Respiratory Health and Disease

Compare the structure of a bronchus to a bronchiole
Bronchus- from trachea to bronchiole, contains cartilage and smooth muscle
Bronchiole- No cartilage, smooth muscle
Describe respiratory mucosa
mucosa moisten air to prevent dehydration of lungs and trap incoming foreign particles with help of hair
Describe the mucociliary escalator and its action with smoking
The celia moves the mucous with anything that gets stuck in there
Mucociliary escalator – debris removal
What is the effect of smoking on respiratory cilia?
It destroys the celia in the airway
It paralyzes them
Smoking a single cigarette has an effect on cilia for how long? What chemical in tobacco smoke destroys ciliated respiratory cells?
c. When you inhale smoke, dust, etc your cells get irritated and they change from a thin layer of cells to a thicker layer of cells.
d. They change the squamous cells, then they keep changing.
e. Once you stop smoking, it goes back to normal.
f. A smoker who has stopped smoking for ten years has a slightly higher risk than a nonsmoker
Discuss the function of the alveoli
1. Reduces surface tension
2. If we didn’t have it, the walls of the “air sacks” would stick together
Explain what occurs during ventilation. What causes air to move in and out of the lungs?
When you breathe in, or inhale, your diaphragm contracts (tightens) and moves downward. This increases the space in your chest cavity, into which your lungs expand. The intercostal muscles between your ribs also help enlarge the chest cavity. They contract to pull your rib cage both upward and outward when you inhale.
What is the greatest single preventable cause of disease, disability and death in our society?
early detection
What causes newborn respiratory distress syndrome?
Because they don’t have the surfactant, the alveoli stick together and they can’t stay inflated, therefore not getting oxygenated enough.
What is chronic obstructive pulmonary disease (COPD)?
is one of the most common lung diseases. It makes it difficult to breathe. There are two main forms of COPD: Chronic bronchitis, which involves a long-term cough with mucus; Emphysema, which involves destruction of the lungs over time
Define asthma
a reversible episodic disorder, caused inflammatory process leading to hyperactive airways where bronchostriction closes off the airways
Describe the pathology that occurs with asthma
proliferation/hyperplasia of synovial membrane and increased vascularity –> formation of pannus and presence of inflammatory cells –> pannus invades cartilage and bone leading to erosion and destruction of joint
What are the causes of asthma?
-Allergic reaction to airborne allergens
-Intense constriction of bronchial muscles (bronchospasm)
-Airway inflammation
-Exposure to extrinsic antigen
-Genetic pre-dispositions
-Non-immune mechanisms
-Lung infections – cold or flu
-Cold weather
What is the cause of death in asthma?
-Possible death due to suffocation
-5000 people per year in US
-Lungs plugged with mucus – can’t exhale
Define chronic bronchitis
Inflammation of the mucous membrane of the bronchi
What are symptoms of chronic bronchitis?
SOB or dyspnea, restlessness, fatigue, anxious, impaired coordination, paniac and facial expressions. Breathing muscles, gasping, wheezing, mental changes, changes in skin color, mucous membranes and cyanosis.
What are the causes of chronic bronchitis? Which is the greatest?
1. Cigarette smoking
2. atmospheric pollution
3. bacterial / viral infections
4. genetics
Define emphysema
Emphysema is a destructive disease of the lung in which the alveoli (small sacs) that promote oxygen exchange between the air and the bloodstream are destroyed.
What are symptoms of emphysema?
Main symptom: shortness of breath
-Gasping for breath
Describe the pathology that occurs with emphysema
Emphysema changes the anatomy of the lung in several important ways. This is due to in part to the destruction of lung tissue around smaller airways. This tissue normally holds these small airways, called bronchioles, open, allowing air to leave the lungs on exhalation. When this tissue is damaged, these airways collapse, making it difficult for the lungs to empty and the air (gases) becomes trapped in the alveoli.
What is the main cause of emphysema?
is long-term regular smoking
What is silicosis? What causes it?
most common chronic occupational disease in the world
-Coal dust (black lung disease)
-Farmer’s lung (moldy hay)
-Breathing in sand
-type of chronic restrictive disorder
What is the term for an inflammation of the lung in which fluid accumulates in the alveoli?
