1. 29 The Respiratory System Lesson 2:
The Pathology of the Respiratory System

2. Lesson Objectives
Upon completion of this lesson, students should be able to …
Define and spell the terms to learn for this chapter.
Identify and discuss common disorders associated with the respiratory system.

3. Asthma Chronic, inflammatory disease of the bronchi
May be related to allergies
Causes:
Irritations causes swelling
Affects trachea and/or bronchial tubes
Results in coughing, which adds to irritation
Treatment:
Inhalant for acute episodes
Long-term medications for prevention 3

4. Critical Thinking Question
What types of irritants contribute to asthma? 4

5. Chronic Obstructive Pulmonary Disease (COPD)
Description:
Combination of related diseases–chronic bronchitis and emphysema
Airways become obstructed
Chronic and progressive
Causes:
Smoking is a major cause
Air and other pollution may increase risk 5

6. Chronic Obstructive Pulmonary Disease (COPD)
Diagnosis is made through observation and testing
Signs and symptoms include:
Moderate to severe dyspnea
Air hunger
Pursed lips
Use of accessory muscles in order to breathe 6

7. Chronic Obstructive Pulmonary Disease (COPD)
Treatment:
Prevent further deterioration of lungs
Alleviation of symptoms
Medications
Vaccination against complicating illnesses such as influenza and pneumonia 7

8. Bronchitis
A respiratory disease in which the mucous membrane in the bronchial passages becomes inflamed
As the irritated membrane swells and grows thicker, it narrows or shuts off the tiny airways in the lungs
The disease can be either acute or chronic.
Acute = lasts less than 6 weeks
Chronic = recurring frequently for more than 2 years 8

9. Signs and Symptoms of Acute Bronchitis
A hacking cough
Yellow, white, or green phlegm, usually appearing 24 to 48 hours after the cough begins
Fever and chills
Soreness and tightness in the chest
Pain below the breastbone during deep breathing
Shortness of breath 9

10. Signs and Symptoms of Chronic Bronchitis
A persistent cough that produces yellow, white, or green phlegm (for at least 3 months of the year and for more than two consecutive years)
Sometimes wheezing and breathlessness
Symptoms of chronic bronchitis are worsened by air pollution

11. Treatment for Acute and Chronic Bronchitis
Conventional treatment for acute bronchitis may be:
Getting plenty of rest
Drinking lots of fluids
Avoiding smoke and fumes
Possible use of an inhaled bronchodilator and/or cough syrup

12. Treatment for Acute and Chronic Bronchitis
In severe cases of chronic bronchitis treatment may include:
Inhaled or oral steroids to reduce inflammation of the airways
Supplemental oxygen may be necessary
If the patient has COPD as well, a physician may prescribe oxygen therapy, either on a continuous or as-needed basis

13. Emphysema
A long-term, progressive lung disease in which the tissues that support the physical shape and function of the lung are destroyed
Emphysema usually develops slowly
Acute episodes of shortness of breath may not occur
Slow deterioration is the rule, and it may go unnoticed
Tobacco smoking is by far the most common, but also the most preventable, cause of emphysema 13

14. Risk Factors Emphysema
A deficiency of an enzyme called alpha-1 -antitrypsin
Air pollution
Airway reactivity
Heredity
Gender (male)
Age 14

15. Signs and Symptoms of Emphysema
Shortness of breath is the most common symptom of emphysema
Coughing, sometimes caused by the production of mucus, and wheezing may also be symptoms
Tolerance for exercise may also decrease over time

16. Treatment for Emphysema
Smoking cessation
Bronchodilating medications
Steroids and antibiotics
If the patient experiences shortness of breath, oxygen therapy may be given
In very severe cases, surgery to remove a lung may be required

17. The Common Cold Inflammation of the upper respiratory tract
Many cold viruses are highly contagious
The common cold can be spread by droplets
Droplets can be transmitted through sneezing and coughing, hand-to-hand contact with someone who has a cold, or the use of shared objects
Even though colds can be caused by over 200 viruses, the most common cold-causing virus is the rhinovirus. 17

