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Respi Pathophysio

The document discusses several common respiratory conditions that affect the upper and lower respiratory tract. In the upper respiratory tract, common conditions include the common cold, seasonal rhinitis, and sinusitis, which are characterized by inflammation and congestion. Lower respiratory tract conditions discussed include atelectasis, pneumonia, bronchitis, bronchiectasis, and various obstructive pulmonary diseases such as asthma, COPD, cystic fibrosis, and respiratory distress syndrome. These lower respiratory conditions involve inflammation and obstruction of the small airways and alveoli, reducing gas exchange and ventilation.

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Ismael Jaani
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32 views31 pages

Respi Pathophysio

The document discusses several common respiratory conditions that affect the upper and lower respiratory tract. In the upper respiratory tract, common conditions include the common cold, seasonal rhinitis, and sinusitis, which are characterized by inflammation and congestion. Lower respiratory tract conditions discussed include atelectasis, pneumonia, bronchitis, bronchiectasis, and various obstructive pulmonary diseases such as asthma, COPD, cystic fibrosis, and respiratory distress syndrome. These lower respiratory conditions involve inflammation and obstruction of the small airways and alveoli, reducing gas exchange and ventilation.

Uploaded by

Ismael Jaani
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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RESPIRATORY

PATHOPHYSIOL
OGY
UPPER RESPIRATORY TRACT
CONDITIONS
 The most common conditions that affect the upper respiratory tract involve the infl ammatory
response and its effects on the mucosal layer of the conducting airways.
THE COMMON COLD
 Cause: Virus
 Example: Influenza Virus

 These viruses invade the tissues of the upper respiratory tract, initiating the release of histamine and
prostaglandins and causing an inflammatory response.
 As a result of the inflammatory response, the mucous membranes become engorged with blood, the
tissues swell, and the goblet cells increase the production of mucus.
 These effects cause the person with a common cold to complain of sinus pain, nasal congestion,
runny nose, sneezing, watery eyes, scratchy throat, and headache.
 In susceptible people, this swelling can block the outlet of the eustachian tube, which drains the inner
ear and equalizes pressure across the tympanic membrane. If this outlet becomes blocked, feelings of
ear stuffiness and pain can occur, and the individual is more likely to develop an ear infection
SEASONAL RHINITIS
 an inflammation of the nasal cavity
 commonly called hay fever
 This condition occurs when the upper airways respond to a specific antigen
 pollen
 mold
 Dust

 with a vigorous inflammatory response, resulting again in nasal congestion, sneezing, stuffiness, and
watery eyes.
SINUSITIS
 occurs when the epithelial lining of the sinus cavities becomes inflamed.
 The resultant swelling often causes severe pain due to pressure against the bone, which cannot
stretch, leading to blockage of the sinus passage.
 The danger of a sinus infection is that, if it is left untreated, microorganisms can travel up the
sinus passages and into brain tissue.
PHARYNGITIS AND
LARYNGITIS
 Pharyngitis and laryngitis are infections of the pharynx and larynx, respectively. These
infections are frequently caused by common bacteria or viruses. Pharyngitis and laryngitis are
frequently seen with influenza, which is caused by a variety of different viruses and produces
uncomfortable respiratory symptoms or other inflammations along with fever, muscle aches
and pains, and malaise
LOWER RESPIRATORY TRACT
CONDITIONS
ATELECTASIS
 the collapse of once-expanded alveoli
 can occur as a result of outside pressure against the alveoli— for example, from a pulmonary tumor, a
pneumothorax (air in the pleural space exerting high pressure against the alveoli), or a pleural effusion.
 commonly occurs as a result of airway blockage, which prevents air from entering the alveoli, keeping
the lung expanded.
 This occurs when a mucous plug, edema of the bronchioles, or a collection of pus or secretions
occludes the airway and prevents the movement of air
 Patients may experience atelectasis after surgery, when the effects of anesthesia, pain, and decreased
coughing refl exes can lead to a decreased tidal volume and accumulation of secretions in the lower
airways
 . Patients may present with crackles, dyspnea, fever, cough, hypoxia, and changes in chest wall
movement.
Reduced ventilation or blockage

Obstruction of passage of air from & to alveoli

Trapped alveolar air absorbed into the bloodstream

Affected portion of alveoli becomes airless

Alveoli collapse ( Atelectasis)


 Tx:
 clearing the airways
 delivering oxygen
 assisting ventilation
 In the case of a pneumothorax, treatment also involves the insertion of a chest tube to restore
the negative pressure to the space between the pleura
PNEUMONIA
 is an inflammation of the lungs caused either by bacterial or viral invasion of the tissue or by
aspiration of foreign substances into the lower respiratory tract.
 The rapid inflammatory response to any foreign presence in the lower respiratory tract leads to
localized swelling, engorgement, and exudation of protective sera.
 The respiratory membrane is affected, resulting in decreased gas exchange.
 S/S: Patients complain of difficulty breathing and fatigue, and they present with fever, noisy
breath sounds, and poor oxygenation
Infection to the lung (bacteria or virus)
Inflammatory response initiated
Alveolar edema + exudate formation
Alveoli & respiratory bronchioles fill with serous exudate, blood cells, fibrin, bacteria

