1. Respiratory System Diseases and Disorders
Chapter 9
Respiratory System Diseases and Disorders 1

2. Anatomy and Physiology
Chest, lungs, and conducting airways
Two parts:
Upper respiratory system consists of nose, mouth, sinuses, pharynx, and larynx
Lower respiratory system consists of trachea, bronchi, and bronchioles 2

3. Anatomy and Physiology
Alveoli
At distal end of terminal bronchioles
Place of carbon dioxide-oxygen exchange
Inhalation and exhalation
Air movement in and out of lungs 3

4. Common Signs and Symptoms p. 187
Dyspnea—difficulty breathing
Orthopnea—lying position causes difficulty
Apnea—no breathing
Wheezing – high pitched sounds caused by partial obstruction
hypoxemia –low blood oxygen levels
cyanosis—a blue color in nail beds and lips
Coughing—productive or non productive
Nasal discharge—present in infections, inflammation and allergic reactions 4

5. p. 188 haemochromatosis, lupus erythematosus(
koilonychia)
iron-deficiency anaemia
haemochromatosis,
lupus erythematosus

6. lung cancer, bronchiectasis, or endocarditis
Fingernail or toenail abnormalities can tell you a lot about your health. They're often a sign of a fungal nail infection or injury, but can sometimes indicate a more serious underlying disease. *Spoon shaped: iron-deficiency anaemia, haemochromatosis, Raynaud’s disease, lupus erythematosus,
Clubbing:
lung cancer, bronchiectasis, or endocarditis
inflammatory bowel disease, stomach cancer or bowel cancer
cirrhosis (scarring of the liver)
polycythaemia,
“splinters” (dried blood)
if many nails are affected, these splinters may be a sign of lupus erythematosus, psoriasis, an infection of the heart valves (endocarditis) or another underlying disease.

7. White spots – zinc deficiency
Color
White spots – zinc deficiency
Yellow nails – liver and/or gallbladder issues
Bluish or grey colored nails – heart condition
Brown nails – adrenal gland dysfunction
Ridges
Vertical ridges – metabolic disorders or lung issues
Horizontal ridges – gout, heart and circulation conditions
Small bulges – nail fungi or iron deficiency
Shape
Spoon shaped – iron deficiency or damage from harsh detergents
Hourglass shape – bronchial or lung conditions
Read more:

8. Diagnostic Tests p. 189 Auscultation
Breathing quality and rate—deep, shallow, times per min
Tachypnea
Rapid respirations
Crackles or rales
Musical (crackling sounds) heard on inhalation
Rhonchi
Rattling sounds in bronchi due to obstruction 8

9. Diagnostic Tests Chest X-ray Sputum culture Tissue biopsy Bronchoscopy
Arterial blood gases
Pulmonary function tests 9

11. how to read a chest x-ray | Tumblrwww.tumblr.com473 × 386PA AP
how to read a chest x-ray | Tumblrwww.tumblr.com473 × 386

12. Bronchoscopy 12

16. Pulmonary function tests are a group of tests that measure how well the lungs take in and release air and how well they move gases such as oxygen from the atmosphere into the body's circulation.

17. Incentive Spirometer

18. Diseases of the Upper Respiratory Tract p. 189-193
Smoking is the number one risk behavior for developing chronic respiratory disease
Upper respiratory infection (URI)—a broad term referring to several infectious diseases of the upper respiratory tract
Account for approximately 50% of all acute illnesses
Most commonly caused by rhinovirus– the common cold. There are several hundred virus strains that cause a cold. 18

19. Diseases of the Upper Respiratory Tract
URI
Treatment:
Rest
Fluids
Antipyretics
Analgesics
Antibiotics for secondary infections
Prevention: Regular hand washing 19

20. Diseases of the Upper Respiratory Tract
Common cold
Acute rhinitis
Hay fever
Allergic rhinitis
Sinusitis—sinus infections should not be ignored
Pharyngitis—sore throat, most common cause is viral. Streptococcus bacteria can also occur,
Laryngitis—can be caused by viral or bacterial infections or by irritants or strain 20

21. Diseases of the Bronchi and Lungs p. 193-203
Diseases usually more severe than URIs
Many can be life-threatening
Often more dangerous in older populations 21

