diseases of the respiratory system l.
Download
Skip this Video
Download Presentation
Diseases of the Respiratory System

Loading in 2 Seconds...

play fullscreen
1 / 48

Diseases of the Respiratory System - PowerPoint PPT Presentation


  • 200 Views
  • Uploaded on

Diseases of the Respiratory System. Lung Volumes & Capacities. Forced vital capacity (FVC) amount of air expelled from maximum inspiration to maximum expiration regardless of time Forced expiratory volume (FEV 1 ) amount of air expelled from maximum inspiration in the first second of effort

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Diseases of the Respiratory System' - ashley


Download Now An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
lung volumes capacities
Lung Volumes & Capacities
  • Forced vital capacity (FVC)
    • amount of air expelled from maximum inspiration to maximum expiration regardless of time
  • Forced expiratory volume (FEV1)
    • amount of air expelled from maximum inspiration in the first second of effort
  • FEV1/FVC ratio is critical in separating obstructive & restrictive lung disease
obstructive lung disease
Obstructive Lung Disease
  • Limitation of airflow
  • Rate of expiration is slowed
  • Volume usually normal
restrictive lung disease
Restrictive Lung Disease
  • Limitation of lung expansion
  • Limit to both volume & flow rate
major determinants of disease
Major Determinants of Disease
  • Diseases of one lung compartment tend to affect the others
  • The lungs are open to the environment, exposing them to infectious agents, allergens, irritants, & carcinogens
  • Most lung disease is caused by inhalation of material; the most common exception is autoimmune lung disease
  • Lost pulmonary membrane is not recoverable
  • Smoking is a major cause of lung disease
  • The heart & lungs are a functional unit; lung disease usually affects the heart; & heart disease usually affects the lungs
upper respiratory infections
Upper Respiratory Infections
  • Allergic rhinitis
    • “hay fever”
    • nasal mucosal edema
    • nasal discharge
    • sneezing
    • allergic conjunctivitis
  • “Colds”
    • transmitted through respiratory droplets
    • clear nasal discharge
    • low grade fever
    • if nasal discharge becomes colorful, it is an indication of secondary bacterial infection
  • Acute pharyngitis
    • “sore throat”
    • usually viral
    • bacterial infections more serious
    • red, swollen tonsils
carcinoma of the larynx
Carcinoma of the Larynx
  • Common
  • Mostly in male smokers over 40
  • Alcohol abuse increases the risk
  • Presents with
    • hoarseness
    • pain
    • cough
    • dysphagia
    • hemoptysis
atelectasis
Atelectasis
  • Collapse of a lung or part of a lung
  • Resorption
    • bronchial obstruction
    • air below obstruction completely absorbed
    • obstructions are
      • mucous plug
      • asthma
      • bronchitis
      • tumors
  • Compression
    • pressure exerted from pleural space or upward pressure on diaphragm
  • Contraction
    • scars cause constriction & collapse
    • TB
asthma
Asthma
  • Chronic inflammatory disease of small bronchi & bronchioles
  • Characterized by bronchospasm & air trapping
  • Airflow out is impaired
  • Triggered by inhaled irritants & classified by irritant
  • Allergic
    • type I hypersensitivity
  • Occupational
  • Exercise-induced
  • Infectious
  • Others
    • drug reactions
    • emotional stress
    • severe air pollution
  • Hyperplastic mucous glands in bronchi, hypertrophied smooth muscle, edema, & marked inflammation
chronic obstructive pulmonary disease copd
Chronic Obstructive Pulmonary Disease (COPD)
  • Related diseases
  • Chronic bronchial outflow obstruction
  • Overlapping features
emphysema
Emphysema
  • Destruction of alveolar walls, alveoli merge to form large air spaces
  • Loss of surface area affects diffusion
  • 90% of cases are smokers
slide14
Cigarette smoke irritates lung & causes inflammation
  • Inflammatory cells release digestive enzymes
  • These enzymes normally inhibited by alpha-1 antitrypsin
  • AAT inhibited by smoke & so enzymes digest lung tissue
slide15
Shortness of breath
  • Wheezing & coughing
  • Weight loss
  • Barrel-chested
  • Exhibits “tripoding”
