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group_4_presentation_1_-_sneezing [2020/01/30 13:44]
mirbahas [Sneezing]
group_4_presentation_1_-_sneezing [2020/01/31 19:53] (current)
hunteh2
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-A **sneeze**, also known as a **sternutation**,​ is a defense mechanism for the human body to protect the airway of the respiratory system. It is a sudden, forceful, involuntary expulsion of air from the lungs through the nose and mouth caused by foreign particles irritating the mucous membranes of the nose or throat. Sneezing is the body's way of clearing irritants from the nose or throat. It can be provoked by a variety of things, including allergens, microbes, nasal irritants, inhalation of corticosteroids through a nasal spray, and drug withdrawal ("​Everything You Need to Know About Sneezing", ​2020). This page will discuss the biological and pathophysiological aspects of the sneezing, severe implications of sneeze and its treatment methods, and a case study describing the implications,​ symptoms, and treatments on an individual who attempted to hold his sneeze. ​+A **sneeze**, also known as a **sternutation**,​ is a defense mechanism for the human body to protect the airway of the respiratory system. It is a sudden, forceful, involuntary expulsion of air from the lungs through the nose and mouth caused by foreign particles irritating the mucous membranes of the nose or throat. Sneezing is the body's way of clearing irritants from the nose or throat. It can be provoked by a variety of things, including allergens, microbes, nasal irritants, inhalation of corticosteroids through a nasal spray, and drug withdrawal ("​Everything You Need to Know About Sneezing", ​2019). This page will discuss the biological and pathophysiological aspects of the sneezing, severe implications of sneeze and its treatment methods, and a case study describing the implications,​ symptoms, and treatments on an individual who attempted to hold his sneeze. ​
  
 ====== Pathophysiology ====== ====== Pathophysiology ======
  
 **Nose** ​ **Nose** ​
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 The human body is trained to fight intruders and maintain a healthy internal system. Sneezing is a protective reflex. Foreign particles such as bacteria, dirt, dust, smoke, perfumes or other irritate the respiratory epithelium lining of the nose and trigger the immune system. A signal is sent out to release chemicals known as histamine and leukotriene (Scientific American, 2000)]. These substances are manufactured by inflammatory cells such as eosinophils and mast cells typically found within the nasal mucosa. Histamine travels to the site of irritation, in this case the nose, and binds with special receptors to produce inflammation or increased mucus production (Söldner, Horn, & Sticht, 2018). Allergic reactions with the nasal mucosa require the presence of IgE (allergy antibody specific for the allergen). This leads to fluid leakage from vessels in the nose, causing symptoms of congestion and nasal drip.  The human body is trained to fight intruders and maintain a healthy internal system. Sneezing is a protective reflex. Foreign particles such as bacteria, dirt, dust, smoke, perfumes or other irritate the respiratory epithelium lining of the nose and trigger the immune system. A signal is sent out to release chemicals known as histamine and leukotriene (Scientific American, 2000)]. These substances are manufactured by inflammatory cells such as eosinophils and mast cells typically found within the nasal mucosa. Histamine travels to the site of irritation, in this case the nose, and binds with special receptors to produce inflammation or increased mucus production (Söldner, Horn, & Sticht, 2018). Allergic reactions with the nasal mucosa require the presence of IgE (allergy antibody specific for the allergen). This leads to fluid leakage from vessels in the nose, causing symptoms of congestion and nasal drip. 
  
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 **Abdominal & Chest** **Abdominal & Chest**
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 The abdominal and chest muscles are then activated, compressing the lungs to produce a blast of air (WebMD, n.d.). ​ The abdominal and chest muscles are then activated, compressing the lungs to produce a blast of air (WebMD, n.d.). ​
  
  
 **Tongue & Vocal Cords** **Tongue & Vocal Cords**
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 The high velocity of the airflow is achieved by the buildup of pressure inside the chest and with the vocal cords closed. The sudden opening of the cords allows the pressurized air to flow back up the respiratory tract to expel the irritants. This helps to remove offending particles in the nose. The back of the tongue is elevated to force the air out of the mouth and nose (WebMD, n.d.). However, in infected individuals,​ it also allows for the spread of the common cold, as innumerable viral particles are contained within each droplet of mucus expelled. Germs from a sneeze can travel up to 6 feet (CDC, n.d.). ​ The high velocity of the airflow is achieved by the buildup of pressure inside the chest and with the vocal cords closed. The sudden opening of the cords allows the pressurized air to flow back up the respiratory tract to expel the irritants. This helps to remove offending particles in the nose. The back of the tongue is elevated to force the air out of the mouth and nose (WebMD, n.d.). However, in infected individuals,​ it also allows for the spread of the common cold, as innumerable viral particles are contained within each droplet of mucus expelled. Germs from a sneeze can travel up to 6 feet (CDC, n.d.). ​
  
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 **Eyes** **Eyes**
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 The split second the air is being forced out, the cranial nerves link both the eyes and the nose to the brain. Therefore, the stimulus also triggers the eyelid muscles to locked shut, making it impossible to keep eyes open while sneezing (WebMD, n.d.).  ​ The split second the air is being forced out, the cranial nerves link both the eyes and the nose to the brain. Therefore, the stimulus also triggers the eyelid muscles to locked shut, making it impossible to keep eyes open while sneezing (WebMD, n.d.).  ​
  
  
 **Heart** **Heart**
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 The moment a sneeze occurs, all the pressure built up in the abdomen gets released quickly. This increases the blood flow back to the heart, raises blood pressure, and lowers the BPM all at once. The moment a sneeze occurs, all the pressure built up in the abdomen gets released quickly. This increases the blood flow back to the heart, raises blood pressure, and lowers the BPM all at once.
  