22. Diseases of the Bronchi and Lungs p. 193
Asthma—most common cause of missed school days
Hypersensitivity reaction results in constriction of bronchi leading to difficulty breathing
Episodes of wheezing and dyspnea
Treatment:
Avoid causative allergens, desensitization, medications such as bronchodilators
Prevention:
Identify and control allergic factors 22

23. Diseases of the Bronchi and Lungs p.193
Acute bronchitis
Inflammation of lining of bronchus
Short-term following URI
Symptoms:
Fever
Tight feeling behind sternum
Productive cough (bringing up sputum) 23

24. Diseases of the Bronchi and Lungs
Acute bronchitis--bronchitis that is short-lived; the bronchitis lasts about two weeks and usually people recover with no permanent damage to the bronchial tree
Treatment:
Rest
Increased fluids
Cough syrup
Antipyretics
Analgesics
Antibiotics for secondary infections 24

25. Diseases of the Bronchi and Lungs p.194
Influenza
Highly contagious respiratory infection
Viral disease with many strains spread by coughing of respiratory secretions (A,B,C)
Symptoms:
Onset of fever, chills, and headache
Back and muscle pain
Cough, runny nose, sore throat, and sneezing
Hoarseness
Nausea and vomiting
Diarrhea 25

26. Influenza viruses are divided into three types, designated A, B, and C, with influenza A types usually causing the most problems in humans.
Influenza A undergoes frequent antigenic changes that require new vaccines to be developed and people to obtain a new vaccination every year. New vaccine technology is being developed.
In April 2009, a new flu virus termed novel H1N1 swine flu developed in Mexico, rapidly spread worldwide, and caused the WHO to declare a flu pandemic. Eventually, the WHO declared the pandemic over in In 2012, a new type of flu strain developed, H3N2v, but has not developed into any epidemic situations currently.
Bird flu (H5N1) mainly infects birds but it also infects humans who have
close contacts with birds.

27. Influenza Influenza Symptomatic treatment: Rest Analgesics
Antipyretics
Antivirals
Prevention—vaccination is the best way to prevent influenza. Antiviral medications are also effective in prevention. 27

28. Diseases of the Bronchi and Lungs p. 194
Chronic obstructive pulmonary disease (COPD)
Group of pulmonary diseases primarily, but not solely due to cigarette smoking
Two most common types:
Chronic bronchitis
Emphysema
Diagnosis by history and physical, chest X-ray, pulmonary function tests, and arterial blood gases 28

29. Diseases of the Bronchi and Lungs
COPD
Symptomatic treatment:
Bronchodilators
Inhalers
Mucolytics
Cough suppressants
Avoidance of contact with people with URIs
Influenza vaccine
Quit smoking 29

30. Diseases of the Bronchi and Lungs p. 196-197
Chronic bronchitis-- a cough that occurs every day with sputum production that lasts for at least 3 months, two years in a row.
Inflammation and scaring of bronchial tubes
Bronchiectasis with pooling of mucus and foul-smelling cough (smoker’s cough)
Emphysema
-- Air trapping –alveoli break down causing large spaces instead of small. Air cannot be exhaled
--pursed-lip breathing –victim trying to exhale stale air in large alveoli
-- barrel chest—set costal muscles due to prolonged chest expansion
Increased production of mucus (with exacerbation)causing air trapping in the alveoli 30

32. Diseases of the Bronchi and Lungs p. 197
Atelectasis
Collapse or airless state of the alveoli or parts of the lung
Causes:
Surgical pain (not inhaling due to pain)
Fractured ribs
Blockage of airway by mucus plug
Not ambulating after surgery
Treatment:
Ambulation
Frequent deep breathing and coughing
Analgesics for pain 32

33. Diseases of the Bronchi and Lungs p. 197-198
Pneumonia—bacterial pneumonias tend to be the most serious. Vial pneumonias are the most common.
Aspiration pneumonia caused by food or liquids aspirated into the lungs
Inflammation of bronchioles and alveoli due to infection by bacteria, virus, or other pathogen
Symptoms related to area and tissue involved
Diagnosis by history and physical, chest X-ray, and sputum culture
Treatment depends on cause
Prevention – not smoking, frequent hand washing, wearing a mask when working with fumes, dust, mold 33

