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DISEASES OF THE RESPIRATORY SYSTEM

DISEASES OF THE RESPIRATORY SYSTEM. Respiratory System. DISEASES OF NOSE, SINUSES & PHARYNX. Rhinitis Rhinitis is inflammation of the nasal mucosa. It is usually accompanied by sinusitis. Types: acute or chronic Acute. Acute catarrhal rhinitis. Acute allergic rhinitis.

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DISEASES OF THE RESPIRATORY SYSTEM

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  1. DISEASES OF THE RESPIRATORY SYSTEM

  2. Respiratory System

  3. DISEASES OF NOSE, SINUSES & PHARYNX • Rhinitis • Rhinitis is inflammation of the nasal mucosa. It is usually accompanied by sinusitis. • Types: acute or chronic • Acute Acute catarrhal rhinitis Acute allergic rhinitis

  4. Acute catarrhal rhinitis • Aetiology: viral: rhinoviruses may be followed by bacterial infection, exposure to cold • Pathology: catarrhal inflammation • Complications: Spread of infection may lead to sinusitis, pharyngitis, adenoids, laryngitis, otitis media, bronchitis, bronchopneumonia….

  5. ACUTE ALLERGIC RHINITIS • Aetiology: caused by inhalation of certain allergen (as pollens) hypersensitivity reaction. • Pathology: Inflammation is rich in eosinophils. • Complications: chronicity may lead to nasal polyps

  6. Nasal polyps • are polypoidal masses arising mainly from the mucous membranes of the nose and paranasal sinuses. They are overgrowths of the mucosa that frequently accompany allergic rhinitis.

  7. Nasal polyps • Aetiology: Repeated attacks of allergic rhinitis and sinusitis. • Gross: Multiple pink polyps, projecting from the mucosa of the nose and sinuses. • Complications: • Nasal obstruction: This predisposes to infection leading to chronic rhinitis and sinusitis. • Epistaxis.

  8. Non specific Chronic Rhinitis Specific • Non specific: • The condition is caused by nasal obstruction due to : nasal polyps, deviated nasal septum. These leads to mucous retention, which favors bacterial infection & chronicity. • Pathology: The affected mucosa shows chronic inflammatory changes, fibrosis. • Types of Chronic Nonspecific Rhinitis: a) Simple (non thickened mucosa). b) Hypertrophic: Mucosa is thickened & polypoid

  9. Specific Chronic (granulomatous) Rhinitis Due to specific cause • Bacterial as rhinoscleroma, tuberculosis, leprosy, syphilis. • Fungal as rhinosporidiosis. - Parasitic as leishmaniasis. Rhinoscleroma Mucocutaneousleishmaniasis

  10. Scleroma (Rhinoscleroma) • Aetiology: Klebsiella rhinoscleromatis. • Nose is the most common site (rhinoscleroma), but pharynx (pharyngioscleroma), larynx (laryngioscleroma) & upper trachea may be also affected. • Pathology: • Gross Features: Single or multiple hard nodular swelling filling the nasal cavity & may extend to sinuses, pharynx, larynx & upper trachea. - Microscopy: • 1- The covering nasal mucosa may show squamous metaplasia. • 2- The submucosa is densely infiltrated with inflammatory cells & shows progressive fibrosis. • Complication: • 1- Nasal obstruction and deformity. • 2- Ulceration, bleeding (epistaxis) and secondary bacterial infection.

  11. Nasal sinuses

  12. 1. Frontal Sinuses, 2. Ethmoid Sinuses 3. Sphenoid Sinuses 4. Maxillary Sinuses

  13. Sinusitis • inflammation of the mucosa of the paranasal sinuses commonly occurs in association with rhinitis. • Acute Catarrhal & Allergic Sinusitis: Occur in association with similar types of acute rhinitis. • Chronic Sinusitis: • a) A complication of repeated attacks of acute rhinitis and sinusitis. • b) Spread of infection from an infected tooth (mainly maxillary sinus).

