Essentials of Human Diseases and Conditions 4 th edition Margaret Schell Frazier Jeanette Wist Drzymkowski

Chapter 9 Diseases and Conditions of the Respiratory System

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 2 Orderly Function of the Respiratory System

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 3 Respiration  Maintains life by supplying oxygen to organs, tissues and cells and allows removal of carbon dioxide.  External respiration - in the lungs, oxygen inhaled from the air is exchanged with carbon dioxide from the blood.  Internal respiration - exchange of gases between the blood and tissue cells

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 4 Respiration (cont’d.) Pulmonary circulation  Pulmonary arteries - carry deoxygenated venous blood from the heart to the lungs  Pulmonary capillaries - where gas exchange occurs  Pulmonary veins - return the freshly oxygenated blood to the heart for systemic circulation

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 5 Causes:  Infection  Circulatory disorders  Tumors  Trauma  Immune diseases  Inflammatory disturbances  Congenital defects  Central nervous system damage or diseases  Environmental conditions Diseases of the Respiratory System

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 6  Chest pain  Dyspnea (difficulty breathing)  Productive or nonproductive cough (acute or chronic)  Hemoptysis (spitting up blood)  Dysphonia (hoarseness)  Chills  Low- or high-grade fever  Wheezing  Fatigue Symptoms of Respiratory Disorder

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 7  Common cold: acute inflammatory process that affects the mucous membrane that lines the upper respiratory tract  Sinusitis: acute or chronic inflammation of the mucous membranes of the paranasal sinuses Upper Respiratory Tract Infections

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 8  Pharyngitis: acute or chronic infection of the pharynx  Laryngitis: inflammation of the larynx, including the vocal cords Upper Respiratory Tract Infections (cont'd.)

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 9 Sinusitis Treatments for Sinusitis  Broad-spectrum antibiotics  Decongestants  Antihistamines

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 10 Pharyngitis Causes:  Viral infections - often an extension of bacterial streptococcal infection from tonsils, adenoids, nose, or tonsils (particularly in children)  May be secondary to systemic viral infection such as chickenpox or measles

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 11 Nasal Disorders  Deviated septum: crooked nasal septum (cartilage partition between the nostrils)  Nasal polyps: benign growths that form as consequence of distended mucous membranes protruding into the nasal cavity

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 12 Nasal Disorders (cont'd.)  Anosmia: impairment or loss of the sense of smell  Epistaxis (nosebleed): hemorrhage from the nose

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 13 Nasal Polyps Nasal Polyps - benign growths that form as a consequence of distended mucous membranes protruding into nasal cavity Causes:  overproduction of fluid in the cells of the mucous membrane,  often the result of allergic rhinitis

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 14 Epistaxis (nosebleed) First aid:  Mild hemorrhage - controlled by applying direct, constant pressure on either side of nose for 5 to 10 minutes  Persistent bleeding - treated with local application of epinephrine followed by cauterization or nasal packing  Severe - surgical ligation of bleeding artery

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 15 Pulmonary Disorders  Pulmonary embolism: occurs when a blood clot or other material, such as a foreign body or tumor, lodges in and blocks an artery in the pulmonary circulation  Pneumonia: inflammation of the lungs due to infection

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 16 PA Chest-Male

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 17

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 18 PA Chest-Female

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 19 Pulmonary Embolism  Occurs when embolism is lodged in artery and interrupts blood supply  Uncomplicated embolism - cough, chest pain, low- grade fever and apprehension  More extensive - dyspnea, tachypnea (at least 20 breaths/minute), chest pain, occasional hemoptysis  Massive embolism - sudden onset of cyanosis, shock and death

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 20 Pneumonia Causes of Pneumonia: Bacterial infection-  Pneumococci  Staphylococci  Group A hemolytic streptococci  Haemophilus influenzae type B  Klebsiella pneumoniae types 1 and 2  Atypical pneumonia caused by legionella, mycoplasma and chlamydia agents

