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Respiratory System Diseases

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Presentation on theme: "Respiratory System Diseases"— Presentation transcript:

1 Respiratory System Diseases
Introduction to Human Diseases Chapter 11

2 Respiratory System Anatomy
Upper respiratory tract From nasopharynx to trachea Lower respiratory tract From trachea to alveoli Alveoli Respiration Ventilation Oxygen & carbon dioxide

3 Epistaxis (nosebleed)
Hemorrhage More common in children Treatment: Pressure, vasoconstricting meds, cautery Etiology: Trauma, rhinitis, sinutitis, HTN, coagulation diseases, anticoagulant medicines

4 Sinusitis Inflammation of the paranasal sinuses
Acute (infection: viral or bacterial) Chronic (often allergic or hyperplastic) Treatment: Varies with type

5 Acute & Chronic Pharyngitis
Inflammation of the pharynx Most common throat disorder Acute (viral, streptococcal bacteria, etc) Chronic (allergy, persistent cough, etc) Treatment: Varies with etiology

6 Acute & Chronic Laryngitis
Inflammation of the larynx & vocal cords Acute: viral or bacterial infections, excessive use of the voice, inhalational injuries (dust or chemicals) Chronic: often due to other ENT diseases (polyps, sinusitis, allergies, etc) Treatment: Varies with etiology

7 Infectious Mononucleosis
Acute viral infection Usually adolescents & young adults Sore throat, fever, enlarged cervical LN Etiology: Epstein-Barr virus (EBV) Disease: episodes of the above symptoms, fatigue, splenomegaly, often 6-8 week course. Treatment: pain & fever relief, steroids in some cases.

8 Pneumonia Inflammation of bronchioles and alveoli Usually infectious
Bacterial & viral = most common Also fungal, protozoa, rickettsiae May be unilateral or bilateral May involve one to all five lobes of the lungs

9 Pneumonia Aspiration pneumonia: Most common infectious agents:
Inhalation of gastric contents, then chemical irritation & infection Most common infectious agents: Pneumococcus and influenza virus S/S: cough, fever, sputum production, dyspnea, rales, wheezing Testing: chest X-ray (CXR) Treatment: antibiotics (if bacterial)

10 Legionnaire’s Disease Legionella Pneumonia
Pneumonia caused by bacteria: Legionella pneumophilia Named for 1976 outbreak at an American Legion convention Severity varies S/S: nonproductive cough at first, then grayish sputum Treatment: antibiotics

11 Lung Abscess Area of necrotic & purulent lung
More common in dependent areas of lungs and in right lung May be caused by pneumonias or by spread of infection by blood from other areas of the body Testing & treatment: Often seen on CXR, antibiotics & possible excision

12 Pneumothorax Abnormal collection of air between the two pleural layers
This implies that the lung is collapsed to some degree on that side S/S: pleuritic chest pain, dyspnea, decreased audible breath sounds Etiology: Trauma, bleb rupture, iatrogenic, asthma

13 Pneumothorax Types: simple, open, tension, spontaneous
In tension PTX: shock (hypotension) develops Testing: seen on CXR Treatment: varies with severity Small: observation, will reabsorb Others: tube thoracostomy (chest tube)

14 Pleurisy/ Pleuritis Inflamation of parietal & visceral pleura
May be primary or secondary Etiology: Infection, SLE, traumatic, etc S/S: Pleuritic or sharp chest pain Treatment: pain relief and treatment of underlying cause

15 Pleural Effusion Excess fluid in the pleural space (in between the parietal & visceral pleura) Types of effusion: Transudate-more watery Exudate-contains more protein, cells S/S: Pleuritic pain, dyspnea, decreased breath sounds on that side of the chest, abnormal percussion testing

16 Pleural Effusion Diagnostics & treatment:
CXR, thoracentesis, treatment of underlying cause, chest tube

17 Chronic Obstructive Pulmonary Disease (COPD)
Chronic, often progressive pulmonary disease with three components Emphysema (alveolar wall breakdown) Chronic bronchitis (chronic irritation, cough) Wheezing or reactive airways Etiology: Smoking, chronic dust or irritant inhalation, alpha-1 antitrypsin deficiency, prolonged respiratory infections or allergy

18 COPD S/S: variable shortness of breath, cyanosis, decreased exercise tolerance, chronic hypoxia, increased risk of pulmonary infections or Ca, chronic cough Diagnosis: pulmonary function testing, CXR Treatment: bronchodilators, steroids, antibiotics when needed

19 Asthma Chronic respiratory disease characterized by episodes of reversible wheezing and dyspnea. In between episodes, lungs appear normal Three components: Bronchospasm Airway inflammation Increased mucous production

20 Asthma S/S: audible wheezing, cough, shortness of breath, increased risk of pulmonary infections Diagnosis: pulmonary function testing, CXR, response to bronchodilators Treatment: Inhaled bronchodilators, some steroid use(oral or inhaled), some antiinflammatories

21 Pulmonary Tuberculosis
Slow-growing bacterial infection that initially infects the lungs and may become chronic multisystemic illness Caused by Mycobacterium tuberculosis Characterized by granulomas (granular appearing tissue) Diagnosis: via CXR, Mantoux skin test

22 TB S/S: chronic cough, hemoptysis, rales, wheezing, weight loss
Treatment: long term (at least 6 months) of antibiotics, often multiple antibiotics required for several years

