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Session 12: Ch 13 PowerPoint Presentation
- 1. Lecture Notes 13 Respiratory System Diseases and Disorders Classroom Activity to Accompany Diseases of the Human Body Fifth Edition Carol D. Tamparo Marcia A. Lewis
- 2. Copyright © 2011 by F.A. Davis Company. All rights reserved. This product is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means— electronic, mechanical, photocopying, recording, or otherwise—without written permission from the publisher.
- 3. Good timber does not grow with ease. The stronger the wind, the stronger the trees. —Willard Marriott 3
- 4. Common Signs and Symptoms of Respiratory System Diseases and Disorders • Pain anywhere in the respiratory tract, especially sore throat • Cough • Productive or nonproductive • Chronic or acute • Hemoptysis, hematemesis 4
- 5. Common Signs and Symptoms of Respiratory System Diseases and Disorders • Breathing irregularities • Dyspnea • Wheezing • Tachypnea • Rales • Fever • Malaise • Headache • Cyanosis 5
- 6. Allergic Rhinitis • Description • Inflammation of the nasal membranes due to an allergic reaction to air particles causing sneezing and rhinorrhea • Acute or chronic • Very common; affects about 20% of the 6 population
- 7. Sinusitis • Description • Inflammation of the paranasal sinuses • Acute caused by common cold • Chronic follows bacterial or viral infection • Allergic due to allergic rhinitis • Hyperplastic combination 7 of purulent acute and
- 8. Pharyngitis • Description • Inflammation of the throat • May be acute or chronic • Most common throat disorder • Children often have five incidents per year • Adults often have two incidents per year 8
- 9. Pharyngitis • Etiology • Bacteria (Streptococcus pyogenes) or viral (influenza or common cold) infectious agents • Secondary to measles, chickenpox • Trauma to mucosa from heat, sharp objects, chemical irritants • Chronic usually due to 9 persistent cough or allergies
- 10. Pharyngitis • Signs and symptoms • Sore throat • Difficulty swallowing • Malaise • Fever • Headache • Coryza (common cold) • Rhinorrhea 10
- 11. Pharyngitis • Diagnostic procedures • Physical exam reveals red, swollen mucous membranes • Pustular pharyngeal ulcerations visible • Throat culture to identify infecting organism 11
- 12. Pharyngitis • Treatment • Antibiotics, if bacterial • Warm saline gargles • Analgesics • Antipyretics • Rest • Adequate fluid intake 12
- 13. Pharyngitis Complementary therapy • Aromatherapy with inhalation of lavender, thyme, eucalyptus , sandalwood • Gargle with warm water, ¼ tsp turmeric powder, pinch of salt • Herbal teas Client communication • If strep is found, treat to13 prevent rheumatic fever or
- 14. Pharyngitis • Prognosis • Generally good • Complications can occur with untreated strep • Prevention • Avoid such irritating substances as cigarette smoke, known allergens 14
- 15. Laryngitis • Description • Inflammation of the laryngeal mucosa and the vocal cords causing hoarseness in voice • May be acute or chronic; viral or bacterial 15
- 16. Infectious Mononucleosis • Description • Acute infectious disease characterized by sore throat, fever, and swollen cervical lymph glands • Primarily affects adolescents and young adults 16
- 17. Infectious Mononucleosis • Etiology • Caused by Epstein-Barr virus (EBV) • Shed in saliva; spreads through oral-pharyngeal route • EBV infects the B lymphocytes • Person contagious before 17 symptoms develop until
- 18. Infectious Mononucleosis • Signs and symptoms • Initially vague symptoms of malaise, anorexia, and chills • After 3 to 5 days, fever, sore throat, and swollen lymph nodes in throat 18 and neck occur
- 19. Infectious Mononucleosis • Diagnostic procedures • History and physical exam • Blood test showing increased leukocytes, lymphocytes, monocytes, and antibodies to EBV 19
- 20. Infectious Mononucleosis • Treatment • Supportive treatment • Bed rest during acute phase • Analgesics • Warm saline gargles 20
- 21. Infectious Mononucleosis Complementary therapy • Bed rest • Drink filtered water • Organic diet containing no growth hormone or antibiotics Client communication • Stress reduction of 21 activities until infection
- 22. Infectious Mononucleosis • Prognosis • Excellent, but takes several weeks or months • EBV remains in a dormant state for life • Prevention • Avoid oral-pharyngeal contact with known EBV infected persons 22
- 23. Infectious Mononucleosis • The Epstein-Barr virus causes an infection of the 1. B lymphocytes 2. pharynx 3. T lymphocytes 4. lymph nodes 23
- 24. Pneumonia • Description • Acute inflammation of respiratory bronchioles, alveolar ducts, sacs, and alveoli of lungs • Uni- or bilateral; affecting all or portion of lung • Lobar: affects more than one lobe • Bronchopneumonia: bacterial form 24 • Interstitial pneumonia: scars
- 25. Pneumonia • Etiology • Bacteria (pneumococcus), viruses (influenza) two main types with bacterial more serious • Fungi, protozoa, rickett siae • Secondary to systemic 25 diseases
- 26. Pneumonia • Signs and symptoms • Coughing, sputum production • Pleuritic chest pain • Shaking chills, fever • Rales, dyspnea • Cyanosis • Generalized weakness 26
- 27. Pneumonia • Diagnostic procedures • History and physical exam • Chest x-ray • Sputum smears and blood cultures 27
- 28. Pneumonia • Treatment • Varies with etiology • Antibiotics if bacteria • Humidified oxygen therapy • Mechanical ventilation 28