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 These pharmaceutical treatments and medications are known as antihistamines targeting histamine, which the body significantly produces during the allergic reaction. These pharmaceutical treatments and medications are known as antihistamines targeting histamine, which the body significantly produces during the allergic reaction.
  
-Medications for non-allergic sneezes and nonallergic rhinitis include:  +Medications for non-allergic sneezes and nonallergic rhinitis include ​("​Nonallergic rhinitis",​ 2019):  
-azelastine (Astelin) +azelastine (Astelin), 
-Olopatadine (Patanase)  +Olopatadine (Patanase), and  
-Nasal glucocorticoids+Nasal glucocorticoids.
  
 ====== Case Study: Holding in A Sneeze ====== ====== Case Study: Holding in A Sneeze ======
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 A healthy 34-year-old man presented to the hospital with odynophagia (pain when he swallowed) and a change to his voice after attempting to hold in his sneeze by holding his nose and mouth shut (Yang, Sahota, & Das, 2018). Due to the unusual nature of this condition, doctors had difficulty diagnosing the patient. Physical examination of his throat revealed that there was extreme swelling and tenderness concluding that he had ruptured the back of the throat. Doctors claimed to hear popping and crackling noises, extending from his neck to his ribcage (Yang, Sahota, & Das, 2018). The patient had no previous history of respiratory illnesses and denied swallowing anything sharp (Yang, Sahota, & Das, 2018). Upon admission, vital signs were taken and presented as stable with no fever. Several tests were completed hereafter. A laryngoscopy test showed normal functioning of the vocal cords. A CT taken of the neck showed streaks of air in the retropharyngeal region (Yang, Sahota, & Das, 2018). From this, doctors concluded that the air buildup and emphysema was a result of a pharyngeal tear after holding in the sneeze. The air collection was also the reason for the popping and crackling noises heard previously. The patient was diagnosed with spontaneous perforation of the pharynx similarly seen in those with blunt neck trauma (Yang, Sahota, & Das, 2018). A healthy 34-year-old man presented to the hospital with odynophagia (pain when he swallowed) and a change to his voice after attempting to hold in his sneeze by holding his nose and mouth shut (Yang, Sahota, & Das, 2018). Due to the unusual nature of this condition, doctors had difficulty diagnosing the patient. Physical examination of his throat revealed that there was extreme swelling and tenderness concluding that he had ruptured the back of the throat. Doctors claimed to hear popping and crackling noises, extending from his neck to his ribcage (Yang, Sahota, & Das, 2018). The patient had no previous history of respiratory illnesses and denied swallowing anything sharp (Yang, Sahota, & Das, 2018). Upon admission, vital signs were taken and presented as stable with no fever. Several tests were completed hereafter. A laryngoscopy test showed normal functioning of the vocal cords. A CT taken of the neck showed streaks of air in the retropharyngeal region (Yang, Sahota, & Das, 2018). From this, doctors concluded that the air buildup and emphysema was a result of a pharyngeal tear after holding in the sneeze. The air collection was also the reason for the popping and crackling noises heard previously. The patient was diagnosed with spontaneous perforation of the pharynx similarly seen in those with blunt neck trauma (Yang, Sahota, & Das, 2018).
- +  ​
 As this was an unusual case, the patient was treated with prophylactic intravenous antibiotics until the pain and swelling had gone down. The patient was fed via a nasogastric tube. After 7 days of admission, the patient’s emphysema had decreased and the nasogastric tube was removed (Yang, Sahota, & Das, 2018). The patient was given a soft-food diet. The patient was discharged and prescribed with advice on avoiding blocking the nose and covering the mouth when having to sneeze. After a two-month follow-up, the patient presented healthy, with no complications (Yang, Sahota, & Das, 2018). As this was an unusual case, the patient was treated with prophylactic intravenous antibiotics until the pain and swelling had gone down. The patient was fed via a nasogastric tube. After 7 days of admission, the patient’s emphysema had decreased and the nasogastric tube was removed (Yang, Sahota, & Das, 2018). The patient was given a soft-food diet. The patient was discharged and prescribed with advice on avoiding blocking the nose and covering the mouth when having to sneeze. After a two-month follow-up, the patient presented healthy, with no complications (Yang, Sahota, & Das, 2018).
    
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