chronic bronchitis
Chronic Bronchitis
  • Chronic cough that produces sputum for 3 consecutive months 2 years in a row
  • Primary cause is cigarette smoking
  • Chronic inflammation of bronchi
  • Simple chronic bronchitis
  • Chronic asthmatic bronchitis
  • Obstructive chronic bronchitis
slide17
Most patients have chronic bronchitis & emphysema in varying degrees
  • “pink puffers”
    • emphysema
    • usually thin
    • barrel-chested
    • short of breath but well oxygenated
  • “blue bloaters”
    • obstructive chronic bronchitis
    • wheezing, coughing
    • sputum production
    • cyanotic
    • no lost pulmonary membrane
  • All at risk of chronic hypoxia
bronchiectasis
Bronchiectasis
  • Marked, permanent dilation of small bronchi
  • Destruction of smooth muscle & elastic supporting tissue
  • Must have obstruction & infection
    • obstruction causes mucus retention
    • infection damages bronchial walls which causes excess mucus production
  • Not a primary condition
  • Typically involves lower lobes
  • Persistent cough
restrictive lung disease19
Restrictive Lung Disease
  • Chronic inflammation making lungs stiff & inelastic
  • Affects diffusion
  • Scar tissue accumulates in the interstitium
  • Mostly cause is unknown
  • Equal decline in FEV1 & FVC
  • Usually presents with shortness of breath
  • Can lead to pulmonary HTN
interstitial fibrosis without granulomatous inflammation
Interstitial Fibrosis without Granulomatous Inflammation
  • Usually middle-aged men at time of diagnosis
  • Shortness of breath; may progress to cor pulmonale, hypoxia
  • Pneumoconioses
    • black lung disease
    • silicosis
      • most common chronic occupational disease
    • asbestosis
      • mesothelioma
interstitial fibrosis with granulomatous inflammation
Interstitial Fibrosis with Granulomatous Inflammation
  • Sarcoidosis
    • cause unknown
    • affects many tissues but mostly lungs
    • present with shortness of breath, cough, chest pain, hemoptysis
pulmonary edema
Pulmonary Edema
  • Fluid in alveoli
  • Increased BP in lung
    • normal is 25/8 mmHg with average at 15 mmHg
  • Microvascular injury
    • due to
      • toxic fumes
      • hot gases
      • septicemia
      • IV drug abuse
  • Main symptom is SOB
pulmonary thromboembolism
Pulmonary Thromboembolism
  • About 50,000 deaths annually
  • Mostly from DVT
  • Inflammation predisposes you to it
  • Promoted by
    • CHF
    • pregnancy
    • birth control pills
    • prolonged bed rest
    • metastatic cancer
    • genetics
  • Most associated with no symptoms but some
    • cause lung infarcts
    • chest pain & dyspnea
    • death
pulmonary hypertension
Pulmonary Hypertension
  • Sustained systolic pressure over 30 mmHg or average in excess of 25 mmHg
  • Vicious cycle
  • Most common cause is increased pulmonary vascular resistance
  • Usually secondary to
    • COPD
    • heart disease
    • collagen vascular diseases
    • recurrent pulmonary thromboemboli
  • With R heart failure is cor pulmonale
  • Thickening of arteriolar walls
  • SOB
    • chest pain
    • fatigue
adult respiratory distress syndrome
Adult Respiratory Distress Syndrome
  • ARDS
  • Alveolar or pulmonary capillary damage
  • Pathogenesis
    • injury to endothelium or alveoli
    • neutrophils infiltrate
    • protein-rich fluid exudes into alveolar space
    • SOB occurs with rapid breathing which dries the fluid into a thick membrane
    • stiffens lungs
    • limits airflow & interferes with diffusion
    • hypoxia
  • 50% fatality
  • Causes
    • sepsis
    • smoke inhalation
    • near drowning
    • O2 toxicity
    • burns
    • DIC
    • fat embolism
    • endotoxic shock
pneumonia
Pneumonia
  • Inflammation of the lungs
  • Usually caused by bacteria
  • 80,000 deaths/yr
  • Alveolar pneumonia
    • usually acute
    • fill with inflammatory exudate
    • most common
slide27
Bronchopneumonia
    • patchy inflammation
    • involves alveoli of more than 1 lobe
    • usually in basilar parts
  • Lobar pneumonia
    • consolidation of an entire lobe
    • almost always caused by S. pneumoniae
interstitial pneumonia
Interstitial Pneumonia
  • Inflammation in septa
  • Diffuse & bilateral
  • Usually viral
slide29
Etiology