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 21 Pneumonia (cont’d.) Causes of Pneumonia: Virus  Adenoviruses  Influenza viruses  Syncytial viruses  May also be caused by damage to lungs, such as inhalation of poisonous gas such as chlorine or aspiration of foreign matter

Chapter 9 Lesson 9.2

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 23 Pulmonary Disorders (cont'd.)  Legionellosis (Legionnaires disease): pneumonia caused by the bacterium Legionella pneumophila  Pontiac fever: milder form of legionellosis

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 24 Pulmonary Disorders (cont'd.)  Respiratory syncytial virus pneumonia (RSV): inflammatory and infectious condition of the lungs  Histoplasmosis: fungal disease originating in the lungs caused by inhalation of dust containing Histoplasma capsulation

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 25 Groups at risk for RSV  Children younger than three years old  Elderly individuals  Patients with compromised respiratory systems  Infants who were premature or who have a congenital cardiac defect or preexisting pulmonary disorder

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 26 Influenza Influenza:  Highly contagious, acute viral disease that occurs in annual outbreaks

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 27 Influenza (cont’d.) At risk of complications of influenza:  Persons over 50 years of age  Residents of nursing homes  Patients with chronic pulmonary cardiac disorder (including asthma)  Patients with chronic metabolic disease (diabetes), renal dysfunction, hemoglobinopathies, immunosuppression  Children and teens receiving long-term aspirin  Health care employees

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 28 Acute and chronic bronchitis: inflammation of the mucous membrane lining the bronchi  COPD includes:  Chronic bronchitis  Bronchiectasis  Asthma  Emphysema  Cystic fibrosis  pneumoconiosis Chronic Obstructive Pulmonary Disease (COPD)

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 29 Acute and Chronic Bronchitis  Acute - symptoms subside within a week, cough may continue for 2-3 weeks  Physical signs within lungs are few or absent  Chronic - inflammation persists and worsens, often occurs after colds or flu  Obstructive and asthmatic symptoms appear  Dyspnea, scattered rales and wheezing

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 30 Chronic Obstructive Pulmonary Disease (cont'd.)

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 31 Effects of Smoking  Cancer of oral cavity, larynx, esophagus  Lung cancer  Peptic ulcer  Chronic bronchitis  Emphysema  Myocardial infarction  Systemic atherosclerosis  Cancer of pancreas  Cancer of bladder

Chapter 9 Lesson 9.3

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 33 Pleurisy  Pleurisy (pleuritis): inflammation of membranes surrounding the lungs and lining the pleural cavity  Symptoms  Sharp, needle-like pain that increases with inspiration and coughing  May also experience fever, chills, and shallow breathing

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 34 Pneumothorax and Hemothorax  Pneumothorax: collection of air or gas in the pleural cavity that results in a collapsed or partially collapsed lung  Hemothorax: accumulation of blood and other fluids in the pleural cavity

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 35 Pneumothorax  Symptoms of Collapsed Lung  Severe shortness of breath  Sudden sharp chest pain  Falling blood pressure  Rapid weak pulse  Shallow and weak respirations  May be cyanotic and anxious

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 36

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 37 Tuberculosis  Pulmonary tuberculosis: chronic, acute, or subacute infection of the lungs by Mycobacterium tuberculosis  Acquired by inhaling a dried droplet nucleus that contains the tubercle bacillus

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 38 Infectious Mononucleosis  Infectious mononucleosis (Epstein-Barr virus infection): acute herpesvirus infection (glandular fever)  Symptoms:  Lymphadenopathy  Fever that typically peaks in afternoon  Listlessness, malaise, chills, anorexia  Sore throat, fever, headache, fatigue, and cervical generalized lymphadenopathy

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 39 Lung Cancer  Lung cancer: cancerous condition caused by repeated carcinogenic irritation to bronchial epithelium, leading to increased rates of cell division  Leading cause of death worldwide in both men and women, 30% of all cancer deaths