Your SlideShare is downloading. ×
0
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Diseases of the respiratory system
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×
Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

Diseases of the respiratory system

1,354

Published on

Published in: Health & Medicine
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
1,354
On Slideshare
0
From Embeds
0
Number of Embeds
1
Actions
Shares
0
Downloads
236
Comments
0
Likes
0
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide

Transcript

  • 1. DiseasesDiseases of theof the RespiRatoRRespiRatoR y systemy system
  • 2. Major Determinants of Disease • Diseases of one lung compartment tend to affect the others • The lungs are open to the environment, exposing them to infectious agents, allergens, irritants, & carcinogens • Most lung disease is caused by inhalation of material; the most common exception is autoimmune lung disease • Lost pulmonary membrane is not recoverable • Smoking is a major cause of lung disease • The heart & lungs are a functional unit; lung disease usually affects the heart; & heart disease usually affects the lungs
  • 3. UppeR RespiRatoRyUppeR RespiRatoRy infectionsinfections • Allergic rhinitis – “hay fever” – nasal mucosal edema – nasal discharge – sneezing – allergic conjunctivitis • “Colds” – transmitted through respiratory droplets – clear nasal discharge – low grade fever – if nasal discharge becomes colorful, it is an indication of secondary bacterial infection • Acute pharyngitis – “sore throat” – usually viral – bacterial infections more serious – red, swollen tonsils
  • 4. caRcinoma of thecaRcinoma of the LaRynxLaRynx • Common • Mostly in male smokers over 40 • Alcohol abuse increases the risk • Presents with – hoarseness – pain – cough – dysphagia – hemoptysis
  • 5. ateLectasisateLectasis • Collapse of a lung or part of a lung • Resorption – bronchial obstruction – air below obstruction completely absorbed – obstructions are • mucous plug • asthma • bronchitis • tumors • Compression – pressure exerted from pleural space or upward pressure on diaphragm • Contraction – scars cause constriction & collapse – TB
  • 6. asthmaasthma • Chronic inflammatory disease of small bronchi & bronchioles • Triggered by inhaled irritants & classified by irritant • Allergic • Occupational • Exercise-induced • Infectious • Others – drug reactions – emotional stress – severe air pollution • Hyperplastic mucous glands in bronchi, hypertrophied smooth muscle, edema, & marked inflammation
  • 7. chRonic obstRUctivechRonic obstRUctive pULmonaRy Disease (copD)pULmonaRy Disease (copD) • Related diseases • Chronic bronchial outflow obstruction • Overlapping features
  • 8. emphysemaemphysema • Destruction of alveolar walls, alveoli merge to form large air spaces • Loss of surface area affects diffusion • 90% of cases are smokers
  • 9. chRonic bRonchitischRonic bRonchitis • Chronic cough that produces sputum for 3 consecutive months 2 years in a row • Primary cause is cigarette smoking • Chronic inflammation of bronchi • Simple chronic bronchitis • Chronic asthmatic bronchitis • Hereditary • Shortness of breath • Wheezing & coughing • Weight loss • Barrel-chested
  • 10. • Cigarette smoke irritates lung & causes inflammation • Inflammatory cells release digestive enzymes • These enzymes normally inhibited by alpha-1 antitrypsin • AAT inhibited by smoke & so enzymes digest lung tissue
  • 11. BronchiectasisBronchiectasis • Marked, permanent dilation of small bronchi • Destruction of smooth muscle & elastic supporting tissue • Must have obstruction & infection – obstruction causes mucus retention – infection damages bronchial walls which causes excess mucus production • Not a primary condition • Typically involves lower lobes • Persistent cough
  • 12. restrictive Lungrestrictive Lung DiseaseDisease • Chronic inflammation making lungs stiff & inelastic • Affects diffusion • Scar tissue accumulates in the interstitium • Mostly cause is unknown • Equal decline in FEV1 & FVC • Usually presents with shortness of breath • Can lead to pulmonary HTN
  • 13. interstitiaL FiBrosisinterstitiaL FiBrosis without granuLomatouswithout granuLomatous inFLammationinFLammation• Usually middle-aged men at time of diagnosis • Shortness of breath; may progress to cor pulmonale, hypoxia • Pneumoconioses – black lung disease – silicosis • most common chronic occupational disease – asbestosis • mesothelioma
  • 14. interstitiaL FiBrosis withinterstitiaL FiBrosis with granuLomatousgranuLomatous inFLammationinFLammation • Sarcoidosis – cause unknown – affects many tissues but mostly lungs – present with shortness of breath, cough, chest pain, hemoptysis
  • 15. PuLmonary eDemaPuLmonary eDema • Fluid in alveoli • Increased BP in lung – normal is 25/8 mmHg with average at 15 mmHg • Microvascular injury – due to • toxic fumes • hot gases • septicemia • IV drug abuse • Main symptom is SOB
