Opp 2 Thompson - Flu

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SWINE FLU H1N1masks

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The effectiveness of respirators and facemasks in preventing transmission of novel H1N1 (or seasonal influenza) in various settings is not known. Use of a facemask or respirator (N95) is likely to be of most benefit if used correctly and consistently when exposed to an ill person.

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symptoms of seasonal flu and include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue.diarrhea and vomiting.

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SWINE FLU H1N1

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SWINE FLU H1N1 sympt

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symptoms of seasonal flu and include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue.diarrhea and vomiting.

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Avian Flu
mortality

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This represents a mortality of 59%.

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Initial symptoms include a high fever, usually with a temperature higher than 104 degrees F , and influenza-like respiratory symptoms. Diarrhea, vomiting, abdominal pain, chest pain, and bleeding from the nose and gums have also been reported as early symptoms in some patients. Watery diarrhea without blood and prolonged prodrome

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H5N1 avian influenza

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H5N1 avian influenza sympt

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Initial symptoms include a high fever, usually with a temperature higher than 104 degrees F , and influenza-like respiratory symptoms. Diarrhea, vomiting, abdominal pain, chest pain, and bleeding from the nose and gums have also been reported as early symptoms in some patients. Watery diarrhea without blood

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Difficulty in breathing develops around five days following the first symptoms. Respiratory distress, a hoarse voice, and a crackling sound when inhaling are commonly seen. Sputum production is variable and sometimes bloody. Almost all patients develop pneumonia.

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H5N1 avian influenza sympt

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respiratory failure three to five days after symptom onset. Another common feature is multiorgan dysfunction. Common laboratory abnormalities, include leucopenia (mainly lymphopenia), mild-to-moderate thrombocytopenia, elevated aminotransferases, and with some instances of disseminated intravascular coagulation

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H5N1 avian influenza

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Bird flu patients die from

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acute respiratory distress syndrome (ARDS) caused by the cytokine storm and its consequences, and not directly from the virus. Historic survival in ARDS is 60%-85%; with bird flu-associated ARDS it is 43%.

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H5N1 avian influenza TX

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Limited evidence suggests that some antiviral drugs, notably oseltamivir ( Tamiflu®), can reduce the duration of viral replication and improve prospects of survival, provided they are administered within 48 hours following symptom onset.

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Process of respiration-4 major events

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Ventilation
Gas exchange
Gas transport to and from body tissues
Regulation of breathing

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The quality of ventilation depends on the following

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Respiratory muscles and their associated structures (best for OMT)
Mechanical properties of the airways
Lung parechymal respiratory units

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Work associated with the Respiratory Effort

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Tissue resistance- force required to expand the lung tissue or parenchyma. Work of normal quiet breathing mainly involves overcoming this force.
Airway resistance-Not a factor in quiet breathing but the main force to overcome in heavy breathing. Increased by asthma, interstitial fluid, flu, etc...
Compliance (lack of Resistance)-the area we can improve the most with the use of OMT

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force required to expand the lung tissue or parenchyma. Work of normal quiet breathing mainly involves overcoming this force.

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Tissue resistance-

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Tissue resistance-

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force required to expand the lung tissue or parenchyma. Work of normal quiet breathing mainly involves overcoming this force.

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Airway resistance-

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Not a factor in quiet breathing but the main force to overcome in heavy breathing. Increased by asthma, interstitial fluid, flu, etc...

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Not a factor in quiet breathing but the main force to overcome in heavy breathing. Increased by asthma, interstitial fluid, flu, etc...

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Airway resistance-

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the area we can improve the most with the use of OMT

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Compliance (lack of Resistance)-

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Compliance (lack of Resistance)-

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the area we can improve the most with the use of OMT

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Compliance

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Definition-the change in volume resulting from a change in pressure. Increased compliance means a greater change in volume with the same amount of pressure.

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Definition-the change in volume resulting from a change in pressure. Increased compliance means a greater change in volume with the same amount of pressure.

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Compliance

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the insertion of the diaphragm

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on the central tendon

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there are three origins of the diaphragm

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sternal origin-from the xiphoid process
costal origin-ribs 7-12and their cartilages
vertebral origin-right crus -bodies of L1-L3 left crus-L1-L2

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motor innervation is via the phrenic nerve originating at

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C3,4,5

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Somatic dysfunctions of the “pump” have direct effects on the viscera

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decreased arterial supply
decreased venous drainage
decreased lymphatic drainage
decreased responsiveness of the respiratory mechanism to body demands (acid/base, oxygen demand, CO2 removal)
Neurologic control of autonomics

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Parasympathetic innervation.

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Vagus

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Sympathetic innervation

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Sympathetic chain ganglion (pre and post ganglionic)

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Respiratory Diaphragm

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Phrenic nerve
brain stem

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Vascular sympathetics to the diaphragm come from

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T1-T4

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Sympathetics to the lungs include

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T2-5

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Sympathetic innervation also supplies vasomotor fibers to the

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trachea, bronchi and pulmonary blood supply originating from middle, superior cervical, stellate and upper thoracic paravertebral chain ganglion.

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Parasympathetic innervation from the vagus to the bronchi and bronchioles are mainly

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secretory and bronchconstrictive.

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Increased sympathetic tone result in

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Results in Lung vasoconstriction, regional hyperinflation and increased secretion from up-regulated goblet cell production.
Decreases lymph flow through the Thoracic duct; its one way valves respond to sympathetic control.

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Increased sympathetic tone in heart result in

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Tachycardias
Vasoconstriction
Increases work-load

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Increased sympathetic tone in lung result in

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↑ goblet cells
Thick, tenacious mucous
Bronchodilation, vasoconstriction

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Increased parasympathetic tone in lung result in

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↑ ciliated epithelial cells
Clear, thin mucous
bronchoconstriction

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Increased parasympathetic tone in heart result in

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Bradycardias
Limited vasodilatation

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Anatomy of SNS on Heart

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- T 1-5
- R = SA node
- L = AV node
- Sympathetic chain ganglion

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Anatomy of SNS on Lung

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- T 2-5
- Upper thoracic sympathetic chain ganglion
- Ipsilateral

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Anatomy of PNS on Heart

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- Midbrain
- Vagus nerve
- R = SA node
- L = AV node

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Anatomy of PNS on Lung

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- Midbrain (medulla oblongata)
- Vagus nerve
Ipsilateral

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The sympathetic preganglionic neurons that contribute to the pulmonary plexus are located in the lateral horn of the spinal segments ___

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T2-T5 .

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B-adrenergic receptors are present on the glandular cells and on bronchial smooth muscle cells. Stimulation of the B-adrenergic, sympathetic nervous system leads

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to bronchial dilation and the release of a more viscous secretion.

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The primary source of parasympathetic innervations comes from the Vagus nerve (CN X). Stimulation of the parasympathetic fibers causes

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bronchioconstriction, hypersecretion of serous fluid, and vasodilation.