pathophysiology by dr: hana omer. review of anatomy & physiology
TRANSCRIPT
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Pathophysiology By Dr: HANA OMER Pathophysiology By Dr: HANA OMER
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Review of Anatomy & PhysiologyReview of Anatomy & Physiology
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UPPER RESPIRATORY TRACTUPPER RESPIRATORY TRACTRESPIRATORY MUCOSA
1. lined with ciliated mucus producing cells125cc/ day
2. purifies air
NOSE
1. paranasal sinusesfrontal, maxillary, sphenoid, ethmoid lighten skullsound resonant chambers
2. conchae (3 pairs)warm & humidify air
3. lacrimal ducts4. olfactory receptors
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UPPER RESPIRATORY TRACTPHARYNX
1. 3 parts: Nasopharynx, Oropharynx, Laryngopharynx
2. Tonsils(3 pairs) pharyngeal (adenoids) palatine lingual
3. Eustachian (auditory) tubes open into nasopharynx equalizes pressure between middle ear & the
outsideLARYNX
1. composed of pieces of cartilage Thyroid cartilage= Adam’s apple
2. epiglottis & glottis
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1. TRACHEA1. composed of C- shaped cartilaginous rings
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LOWER RESPIRATORY TRACTLOWER RESPIRATORY TRACTBRONCHI, BRONCHIOLES, ALVEOLAR DUCT,
ALVEOLI1. Gas exchange occurs in alveoli
occurs via Passive Diffusion2. Respiratory Membrane
2 cell thick layersurfactant = reduces surface tension to keep alveoli
distendedlining of alveolus (alveolar epithelium)lining of capillary ( capillary endothelium)
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LOWER RESPIRATORY TRACT
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LOWER RESPIRATORY TRACTLOWER RESPIRATORY TRACTLungs & Pleura
1. Right Lung = 3 lobes; Left Lung = 2 lobes2. lower part of lung resting on diaphragm =
Base of lung3. upper part of lung under clavicle = Apex of
lung 4. Pleura = serous membrane (i.e. secretes
some fluid)Parietal Pleura lines thoracic cavityVisceral Pleura lines organs (viscera)
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Respiratory System DiseasesRespiratory System Diseases General Outline General Outline1) INFECTIOUS DISEASES
Upper Upper respiratory infection Croup Epiglottitis Flu (Influenza)
Lower Bronchiolitis Pneumonia TB Fungal diseases
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RESPIRATORY SYSTEM DISEASES
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RESPIRATORY SYSTEM DISEASESRESPIRATORY SYSTEM DISEASES GENERAL OUTLINE GENERAL OUTLINE2) COPD (chronic obstr. pulm. dis)
EmphysemaChronic bronchitis
3) Restrictive lung diseasesChest wall abnormalitiesConnective tissue abnormalities
Pneumoconioses
4) Obstructive lung diseasesCystic fibrosisCancerAspiration pneumoniaAsthma
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RESPIRATORY SYSTEM DISEASESRESPIRATORY SYSTEM DISEASES GENERAL OUTLINE GENERAL OUTLINE
5) Vascular disordersPulmonary edemaPulmonary embolism
6) Expansion disordersAtelectasisPleural effusionPneumothoraxResp. distress syndrome
Infantadult
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Manifestations of PulmonaryManifestations of Pulmonary DiseaseDisease1. Sneezing = reflex response to irritation of upper
respiratory tract
2. Coughing = reflex response to irritation of lower respiratory tract
3. Sputum productionIf yellowish- green ------ infectionIf rusty ------- blood + pus = pneumococcal pneumoniaIf bloody , called “hemoptysis” ---- usually frothy --- seen
in pulm. EdemaAlso seen in pulm. TB & cancer
Large amounts & foul = bronchiectasisThick & sticky = asthma, cystic fibrosis
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Manifestations of PulmonaryManifestations of Pulmonary DiseaseDiseaseBreathing patterns
Labored (dyspnea) , wheezing, stridorBreath sounds
Normal, rales, rhonchi, decreased breath sounds
Dyspnea --- discomfort feeling when can’t get enough airOrthopnea = dyspnea lying down
Cyanosis --- not a reliable early indicator of hypoxia
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UPPER RESPIRATORY TRACT INFECTIONSUPPER RESPIRATORY TRACT INFECTIONSDefinition
Acute inflammatory process that affectsmucus membrane of the upper respiratorytract
Includes one or more of the followingProblems
Rhinitis also called CoryzaPharyngitisLaryngitisSinusitis
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Upper Respiratory Infection (URI)
S/S = low-grade fever, malaise, sore throat, & discharge
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INFLUENZA
1) Viral types---- A,B, &C
They mutate constantly thus preventing effective immune defense for prolonged time periods
2) Short incubation ---- 3 days
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Pneumonia
Definition
It is an inflammatory process of the lung parenchyma that is commonly caused by infectious agents.