mostly bacterial

S. pneumoniae

Haemophilus influenzae

Staph

E. coli

Pseudomonas

Pathogenesis

inhalation of droplets, aspiration of gastric contents, blood-borne spread

those susceptible include

immune deficiency

decreased cough reflex

impaired cilia

accumulated secretions

pulmonary congestion

slide30
Community-acquired

acute pneumonia

bronchopneumonia

lobar pneumonia

Legionnaire’s disease

atypical pneumonia

Mycoplasma

Nosocomial

Commonly S. aureus & E.coli

Seen in

People with severe disease

Prolonged antibiotic therapy

People with internal mechanical devices

Aspiration

Inflammatory reaction due to corrosive effects

Those who are comatose or those with a stroke

Hi mortality rate

slide31
Seen mostly in the young & the elderly
  • Hypoxia & death
  • Bacterial
    • high fever & chills
    • purulent sputum
    • increased neutrophils
    • cough
    • SOB
  • Interstitial
    • less severe
    • increased lymphocytes
    • cough
    • SOB
lung abscess
Lung Abscess
  • Purulent inflammation with tissue necrosis & liquefaction
  • Usually have several types of bacteria with anaerobic
  • Most commonly due to aspiration of gastric contents
  • Foul-smelling sputum
tuberculosis
Tuberculosis
  • Mycobacterium tuberculosis
  • Chronic granulomatous inflammation with caseous necrosis
slide37
Affects about 2 billion worldwide
  • Kills about 2 million/yr
  • 2nd only to AIDS
  • Associated with poverty, crowding, malnourishment, & chronic disease
  • PPD
slide38
Low-grade fever
  • Night sweats
  • Malaise
  • Weight loss anorexia
mycoses
Mycoses
  • Histoplasmosis
  • Coccidiomycosis
  • Cryptococcus
lung neoplasms
Lung Neoplasms
  • Mostly due to metastasis
  • Bronchogenic carcinoma is the most common
    • most common of all cancers
    • #1 cancer death
    • about 90% are cigarette smokers
bronchogenic carcinoma
Bronchogenic Carcinoma
  • Mostly caused by cigarettes
    • Direct relationship between incidence of cancer & number of cigarettes smoked
    • Direct relationship between precancerous changes in bronchial mucosa & number of cigarettes smoked
slide44
Small cell carcinoma

20% of cases

arise from specialized neuroendocrine cells of the bronchus

strongest relationship to cigarettes

aggressively malignant

Squamous cell carcinoma

30% of cases

bronchial epithelium that has undergone metaplasia

arises centrally

most common in men who smoke

grows slower so better prognosis

Adenocarcinomas

30% of cases

most well-differentiated

somewhat better prognosis

more peripheral in smaller bronchi

less associated with smoking

Large cell carcinoma

15% of cases

poor prognosis

metastasizes early

bronchial carcinoid tumor
Bronchial Carcinoid Tumor
  • 5% of lung cancers
  • Arise from bronchial neuroendocrine cells
  • Much less aggressive
  • Grows slow
pneumothorax
Pneumothorax
  • Air in pleural space
  • Causes atelectasis
  • May occur spontaneously
  • More frequent in people with emphysema who have large blebs near pleura
  • Traumatic penetration
  • Can be fatal
  • Tension pneumothorax
    • air in but not out
pleural effusion
Pleural Effusion
  • Fluid in pleural space
  • Transudate from CHF most common
  • If blood, called hemothorax
pleuritis
Pleuritis
  • Inflammation
  • Pleurisy with each breath
  • Mostly caused by pneumonia