Chapter 9 Respiratory Diseases and Disorders 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 broncioles Anatomy and Physiology Alveoli - place of carbon dioxide-oxygen exchange Inhalation and Exhalation - air movement in and out of lungs Copyright 2006 by Thomson Delmar Learning. ALL RIGHTS RESERVED 3 Copyright 2006 by Thomson Delmar Learning. ALL RIGHTS RESERVED 4 Common Signs and Symptoms Dyspnea Orthopnea Apnea Wheezing Coughing Nasal discharge Diagnostic Tests Auscultation: breathing quality and rate Tachypnea - rapid respirations Rales - musical sounds heard on inhalation and often called crackles Rhonchi - rattling sounds in bronchi due to obstruction Copyright 2006 by Thomson Delmar Learning. ALL RIGHTS RESERVED 5 Copyright 2006 by Thomson Delmar Learning. ALL RIGHTS RESERVED 6 1
Diagnostic Tests Chest X-ray Sputum culture Tissue biopsy Bronchoscopy Arterial blood gases Pulmonary function tests Common Diseases of the Respiratory System Most disorders of upper respiratory system are not life threatening Upper Respiratory Infection (URI) Most commonly caused by the rhinovirus Copyright 2006 by Thomson Delmar Learning. ALL RIGHTS RESERVED 7 Copyright 2006 by Thomson Delmar Learning. ALL RIGHTS RESERVED 8 Common Diseases of the Respiratory System Upper Respiratory Infection (URI) Treatment: Rest Fluids Antipyretics and analgesics Antibiotics for secondary infections Common Diseases of the Respiratory System Common Cold (acute rhinitis) Hay Fever (allergic rhinitis) Sinusitis Pharyngitis Laryngitis Copyright 2006 by Thomson Delmar Learning. ALL RIGHTS RESERVED 9 Copyright 2006 by Thomson Delmar Learning. ALL RIGHTS RESERVED 10 Diseases usually more severe than URIs Many can be life threatening Acute Bronchitis - inflammation of lining of the bronchus Short term following URI Symptoms include fever, tight feeling behind sternum, productive cough Copyright 2006 by Thomson Delmar Learning. ALL RIGHTS RESERVED 11 Copyright 2006 by Thomson Delmar Learning. ALL RIGHTS RESERVED 12 2
Acute Bronchitis Treatment: Rest Increased fluids Cough syrup Antipyretics Analgesics and antibiotics for secondary infections Influenza - highly contagious respiratory infection Symptoms: Symptoms: Onset of fever, chills, headache Back and muscle pain Cough, runny nose, sore throat, sneezing Hoarseness, nausea, vomiting, and diarrhea Copyright 2006 by Thomson Delmar Learning. ALL RIGHTS RESERVED 13 Copyright 2006 by Thomson Delmar Learning. ALL RIGHTS RESERVED 14 Influenza Viral and spread by coughing of respiratory secretions Treatment for influenza is symptomatic Rest Analgesics Antipyretics Antibiotics only if secondary infection Copyright 2006 by Thomson Delmar Learning. ALL RIGHTS RESERVED 15 Copyright 2006 by Thomson Delmar Learning. ALL RIGHTS RESERVED 16 Chronic Obstructive Pulmonary Disease (COPD) Group of pulmonary diseases due to cigarette smoking Two most common types of COPD: Chronic bronchitis Emphysema Chronic Obstructive Pulmonary Disease (COPD) Diagnosis: History and physical (Chest x-rays) Pulmonary function tests Arterial blood gases No cure Copyright 2006 by Thomson Delmar Learning. ALL RIGHTS RESERVED 17 Copyright 2006 by Thomson Delmar Learning. ALL RIGHTS RESERVED 18 3
