1. Respiratory System Anatomy

6. Asthma

7. most common cause of chronic illness in children unusually sensitive and irritable conducting passageways often immediate hypersensitivity reaction to inspired antigen 2.4 x more likely in early preterm

8. Smoking and asthma Mother smoking during pregnancy 1.5 x Mother and grandmother smoking during pregnancy 2.6 x Grandmother smoking during pregnancy, mother smoke free Almost 2 x

9. Maternal Weight and Asthma Maternal BMI 35 or higher increases risk for child by 63% Obese mother increases risk by 41% Overweight mother increases risk by 18%

10. bronchial tree smooth muscle constriction oedema of walls of respiratory passages incr. mucous production Asthma - Signs

11. mucous transport slows, fluids accumulate - coughing and wheezing breathing difficulties –exhalation most affected Asthma - Signs

12. severe attacks reduce respiratory function periphery becomes oxygen starved can prove fatal severity of attack is inversely related to vitamin D level Asthma

13. Two initiators intrinsic extrinsic Asthma

14. Antigen? Lymphocyte Eosinophils Inflammatory chemicals Chronic wheeze Extreme irritability Other cells are stimulated to produce substances that strengthen the response of eosinophils Intrinsic Asthma Interleukin 5 and other substances that stimulate Severe inflammation TH1/TH2?

15. Extrinsic Asthma Eosinophil Allergen B cell TH 2 Mast cell Histamine and other substances Contraction of smooth muscle in airways Wheeze Interleukin 4 IgE Interleukin 5 and other substances that stimulate Inflammatory chemicals Mild inflammation of airways Mild irritability and some wheeze

16. chest tightness - acute immobilising attacks expiration becomes prolonged FEV 1 is decreased Asthma - Manifestations

18. residual volume increased fatigue Asthma - Manifestations

20. inspiratory reserve capacity and vital capacity decrease Asthma - Manifestations

22. cough less effective alveolar ventilation decreases ventilation - perfusion mismatch Asthma - Manifestations

23. Normal V/Q Alveolus Capillaries Respiratory Bronchiole

24. Normal V/Q Low V/Q Impaired ventilation

26. initially hypoxemia with hypocapnia hypoxemia and hypercapnia Asthma - Manifestations

27. preventive avoidance of bronchial irritants desensitisation stabilises mast cells Asthma - Treatment

28. during attack andrenergic drugs theophylline adrenocorticosteroid drugs Asthma - Treatment

29. Asthma