The given presentation contains the symptoms of respiratory system and their causes. I tried to cover the major causes. I hope it will help you somehow.

1. SYMPTOMTOLOGY OF
RESPIRATORY DISEASES
Ahsan Sajjad RMU-43

2. 2
STRUCTURE & FUNCNTION
 Gas exchange
 Accomplished through resp. mucosa
 Nasopharynx to alveoli

3. 3
ANATOMY OF NOSE

4. 4
Structure & function –cont
UPPER AIRWAYS
 Humidification of air
 Clearing particles & reactive substances
contained in inhaled air
 Lymphoid tissue-immune processing

5. 5
Structure &function-cont
LOWER AIRWAYS
 Trachea
 Bronchi
 Smaller bronchioles
 Terminal bronchioles ----2 to 4
respiratory bronchioles
 Lobules-Smallest units of lung separated by
fibrous septa.Approx. 2 cm in size &
contain 4-8 terminal bronchioles.

6. 6
Structure & function –cont
ALVEOLAR REGION
 Branching system of alveolar ducts whose
walls are made up of alveoli
 Alveolar ducts branch into 3-13 alveolar
sacs.
 Gas exchange occurs across alveolar walls
which are highly vascular
 Surface area of alveolar region –100 m2
=Approx.size of tennis court

7. TERMINALAIRWAYS

8. 8
Structure & funtion –cont
ALVEOLAR REGION
Alveoli are kept dry
 Permeability barrier of alveoli,disturbed
pul. Cappilary lymphatic drainage, or
increased pul. Hydrostatic pressure---------
Accumulation of fluid in alveoli

9. STRUCTURE OF ALVEOLI

10. 10
Structure & function- cont
LUNGS
R L
LOBES 3 2
SEGMENTS 10 8
Rt. upper Lobe lies in front of lower lobe.Therefore
it produces signs on front of chest.
Lobes--Bronchopulmonary segments---Lobules(1
cm diameter each)—A terminal bronchus supplies
an acinus—further divisions of resp. bronchioles
& alveolar ducts eventually form alveoli

11. TERMINALAIRWAYS

12. LOBES OF THE LUNGS

13. NORMAL CNORMAL CHEST X-RAY

14. NORMAL CXR-lateral

15. 15
Structure & function-cont
PLEURA
C.T. layer lined by simple squamous
epithelium.
• Visceral(lung,interlobar fissures)
• Parietal(inside of hemithorax)
• Pleural cavity is a potential space

16. 16
Structure & function- cont
DIAPHRAGM
• Skeletal muscle
• Relatively resistant to fatigue
• Arises from lower 6 ribs & inserted into
central tendon
• Phrenic nerve

17. 17
Structure & Function –cont.
PULMONARRY VESSELS
• Receives venous blood---Pulmonary As.----
accompany bronchial tree
• Oxygenated blood through------ Bronchial As.
• Pul. Venules drain blood from lobules---pass in
interlobular & intersegmental septa & ultimately
form 4 main Pul. Veins which bring oxygenated
blood to L heart

18. 18
Structure & function--
pulmonary vessels-cont.
• Bronchial As. arise from descending aorta
& supply tissues upto resp bronchioles
• Bronchial Vs. drain into
Pul.Vs.(physiological shunts)
• Lymphatics run in interstitial spaces.

19. 19
Structure & function—Cont.
NERVE SUPPLY
• Parasympathetic------------Vagus
• Sympathetic-------Adjacent sympathetic chain
accompanies Pul. As. & airways
• Airways smooth muscle—VAGUS
• Parietal pleura----Intercostal & phrenic nerves
• Visceral pleura----No innervation

20. 20
SYMTOMTOLOGY
 COUGH
SPUTUM PRODUCTION
 HEMOPTYSIS
 SHORTNESS OF BREATH
 CHEST PAIN
 WHEEZING
 Same symptoms in different diseases but
have different onset,duration,severity,
associated features etc.

21. 21
Symptomtology –cont.
I-COUGH
 Function of cough
 Protective reflex-Voluntary or involuntary
Mechanism------Stimulation of sensory
nerves in nasopharynx to alveoli-cough
center in brain-Increased intrathoracic pr.
Against closed glottis-rapid release of air

22. 22
Symtomtology-CONT
COUGH
 Duration
 Sound of cough
 Timing
 Associations
 Dry or productive

23. 23
Symptomtology-cont
COUGH
1)DURATION
Acute cough-----------<3 wk
a) Short
Infections
acute left ventricular dysfunction(LVF)
drugs-ACE Inhibitors
In common cold within 2 days 85% are coughing.After 2
wks. 26% still coughing & a few cough till 6-8 weeks.