Symptomatic treatment: Bronchodilator medications Inhalers Mucolytics Cough medications Symptomatic treatment: Avoid people with URIs Flu shots Prognosis is poor Copyright 2006 by Thomson Delmar Learning. ALL RIGHTS RESERVED 19 Copyright 2006 by Thomson Delmar Learning. ALL RIGHTS RESERVED 20 Atelectasis Collapse or airless state of all or part of lung Causes: Surgical pain Fractured ribs Blockage of airway by mucus plug Atelectasis Treatment: Analgesics for pain Ambulation Frequent deep breathing and coughing Copyright 2006 by Thomson Delmar Learning. ALL RIGHTS RESERVED 21 Copyright 2006 by Thomson Delmar Learning. ALL RIGHTS RESERVED 22 Pneumonia Inflammation of bronchioles and alveoli due to infection by bacteria, virus, or other pathogens Pneumonitis is inflammation without infection Symptoms related to area and tissue involved Pneumonia Diagnosis is made after chest X-ray, history and physical, and sputum culture Treatment depends on cause Copyright 2006 by Thomson Delmar Learning. ALL RIGHTS RESERVED 23 Copyright 2006 by Thomson Delmar Learning. ALL RIGHTS RESERVED 24 4
Pulmonary Abscess Collection of infectious material within a capsule May be complication of bacterial pneumonia, aspiration of food, or a foreign body Pulmonary Abscess Symptoms: chills, fever, chest pain, cough Treatment includes long-term antibiotic therapy Surgical resection if area is large or antibiotic therapy is unsuccessful Copyright 2006 by Thomson Delmar Learning. ALL RIGHTS RESERVED 25 Copyright 2006 by Thomson Delmar Learning. ALL RIGHTS RESERVED 26 Pulmonary Tuberculosis (TB) Infection caused by Mycobacterium tuberculosis Acquired by breathing air infected with bacteria or by coughing and sneezing Diagnosed by skin testing, chest X-ray, sputum culture Extended antibiotic therapy Adult Respiratory Distress Syndrome (ARDS) Follows episode of severe trauma Causes acute respiratory failure needing mechanical ventilation High mortality rate even with proper treatment Copyright 2006 by Thomson Delmar Learning. ALL RIGHTS RESERVED 27 Copyright 2006 by Thomson Delmar Learning. ALL RIGHTS RESERVED 28 Lung Cancer Leading cause of cancer deaths in United States Often asymptomatic until it metastasizes to brain, bone, and liver Most often caused by cigarette smoking Symptoms are dyspnea, coughing, hemoptysis Diagnosis: X-ray and tissue biopsy Treatment: chemotherapy, radiation, surgery Diseases of Pleura and Chest May be caused by infection, trauma, other diseases Common symptoms: pain and shortness of breath Copyright 2006 by Thomson Delmar Learning. ALL RIGHTS RESERVED 29 Copyright 2006 by Thomson Delmar Learning. ALL RIGHTS RESERVED 30 5
Diseases of Pleura and Chest Common diseases: Pleurisy (pleuritis) Pneumothorax - air in pleural cavity Hemothorax - blood in chest cavity Pleural Effusion (Hydrothorax) - fluid in chest Empyema - pus in chest cavity Diseases of Cardiovascular and Respiratory Systems Pulmonary Embolism (PE) - sudden blockage of an artery by an embolism Suffocation - not breathing to the point that the individual loses consciousness and eventually dies Copyright 2006 by Thomson Delmar Learning. ALL RIGHTS RESERVED 31 Copyright 2006 by Thomson Delmar Learning. ALL RIGHTS RESERVED 32 Diseases of Cardiovascular and Respiratory Systems Suffocation Possible causes: Aspiration Strangulation Drowning Copyright 2006 by Thomson Delmar Learning. ALL RIGHTS RESERVED 33 Rare Diseases Pneumoconiosis - environmentally induced diseases causing progressive, chronic inflammation and infection Causes include: Asbestosis Anthracosis - Coal miner s disease; black lung Silicosis Copyright 2006 by Thomson Delmar Learning. ALL RIGHTS RESERVED 34 Rare Diseases Fungal Diseases Caused by inhaling an airborne fungus Two forms Histoplasmosis Coccidioidomycosis - Desert fever and valley fever Rare Diseases Legionnaire s Disease Bacterial pulmonary infection Not limited to pulmonary system May cause liver damage and renal dysfunction Copyright 2006 by Thomson Delmar Learning. ALL RIGHTS RESERVED 35 Copyright 2006 by Thomson Delmar Learning. ALL RIGHTS RESERVED 36 6