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Smoking & Diseases

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by

Michelle Chew

on 4 November 2014

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Transcript of Smoking & Diseases

First World War - Smoking is
fashionable
among European men
Each day,
1200
young boys & girls take up smoking
5 million people die
in a year due to smoking
3 unhealthy components found in cigaratte smoke
Tar
Carbon Monoxide, CO
Nicotine
Carcinogen
Changes the lining of airways
Combines with Hb --> forms carboxyhaemoglobin
Reduce Oxygen in blood and heart
Damages lining of arteries
Acts as vasoconstrictor
Increase blood pressure & heart rate
Increase 'stickiness' of blood platelet
Reduce bloodflow to extremeties
Damages endothelium of arteries
Less glucose & oxygen supplied to heart
Less waste removed
Causes heart to contract less strongly
Lung diseases
Chronic Bronchitis
long term
life threatening
Signs, symptoms and complications
severe cough (smoker's cough)
large phlegm (mixture of mucus, bacteria and WBC)
leads to pneumonia due to accumulated mucus
Emphysema
Signs, symptoms and complications
Wheezing & coughs
Bedridden in severe case
dependent on oxygen masks to survive
Die of respiratory failure and often accompanied by infection
Small number will die from heart failures --> heart is enlarged and overworked in trying to pump blood through arteries that have been constricted as a result of lack of oxygen
About 1 every 5
smokers will develop
emphysema
<div style='position: relative; float: left; text-align: center;'><a href='http://www.careflash.com/video/emphysema'><img alt='Emphysema' src='http://www.careflash.com/newblausen/atlas/global/assets/thumbnails/0094.png'/><br/>Emphysema</a></div>
<div style='position: relative; float: left; text-align: center;'><a href='http://www.careflash.com/video/bronchitis'><img alt='Bronchitis' src='http://www.careflash.com/newblausen/atlas/global/assets/thumbnails/0210.png'/><br/>Bronchitis</a></div>
Chronic Obstructive Pulmonary disease (COPD)
Emphysema + chronic bronchitis
Signs & Symptoms
coughing with large amounts of mucus
wheezing
Shortness of breath
Chest tightness
No cure
Disease is irreversible
Can be prevented from further damage from early intervention (quit smoking at early age)
Lung cancer
80% of all lung cancer
deaths are caused
by smoking
Did you know?
it takes 20 -30 years to develop lung cancer
Symptoms
coughing blood --> due to tissue damage
Shortness of breath --> tumour obstructing the airways
Diagnosis
Bronchoscopy
Chest X-ray
CT scan
Tobacco smoke
contains a number of
carcinogens
causes
damage to the genes
of the epithelial cells which line the lungs --> exposed to carcinogens
Benzopyrene
(BP) --> found in tar
-->
causes mutation
As the cancer develops, it will
spread
through bronchiol epithelium and enters into the lymphatic tissue in the lung

Cells may break away and spread to other organs (
metastasis
)to become
secondary tumours
Tar
Lining of Airways
Tar settles on the lining of airways
Is an irritant --> cause inflammation of the mucus membranes (Bronchitis)
In response,
goblet cells produce more mucus
Cilia paralysed
as mucus & tar accumulates
Cilia cannot remove the mucus secreted by epithelial lining
Carcinogen
Benzopyrene
found in tar
carcinogenic
= causes cancer
Carbon monoxide (CO)
CO readily diffuses through the wall of alveoli in the lung
Haemoglobin
(Hb) has high affinity towards CO
than oxygen

CO + HB -->
Carboxyhaemoglobin
(permanent)
O2 + HB -->
Oxyhaemoglobin
(not permanent)

