Presentation 2: AIRWAY

Dr. Bushra Bilal

Dr. Miada Mahmoud Rady

CLS 243

Introduction

The common respiratory system disorders :

1. Infections such as pneumonia.

2. Obstructive disorders that obstruct airflow into and out of the

lungs such as asthma, bronchitis and emphysema.

3. Restrictive disorders are conditions that limit normal expansion

of the lungs such as pneumothorax, atelectasis and respiratory

distress syndrome

4. Cancers.

Important terminology

1. Hypoxia : Decreased levels of oxygen in the tissues

2. Hypoxemia : Decreased levels of oxygen in arterial

blood.

3. Hypercapnia : Increased levels of CO2 in the blood

4. Hypocapnia : Decreased levels of CO2 in the blood

5. Dyspnea : Difficulty breathing

Important terminology

6. Tachypnea : Rapid rate of breathing.

7. Cyanosis : Bluish discoloration of skin and mucous

membranes due to poor oxygenation of the blood.

8. Hemoptysis : Blood in the sputum.

Presentation of chest diseases

Cardinal Manifestation

1. Cough ( Dry or Productive).

2. Hemoptysis.

3. Dyspnea.

4. Wheezes.

5. Chest pain.

Other presenting symptoms

1. Hoarseness.

2. Stridor.

3. Snoring .

4. Fever.

5. Night sweating.

6. Weight loss.

Signs and Symptoms Of Respiratory Disorders

1. Cough : It could be either acute or chronic

Dry ( Bronchial asthma ) or productive ( pneumonia ).

A. Acute : acute bronchitis , pneumonia .

B. Chronic : cough that persists more than 8 weeks e.g.

bronchial asthma , chronic bronchitis and lung cancer.

2. Cyanosis : Central ( blue hands and blue tongue ) as in Sever

Asthma or Peripheral ( blue hands and red tongue ) as in

Cold Weather .

Signs and Symptoms Of Respiratory Disorders

Hemoptysis: blood in the sputum as in

1. Lung cancer.

2. Tuberculosis.

3. Pneumonia.

Wheezes : seen in asthma and chronic bronchitis.

Chest pain : Caused by multiple disorders e.g. Angina

pectoris.

Chest Diseases

Infections

It can affect upper or the lower airway or both.

It can be caused by bacteria , viruses or fungi.

Most common forms :

1. Common cold .

2. Pneumonia .

3. Bronchitis.

Common Cold

• Viral infection mostly caused by :

1. Rhinoviruses .

2. Respiratory syncytial virus .

3. Adenovirus .

4. Influenza and parainfluenza virus .

5. Corona virus.

Presentation of common cold

1. Systemic : Fever , Headache and bone aches.

2. Local :

Rhinitis and sinusitis : inflammation of mucosa of the nose

and nasal sinuses , present with nasal discharge and congestion.

Pharyngitis : inflammation of the throat , which present with

pain in the throat and painful swallowing .

Bronchitis : inflammation of the bronchi , which present with

acute cough and chest pain.

Pneumonia

• Definition : inflammation of the lung alveoli.

• It can be Caused By bacteria , viruses or fungi.

• Presentation :

1. Systemic : fever , chills , headache and bone aches .

2. Local :

Difficulty in breathing (dyspnea).

Cough ( productive) : with yellowish , greenish or blood

tinged sputum.

Cyanosis in sever cases.

Investigation and Treatment

1. Investigation :

X-ray .

CBC : leucocytosis.

Sputum analysis.

2. Treatment : hospitalization , oxygen , antibiotic and

antipyretics .

Chronic Obstructive Pulmonary Disease( COPD)

Definition : It is a group of disorders characterized by chronic

progressive Airway Obstruction.

It include 3 disorders : bronchial asthma , emphysema and

chronic bronchitis .

It divided into two categories :

1. Type A ( Pink Buffer ) : mainly emphysema .

2. Type B ( Blue Bloaters ) : mainly chronic bronchitis .

Investigation

1. CXR .

2. C.T .

3. Pulmonary function test.

4. ECG .

5. Echocardiography.

6. Laboratory finding.

Laboratory investigation

1. CBC : anemia , leucocytosis.

2. ABG : hypoxemia and hypercapnea .

3. Sputum analysis and culture .

4. Alpha- 1 antitrypsin level.

Emphysema

Definition : COPD characterized by abnormal and permanent

enlargement of the airspaces distal to the terminal bronchioles

accompanied by destruction of the alveolar walls.

Signs and Symptoms of Emphysema

1. Barrel-chest appearance.

2. Dry cough.

3. Severe exertional dyspnea.

4. Pink skin color (pink puffer).

5. Wheezing and rhonchi.

6. Pursed-lip breathing (prolonged inspiration).

BRONCHITIS

• Definition : a chronic productive cough for three months in

two successive years in a patient in whom other causes of

chronic cough have been excluded .

Clinical Presentation

1. Productive, chronic cough with purulent sputum

2. Recurrent acute respiratory infections

3. Dyspnea.

4. wheezing

5. Hypoxia, cyanosis

6. Fluid accumulation and heart failure in later stages

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Chronic bronchitis EmphysemaMild Dyspnea More Severe

Productive cough Dry or no cough

Cyanosis common Cyanosis rare

Respiratory infection common

Infrequent infections

Onset usually after 40 years of age

Onset usually after 50 years of age

History of cigarette smoking

History of cigarette smoking

Cor pulmonale common Cor pulmonale in terminal stages

Comparison of Symptoms for Chronic Bronchitis and Emphysema

ASTHMA

• Respiratory disease characterized by recurrent episodes of dyspnea, cough and wheeze caused by reversible airways obstruction.

Common Asthma causes:

• Animals (pet hair or dander) • Dust • Changes in weather (most often cold weather) • Chemicals in the air or in food • Exercise • Mold • Pollen • Respiratory infections, such as the common cold • Strong emotions (stress) • Tobacco smoke

Management:

• Controlled oxygen therapy• Nabulized bronchodilators e.g. albuterol

(ventolin)• Antibiotics if evidence of infection

(amoxicillin)

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