  14. Pharyngitis

  15. Pharyngitis • - ACUTE PHARYNGITIS: • Aetiology: Commonly streptococcus hemolyticus infection. • Pathology: Catarrhal or suppurative inflammation. • Complications: • a) spread of infection  i) adenoids, laryngitis, otitis media, bronchitis, pneumonia …. • ii) cellulitis of neck. iii) retropharyngeal abscess. • b) Development of autoimmune disease as rheumatic fever of glomerulonephritis • Chronic pharyngitis • a) Nonspecific following acute pharyngitis. • b) Specific as scleroma.

  16. Adenoids • Hyperplasia of the lymphoid tissue present at the posterior wall of the nasopharynx of infants and children due to chronic infection. • Pathology: • Gross features: Swollen adenoid tissue. • Microscopic features: Hyperplastic lymphoid follicles. • Effects: Nasopharyngeal obstruction  mouth breathing. Spread of infection otitis media, bronchitis

  17. Diphtheria • Aetiology: infection of the upper respiratory tract with Corynbacterium diphtheriae. The disease mainly affects unimmunized children 2-5 years. • Pathology: Pseudomembranous inflammation. • Complications: 1. Asphyxia 2.Severe toxaemia.

  18. Diphtheria

  19. Epistaxis • means bleeding from the nose. • Aetiology: • 1- Local Causes: a) Trauma b) Foreign bodies c) Tumors (of nose & sinuses) d) Nasal polyp e) Rhinoscleroma f) Rhinitis • 2- General Causes: a) Hypertension b) Fevers (febrile disease as typhoid) c) Hot climate d) Blood diseases as leukemia e) Vitamin C or K deficiency

  20. Acute Tonsilitis Three types: 1-Catarrhal Tonsillitis: Enlarged tonsils with hyperaemic mucosa. 2-Follicular (suppurative) Tonsillitis: Remarkably enlarged tonsils with suppuration of lymphoid follicles. 3-Membranous Tonsillitis: In severe cases mucosal necrosis, exudates and pus form a yellowish membrane covering the tonsils. • Complications: - Direct spread of infection leading to: a) Peritonsillar abscess. b) Otitis media. c) Pharyngitis, laryngitis, bronchitis. • Lymphatic spread leads to cervical lymphadenitis. • Blood spread leads to bacteraemia, toxaemia. • Immunological reactions as: a) Rheumatic fever. B) Glomerulonephritis. • CHRONIC TONSILLITIS • Characterized by hyperplasia of lymphoid follicles, chronic inflammation and fibrosis

  21. Tonsilitis

  22. The ear

  23. Acute suppurative otitis media • Occurs due to spread of pyogenic bacteria through the Eustachian tube from nearby infections as tonsillitis, adenoids and pharyngitis. • Pathology: • 1-The Eustachian tubes are obstructed due to inflammation and swelling of their mucosa. • 2- The cavity of the middle ear is filled with pus due to suppurative inflammation. • 3- The tympanic membrane bulges then becomes perforated due to high tension of the accumulating pus leading to purulent discharge from the ear. • Complications: • 1- Spread of infection, which may lead to intracranial infections as meningitis & brain abscess • 2- Aural polyp: Mass of granulation tissue. • 3- Chronic suppurative otitis media, this may lead to tympanosclerosis

  24. Diseases of the larynxLaryngitis • ACUTE LARYNGITIS: • Aetiology: 1-Bacterial infection: commonly streptococcus hemolyticus. 2- Viral infection e.g. measles. 3- Chemical irritation e.g. inhalation of irritant gases as chlorine and fumes. 4-Mechanical irritation faulty excessive use of voice leads to vocal cord irritation. • Pathology: Catarrhal inflammation • Chronic Laryngitis: • a) Nonspecific due to chronic irritation with smoking or chronic faulty use of voice. The vocal cords show chronic inflammation or laryngeal nodules. Clinically hoarseness of voice. • b) Specific as: laryngoscleroma , tuberculous laryngitis, syphilitic laryngitis

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