23 Pneumoconiosis Pulmonary diseases caused by chronic dust inhalation
Often occupational disorders S/S: chronic cough, shortness of breath Multiple types: Silicosis Asbestosis Berylliosis anthracosis

24 Pneumoconiosis Silicosis Asbestosis Berylliosis Anthracosis
Most common, inhalation of quartz dust Asbestosis Inhalation of asbestos fibers, “ground glass appearance” on CXR Berylliosis Berylium metal dust inhalation Anthracosis Coal workers “black lung” disease

25 Respiratory Mycoses Deep fungal infections of the lungs
Diagnosis: via CXR & serologic or skin testing Types: Histoplasmosis (Ohio Valley Disease) Coccidiodomycosis (Valley Fever) Blastomycosis (North American blastomycosis)

26 Respiratory Mycoses Treatment: Long-term antifungal meds
Valley fever may resolve spontaneously

27 Pulmonary Edema Excess fluid (transdate type) in the pulmonary tissues and alveoli Due to cardiac diseases usually (left sided heart failure most commonly) S/S: like those of CHF Diagnosis: CXR Treatment: Oxygen, diuretics, bronchodilators, contractility enhancers

28 Cor Pulmonale Right ventricular failure
Difficulty pumping blood into pulmonary circulation Eventual development of pulmonary hypertension due to chronic hypoxia Etiologies: Any cardiac, pulmonary, congenital, or chest wall disease that impedes RV outflow

29 Cor Pulmonale Treatament:
Oxygen, medicines to enhance contractility of ventricle or vasodilate the pulmonary vessels

30 Pulmonary Embolism Embolus (thrombus from elsewhere in the body) that traversed bloodstream to become lodged in a pulmonary blood vessel. Usual source is thrombi from the legs May be small or large, multiple or single S/S: dyspnea, often pleuritic chest pain, unexplained tachycardia, cardiac arrest (if large embolism), hypoxia

31 Pulmonary Embolism Diagnosis: arterial blood gases (to check oxygen in arterial blood), CXR, CT scan of the chest Treatment: Oxygen, anticoagulants, hospitalization if large embolism, may use fibrinolytics/thrombolytics

32 Respiratory Acidosis (Hypercapnia)
Excess carbon dioxide in the blood Due to inability of lungs to dispose of the usual carbon dioxide products of metabolism Acid (hydrogen ions) increases, so pH falls (less than 7.4) Etiology: respiratory insufficiency or failure, may be due to many etiologies

33 Respiratory Acidosis May be due to neurological illness and decreased level of consciousness Treatment: Manual or mechanical ventilation with oxygen Find and treat the underlying source

34 Respiratory Alkalosis Hypocapnia
Carbon dioxide in the blood is at a lower than normal level Excessive removal of CO2 by the lungs The blood is now alkaline (more base, less acid) and pH is high (above 7.4) Etiology: Hyperventilation due to disease, incorrect mechanical ventilation, overdoses, anxiety

35 Respiratory Alkalosis
Much less common than respiratory acidosis Treatment: Slow respiratory efforts, try to relieve hyperventilation according to mechanism

36 Atelectasis Collapse of an area of smaller, distal airways in a part(s) of the lungs Results in hypoxia, increased temperature May be seen on CXR Etiology: numerous Treatment: Chest PT, spirometry, oxygen as needed, postural drainage

37 Bronchiectasis Permanent abnormal dilation of small and medium-sized bronchi Due to destruction of muscular & elastic components of bronchial walls Greatly decreased over last few decades Etiology: CF, inhalation injury, infections, smoking

38 Bronchiectasis S/S: Treatment:
Chronic cough (productive), variable dyspnea, increased infections Treatment: Antibiotics, bronchodilators, etc.

39 Lung Cancers Leading cause of cancer deaths in men and women
Multiple types: Non-small cell More common, slower to grow & metastasize Squamous cell Ca, adenoca, large cell Ca Small cell Oat cell cancer Less common, quicker growing & metastatic

40 Lung Cancers Etiology:
Associated with smoking directly or indirectly 87% of the time Radon gas inhalation (odorless, tasteless, radioactive gas) Asbestos, uranium, arsenic, some petroleum products

41 Lung Cancers Often asymptomatic until late Treatment:
Surgery, radiation, chemotherapy, often in combination Photodynamic therapy (laser therapy)

42 Sudden Infant Death Syndrome (SIDS)
Unexplained death of normal-appearing infants Usually weeks Typically during sleep More risk in: Males, premature infants, during winter months Leading COD in first 6 months of life

43 SIDS Etiology: unknown
Suspected: mechanical suffocation, prolonged apnea, deficiency of part of vitamin B complex, immune problem, abnormal larynx

44 Acute Tonsillitis Tonsillar inflammation Acute or chronic
Most common: infection Strep pyogenes, Staphylococcus aureus S/S: sore throat, hoarseness, fever, dysphagia Treatment: antibiotics

45 Adenoid Hyperplasia Enlargement of the lymphoid tissues in the nasopharynx Causes partial obstruction to breathing Snoring, nasal quality to speech More obvious during sleep and URI’s Etiology: unknown Treatment: surgical removal

46 Croup Inflammation of the upper airways (the subglottic area)
Viral etiology Winter illness Usually in infants & up to 3 YOA S/S: barking (seal-like) cough, worse when supine Treatment: humidified air, cool air

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