18. Signs and Symptoms of the Common Cold
A runny or stuffy nose
Itchy or sore throat
Cough
Congestion
Slight body aches
Mild headache
Sneezing
Watery eyes
Low-grade fever of less than 102°F
Mild fatigue
Nasal discharge may become thicker and turn yellow or green as the cold runs its course

19. Treatment for the Common Cold
No treatment
Antibiotics are useless against cold viruses, and over-the-counter cold preparations do not cure a common cold or shorten its duration
Over-the-counter medications can relieve some symptoms
For fever, sore throat, and headache, mild pain relievers may be helpful
For runny nose and nasal congestion, antihistamines or decongestants may be useful

20. Measures to Slow the Spread of the Common Cold
Washing the hands
Scrubbing countertops clean, especially when someone in the household has a cold
Using tissues to sneeze and cough into and discarding them immediately
Not sharing drinking glasses or other utensils with family members who may be sick

21. Hay Fever Also called seasonal allergic rhinitis or pollinosis
A seasonal allergy in which the mucous membranes of the nose and eyes become inflamed
About 26 million Americans experience hay fever symptoms each year 21

22. Hay Fever Symptoms: Frequent and prolonged sneezing
Itchy nose and eyes
Clear mucous discharge
Difficulty breathing
Coughing
Diminished senses of smell and taste 22

23. Hay Fever Treatment: Antihistamines Avoiding allergens
Using air filters 23

24. Influenza (The “Flu”)
An illness caused by viruses that infect the respiratory tract
Often more serious than the common cold
Most people who get the flu recover completely in 1 to 2 weeks, but some people develop serious and potentially life-threatening medical complications such as pneumonia 24

25. Critical Thinking Question
Are antibiotics an effective treatment for the flu? Why or why not? 25

26. Signs, Symptoms, and Treatment of Influenza
Fever (usually 100°F to 103°F in adults, often higher in children)
Respiratory symptoms such as cough, sore throat, and runny or stuffy nose
Headache
Muscle aches
Extreme fatigue
Treatment involves antiviral medications to shorten the course of the illness, but only if taken early in the disease process

27. The Flu Vaccine The best defense against influenza
The patient who receives an influenza vaccination may succumb to other strains, but the immune system will be more efficient from having developed a defense against the strains in the vaccination
Vaccines should be received by health care workers, the elderly, those who are immunosuppressed, and children

28. Legionnaire’s Disease
Type of pneumonia
Usually affects the elderly or middle-aged
Cause is the Legionella germ that is spread through large groups
Breakouts of Legionnaire’s Disease tend to occur in places such as hotels where there are large groups of people and where the germs can be spread through ventilation systems. 28

29. Lung Cancer
The leading cause of cancer deaths in both women and men in the United States and throughout the world
85% of cases occur in smokers and former smokers
Other causes are pollution, second-hand smoke, and asbestos exposure
The risk of developing lung cancer increases with the years of smoking and the number of cigarettes smoked. 29

30. Treatment for Lung Cancer
Surgery
Chemotherapy
Radiation therapy 30

31. Pertussis
There is an effective vaccination against pertussis; however, some people choose not to vaccinate their children
If they decide against vaccination, their child may not be able to enter public schools
Recently more cases of pertussis are arising in unvaccinated adults and children

32. Pertussis
The sign or symptom of pertussis is persistent and severe coughing
For the treatment of pertussis, patients are usually hospitalized, medicated, and carefully monitored

33. Pleurisy (Pleuritis)
An inflammation of the membrane that surrounds and protects the lungs (the pleura)
Causes include:
Infections, such as pneumonia, tuberculosis, and other bacterial or viral respiratory infections
Immune disorders, including systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and sarcoidosis
Other diseases, including pancreatitis, liver cirrhosis, and heart or kidney failure
An injury 33

34. Pleurisy (Pleuritis) Symptoms: Sudden, sharp chest pain Referred pain
Pain relief with exertion of pressure on chest
Rapid, shallow breathing
Cyanosis 34