24. 24
Symptomtology---Cont.
COUGH
b)Long
Bacterial infections
Tuberculosis
Bronchiectasis
Chronic sinusitis
Gastroesophageal reflux(GERD)
COPD
Allergic asthma
Tumor
Interstitial lung disease

25. 25
Symptomtology- cont
COUGH
2) SOUND OF COUGH
a)Bovine cough
Feeble,nonexplosive +hoarseness
ca .bronchus
Thoracic aortic aneurysm
b)Prolonged wheezy cough
COPD
Asthma
c)Barking harsh cough
Usually painful,hoarseness or stridor.
laryngeal tumor or inflammation

26. 26
COUGh-cont
sound of cough
d)Moist cough
•Secretions in upper & larger airways e.g.
•COPD (early morning)
•Bronchiectasis
e) Dry centrally painful
•Trachietis
•Pneumonia
•Asthma( post viral infection)

27. 27
COUGH- cont.
3)TIMING OF COUGH
a)Nocturnal
Asthma
GERD
LVF
b)Day time
Ch. Sinusitis

28. 28
Cough- cont
4)ASSOCIATIONS
a)ACE inhibitors
b)Cough during swallowing liquids
Neuromuscular diseases
c)Relation with environment
Fumes- chemical factories
Dust-flour mills, cotton mills
Pets

29. 29
COUGH- cont.
5)DRY OR PRODUCTIVE
a)Dry
• Allergic phenomenon
• F.B.
• Upper resp. tract infections
• Drugs
b)Productive

30. 30
COUGH- cont
Summary
• Duration
• Sound
• Timing
• Associations
• Dry / productive

31. 31
Sumptomtology –cont
II-Sputum production
 COLOR
 AMOUNT
 ODOUR
 CONTENTS

32. 32
Symptomtology-cont.
II-Sputum production
Approx. 100 ml per day normally
Definition:
Expectorated respiratory secretions.
Phlegm.
1-WHAT IS THE COLOR
a)white----------Clear, mucoid
• Asthma
• COPD without infection
• Alveolar cell ca.

33. 33
Sputum production- cont.
COLOUR
b)Yellow
• Asthma -----------Live eosinophils
• Ac. L.R.T.I.--------Live neutrophils
c)Green
Chronic infection(Dead neutrophils)
e.g.
• COPD
• Bronchiectasis
• Pseudomonas

34. 34
Sputum production- cont
COLOUR
d) Red
• Pneumonia
• LVF----Pink
• Other causes of hemoptysis
e)Black
• Coal miners

35. COLOR OF
SPUTUM

36. 36
Sputum production-cont
2)Amount of sputum
Small---TSF
Large---Cups
• Bronchiectasis
• Lung abscess
• Empyema
• Ac. LVF
• Alveolar cell CA (watery sputum for weeks)

37. 37
Sputum production- cont
3)ODOUR
Foul -------Anaerobic infections
• Lung abscess
• Bronchiectasis
• Empyema
4)CONTENTS OF SPUTUM
Food
• Tracheoesophageal fistula
• Aspiration

38. 38
Sputum production--
contents of sputum---Cont.
Foreign body
• Teeth
• Tablets
Bronchial casts
Viscid secretions,Worm like
e.g.
• ASTHMA
• Allergic bronchopulmonary aspergilosis

39. BRONCHIAL CAST cast

40. 40
Symptomtology- cont
III-HEMOPTYSIS
Expectoration of blood that originates below the
vocal cords.
Whether
 Coughed up
 Vomited
 Bleeding without cough
Dual circulation of lungs i.e.
 Low pressure---------------pulmonary A.
 High pressure--------Bronchial A. 1-2%of total pul.
Blood flow BUT A FREQUENT SOURCE OF
HEMOPTYSIS

41. 41
Symptomtology
Hemoptysis- cont.
1)Appearance
2)Amount
3)Duration & frequency

42. 42
Symptomtology
Hemoptysis--Cont
1)APPEARANCE
Streaking of clear sputum
 Lung cancer
 Pul .Infarct
 Pul. Edema
Large clots of blood
 Lung cancer
 Pul. Infarct
 Pul edema

43. 43
Hemoptysis—
Appearance-cont
Hemoptysis with purulent sputum
 Infection
 Pneumonia
 Bronchiectasis
 Lung abscess
Pinkish frothy
 Pul. Edema
Mitral valve disease
Ac. LVF

44. 44
Hemoptysis-cont
2) AMOUNT
Massive hemoptysis-----200-600 ml/d
 B/L Cavitating T.B.
 Bronchogenic Ca.
 Pul. Infarction
 Bronchial Carcinoid
 Aorto bronchial fistula

45. 45
Symptomtology-cont
3) DURATION & FREQUENCY
 Daily for weeks & months
 T.B.
 Lung cancer
 Lung abscess
 Intermittently for years
 Bronchiectasis
 Single episode (Massive, chestpain,dyspnea)
 Pul .infarct