  • 16. PuLmonaryPuLmonary thromBoemBoLismthromBoemBoLism • About 50,000 deaths annually • Mostly from DVT • Inflammation predisposes you to it • Promoted by – CHF – pregnancy – birth control pills – prolonged bed rest – metastatic cancer – genetics • Most associated with no symptoms but some – cause lung infarcts – chest pain & dyspnea – death
  • 17. PuLmonaryPuLmonary hyPertensionhyPertension • Sustained systolic pressure over 30 mmHg or average in excess of 25 mmHg • Vicious cycle • Most common cause is increased pulmonary vascular resistance • Usually secondary to – COPD – heart disease – collagen vascular diseases – recurrent pulmonary thromboemboli • With R heart failure is cor pulmonale • Thickening of arteriolar walls • SOB – chest pain – fatigue
  • 18. aDuLt resPiratoryaDuLt resPiratory Distress synDromeDistress synDrome • ARDS • Alveolar or pulmonary capillary damage • Pathogenesis – injury to endothelium or alveoli – neutrophils infiltrate – protein-rich fluid exudes into alveolar space – SOB occurs with rapid breathing which dries the fluid into a thick membrane – stiffens lungs – limits airflow & interferes with diffusion – hypoxia • 50% fatality • Causes – sepsis – smoke inhalation – near drowning – O2 toxicity – burns – DIC – fat embolism – endotoxic shock
  • 19. PneumoniaPneumonia • Inflammation of the lungs • Usually caused by bacteria • 80,000 deaths/yr • Alveolar pneumonia – usually acute – fill with inflammatory exudate – most common
  • 20. • Bronchopneumonia – patchy inflammation – involves alveoli of more than 1 lobe – usually in basilar parts • Lobar pneumonia – consolidation of an entire lobe – almost always caused by S. pneumoniae
  • 21. InterstItIal PneumonIaInterstItIal PneumonIa • Inflammation in septa • Diffuse & bilateral • Usually viral
  • 22. • Etiology – mostly bacterial • S. pneumoniae • Haemophilus influenzae • Staph • E. coli • Pseudomonas • Pathogenesis – inhalation of droplets, aspiration of gastric contents, blood-borne spread – those susceptible include • immune deficiency • decreased cough reflex • impaired cilia • accumulated secretions • pulmonary congestion
  • 23. • Community-acquired – acute pneumonia – bronchopneumonia – lobar pneumonia – Legionnaire’s disease – atypical pneumonia • Mycoplasma • Nosocomial – Commonly S. aureus & E.coli – Seen in • People with severe disease • Prolonged antibiotic therapy • People with internal mechanical devices • Aspiration – Inflammatory reaction due to corrosive effects – Those who are comatose or those with a stroke – Hi mortality rate
  • 24. • Seen mostly in the young & the elderly • Hypoxia & death • Bacterial – high fever & chills – purulent sputum – increased neutrophils – cough – SOB • Interstitial – less severe – increased lymphocytes – cough – SOB
  • 25. lung abscesslung abscess • Purulent inflammation with tissue necrosis & liquefaction • Usually have several types of bacteria with anaerobic • Most commonly due to aspiration of gastric contents • Foul-smelling sputum
  • 26. tuberculosIstuberculosIs • Mycobacterium tuberculosis • Chronic granulomatous inflammation with caseous necrosis
  • 27. Pathogenesis
  • 28. • Affects about 2 billion worldwide • Kills about 2 million/yr • 2nd only to AIDS • Associated with poverty, crowding, malnourishment, & chronic disease • PPD
  • 29. • Low-grade fever • Night sweats • Malaise • Weight loss anorexia
  • 30. Mycoses • Histoplasmosis • Coccidiomycosis • Cryptococcus
  • 31. Lung neopLasmsLung neopLasms • Mostly due to metastasis • Bronchogenic carcinoma is the most common – most common of all cancers – #1 cancer death – about 90% are cigarette smokers
  • 32. Bronchogenic CarcinomaBronchogenic Carcinoma • Mostly caused by cigarettes – Direct relationship between incidence of cancer & number of cigarettes smoked – Direct relationship between precancerous changes in bronchial mucosa & number of cigarettes smoked
  • 33. • Small cell carcinoma – 20% of cases – arise from specialized neuroendocrine cells of the bronchus – strongest relationship to cigarettes – aggressively malignant • Squamous cell carcinoma – 30% of cases – bronchial epithelium that has undergone metaplasia – arises centrally – most common in men who smoke – grows slower so better prognosis • Adenocarcinomas – 30% of cases – most well-differentiated – somewhat better prognosis – more peripheral in smaller bronchi – less associated with smoking • Large cell carcinoma – 15% of cases – poor prognosis – metastasizes early
  • 34. Bronchial Carcinoid Tumor • 5% of lung cancers • Arise from bronchial neuroendocrine cells • Much less aggressive • Grows slow
  • 35. pneumothoraxpneumothorax • Air in pleural space • Causes atelectasis • May occur spontaneously • More frequent in people with emphysema who have large blebs near pleura • Traumatic penetration • Can be fatal • Tension pneumothorax – air in but not out
  • 36. pLeuraL effusionpLeuraL effusion • Fluid in pleural space • Transudate from CHF most common • If blood, called hemothorax
  • 37. pLeuritis • Inflammation • Pleurisy with each breath • Mostly caused by pneumonia

×