Chapter 8: Diseases and Disorders of the Respiratory System

Human Diseases and Conditions a Systemic Approach

Common signs of respiratory disease

Chest pain, dyspnea, wheezing, coughing, hemoptysis, fatigue, fever, dysphonia, cyanosis, sinus and nasal drainage, clubbing fingers and toes, tachypnea, abnormal breathing sounds.

Dyspnea

Difficulty breathing

Hemoptysis

coughing blood

dysphonia

hoarseness

Tachypnea

Rapid breathing

Spirometry

(First and most commonly done lung test.) Measures the air capacity of lungs

Peak flow (peak expiratory rate)

measured with a tube and gauge device to measure how much a patient can exhale

Bronchial challenge test

Used to determine and quantify airway hypersensitivity

Pulse oximetry

Used to measure oxygen saturation in the blood. Normally greater than 90%

Arterial blood gases (ABGS)

Evaluate levels of CO2 and O2 and blood pH. Normal levels should be high in O2 in low in CO2

Wheezing

High pitched continous whistle caused by airway secretions and narrowed airway

Crackles

Caused by airway secretions and airway opening. Inhaled air collides with previously deflated airways and the airways suddenly pop open creating the sound.

Pleural rub

Creaking sound like walking on snow. Decreased lubrication causes the 2 pleura to rub together.

Resonance

Low-pitched sound heard over normal lungs

Hyperresonance

Loud, low-pitched sound than normal heard over hyperinflated lungs.

Tympany

Drum-like loud empty sound. Not normal. Indicated excessive air in chest.

Dull

Normally heard in dense areas like the heart or liver. Replaces normal sound when fluid or soft tissue replaces air containing lung tissue.

Common cold

Acute contagious infection of the upper respiratory tract. Marked by inflammation of mucous membranes with a watery then purulent discharge.

Allergic Rhinitis

Inflammation in the mucous membrane of the nose caused by allergic reaction to airborne substances. IgE binds to mast cells.

Sinusitis

Inflammation of the sinuses.

Tonsilitis

Infection of the lymphatic tissue at the back of the throat.

Pharyngitis

Inflammation of the pharynx characterized by throat pain. Causes sore throat

Laryngitis

Inflammation of the voice box. Dysphonia is the main sign. Can be caused by overuse of voice, viral infection, or exposure to irritating substances.

Influenza

Acute highly contagious respiratory infection causing 200k hospitalizations and 36k deaths in the US in a year and 250-500k deaths globally.

Pneumonia

Infection in lungs where the alveoli are filled with pus and fluid. Crackly breath sounds and dull percussion note.

Fungus causing pneumonia in AIDS patients

Pneumocystis jirovecii

Most common cause of bacterial pneumonia

Streptococcus pneumoniae

Pneumonia vaccine

PPSV (Pneumococcal polysaccharide vaccine)

Tuberculosis (TB)

Potentially fatal contagious disease. Causes tissues to die and become soft or cheese-like (caseous lesion). Bacteria gets walled off into pockets with fibrosis and calcification in lesions called tubercles.

Chronic Obstructive Pulmonary Disease (COPD)

Preventable and treatable disease characterized by not fully reversible airflow limitation. Mainly caused by smoke. Encompasses several obstructive diseases. Auscultation reveals wheezing, or crackles and decreased breathing. Hyperressonance percussion note.

Emphysema

Irreversible obstructive lung disease where the alveoli are destroyed causing shortness of breath and loss of elasticity in remaining alveoli. Patient may develop barrel chest. Pursed lip breathing, puckered lip exhaling.

Barrel chest

Caused by enlargement of the lungs and chest wall and ineffective use of breathing muscles.

Chronic bronchitis

Chronic inflammation of bronchi. Cough with sputum lasting >3 months. Excessive mucus production blocks airflow through bronchi resulting in hypoxia.

Immediate health benefits of smoking cessation

Heart rate and BP return from high to normal, blood carbon monoxide levels decrease, improved circulation, less phlegm, and less coughing/wheezing, substantial lung function improvement, improved sense of smell and better tasting food.

asthma

condition where the bronchial tubes react to stimuli with inflammation.

Cystic Fibrosis (CF)

Autosomal recessive disease affecting exocrine glands of the lungs causing them to excrete excessive thick mucus. Bronchiectasis is a common complication for it. Infants tested for levels of IRT from the pancreas.

Bronchiectasis

Weakened or dilated bronchial tubing

Pleurisy

Inflammation of the pleural membranes of the lungs. main sign is sharp chest pain worsening with breathing. Auscultation reveals pleural rub.

Pneumothorax

Collection of air or gas in the chest/ pleural space causing lung collapse. Occurs when there is greater pressure in pleural space than lungs.

Blebs

Air-filled blisters in the lungs of some tall and underweight people

Atelectasis

Collapse of lung tissue. The alveoli in affected area no longer fill with air. A mucus plug is the most common cause.

Pulmonary Embolism (PE)

Blockage in one or more lung arteries.

Non Small cell lung cancer (NSCLC)

80% of lung cancers

Small cell lung cancers

20% of lung cancers

Aging effects of Respiratory system

Elastic tissue of lung deteriorates reducing lung capacity, muscles weaken, arthritis in joints of ribcage and vertebrae impair breathing causing labored breathing. 1 square foot of respiratory membrane lost each year after age 30.