Consolidation of lung tissues


BRONCHITIS
 Acute bronchitis occurs when bacteria, viruses, or foreign materials infect the inner layer of
the bronchi
 There is an immediate inflammatory reaction at the site of the infection, resulting in swelling,
increased blood flow in that area, and changes in capillary permeability, leading to leakage of
proteins into the area.
 The person with bronchitis may have a narrowed airway during the inflammation; this
condition can be very serious in a person with obstructed or narrowed airflow.
 Chronic bronchitis is an inflammation of the bronchi that does not clear.
Due to Bacteria or virus
Microorganism enter into the respiratory tract by inhalation
Widespread inflammation occurs
Thin mucus lining of the bronchi can become irritated and swollen
Cell that makes up this lining may leak fluid in response to the inflammation
Coughing as a reflex that works to clear secretion from the lungs
Alveolar fluid response
Narrowing of airways
Ventilation decrease as a secretion thickens
Mucus within the airways produces resistance in small airways and cause severe ventilation
perfusion imbalance
Bronchitis
BRONCHIECTASIS
 Bronchiectasis is a chronic disease that involves the bronchi and bronchioles
 It is characterized by dilation of the bronchial tree and chronic infection and inflammation of the
bronchial passages
 With chronic inflammation, the bronchial epithelial cells are replaced by a fi brous scar tissue
 The loss of the protective mucus and ciliary movement of the epithelial cell membranes,
combined with the dilation of the bronchial tree, leads to chronic infections in the now-
unprotected lower areas of the lung tissue
 Patients with bronchiectasis often have an underlying medical condition that makes them more
susceptible to infections (e.g., immune suppression, acquired immune deficiency syndrome,
chronic inflammatory conditions)
 Patients present with the signs and symptoms of acute infection, including fever, malaise,
myalgia, arthralgia, and a purulent, productive cough
OBSTRUCTIVE PULMONARY
DISEASES
 include asthma, CF, COPD, and RDS
 is characterized by reversible bronchospasm, inflammation, and hyperactive airways
 The hyperactivity is triggered by allergens or nonallergic inhaled irritants or by factors such as
exercise and emotions
 The trigger causes an immediate release of histamine, which results in bronchospasm in about
10 minutes
 The later response (3–5 hours) is cytokine mediated inflammation, mucus production, and
edema contributing to obstruction
 The extreme case of asthma is called status asthmaticus- this is a life-threatening
bronchospasm that does not respond to usual treatment and occludes airfl ow into the lungs
CHRONIC OBSTRUCTIVE
PULMONARY DISEASE
 is a permanent, chronic obstruction of airways, often related to cigarette smoking
 It is caused by two related disorders—emphysema and chronic bronchitis—both of which
result in airflow obstruction on expiration, as well as overinflation of the lungs and poor gas
exchange
 Emphysema is characterized by loss of the elastic tissue of the lungs, destruction of alveolar
walls, and a resultant alveolar hyperinfl ation with a tendency to collapse with expiration
 Chronic bronchitis is a permanent infl ammation of the airways with mucus secretion, edema,
and poor infl ammatory defenses. Characteristics of both disorders often are present in a
person with COPD
CYSTIC FIBROSIS
 is a hereditary disease involving the exocrine glands of the respiratory, gastrointestinal, and
reproductive tracts
 CF results in the accumulation of copious amounts of very thick secretions in the lungs
 Eventually, the secretions obstruct the airways, leading to destruction of the lung tissue.
 Treatment is aimed at keeping the secretions fl uid and moving and maintaining airway
patency as much as possible.
Respiratory Distress Syndrome
RESPIRATORY DISTRESS
SYNDROME
 causes obstruction at the alveolar level
 It is frequently seen in premature infants who are delivered before their lungs have fully
developed and while surfactant levels are still very low
 Surfactant is necessary for lowering the surface tension in the alveoli so that they can stay
open to allow the flow of gases
 If surfactant levels are low, the alveoli do not expand and cannot receive air, leading to
decreased gas exchange, low oxygen levels, and generalized distress throughout the body as
cells do not receive the oxygen that they need to survive
 Treatment is aimed at instilling surfactant to prevent atelectasis and to allow the lungs to
expand
ACUTE RESPIRATORY
DISTRESS SYNDROME (ARDS)
 is characterized by progressive loss of lung compliance and increasing hypoxia
 This syndrome typically results from a severe insult to the body, such as cardiovascular
collapse, major burns, severe trauma, or rapid depressurization
 Treatment of ARDS involves reversal of the underlying cause of the problem combined with
ventilatory support

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