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Classification of pneumoniaAccording to causes Bacterial (the most common cause of pneumonia)
Streptococcus pneumoniae, Haemophilus influenzae
Viral pneumonia
Respiratory syncytial virus, parainfluenza viruses
Fungal pneumonia
Candida species, Aspergillus species
Chemical pneumonia (ingestion of kerosene or inhalation of
irritating substance)
Inhalation pneumonia (aspiration pneumonia)
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Classification of pneumoniaAccording to areas involved
Lobar pneumonia; if one or more lobe is
involved
Broncho-pneumonia; the pneumonic process
has originated in one or more bronchi and
extends to the surrounding lung tissue.
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Mode of transmissionWAYS YOU CAN GET PNEUMONIA INCLUDE:
Bacteria and viruses living in your nose, sinuses, or mouth may spread to your lungs.
You may breathe some of these germs directly into your lungs (droplets infection).
You breathe in (inhale) food, liquids, vomit, or fluids from the mouth into your lungs (aspiration pneumonia).
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Predisposing factors1. Immuno-suppresed patients
2. Cigarette smoking
3. Difficult swallowing (due to stroke, dementia,parkinsons disease, or other neurological conditions)
4. Impaired consciousness ( loss of brain function due to dementia, stroke, or other neurological conditions)
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Predisposing factors
5. Chronic lung disease (COPD, bronchostasis)
7. Other serious illness such as heart disease, liver cirrhosis, and DM
8. Recent cold, laryngitis or flu.
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PATHOPHYSIOLOGY OF PNEUMONIA
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CLINICAL MANIFESTATION OF PNEUMONIA
Shaking chills
Rapidly rising fever ( 39.5 to 40.5 degree)
Stabbing chest pain aggravated by respiration and coughing
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CLINICAL MANIFESTATION OF PNEUMONIA
Tachypnea, nasal flaring
Patient is very ill and lies on the affected side to decrease pain
Use of accessory muscles of respiration e.g. abdomen and intercostals muscles
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CLINICAL MANIFESTATIONS…..
Cough with purulent, blood tinged, rusty sputum
Shortness of breath
Flushed cheeks
Loss of appetite, low energy, and fatigue
Cyanosed lips and nail beds
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DIAGNOSTIC TESTS FOR PNEUMONIA
History takingPhysical examinationChest x-rayBlood testSputum culture
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MEDICAL MANAGEMENT OF PNEUMONIA
Antibiotic, depending on sputum and blood culture
Oxygen therapy
Chest physiotherapy
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COMPLICATIONS
Acute respiratory distress syndrome (ARDS)
Pleural effusion
Lung abscesses
Respiratory failure (which requires mechanical ventilator)
Sepsis, which may lead to organ failure
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BRONCHITISLOWER RESPIRATORY TRACT
INFECTION
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BRONCHITIS
DEFINITION Bronchitis is defined as the inflammation or
infection of bronchi and bronchioles.
Depending on the duration of disease , it can be
1. Acute (lasts for few days)2. Chronic (for prolonged time)
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BRONCHITISCAUSES FOR ACUTE TYPE
1. Viral infections 90% Influenza virus A,B ,adenovirus ,
respiratory syncytial virus. 2. Bacterial infections 10% Mycoplasma pneumoniae,
streptococcus pneumoniae
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BRONCHITIS
PREDISPOSING FACTORS
1. Chronic sinusitis2. Chronic obstructive pulmonary disease3. Asthma4. Bronchiectasis5. Smoking and second hand smoke.6. Alcoholism
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BRONCHITISClinical manifestations SYMPTOMS
History of dry or productive cough 5- 10 days
Body aches Chest pain on coughing Soar throat
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BRONCHITIS
SIGNS
1. Mild to moderate fever2. Increased respiratory rate3. Increased heart rate4. Wheezing on auscultation
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BRONCHITISMANAGEMENTGoals of management are
1. To releive the symptoms2. To prevent the PneumoniaTreatment
1. Symptomatic treatment to relieve the pain, fever and cough
2. Increase the rest time3. Increase the hydration(8-10 glasses of water)4. Avoid the aggravating factors
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