Secondhand Smoke Kills By Jordan, Lisa, Taylor,

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Secondhand Smoke KillsBy Jordan, Lisa, Taylor,
John
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This is Moe
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The Question

• Moe, a healthy 35 year old tavern owner
  experienced sudden stabbing pain in his right
  upper chest.
• He felt out of breath and both his respiratory
• rate and heart rate increased dramatically.
• An EKG, blood gas analysis, and a chest x-ray
  were
• ordered in the emergency room.
• The nurse noted that Moe had no previous medical
  history of cardiac or respiratory problems, but
  suffered chronic exposure to second hand smoke as
  a result of his occupation.
• Why did Moes x-ray show that his ribs were
  farther apart than normal?
• What is the problem with Moe?

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Our Diagnosis

• We believe the stabbing pain and inability to
  breathe could be a result of Pneumothorax.

Emphysema
Secondhand Smoke
Spontaneous Pneumothorax
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Secondhand Smoke Emphysema

• Causes release of enzyme Elastase by the cells
  of the immune system
• Elastase is released in order to destroy the
  irritants present in the lungs after inhaling
  smoke
• Elastase destroys Elastin, the elastic tissue
  that enables the alveoli to recoil and relax
  during expiration (exhalation)

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Emphysema

• Less Elastin decreased ability to contract
• Old air gets trapped taking up space
• Next breath starts with more air present
• Therefore alveoli cant get enough oxygen rich
  air to supply the body

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Spontaneous Pneumothoraxaka A Collapsed Lung

• Bleb A weakened section of the lung tissue that
  when ruptures expels air from the inside of the
  lung into the pleural cavity
• This air then breaks the fluid bond between the
  pleural membranes
• Chest wall expands, however elastic lung
  collapses as the negative air pressure can no
  longer be contained inside the lung

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Why are the ribs further apart?

• During normal passive exhalation the lungs are
  pulled back in by elastic recoil
• This in turn pulls in the ribs.
• After Pneumothorax
• Lungs not attached results in the ribs not being
  pulled in

Which lung collapsed?
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Why Did Heart Rate and Respiratory Rate
Increase???

• When the lung collapsed, there was a mismatch
  between ventilation and perfusion.
• The hypothalamus doesnt know what the stress is,
  except that its BIG and SCARY and that something
  needs to change immediately
• In an attempt to maintain homeostasis, heart rate
  and respiratory rate are both dramatically
  increased in hopes of lining the two up again.

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Analogy Normal Lung

• A latex balloon inflates then passively deflates
  using the elastic recoil to push out the air.

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Analogy Blebs and Lack of Elastic tissue and

• Emphysema
• Silly putty bubble expands with air, but due to
  lack of elasticity, it doesnt fully deflate so
  air gets trapped.
• Bleb causing Pneumothorax

Like Magic Balloon-the more you blow it up the
thinner the bubble gets and eventually can pop.
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Analogy Suction between Visceral and Parietal
Pleura

• Two window panels have a thin layer of water
  between them. The hydrogen bonds in the water
  hold the panels together.
• If you were to blow air in between the glass
  panels, the water would be displaced by air and
  the panels of glass would separate.
• (Parietal would remain
• with ribs, visceral on
• lung)

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How This Relates To Class

• Respiratory was discussed in lab!
• Gaseous exchange between blood and alveoli
• Pressure gradients
• Mismatch between ventilation and circulation
• Homeostasis

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References

• Barnoya, J., Glantz, S. A. (2005).
  Cardiovascular effects of secondhand smoke
  nearly as large a smoking. Journal of The
  American Heart Association, 111, 2684-2698.
• Kawachi, I., Colditz, G. A., Speizer, F. E.
  (1997). A prospective study of passive smoking
  and coronary heart disease, 95, 2374-2379.
• Silverthorn, D. U. (2009). Human Physiology An
  Integrated Approach, 4.
• http//Emysema.org/
• http//ehealthmd.com