1. Diseases of the Respiratory Tract

2. The MIND Paradigm M = metabolic diseases –Hormonal, nutritional, compromised organ systems I = inflammatory diseases –Trauma, reactive, Infection, immunologic N = neoplastic diseases –Benign, premalignant, malignant D = developmental diseases –Disorders of growth & embryologic defects

3. The Respiratory Tract Upper Respiratory Tract –Oral Cavity –Nasal Cavity –Paranasal Sinuses –Nasopharynx –Larynx Lower Respiratory Tract –Lungs (alveoli, bronchi, bronchioles)

4. Definitions Pulmonary function tests – physiologic tests that measure the airway space capacities Dyspnea – shortness of breath Stridor – closing off of vocal cords Productive cough – bring up phlegm Nonproductive cough – dry hack Hemoptysis – coughing up blood

5. Diseases of the Upper Airway Sinusitis, rhinitis Sinonasal papillomas Sinonasal cancer Laryngitis Vocal cord paralysis Cancer of the Larynx

6. Sinusitis Infectious (Bacterial, viral, fungal) Allergic Signs and Symptoms –Nasal Blockage/Obstruction (Edema) –Sneezing –Nasal Discharge –Fever (viral and bacterial)

7. Clouding of the sinus seen on a Radiograph

8. Sinonasal Polyps Arise from respiratory epithelium Growths with narrow stalk (pedunculated) Papillary pattern of growth (papillomas) Nasal Obstruction Visualization –Direct in the nasal cavity –Detected with Radiographs of the sinonasal region Certain types can undergo cancerous change

9. CT scan reveals the patient has a brain, two eyeballs and a polypoid mass (Papilloma) in the nose and sinus

10. Sinonasal Carcinoma Malignant tumors of respiratory epithelium In the antrum, may invade into the mouth through the palate Associated numbness of the maxilla Often fatal

11. Laryngitis Overuse of vocal cords (shouting, yelling, singing loudly, talking naughty) Trauma Viral or Bacterial infection of throat and vocal cords Allergic Signs and symptoms: –Hoarseness –Sore throat –Fever when infectious

12. How to tell a Allergy from a Sinusitis from a Laryngitis from a Bronchitis from a Tonsillitis from a Pneumonia from an Ear Ache from a Flu

13. NO Temp. 100 F or above stuffy nose, sneezing Itchy eyes, nose, throat Pain around eyes, thick yellow nasal discharge Cat, dust, pollen allergy Cold plus sinusitis

14. NO Temp. 100 F or above stuffy nose, sneezing Ear hurts Hoarseness NO Uncomplicated Cold Cold plus otitis media Cold plus laryngitis

15. Temp. 100 F or above NO Headache, chills and sweats, rash, muscle aches, marked fatigue, cough Very sore throat and/or swollen neck glands Strep throat or tonsillitis

16. Temp. 100 F or above Headache, chills and sweats, rash, muscle aches, marked fatigue, cough Wheezing, coughing up gray-yellow phlegm Painful breathing and/or coughing up rust-colored phlegm NO Uncomplicated Flu or Lyme Disease Flu plus bronchitis Flu plus pneumonia

17. Diseases of the Lungs Chronic Obstructive Pulmonary Disease (COPD Pneumonias Granulomatous Infections Cancer

18. COPD Loss of airway space Major underlying causes –Bronchitis (smoking) –Emphysema (smoking) –Asthma (allergy, familial, anxiety) Signs and Symptoms: –Wheezing (asthma) –Productive cough (bronchitis) –Dyspnea (shortness of breath) Cannot walk up a staircase without resting Sleep with many pillows

19. Pneumonia Bacterial and Viral Etiologies Filling of air spaces with edema fluid Requires hospitalization, antibiotics Symptoms: –Dyspnea –Cough, productive or nonproductive –Fever

20. Tuberculosis Mycobacterium tuberculosum Mildly contagious, repeated exposures Lung Granulomas fill airspaces Necrosis of granulomas Signs and symptoms: –Productive cough –Bloody sputum, hemoptysis –Dyspnea

21. Lung Cancer Bronchogenic Carcinoma –Cigarette smoking is chief environmental risk factor Small Cell Carcinoma Both types metastasize Predispose lungs to pneumonia

22. Dental Implications Upper tract diseases may cause maxillary pain, mimicking toothache Antral tumors may involve the palate Infections can be transmitted in the dental operatory setting COPD and other pulmonary diseases with dyspnea require frequent uprighting of patient Asthmatics – keep inhalers in easy reach Oxygen tank for pulmonary emergencies

23. Goodbye and Good Luck Peter J.