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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

16. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Pulmonary Disorders Pulmonary abscess: area of contained infectious material in the lung Causes:  Often a complication of pneumonia caused by bacteria  Aspiration of food, foreign object, bronchial stenosis or neoplasms  Septic embolism is carried to lung via pulmonary circulation

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

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

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

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

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

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

23. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.  Pulmonary emphysema: chronic obstructive pulmonary disorder characterized by destructive changes in alveolar walls and irreversible enlargement of alveolar air spaces Chronic Obstructive Pulmonary Disease (cont'd.)

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

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

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

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

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