Cardio

11/22/99

 

Irritant receptors

• All conditions know to stimulate lung irritant receptors are shown to cause vagal reflex
• Bronchoconstriction
• Reduce irritation to the irritant receptors—job of chiropractor
• Increase in mucus production
• Asthma is mediated through the Vagus nerve
• Sympatheticotonia will release NE
• NE decreases the threshold of the irritant receptors (line the airways of the conducting and respiratory zone)—protect the lung tissue from invaders (cough receptors)
• NE directly stimulates—Pickar is investigating (w/grant from NIH)
• NE enhances the function of the structure
• Korr told us that is did but did not give a mechanism
• NE causes mast cells to degranulate which releases histamine which is a stimulant to irritant receptors
• Spinal relationship to the Vagus
• Osteopathic relationship has many correlations
• Nodose ganglion—Vagus ganglion
• Has cell bodies of the irritant receptors
• Only have to stimulate the cell body to get a response of the nerve
• First two cervical nerves transverse through the Nodose ganglion
• It is not known if they synapse in the ganglion though
• Jugular foramen where the Vagus exits
• Superior cervical ganglion of the sympathetics
• Both ganglions have numerous sympathetic cell bodies
• Post ganglionic nerve fibers
• Increase sympathetics will affect the Nodose ganglion

 

Allergies

• Antigen—something to which a person reacts
• Many different portals of entry
• Breath
• Skin
• Eat
• Immunoblast—antibody producing cell
• Produces IgE—esp. in respiratory tract
• IgE lands on receptor sites of the mast cells
• Sensitized mast cells—Atopic sensitization
• 2^nd exposure to the Ag
• Ag links w/the IgE on the surface of the mast cell
• Degranulation
• Release of leukotrienes, histamine, ECF, SRS-A, NCF, PAF, kinin protease
• Get bronchospasm, mucus secretion, eosinophils—asthma
• No where is there anything mediated by the CNS
• The nervous system does communicate w/the mast cell
• Mast cells have at least dual commands

 

Receptors

• Type I and II articular receptors
• Mechanoreceptors to let the brain know that everything is okay
• Costovertebral mechanoreceptors
• Spinal
• J receptors
• Sinopulmonary reflex—what ever is happening in the sinuses is happening in the lungs
• Sneeze

 

Dyspnea

·        Obstructive diseases

·        ¯ FEV1

·        ¯ FEV1/FVC

·        ¯ PEFR

·        ­ RV

·        Mechanoreceptors

·        “J” receptors—found in the respiratory zone

·        Fire in both asthma and in emphysema

·        In order not to experience SOB, the “J” receptors firing at a constant rate signifying the in and out of air into the lungs

·        “Spindle fibers”—found in the respiratory muscles

·        “Costovertebral mechanoreceptors”

·        Type I

·        Type II

·        If any change occurs to prevent the mechanoreceptors firing such as inflammation than the feeling of dyspnea occurs.

·        Deflation reflex—small airway collapse halts “J” receptor firing, which can cause dyspnea—can occur in Atelectasis and dyspnea.

·        Generally a short term event

·        Relief from SOB can be facilitated by an inhaler as well as an adjustment to the spine

·        Gamma receptors keep the spindles tight

·        Rhythmic gamma—wants to keep the spindles in motion—influenced by CNS

·        Tonic gamma—wants to keep the spindles tight—influenced by cerebellar and spinal influences.

·        Sinopulmonary reflex—what ever occurs in the sinuses (inflammation) occurs in the lungs.

 

 

Bronchitis

• 3 categories
• Acute bronchitis
• Everyone at some point has had—viral, bacterial, pollution, allergic
• Lasts about 2 weeks
• 2 symptoms
• Mucus
• Productive cough
• Affects only the conducting zone (mechanical)
• Has no affect on blood gases
• No affect on respiration
• Does not affect spirometry
• Not a life threatening situation
• More serious situation if the person has asthma
• Tx—antibiotic, mucolytic agent (guanefersin, Fenegrek Tea, licorice, ephedra [most potent, 150mg/day], water taken in quantities 8-10 glasses/day, steam), anti-tussin
• Bronchopulmonary reflex—irritant receptors
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