Disorders of the respiratory system 2

Obstructive Respiratory Disorders Bronchitis Bronchitis is an obstructive respiratory disease that may occur in both acute and chronic forms. Acute bronchitis: Inflammation of the bronchial passages most commonly caused by infection with bacteria or viruses. Acute bronchitis is generally a self-limiting condition in healthy individuals but can have much more severe consequences in individuals who are weakened with other illness or who are immunocompromised.

Symptoms of acute bronchitis often include productive cough, Dyspnea and possible fever. Chronic bronchitis: Chronic bronchitis is a chronic obstructive pulmonary disease that is most frequently associated with cigarette smoking (approximately 90% of cases). Chronic bronchitis may also be caused by prolonged exposure to inhaled particulates such as coal dust or other pollutants.

Obstructive Respiratory Disorders Bronchitis The disease is characterized by excess mucus production in the lower respiratory tract. This mucus accumulation can impair function of the ciliated epithelium and lining of the respiratory tract and prevent the clearing of debris and organisms. As a result, patients with chronic bronchitis often suffer repeated bouts of acute respiratory infection. Chronic bronchitis sufferers are often referred to as “blue bloaters” as a result of the cyanosis and peripheral edema that is often present.

Obstructive Respiratory Disorders Bronchitis Manifestations of chronic bronchitis: • Productive, chronic cough • Production of purulent sputum • Frequent acute respiratory infections • Dyspnea • Hypoxia, cyanosis • Symptoms of cor pulmonale (Cor pulmonale is defined as an alteration in the structure and function of the right ventricle caused by a primary disorder of the respiratory system. Pulmonary hypertension is the common link between lung dysfunction and the heart in cor pulmonale). • Fluid accumulation (edema) in later stages Cor pulmonale is defined as an alteration in the structure and function of the right ventricle caused by a primary disorder of the respiratory system. Pulmonary hypertension is the common link between lung dysfunction and the heart in cor pulmonale.

Obstructive Respiratory Disorders Bronchitis Treatment of chronic bronchitis: 1. Cessation of smoking or exposure to irritants 2. Bronchodilators to open airway passages 3. Expectorants to loosen mucus 4. Anti - inflammatory to relieve airway inflammation and reduce mucus secretion 5. Prophylactic antibiotics for respiratory infections 6. Oxygen therapy

Obstructive Respiratory Disorders Emphysema Emphysema is a respiratory disease that is characterized by destruction and permanent enlargement of terminal bronchioles and alveolar air sacs

Obstructive Respiratory Disorders Emphysema Well over 95% of all patients with emphysema were chronic cigarette smokers. Although the exact etiology of emphysema is still uncertain, Chronic exposure to cigarette smoke causes chronic inflammation of the alveolar airways, which results in infiltration by lymphocytes and macrophages. Excess release of protease enzymes such as trypsin from lung tissues and leukocytes can digest and destroy the elastic walls of the alveoli.

Levels of a protective enzyme α-1-antitrypsin have been shown to be lacking in certain individuals who are chronic cigarette smokers. This enzyme inactivates destructive protease enzymes (trypsin) in lung tissue. In fact, a rare form of emphysema occurs in individuals who are not cigarette smokers but who have a genetic lack of α-1- antitrypsin.

Obstructive Respiratory Disorders Emphysema Mainly caused by: Loss of alveolar (lung) elasticity and a decrease in the overall surface area for gas exchange within the lungs. Manifestations include the following: Tachypnea (increased respiratory rate): Because that is effective in maintaining arterial blood gases, one does not usually see hypoxia or cyanosis until the end stages of the disease. Barrel chest from prolonged expiration. Lack of purulent sputum. Possible long-term consequences, including cor pulmonale , respiratory failure.

Obstructive Respiratory Disorders Emphysema Comparison of Symptoms for Chronic Bronchitis and Emphysema Chronic bronchitis Emphysema Mild Dyspnea Dyspnea that may be severe Productive cough Dry or no cough Cyanosis common Cyanosis rare Respiratory infection common Infrequent infections Onset usually after 40 years of age Onset usually after 50 years of age History of cigarette smoking Cor pulmonale common Cor pulmonale in terminal stages

Restrictive Pulmonary Disorders Pneumothorax Pneumothorax is the entry of air into the pleural cavity in which the lungs reside. In order for normal lung expansion to occur, there must be a negative pressure within the pleural cavity with respect to atmospheric pressure outside the pleural cavity. The inside of the pleural cavity is essentially a vacuum and when air enters the pleural cavity the negative pressure is lost and the lungs collapse. Because each lung sits in a separate pleural cavity, pneumothorax of one pleural cavity will not cause collapse of the other lung.

Restrictive Pulmonary Disorders Atelectasis Atelectasis is a condition in which there is incomplete expansion of lung tissues due to blockage of the airways or compression of the alveolar sacs.

Restrictive Pulmonary Disorders Bronchiectasis It is a condition that results from prolonged injury or inflammation of respiratory airways and bronchioles. It is characterized by abnormal dilation of the bronchus or bronchi. It is most frequently associated with chronic respiratory disease, infections, cystic fibrosis, tumor growth or exposure to respiratory toxins. The major manifestations of bronchiectasis are impaired ventilation of the alveoli, chronic inflammation and possible fibrosis of the areas.

Adult respiratory distress syndrome (ARDS) ARDS is a syndrome associated with destruction of alveolar membranes and their related capillaries. It may occur as a result of direct injury to the lungs or as a result of dramatic decreases in blood flow to the lung (“shock lung” .

Respiratory distress syndrome of the newborn The etiology of newborn respiratory distress syndrome differs considerably from that of the adult disorder. Respiratory distress in the newborn is most commonly caused by a lack of surfactant in the lungs.

Respiratory Failure It may occur as: Respiratory failure is a condition that results when the lungs are no longer able to oxygenate the blood sufficiently or remove CO2 from it. It may occur as: the end result of chronic respiratory diseases, or it may be an acute event caused by factors such as pneumothorax or Opioid drug overdose

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