1. Presentation 2: AIRWAY Dr. Bushra Bilal Dr. Miada Mahmoud Rady CLS 243

2. Introduction The common respiratory system disorders : 1.Infections such as pneumonia. 2. Obstructive disorders that obstruct airflow into and out of the lungs such as asthma, bronchitis and emphysema. 3. Restrictive disorders are conditions that limit normal expansion of the lungs such as pneumothorax, atelectasis and respiratory distress syndrome 4.Cancers.

3. Important terminology 1.Hypoxia : Decreased levels of oxygen in the tissues 2.Hypoxemia : Decreased levels of oxygen in arterial blood. 3.Hypercapnia : Increased levels of CO 2 in the blood 4.Hypocapnia : Decreased levels of CO 2 in the blood 5.Dyspnea : Difficulty breathing

4. Important terminology 6.Tachypnea : Rapid rate of breathing. 7.Cyanosis : Bluish discoloration of skin and mucous membranes due to poor oxygenation of the blood. 8.Hemoptysis : Blood in the sputum.

5. Presentation of chest diseases Cardinal Manifestation 1. Cough ( Dry or Productive). 2. Hemoptysis. 3. Dyspnea. 4. Wheezes. 5. Chest pain. Other presenting symptoms 1. Hoarseness. 2. Stridor. 3. Snoring. 4. Fever. 5. Night sweating. 6. Weight loss.

6. Signs and Symptoms Of Respiratory Disorders 1.Cough : It could be either acute or chronic  Dry ( Bronchial asthma ) or productive ( pneumonia ). A.Acute : acute bronchitis, pneumonia. B.Chronic : cough that persists more than 8 weeks e.g. bronchial asthma, chronic bronchitis and lung cancer. 2.Cyanosis : Central ( blue hands and blue tongue ) as in Sever Asthma or Peripheral ( blue hands and red tongue ) as in Cold Weather.

7. Signs and Symptoms Of Respiratory Disorders  Hemoptysis: blood in the sputum as in 1.Lung cancer. 2.Tuberculosis. 3.Pneumonia.  Wheezes : seen in asthma and chronic bronchitis.  Chest pain : Caused by multiple disorders e.g. Angina pectoris.

8. Chest Diseases

9. Infections  It can affect upper or the lower airway or both.  It can be caused by bacteria, viruses or fungi.  Most common forms : 1.Common cold. 2.Pneumonia. 3.Bronchitis.

10. Common Cold Viral infection mostly caused by : 1.Rhinoviruses. 2.Respiratory syncytial virus. 3.Adenovirus. 4.Influenza and parainfluenza virus. 5.Corona virus.

11. Presentation of common cold 1.Systemic : Fever, Headache and bone aches. 2.Local :  Rhinitis and sinusitis : inflammation of mucosa of the nose and nasal sinuses, present with nasal discharge and congestion.  Pharyngitis : inflammation of the throat, which present with pain in the throat and painful swallowing.  Bronchitis : inflammation of the bronchi, which present with acute cough and chest pain.

12. Pneumonia Definition : inflammation of the lung alveoli. It can be Caused By bacteria, viruses or fungi. Presentation : 1.Systemic : fever, chills, headache and bone aches. 2.Local :  Difficulty in breathing (dyspnea).  Cough ( productive) : with yellowish, greenish or blood tinged sputum.  Cyanosis in sever cases.

13. Investigation and Treatment 1.Investigation :  X-ray.  CBC : leucocytosis.  Sputum analysis. 2.Treatment : hospitalization, oxygen, antibiotic and antipyretics.

15. Chronic Obstructive Pulmonary Disease( COPD)  Definition : It is a group of disorders characterized by chronic progressive Airway Obstruction.  It include 3 disorders : bronchial asthma, emphysema and chronic bronchitis.  It divided into two categories : 1.Type A ( Pink Buffer ) : mainly emphysema. 2.Type B ( Blue Bloaters ) : mainly chronic bronchitis.

16. Investigation 1.CXR. 2.C.T. 3.Pulmonary function test. 4.ECG. 5.Echocardiography. 6.Laboratory finding.

17. Laboratory investigation 1.CBC : anemia, leucocytosis. 2.ABG : hypoxemia and hypercapnea. 3.Sputum analysis and culture. 4.Alpha- 1 antitrypsin level.

18. Emphysema  Definition : COPD characterized by abnormal and permanent enlargement of the airspaces distal to the terminal bronchioles accompanied by destruction of the alveolar walls.

22. Signs and Symptoms of Emphysema 1.Barrel-chest appearance. 2.Dry cough. 3.Severe exertional dyspnea. 4.Pink skin color (pink puffer). 5.Wheezing and rhonchi. 6.Pursed-lip breathing (prolonged inspiration).

24. BRONCHITIS Definition : a chronic productive cough for three months in two successive years in a patient in whom other causes of chronic cough have been excluded.

26. Clinical Presentation 1.Productive, chronic cough with purulent sputum 2.Recurrent acute respiratory infections 3.Dyspnea. 4.wheezing 5.Hypoxia, cyanosis 6.Fluid accumulation and heart failure in later stages

28. 28 Chronic bronchitisEmphysema Mild DyspneaMore Severe Productive coughDry or no cough Cyanosis commonCyanosis rare Respiratory infection commonInfrequent infections Onset usually after 40 years of age Onset usually after 50 years of age History of cigarette smoking Cor pulmonale commonCor pulmonale in terminal stages Comparison of Symptoms for Chronic Bronchitis and Emphysema Comparison of Symptoms for Chronic Bronchitis and Emphysema

30. ASTHMA Respiratory disease characterized by recurrent episodes of dyspnea, cough and wheeze caused by reversible airways obstruction.

32. Common Asthma causes: Animals (pet hair or dander) Dust Changes in weather (most often cold weather) Chemicals in the air or in food Exercise Mold Pollen Respiratory infections, such as the common cold Strong emotions (stress) Tobacco smoke

33. Management: Controlled oxygen therapy Nabulized bronchodilators e.g. albuterol (ventolin) Antibiotics if evidence of infection (amoxicillin)

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