presentation 2: airway dr. bushra bilal dr. miada mahmoud rady cls 243
TRANSCRIPT
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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