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Resp - Coggle Diagram

- - - - Aspirin
      - Beta blockers
  - - - Family history
    - - Hygeine hypothesis
        Reduced ealy exposure alters proportion of immune cells
  - - - Short term
        
        Bronchodialators
        
        Anticholinergics
        
        Short acting Beta-adrenoreceptor agonists SABA
      - Severe
        
        Long-acting Beta-adrenoreceptor agonists LABA
        
        Leukotriene antagonists
        
        Corticosteroids
      - Very severe
        
        IV corticosteroids
        
        Magnesium sulfate
        
        Oxygen therapy
- - - - Smoking
    - - Low FVC
      - Low FEV1
      - Low FEV1 / FVC ration
      - High TLC
    - - Exposure to irritants
      - Inflammatory reaction + influx of immune cells
      - Proteases (elastase, collagenase) degrade structural proteins in connective tissue
      - Reduced elastin and elasticity
      - Release of Leukotrien B4, IL-8, TNF-α, Proteases
      - Collapse of airways causing air trapping
      - Compliant airways expand to trap air
      - Septa break down
      - Reduced surface area for gas exchnage
    - - Centriacinar / Centrilobular Emphysema
        
        Seen with Smoking
        
        Proximal acinas
        
        Upper lobes of lungs affected
      - Panacinar Emphysema
        
        Entire acinar affected
        
        α1 antitrypsin deficiency
        
        Lack of protease inhibitor causes damage to lung tissue
        
        Lower lobes
      - Paraseptal Emphysema
        
        Distal Alveoli
        
        Periphery of lobes
        
        May rupture and cause pneumothorax
    - - Dyspnoea
      - Pink Puffers
      - Weight loss
      - Hypoxemia
      - Cough with some sputum
      - Barrel chest - hyperinflation of lungs
      - Xray shows
        
        Increased anterior - posterior diameter
        
        Inreased lung-field lucency
        
        Flattened diaphragm
      - Hypoxic vasconstriction - pulmonary hypertention
      - Cor pulmonale leading to right sided heart failure
    - - Reduce risk factors
  - - - Smoking
      - Exposure to air pollutons
      - Exposure to dust and Silica
      - Genetic factors
    - - Lowered FVC
        Forced vital capacity
      - Very reduced FEV1
      - Low FEW1 / FVC ratio
      - High TLC
        Total Lung Capacity
    - - Exposure to irritants / chemicals
      - Hypertrophy and hyperplasia of bronchial mucinous glands
      - Increased mucous production
      - Airway obstruction
      - Air trapping
    - - Ratio of Thickness of Glands / Thickness of Wall
      - 40% in Bronchitis
        Due to hyperplasia / hypertrophy
      - Not used diagnostically
    - - Wheeze
        Narrowing of passageways
      - Crackles (Rales)
        Popping open of small airways
      - Hypoxemia
      - Hypercapnia
      - Cyanosis
        Hypercapnia
      - Blue Bloaters
      - Vasoconstriction - Pulmonary hypertension
      - Right sided hear failure
      - Causes
        
        Right sided heart failure
        Pulmonary hypertension
        
        Lung infections
        Mucous
      - Productive cough
    - - Reduce risk factors
      - Supplemental O2
      - Bronchodialators
      - Inhaled steroids
      - Antibiotics - 2ndary infx
  - - - In emphysema, the inner walls of the lungs' air sacs (alveoli) are damaged, causing them to eventually rupture. This creates one larger air space instead of many small ones and reduces the surface area available for gas exchange
    - - Chronic bronchitis is a type of chronic obstructive pulmonary disease (COPD) that is defined as a productive cough of more than 3 months occurring within a span of 2 years