Therefore, Hb will not be available to carry oxygen anymore
Cardiovascular diseases
Coronary Heart Disease
Stroke
Atherosclerosis
Coronary heart disease : a disease of these arteries that causes damage to/ malfunction of the heart
What happens when atherosclerosis occurs:-
lining of coronary arteries become narrow
blood flow restricted
heart has to work harder to force blood through the coronary arteries
increased blood pressure
harder to supply extra oxygen and nutrients to the heart muscle during exercise
Coronary heart disease develops when the blood supply to the heart muscle is reduced
3 forms of coronary heart disease
Angina pectoris
Heart attack
Heart failure
Main symptom: severe chest pain brought on by exertion

Cause: severe shortage of blood to heart muscle

Pain starts when exercising, goes when resting

X death of heart tissue
Also known as myocardial infarction
Signs & symptoms: sudden & severe chest pain

Cause: heart attack occurs when a moderately large branch of a coronary artery is obstructed by a blood clot

Part of the heart will be deprived of oxygen & dies

May be fatal but many can survive with prompt treatment
Cause: blockage of main coronary artery ; leading to gradual damage of heart muscle

Heart weakens and failed to pump efficiently
Occurs when an artery in the brain bursts and blood leaks out into brain tissue

OR

blockage in the brain artery due to atherosclerosis / thrombus
How it happens?
Brain tissue in the area supplied by the artery is starved of oxygen and dies (cerebral infarction)
Stroke can be fatal / cause mild or severe disability depending on the amount of the brain affected by shortage of oxygen
Accumulation of fatty material (cholesterol) in artery walls
Begins with damage to the lining of arteries
In response, invasion of phagocytes took place, stimulate growth of smooth muscles and accumulation of LDL cholesterol (aid in repair)
Can begin any time from childhood
Later,
fibres are deposited
in the cholesterol and these often
calcify and become hard
This process in known as
atherosclerosis
The
plaque
(cholesterol rich atheroma) will
increase in size
Linings of arteries become
less elastic & blood flow restricted
Might even block the passage of blood
When
plaque breaks through the lining
of the artery, its
rough surface
will
cause blood clot
to occur
it will eventually
form thrombus
Thrombosis will interrupts blood flow even more, causing
tissues to be starved of oxygen & nutrients
Thrombosis in coronary artery --> heart muscle dies --> heart attack
Thrombosis in an artery in brain --> xtroke
Process leading to atherosclerosis & thrombosis
Epidemiology & Experimental studies on smoking and diseases
Experimental evidence
Epidemiology evidence
Cancer & cigarette smoking
Discovered a correlation btw lung cancer & cigarette smoking
Smokers are 18X more likely to develop lung cancer
1/3 cancer deaths are due to cigarette smoking
25% smokers die of lung cancer increased
Risk of developing cancer decreases if smoker stops smoking; w/n 10 yrs or more to return to the same risk as non-smoker
Risk of cancer increases when:-
smokers inhale
start young
no. of cigarettes smoked per day
smoke high tar cigarette
In general, 50% smokers die due to smoking-related disease.
Smokers are also 3X more likely to die in middle age
COPD & cigarette smoking
Very rare in non-smokers
90% deaths caused by smoking
98% people with emphysemma are smokers
20% smokers suffer from emphysemma
Deaths from pneumonia & influenza is 2X higher in smokers
2 lines of evidence:
tumours (similar to the ones in human) is found in animals exposed to cigarette smoke
carcinogens identified in tar
Tumours found in animals exposed to cigarette smoke
48 dogs were recruited and divided into 2 groups
Exposed to filter cigarette smoke
Did not develop cancer
However, filters does not completely remove all carcinogens from cigarette smoke
some dogs developed pre-cancerous changes in the lining of their airways
Exposed to unfiltered cigarette smoke

Developed abnormalities similar to human with lung cancer
Carcinogens in tar
Smoking machines : has the mechanism of inhaling smoke like smokers do, extract chemicals in smoke and analysed
Analysis show that the black, oily liquid (tar) contains a variety of carcinogens and co-carcinogens (predisposed to mutation)
Carcinogens from tar cause cancerous growth when painted on the skin of mice
Smoking & Diseases
One final thing for you to ponder on....
Full transcript