35. Pleurisy (Pleuritis) Treatment: Anti-inflammatory drugs Cough medicine
After pain, coughing to clear congestion 35

36. Critical Thinking Question
Why is coughing to clear congestion recommended after pain subsides? 36

37. Pneumonia
Inflammation of the lung or lungs caused by bacteria, viruses, fungi, or chemical irritants
Streptococcus pneumoniae (pneumococcus) is the most common bacteria
Pneumonia is a common complication of influenza in the elderly, infants, and individuals with compromised immune systems. 37

38. Pneumonia Symptoms: Treatment: Productive cough
Chills, fever, and fatigue
Chest pain and general aches
Treatment:
Antibiotics and pain medications
Fluids and rest
Respiratory treatments and oxygen as needed 38

39. Pneumothorax Occurs when the air enters the chest outside the lungs
Occurs most frequently when the lung has been punctured from trauma
Signs and symptoms are air hunger, extreme dyspnea, cyanosis, restlessness
The treatment must be quick to prevent compression of the heart and lungs
Normally surgery is required

40. Pulmonary Edema A condition in which fluid accumulates in the lungs
Can be a chronic condition, or it can develop suddenly and quickly become life-threatening
Most cases are caused by failure of the heart’s main chamber, the left ventricle, to pump adequately 40

41. Critical Thinking Question
How would left ventricle failure contribute to pulmonary edema? 41

42. Pulmonary Edema Symptoms: Shortness of breath with exertion
Respiratory distress after sleep
Breathing difficulty
Coughing
Severe = pus in sputum, disturbed heart rhythm, bluish skin, thready pulse 42

43. Pulmonary Edema Treatment: Must be immediate to reduce fluid content
Assisted ventilation
Drug therapy 43

44. Pulmonary Embolism Description: Causes:
A blood clot that travels to the lungs
Blocks small vessels
Causes a pulmonary infarct
Causes:
Extended periods of immobility
Surgery or trauma
Obesity, heart disease, and other medical issues 44

45. Pulmonary Embolism Symptoms: Treatment: Sharp chest pain
Shortness of breath
Dry cough
Sweating
Passing out
Anxiety and apprehension
Treatment:
Treated as medical emergency
Medications to eliminate clot or thin blood and raise blood pressure 45

46. Pulmonary Embolism
For a video about pulmonary embolisms, click here, go to MyHealthProfessionsKit.com, or insert the DVD-Rom found in the back of your book. 46

47. Critical Thinking Questions
In addition to the lungs, where else can a blood clot become lodged?
What is the resulting problem? 47

48. Severe Acute Respiratory Syndrome (SARS)
A recently identified respiratory illness that first infected people in parts of Asia, North America, and Europe in early 2003
Caused by a previously unknown strain of coronavirus
Spread mainly through contact with infected saliva or droplets from coughing
Close proximity, less than 3 feet, or contact is probably necessary to become infected
“Close contact” means direct contact with an individual, such as providing care. It does not include walking past or sitting next to someone. 48

49. Severe Acute Respiratory Syndrome (SARS)
Symptoms:
High fever
Aches and discomfort
Respiratory symptoms
Dry cough
Complication:
Pneumonia usually develops
Treatment:
Antibiotics
Antivirals
Steroids 49

50. Sinusitis Infection of the lining of the sinuses
Swelling = blockage and lack of drainage
Infection occurs due to lack of drainage
Chronic or acute
Caused usually by a viral infection, colds, or bacterial infection 50

51. Critical Thinking Question
How can one differentiate between sinusitis and a cold? 51

52. Sinusitis Symptoms: Treatment: Pain and pressure in the face area
Green or yellow nasal discharge
Treatment:
Medications
Moist heat for pain
Prevention of sinus damage 52

53. Tuberculosis (TB) Contagious
Caused by Mycobacterium tuberculosis bacteria
Individuals become infected by inhaling infected droplets from an infected person
Bacteria is usually found in the lungs where granulomas form
May be found elsewhere in the body
Granulomas are granular tumors that occur in tissue infected by the Mycobacterium tuberculosis bacteria. 53

54. Tuberculosis (TB) Symptoms: Treatment: Coughing Hemoptysis
Frothy sputum
Night sweats
Weakness, fatigue, chills
Treatment:
Long term
Respiratory precautions to prevent spread of bacteria
Antibiotics 54

55. Questions? 55