1. Disorders and Conditions of the Respiratory System

2. Respiratory Diseases
All respiratory diseases and conditions result in insufficient oxygen available to the tissues of the body.
Smoke from cigarette and other tobacco sources is the primary cause of lung disease in Canada

3. Pneumothorax = a collapsed lung
Remember, the pleural membranes surround the lungs. One is connected to the outside of the lungs, and the other is connected to the rib cage.
If lung is punctured, the lung will deflate and air will get into the pleural cavity (the space between the membranes), causing the membranes to separate from each other.

4. Painful; results in difficulty in breathing
This means that even if the respiratory center in the brain moves the rib cage up to inflate the lungs, the lung won’t be able inflate because it is no longer attached to the other membrane or the rib cage.
Painful; results in difficulty in breathing
Small, non-serious cases can resolve themselves.
In more serious cases, a one way chest tube is inserted to allow air to escape the pleural cavity.

6. Asthma
A chronic, long term inflammation of the lining of the bronchi and bronchioles
Inflammation (swelling) is a protective reaction to eliminate foreign substances; also causes overproduction of mucus

8. The swelling and overproduction of mucus reduces airflow into the lungs.
In many cases, the muscles surrounding the bronchi and bronchioles contract to further narrow the passage.
Symptoms: coughing, wheezing, tightness in chest, shortness in breath

9. Asthma Attack
The sudden worsening of these symptoms is an asthma attack
Triggers: smoke, dust, cold air, physical exertion, allergens (pollution, pollen, dust mites, animal dander)
10% for Canadians suffer from asthma

10. Treatments Avoid the triggers (though sometimes impossible)
Medications: work by dilating the bronchi and bronchioles to increase airflow

11. Allergies
(Really related to the immune system and immune response)
Allergens are non parasitic foreign substances that illicit an immune response.
If they are airborne allergens, they enter the body through the respiratory tract and can cause discomfort
Symptoms: inflammation of airways and increased mucus production – both which restrict airflow to lungs.
Also, increased sneezing as a mechanism to remove allergens from body.

12. Chronic Obstructive Pulmonary Disease (COPD)
Long-term respiratory disease that is a combination of 2 diseases: bronchitis and emphysema
BRONCHITIS: irritation and inflammation of the airways
Swelling and mucus overproduction, restricting airflow.
Similar to asthma

13. EMPHYSEMA: permanent damage to the walls between the alveoli causing them to break
This causes the alveolar size to increase
Results in a reduced alveolar surface area for gas exchange
Therefore, less oxygen enters the blood, and carbon dioxide levels in blood increase
The body responds by increasing breathing rate to maintain appropriate gas levels

14. The black spots are the areas where the alveoli are damaged

16. CAUSES of Emphysema
Cigarette smoke (the cause of 80%-90% of all cases!)
Prolonged exposure to:
Air Pollution
Dust (including coal and silica)
Fumes
Genetic disorders
A deficiency in the enzyme alpha-1 –antitrypsin can cause emphysema.

17. Alpha-1 –antitrypsin (A1AT)
Remember there are phagocytes present inside the alveoli to prevent lung infections by engulfing foreign invaders.
They produce the enzyme elastase (a type of protease) that will kill bacteria.
Elastase breaks down lung tissue and degrades the elasticity of the lung
Alpha-1-antitrypsin blocks the activity of elastase
Smoking increases the number of phagocytes in the lung which means more elastase.

18. COPD continued…..
SYMPTOMS: coughing, wheezing, chest tightness, and shortness of breath
TREATMENTS: no cure.
Damage to alveoli is permanent and usually worsens
Medications (to increase airflow) and lifestyle changes can help alleviate the symptoms.
Oxygen therapy
Lung transplants for extreme cases
1.5 million Canadians have COPD; estimated 1.6 million remain undiagnosed

20. Respiratory Infections
Caused by viruses and airborne microorganisms such as bacteria and fungi
The respiratory system is extremely vulnerable to foreign invades because of its constant exposure to the external environment
Mucus and cilia protect airways, however, some can still enter

