1. My lungs hurt!

    This summer I decided to actually try to learn harmonica properly and give it a good shot. I bought a blues harmonica book to help me on my journey to harmonica enlightenment :D

    Except the problem is I feel all out of breath after I play! The only other instrument I play is piano so i’m not used to this whole breathing malarky. I need bigger lungs!

    Its going  well though- I can actually play some blusey stuff now. I might record myself playing and post it up here if i’m brave enough :p

  2. Bronchial breathing vs vesicular breathing

    We had teaching at the hospital the other day and I heard bronchial breathing for the first time which was exciting. It sounds exactly like darth vader! Very cool

  3. Asthma

    Asthma has 5 defining characteristics

    • A chronic inflammatory disorder
    • Genetic link (tends to run in families)
    • Variable airflow obstruction
    • Airway hyperresponsiveness which is triggered by harmless stimuli
    • Obstruction is reversible with drugs e.g. salbutamol

    Triggers for asthma

    • Cold air
    • Excercise
    • Emotional distress
    • Chemicals e.g. nail varnish or some paints
    • Allergens- such as pollen, animal fur, dust mites
    • Drugs- NSAIDS (e.g. aspirin)and beta blockers

    Pathogenesis

    • Asthma is a chronic inflammatory process driven by the Th2 response
    • B cells become activated and IgE is produced
    • Macrophages release leukotrienes and prostaglandins. Leukotrienes cause smooth muscle contraction in the large airways and inflammation
    • Mast cells release inflammatory mediators e.g. histamine which also contributes to the inflammation
    • More goblet cells are found in the airways and there is an increased secretion of mucus. This along with the smooth muscle contraction causes the airways to narrow

    A mild to moderate asthma attack can lead to type 1 respiratory failure. In severe asthma attacks, type 2 respiratory failure can occur.

    Clinical features of asthma

    • Polyphonic wheeze during expiration ( the airways are more narrowed during expiration which causes the pronounced wheeze)
    • In severe asthma attacks, often there is no wheeze and the patient won’t be able to talk as no air is able to move
    • Cough due to excess mucus production- it is often worse at night
    • Prolonged expiratory phase

    Management for asthma

    • Steroids- reduce inflammation
    • B2 agonists which cause bronchodilation such as salbutamol
    • Atrovent nebulisers (anticholingergic drugs) are often given in conjuction with salbutamol for an acute asthma attack
    • Identifying triggers and avoiding them
    • Leukotriene receptor antagonists
  4. X ray of a pleural 
So a pleural effusion is any kind of excess fluid in the pleural space. A haemothorax is blood in the pleural space and an empyema is pus in the pleural space
On the X ray, you can see loss of the hemi-diaphragm
A homogenous dense opacity where the fluid is
The opacity is concave shaped at the top
Percussion: Apparently its meant to sound “stony dull” (I have no idea what stony dull is meant to sound like )
Ascultation: Diminished/ absent breath sounds
Causes of pleural effusion: Lots of things can cause a pleural effusion for example, heart failure, liver failure, malignancy, infection (e.g. pneumonia or TB) etc

    X ray of a pleural

    So a pleural effusion is any kind of excess fluid in the pleural space. A haemothorax is blood in the pleural space and an empyema is pus in the pleural space

    • On the X ray, you can see loss of the hemi-diaphragm
    • A homogenous dense opacity where the fluid is
    • The opacity is concave shaped at the top

    Percussion: Apparently its meant to sound “stony dull” (I have no idea what stony dull is meant to sound like )

    Ascultation: Diminished/ absent breath sounds

    Causes of pleural effusion: Lots of things can cause a pleural effusion for example, heart failure, liver failure, malignancy, infection (e.g. pneumonia or TB) etc

About me

Hello:) Thanks for stopping by to read my blog!
I'm 22, i'm from the UK and I'm a fourth year medical student currently doing an intercalated BSc in stroke medicine. Here you will find thoughts, things that make me smile and things relating to medicine that I find interesting/fascinating/ just plain awesome.

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