What is the main cause of lung cancer?
90% of cases are caused by smoking, therefore are preventable
Exposure to what other environmental factors causes lung cancer?
tobacco (or any smoke)
Uranium (occupational
Ionizing radiation
What is the screening recommendation for lung cancer?
No organization recommends routine screening for lung cancer because it does not affect the outcome
What is the term for a cancer of the pleura of the lung?
What causes this cancer?
100% due to asbestos exposure
What 2 effects of nicotine have caused tobacco to be popular for thousands of years?
1 pack per day = 1 cup of tars deposited in lung per year
-Nicotine is a Stimulant (adrenaline) and has a Opiate effect (endorphins)
Define cigarette. How many are in one pack?
Tobacco rolled in paper, 20 in a pack
What is the effect of filtered cigarettes?
-Filters are air holes that dilute smoke, not folter it
-less nicotine with each inhale (drag)
-Need to smoke more for same nicotine
-Tend to inhale deeper – cancer deeper in lungs
Define cigar
tobacco rolled in tobacco leaf
The smoke in one cigar is equal to how many cigarettes?
1 pack of cigarets
What types of cancer occurs most with cigar smoking? why?
Typically more oral and pharynx cancer than lung, and unlit cigars still cause cancer.
They are typically not inhaled
Pathophysiology of tobacco use: what are the three ways tobacco products can cause disease in the body?
Direct contact with mucosa – Smoking (mouth, throat, lung)
Dissolves in saliva – Smoke, Smokeless (cigar/snuff)
Absorbed through Lung alveoli – Bloodstream (kidney, bladder, pancreas)
Poisonous alkaloid found in tobacco plant (children can overdose)
Used as a stimulant/Insecticide. Not a carcinogen or teratogen.
All particulate matter except water and nicotine
Gases. Name 4 main gases in tobacco smoke. What are the effects of gases on the tissues and cilia?
Carbon Monoxide
Hydrogen Cyanide
Cilia toxins and decreases oxygen to tissues, interferes with oxygen absorbtion
What occurs to the lung damage when someone stops smoking? the risk of lung cancer?
-When you quit smoking, the inflammation in the airways goes down. The little hair-like projections in the airways that we call cilia — which are paralyzed by smoke — begin to work again. So the lungs will get better in weeks to months. Breathing will get better. Exercise capacity will get better. Paradoxically, people find that they cough a little more right after they stop smoking, but that’s natural. That’s the lungs cleaning themselves out.
-we calculate that the risk for lung cancer probably returns to that of a nonsmoker somewhere between 10 and 15 years after smoking cessation
-If people have a lot of pack-years, the risk of, say, lung cancer never goes back down to [the risk of a non-smoker]
What is the principle psychoactive ingredient in weed? is it a carcinogen? teratogen?
THC – Tetrahydrocannibinol-Not carcinogenic
In small to moderate doses, weed produces the feeling of __
well-being and euphoria.
In large doses weed can produce __
Hallucinations and parinoia
What is the long term effect of week smoke on the lungs?
Chronic use: Twice the damage to lungs as tobacco smoke. 20 year old has lungs of 40 year old. 3 times more tars deposited. And users usually inhale more deeply and hold their breath longer.
How does this compare to cigarette smoking?
3 times more. If you have equal doses of tobacco smoke and marijuana smoke, it’s twice as damaging.
What does the FDA say are the medical risks of smoking weed?
Show dysplasia growth of epithelial cells in their lung tissue, which coud lead to cancer, however a recent case-controlled study found no positive associations between marijuana use and lung, upper respiratory, or upper digestive tract cancers. Unsubstantiated.
What are the effects of weed on male and female reproductive systems?
Males who smoke often have lower levels of the sex hormone testosterone and produce fewer sperm than nonusers. Don’t know much about women, but it interferes with ovulation in female monkeys and doctors report menstrual problems and reproductive irregularities in women who smoke MJ.

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