F.A. Davis: Advantage Upper and Lower Respiratory Tract Disorders (11.16.15) Page 1 Upper and Lower Respiratory Tract Disorders The respiratory system is an interconnected network of organs, tissues, and pathways that work together to help you breathe. It has two distinct sections the upper respiratory tract and the lower respiratory tract. Cutaway figure appears on the screen. The script calls for the various labels to appear at the VO says disorders of the upper respiratory tract. However, that doesn t currently appear in the script dialogue they ve provided.
F.A. Davis: Advantage Upper and Lower Respiratory Tract Disorders (11.16.15) Page 2 Not only is the respiratory system connected internally, it is connected to the external environment through the air we breathe. Exposure to the external environment accounts for many of the disorders of this system. New screen. Man emerges from a house and walks forward, breathing in paricles. As he does, his lungs appear and we can see the particles going into them. Let s travel within the respiratory tract as it journeys through our external environment. The man walks past other figures, also breathing in particles.
F.A. Davis: Advantage Upper and Lower Respiratory Tract Disorders (11.16.15) Page 3 When we encounter the rhinovirus, we are likely to suffer from acute rhinitis, or the common cold......and its common symptom of green or yellow nasal discharge. As the man continues walking, a rhino w/ flag enters from the rest, charging towards him. As the rhino passes the man, the camera pans closer. A green drop of mucus falls from his nose and he wipes it with a handkerchief.
F.A. Davis: Advantage Upper and Lower Respiratory Tract Disorders (11.16.15) Page 4 Rhinitis can also result from allergies. Although, in this case, clear nasal discharge occurs. The man continues past several trees, which emit pollen. The man sneezes and a clear drop of mucus forms on his nose. He wipes it with a tissue. Allergies, bacteria, viruses, and fungi can all cause sinusitis, or inflammation of the sinus cavities. The man continues walking towards a cave, with label. Sound: Sneeze.
F.A. Davis: Advantage Upper and Lower Respiratory Tract Disorders (11.16.15) Page 5 Facial pain and headaches are common symptoms. The man walks through the cave, holding his head in pain. Funguses, viruses and bacteria are visible on the walls. Moving along the upper respiratory tract, we encounter the tonsils. Tonsillitis is inflammation of the tonsils. The man exits the cave and walks down the hill across the labeled bridge.
F.A. Davis: Advantage Upper and Lower Respiratory Tract Disorders (11.16.15) Page 6 With tonsillitis, swallowing becomes very difficult, as the tonsils become reddened and enlarged. On the other side of the bridge, the man stops in front of a lemonade stand. He holds his throat and nods no as the kid offers him a lemonade. The next structure along our journey is the epiglottis, which is a flap that covers the trachea to prevent food from entering. The man continues past an open garage. The labeled door lowers as he walks by. Sound: Garage door closing.
F.A. Davis: Advantage Upper and Lower Respiratory Tract Disorders (11.16.15) Page 7 Epiglottitis, inflammation of the epiglottis, is a life-threatening event, as the air passage may become blocked. The camera pans in as the man turns. The garage door swells, bulging out of the door frame as an ambulance enters from the left as the VO says life threatening. Sound: Ambulance siren Often this narrowed passageway appears as a steeple sign on X-ray. The man turns back and continues walkins as the ambulance passes him. He passes an xray with an image of steeple sign. Sound: Ambulance siren passing and fading.
F.A. Davis: Advantage Upper and Lower Respiratory Tract Disorders (11.16.15) Page 8 Pharyngitis is inflammation of the throat, the common sore throat. Although most commonly caused by viruses, it may also be caused by the bacteria Streptococcus pyogenes and result in strep throat. The man continues towards a dark alley. The figure of a mugger emerges from a corner. Resolution of an S. pyogenes infection is crucial, as progression may lead to scarlet fever, rheumatic fever, or glomerulonephritis. Pan closer to the man s head. The labels appear as the VO mentions them.
F.A. Davis: Advantage Upper and Lower Respiratory Tract Disorders (11.16.15) Page 9 Now, let s continue our journey into the lower respiratory tract, in which we may encounter bronchitis, pneumonia, or tuberculosis. Pull back. The man is now descending stairs, past signs on the wall. Bronchitis is inflammation of the bronchioles, most commonly due to viral infection. The bronchioles become obstructed by mucous and leukocytes. As the bottom of the stairs, the man continues on into the tunnels.
F.A. Davis: Advantage Upper and Lower Respiratory Tract Disorders (11.16.15) Page 10 Wheezing and production of red sputum may occur. In the tunnel. There are mucus and leukocytes on the walls. The man coughs, spraying red sputum into a handkercheif. Sound: Wheezing, then a cough Pneumonia is the result of inflammation and the alveolar air spaces filling with fluid. Bacteria, viruses, and fungi, especially in immunocompromised individuals, may cause pneumonia. The man continues through the tunnel. There are now pockets in the sides, with are filling with fluid on the bottoms and bacteria and fungi on the sides.
F.A. Davis: Advantage Upper and Lower Respiratory Tract Disorders (11.16.15) Page 11 Streptococcus pneumoniae is the most common cause of community-acquired pneumonia... The man emerges from the tunnel. He shakes hands with a couple of people on the sidewalk. The label appears above....whereas infection with Staphylococcus aureus is most common in hospital-acquired forms. The man heads towards a hospital entrance. The label appears on the left.
F.A. Davis: Advantage Upper and Lower Respiratory Tract Disorders (11.16.15) Page 12 Ventilator-associated pneumonia may also occur Bacterial pneumonia may also develop as a secondary infection following a virus such as influenza.. New screen. The man is now in bed, on a ventilator. As the VO mentions bacterial pnuemonia, a calendar appears on the upper right. The first page, labeled Viral Infection is visible, then the page flips to reveal the next page, indicating the passage of time. Now, let s talk about the most common infectious disease in the world: Tuberculosis. New screen. A map of the world appears and circles with TB in them pop up all over the map.
F.A. Davis: Advantage Upper and Lower Respiratory Tract Disorders (11.16.15) Page 13 Tuberculosis is transmitted through the inhalation of airborne droplets of Mycobacterium tuberculosis. Once inhaled, the bacteria settle in the lungs. New screen. A woman now walks down the street, breathing in TB particles. White blood cells are unable to kill the organism, but are able to wall off the infection, resulting in a lesion, known as a tubercle. As the immune system attempts to destroy the bacteria, damage to the lung s tissue results... The woman walks past white blood cells, walling off a space. She passes a black xray screen, with shows an xray of her lung, with tubercles visible.
F.A. Davis: Advantage Upper and Lower Respiratory Tract Disorders (11.16.15) Page 14 As the immune system attempts to destroy the bacteria, damage to the lung s tissue results, causing a cheese-like appearance known as caseous necrosis. Clinical signs of tuberculosis include chronic cough, hemoptysis, and weight loss. Up to 20% of patients with active tuberculosis, however, may present with no symptoms. The woman turns towards us. Her lungs become visible, riddled with holes. Back to the map of the world. Several of the circles are highlighted, showing the percentage of people who don t show TB symptoms.