34. Pneumonia 34

35. Diseases of the Bronchi and Lungs p. 199
Pulmonary abscess
Collection of infectious material within capsule
May be complication of pneumonia, tuberculosis, lung cancer, or aspiration of food or foreign body
Symptoms:
Chills
Fever
Chest pain
Cough 35

36. Pulmonary Abscess 36

37. Pulmonary abscess

38. Diseases of the Bronchi and Lungs
Pulmonary abscess
Treatment:
Long-term antibiotic therapy
Surgical resection if large area or unsuccessful antibiotic therapy 38

39. Diseases of the Bronchi and Lungs p. 199-201
Pulmonary tuberculosis (TB)
Infection caused by Mycobacterium tuberculosis
Acquired by breathing air infected with bacteria or by coughing and sneezing
Diagnosis by skin testing, chest X-ray, and sputum culture
Treatment: Extended antibiotic therapy 39

41.
TB disease can be treated by taking several drugs for 6 to 9 months. There are 10 drugs currently approved by the U.S. Food and Drug Administration (FDA) for treating TB. Of the approved drugs, the first-line anti-TB agents that form the core of treatment regimens include:
Of the approved drugs, the first-line anti-TB agents that form the core of treatment regimens include:
isoniazid (INH)
rifampin (RIF)
ethambutol (EMB)
pyrazinamide (PZA)

42. Tuberculosis 42

43. Diseases of the Bronchi and Lungs p. 202
Adult respiratory distress syndrome (ARDS)
Follows episode of severe trauma
Causes acute respiratory failure needing mechanical ventilation
Symptoms: sudden and acute extreme dyspnea
High mortality rate even with proper treatment 43

44. Diseases of the Bronchi and Lungs
Sudden acute respiratory syndrome (SARS)
Severe, easily transmissible new disease
Caused by previously unknown type of coronavirus
Antibiotics ineffective – viral infection
May require ventilatory support 44

45. p. 203 Lung cancer Leading cause of cancer deaths in United States
Often asymptomatic until metastasizes to brain, bone, and liver
Most often caused by cigarette smoking 45

46. Diseases of the Bronchi and Lungs
Lung cancer
Symptoms:
Dyspnea
Coughing
Hemoptysis
Diagnosis by X-ray and tissue biopsy
Treatment:
Chemotherapy
Radiation
Surgery 46

49. Diseases of Pleura and Chest p. 203-205
May be caused by infection, trauma, or other diseases
Symptoms:
Pain
Shortness of breath 49

50. Diseases of Pleura and Chest
Common diseases:
Pleurisy (pleuritis)
Inflammation of the membranes covering the lungs
Pneumothorax
Air in pleural cavity—usually treated with chest tube
Hemothorax
Blood in chest cavity—usually treated with chest tube
Pleural effusion (hydrothorax)
Fluid in chest
Empyema
Pus in chest cavity - 50

51. Pneumothorax 51

53. Diseases of the Cardiovascular and Respiratory Systems p. 206-207
Pulmonary embolism (PE)
Sudden blockage of artery by embolism
Pulmonary edema
Tissues and air spaces of lungs fill with fluid
Cor pulmonale
Right-sided heart failure 53

54. Trauma p. 207 Pneumothorax and Hemothorax Suffocation
Often occur due to some type of trauma
Suffocation
Not breathing to the point that individual loses consciousness and eventually dies
Causes:
Aspiration
Strangulation
Drowning 54

55. Rare Diseases p. 208-209 Pneumoconioses
Environmentally induced diseases causing progressive, chronic inflammation and infection
Types:
Asbestosis
Anthracosis
Coal miner’s disease
Black lung
Silicosis 55

56. Rare Diseases Fungal diseases Caused by inhaling airborne fungus
Two forms:
Histoplasmosis
Coccidioidomycosis
Desert fever
Valley fever 56

57. Rare Diseases Legionnaires’ disease Bacterial pulmonary infection
Not limited to pulmonary system
May cause liver damage and renal dysfunction 57

58. Effects of Aging p. 201 Decreased elasticity in respiratory system
Becomes less efficient and has less reserve
Weakened respiratory muscles
Reduced resistance to infection
Smoking is the major cause of high incidence of lung cancer 58