RTH 112Pathophysiology of the Cardiopulmonary Systems - PowerPoint PPT Presentation
1 / 25
Title:
RTH 112Pathophysiology of the Cardiopulmonary Systems
Description:
Worries, but does nothing to fix. the problem, until afterwards... U. Are ... Inhalation of toxic gases 'SMOKING' is the most common. Inhalation of antigens ... – PowerPoint PPT presentation
Number of Views:72
Avg rating:3.0/5.0
Title: RTH 112Pathophysiology of the Cardiopulmonary Systems
1
RTH 112-Pathophysiology of the Cardiopulmonary
Systems
- Joseph S. DiPietro, Ph.D., RRT
- Professor and Director, Respiratory Care Programs
- Co-Director, Health Technologys Education
2
Pathophysiology
- The study of abnormal function and its
relationship to disease - In this course, our focus will be the
cardiopulmonary systems - Your text--Textbook of Pulmonary Disease, Baum
3
Your responsibilities
- Pre-read your assignments before class
- We only have 9 and 1/4 weeks to cover 15 weeks of
material - Key to this--your preparation
- This is an open forum classroom--if your are not
prepared, discussion with you will prove difficult
4
Your responsibilities
- Much of the presentation will also tie in things
youve already had, like physiology and physics
and chemistry - If you dont understand--
- ASK!!!!!!!!!!!!!!!
5
Dont act like this person...
Worries, but does nothing to fix the problem,
until afterwards...
6
U
Are ultimately responsible...for your grades
knowledge YOURSELF!!!
7
The Obstructive Lung Diseases
- Bronchitis
- Emphysema
- Asthma
8
Bronchitis
- Inflammation of the conducting zone airways
- Characterized by increased secretion production
- Considered chronic if...sputum production exists
for three consecutive weeks for two consecutive
months
9
Features
- PaO2s lt 50 torr
- PaCO2s gt 50 torr
- pH normal (usually just shy of 7.40)
- increased secretions
- Old nickname blue bloater
- R heart failure, or right CHF (cor pulmonale)
- polycythemia
- increased A-P diameter due to air trapping
- Decreased breath sounds w/air trapping rhonchi
10
Causes
- Inhalation of toxic gases
- SMOKING is the most common
- Inhalation of antigens
- Inhalation of viruses or bacteria
11
Emphysema
- In Greek, this word means swollen with air
- There are two primary types of this disease
- Panlobar, which affects the acinus or alveolar
groups-- usually a genetic predisposition due to
Alpha 1, antitrypsin deficiency - Centralobar, which affects respiratory
bronchioles--smoking is the cause
12
Features
- Increased A-P diameter
- Increased CO2s and decreased PO2s, late
- Old nickname pink puffer
- little or no secretions
- loss of gas surface area for diffusion
- skinny (the better term might be hyposthenic)
- Diminished breath sounds
13
Causes
- SMOKING
- Genetics
- Bronchitis
- Asthma
14
Pulmonary Function in Chronic Airways Obstruction
- Decreased expiratory flowrates such as the
FEF200-1200 and FEF25-75 as well as FEV1 - Increased residual volume, functional residual
capacity and total lung capacity - Decreased capacity of diffusion DLCO
15
Bronchitis v. Emphysema
- Easy to decompensate
- Usually relatively easy to treat
- Can cause emphysema
- Rarely are these patients ever having normal
blood gases
- Usually more difficult to decompensate
- Difficult to treat
- Can be caused by bronchitis
- Early, blood gases are normal
16
Gas Exchange is poor because
- Loss of alveolar structure base thereby causing
decreased gas exchange surface area - Mechanically, elastance is lost due to the
constant stretching of distal airways - Consequently, these patients are very compliant,
because the natural tendency for the lung to
collapse is inadvertently lost
17
Asthma
- Known too, as the disease of reversible airways
obstruction or reactive airways disease - More deaths were associated with asthma in
children in 1996 and 97 than in any time in
documented history - Commonly caused by the TYPE I Hypersensitivity
Reaction or the Mast Cell Reaction
18
Hypersensitivity Reactions
- TYPE I-- Mast cell degraulation resulting from
antigen attachment and release of allergic
mediators - TYPE II--antigen-antibody complex seen in
transfusion reactions - TYPE III-- ARTHUS REACTION or localized
antigen-antibody reactions such as hives - TYPE IV-- delayed hypersensitivity such as
pulmonary TB
19
In Extrinsic Asthma (caused by an external source)
- The antigen attaches to the Mast Cell causing an
antibody response (typically IgE) - The mast cell degranulates and releases allergic
mediators to remove the antigen
20
The Released Mediators
- Histamine---causing bronchoconstriction
- Bradykinin--causing vasodilation
- Leukotrienes--causing bronchconstriction and
vasodilation (Formerly known as SRS-A) - ECF-A--Eosinophilic Chemotactic Factor of
Anaphylaxis causing eosinophils to go to the
sight of reaction - PAF--Platelet Activating Factor causing
production migration of platelets to sight of
reaction - Thromboxanes--causing bronchoconstriction and
vasodilation
21
The Mast Cell Reaction---
- Is a natural response in all people
- But in asthmatics, it is greatly accelerated
- Hence, hypersensitivity
22
Asthma--the 2 types
- Extrinsic--caused by external sources such as
pollen, bacteria, viruses, mold spores - Instrinsic--caused by internal sources such as
infection, chronic disease, stress phenomena
23
Features
- Increased secretion production
- Bronchoconstriction
- WHEEZING
- prolonged expiration (increased ETime)
- air trapping
- initially, CO2s are decreased and so are PO2s
- Use of accessory muscles
- Breath sounds diminished crackles on insp.
- Increased A-P diameter barrelled chest
24
Asthma-Pulmonary Function
- Decreased expiratory flow rates
- Increased residual volume, functional residual
capacity, and total lung capacity - Decreased diffusion
- Increased work of breathing
25
Asthma-Rx
- Bronchodilators, parenteral and inhalants
- Adequate hydration
- In acute episodes, continuous bronchodilator
aerosols - steroids
- supplemental oxygen therapy
- if patient resistant to meds, this is known as
STATIS ASTHMATICUS, and if CO2s are at 40 torr
may need mechanical ventilation
Recommended
CrystalGraphics Presentations
