Upper Pulmonary Pathology

Where is the division between the upper and lower respiratory ststems?

right below the larynx

What is the role of the nasal conchae?

warms and humidifies air

Where is the most common place of nasopharangeal carcinoma (NPC)?

Fossa of Rosenmuller

What do tonsils help with?

fighting infections

What are the 3 tonsils?

pharyngeal, palatine, lingual

What are the upper respiratory tract disorder?

Nasal polyps, Rhinitis, Singer's nodule (vocal cord nodule), Laryngotracheobronchitis (croup), and Laryngeal carcinoma

What is Rhinitis caused by?

inflammation of the nasal mucosa typically seen as an adenovirus (common cold)

aka a runny nose

What are the signs and symptoms of Rhinitis?

common cold, hypersensitivity reaction to pollen (allergies), rhinorrhea, sneezing and congestion

Who are the patients most likely to get Rhinitis?

people who have asthma and atopic dermatitis (eczema)

What are Nasal Polyps?

inflamed and edematous nasal mucosa

What patients are Nasal Polyps seen in?

cystic fibrosis (CF), Aspirin-intolerant asthma (AIA), aspirin induced bronchospasm and nasal polyps

Where do Singer's nodule (vocal cord nodules) arise?

on the true vocal cords and are non-neoplastic and bilaterally

What causes Singer's nodule?

overuse

What do patients with Singer's nodule present with?

hoarseness of the voice

What is the anatomical place where Singer's nodule occur?

Reinke's space: between mucus membrane that covers the vocal cords

What is the space between the vocal cords called?

Rimaglottidas

What is Laryngotracheobronchitis (coup) caused by?

parainfluenza virus

What do patients with Laryngotracheobronchitis (coup) present with?

barking cough, hoarse voice and inspiratory stridor (noisy breathing upon inspiration)

Is Laryngotracheobronchitis (coup) worse during the day or at night?

night

Where does Laryngeal carcinomas arise?

epithelial lining of the vocal cords

What are risk factors of Laryngeal carcinomas?

alcohol and tobacco use

What are the signs and symptoms of Laryngeal carcinomas?

hoarseness, stridor (noisy breathing), and cough

What are the normal lung sounds?

bronchial, broncho-vesicular, and vesicular

Where is bronchial lung sound best heard?

over the trachea

Where is the broncho-vesicular lung sound best heard?

over the main bronchus and upper posterior lung field

Where is the vesicular lung sound best heard?

over the periphery (sides) of the lungs

What are the abnormal lung sounds?

rhonchi (rhoncus), rales (crackles), wheezes, and stridor

What is a Rhonchi (rhoncus) lung sound?

Low pitch rattling noises in the lung which is likened to a snoring sound

Excessive inflammatory secretions, or obstructions, in the larger bronchial passageways can cause this

What is a Rales (crackle) lung sound?

Higher (fine) or lower (coarse) pitched popping noise heard upon inspiration (crackling cellophane)

Fluid found in smaller, distal conduits of airway and alveoli

What is a Wheeze lung sound?

Higher pitched whistling sounds resulting in narrowing of the bronchial tree as seen in asthma

Smooth muscle in bronchi spasm

What is a Stridor lung sound?

Type of high pitched wheeze that is dependent on whether it occurs during inspiration or expiration.

What happens when Stridor occurs during expiration?

an obstruction in the lower respiratory tract

What happens when Stridor occurs during inspiration?

an upper respiratory tract, glottis or trachea

What is it called when a stridor is heard on both inspiration and expiration?

Biphasic

Where are the best places to hear lung sounds?

intercostal spaces