain or liver. Lung cancer can be caused by cancer in other locations – breast, stomach, prostate since it can metastases to the lungs. Radon gas – lung cancer in non-smokers Asbestos – lung cancer Pneumonia – acute infection or inflammation of the alveoli. It is the most common infectious cause of death in the US. The alveolar sacs fill with fluid and dead white blood cells. Oxygen diffusion decreases, carbon dioxide levels remain normal in the blood since CO2 diffuses better than o2 The most common cause ( Streotocaccus) Tuberculosis – Caused by the bacterium Mycobacterium tuberculosis. It often affects the lungs and pleurae. The destroyed lung tissue is replaced by fibrous connective tissue. It becomes thick and inelastic. Spread by inhalation. Carbon Monoxide Poisoning: colorless gas found in exhaust of cars and tobacco smoke. It combines with Hb 200 time faster and stronger than oxygen. If the air is 0.1 percent CO it will combine with 1/2 of al the Hb in the blood. O2 capacity drops by 1/2 – leads to hypoxia, Treatment is pure O2 which will slow the spread of CO to the Hb.