21. Cystic Fibrosis
A genetic disorder in which the gene that controls mucus production is defective.
A person with CF produces unusually thick and sticky mucus that clogs the airways, reducing airflow.
SYMPTOMS: persistent cough, excess mucus
Individuals are more susceptible to lung infections

22. TREATMENTS: clearing excess mucus from the lungs and lung transplants
CF also affects the digestive system
Thick secretions of mucus in the pancreas prevent it from producing insulin (which can cause diabetes)

24. Effects of Smoking
Smoking is the single greatest cause of respiratory disease and preventable deaths in the developed world
It’s known to cause:
Lung cancer
COPD
Bronchitis
Emphysema
Asthma
Linked to diseases of circulatory system (heart attacks)

25. Cigarettes and cigarette smoke contain 3 problem substances:
nicotine
Carbon monoxide
Tar

26. Nicotine
A natural insecticide; produced by tobacco plants to kill insects
Addictive: promotes the brain to produce dopamine and endorphins which are chemicals that act as natural pain killers
Effect lasts 40 minutes
The need for further positive feelings leads to continued smoking and addiction
Nicotine also blocks other chemicals that allow the brain to communicate with the body.

27. Carbon Monoxide
Affects the ability of the respiratory system to deliver oxygen to the body cells
Carbon monoxide “looks similar” to oxygen gas
Hemoglobin has a greater tendency to bond to CO than O2
So if CO is present, hemoglobin picks it up instead of O2, reducing the amount of O2 delivered to the cells
Remember, no O2 means no cellular respiration, which means no ATP energy for the cells!

28. Tar Black, sticky substance that accumulates in the alveoli
Prevents exchange of gases
Tar in cigarettes is made of hundreds of difficult chemicals, many of which are toxic and some of which are carcinogenic (cause cancer)
Some irritate the airways causing inflammation and increases mucus production
Can damage cilia – leading to asthma attacks and emphysema

29. Lung Cancer
Carcinogenic chemicals (such as those found in cigarettes) can cause mutations in genetic material that controls the growth of cells
Cancer results when the damaged cells grow and reproduce too quickly and form a tumor
Cancer can originate in the lungs but can also spread to other parts of the body. Likewise, it could have originated somewhere else.
Cancer can cause blockages, interferes with normal, function, and reduces surface areas for gas exchange

30. Causes of Lung Cancer Lung cancer is the most common cancer
Causes (see page )
87%: smoking
3%: 2nd hand smoke
5%: air pollution (diesel exhaust fumes, coal smoke)
Radon gas exposure
Dust from asbestos, silica, and other solids
Read p316 on Epidemiology

31. Lung Transplants and Other Technologies
Many years ago, lung disease such as COPD and CF were automatically considered fatal
Advancements in medical knowledge, technologies and drug and surgical treatments have changed our understanding of respiratory illnesses and have saved lives

32. FLAP Inhibitors
Many of the disorders we discussed caused the inflammation of the airways, which reduces airflow and respiratory function.
FLAP is a protein released by the immune system that is involved in the inflammation.
FLAP inhibitors are drugs that bind to the FLAP protein preventing inflammation.
These drugs can be used to treat asthma, COPD, etc.

33. Bronchial Thermoplasty
During an asthma attack, the muscles of the bronchioles contract and decrease the diameter of the airways, restricting airflow
Bronchial thermoplasty is a procedure that reduces the thickness of the muscles surrounding the bronchioles resulting in less constriction during an attack.

34. Artificial Lungs
iLA Membrane Ventilator – a temporary artificial lung system
Basically filters CO2 from blood, and adds O2
Connects to the body through femoral (thigh) blood vessels
The blood flows over the membrane and CO2 diffuses into the hollow tubes and O2 diffuses out (and into blood)

35. Lung Transplants
Replacing one or both diseased lungs with health lungs from a donor
Used in serious conditions in which disorders cannot be controlled
The donor’s blood and tissue type bust be a close match to the recipient for a successful transplant.
If they do not match, the recipient’s immune system will reject the transplanted organ.

36. Recipients take immunosuppressive drugs to reduce the rejection response
These drugs will prevent the body from rejecting the transplant however, they suppress the entire immune system making the patient much more susceptible to infections