- 29. Pneumonia • Treatment (cont.) • High-calorie diet • Increased fluid intake • Rest • Analgesics • Postural drainage 29
- 30. Pneumonia Complementary therapy • Supplements to strengthen immune system Client communication • Describe seriousness of illness • Encourage vaccination • Teach deep 30 breathing, postural
- 31. Pneumonia • Prognosis • Varies with etiology • If secondary to another disease, or if elderly person has influenza-type pneumonia, prognosis poor • Complications include lung abscess or bacteremia • Prevention • High-risk persons should receive pneumococcal vaccine 31
- 32. Chronic Obstructive Pulmonary Disease • Description • Functional diagnosis given to any pathological process that decreases the ability of lungs and bronchi to perform ventilation • Pulmonary emphysema • Chronic bronchitis 32
- 33. Chronic Obstructive Pulmonary Disease • Description (cont.) • Chronic pulmonary emphysema: permanent enlargement of air spaces beyond terminal bronchioles resulting from destruction of alveolar walls; lungs lose elasticity • Chronic bronchitis: inflammation of bronchial mucous membranes with hypertrophy, hyperplasia; 33 productive cough
- 34. Chronic Obstructive Pulmonary Disease • Etiology • Diseases that may lead to COPD include chronic asthma, bronchiectasis, silicosis, pulmonary tuberculosis • Predisposing factors are smoking, exposure to polluted air, respiratory infections, allergies, b34 reathing textile dust
- 35. Chronic Obstructive Pulmonary Disease • Signs and symptoms • Insidious; no symptoms until lung is damaged • Chronic cough, chest tightness, increased mucus production • Dyspnea • Barrel chest in pulmonary emphysema • “Blue bloater” – chronic bronchitis 35
- 36. Chronic Obstructive Pulmonary Disease • Diagnostic procedures • History and physical examination • Chest x-ray • Pulmonary function tests • Arterial blood gases • Sputum analysis; CT scan 36
- 37. Chronic Obstructive Pulmonary Disease • Treatment • Prevent complications and further lung damage • Relieve symptoms • Bronchodilators, inhaled corticosteroid medications • Oxygen therapy • Diuretics • Surgery to remove wedges of damaged lung 37
- 38. Chronic Obstructive Pulmonary Disease Complementary therapy • Eat properly • Limit salt, caffeine Client communication • Avoid smoking, cigarette smoke, dust, air pollution, work-related fumes 38 • Avoid excessive
- 39. Chronic Obstructive Pulmonary Disease • Prognosis • Always guarded; cannot be cured • Degree of disability increases with time • High mortality from complications • Prevention • Do not smoke • Periodic exams to 39 evaluate
- 40. Chronic Obstructive Pulmonary Disease • Chronic enlargement of the air spaces beyond the bronchioles due to destruction of the alveolar walls is 1. asthma 2. atelectasis 3. emphysema 4. bronchiectasis 40
- 41. Bronchiectasis • Description • Permanent abnormal dilation of bronchi • Usually bilateral, involving lower lobes of lung 41
- 42. Bronchiectasis • Etiology • Recurrent infections or inflammation • Cystic fibrosis is cause in half of cases • Risk factors • Tuberculosis (TB) • Bronchial obstruction • Recurrent lung infections 42
- 43. Bronchiectasis • Signs and symptoms • Chronic cough • Expectorate large amounts of purulent, foul-smelling sputum, especially first thing in morning • Hemoptysis • Cyanosis and paleness • Fatigue • Shortness of breath and 43 wheezing
- 44. Bronchiectasis • Diagnostic procedures • Auscultation reveals clicking, wheezing, bubb ling, rattling sounds • Chest x-ray, CT scan • CBC • Tuberculin skin test CBC = complete blood count. 44
- 45. Bronchiectasis • Treatment • Aim is to control infection and airway obstruction • Antibiotics • Bronchodilators • Expectorants • Postural drainage 45
- 46. Bronchiectasis Complementary therapy • Coughing exercises that reduce bronchial secretions Client communication • Remind clients to return to primary care provider if chest pain or shortness of breath worsens 46
- 47. Bronchiectasis • Prognosis • Good with treatment • Prevention • Avoid pulmonary irritants, smoking • Influenza vaccine • Treat lung infections promptly 47
- 48. Asthma • Description • Recurrent attacks of labored breathing; wheezing • Intrinsic: attacks without evidence of allergic response; begins in adulthood • Extrinsic: bronchospasm result of allergic response 48 to environmental irritants;
- 49. Asthma • Etiology • Uncertain • Familial history of allergy • Common triggers include URI, allergens, irritant s, tobacco smoke, exercise or exertion, changes respiratory infection URI = upper in 49 temperature or
- 50. Asthma • Signs and symptoms • Pronounced wheezing, dyspnea, tachy pnea, chest tightness • Perspire profusely • Exhibit pallor • Difficulty speaking 50
- 51. Asthma • Diagnostic procedures • History and physical • Chest x-ray • Sputum analysis • Pulmonary function tests • Arterial blood gases • ECG • Skin tests for allergen detection ECG = electrocardiogram. 51
- 52. Asthma • Treatment • Avoid “triggers” • Achieve adequate oxygenation • Bronchodilation • Decrease airway inflammation • Use long-term preventative controller 52 drugs and quick-relief
- 53. Asthma Complementary therapy • Neurobiofeedback • Hydrotherapy • Avoid known triggers • Enhance immune system Client communication • Identify triggers and asthma-proof home • Stress importance of 53 medication regimen
- 54. Asthma • Prognosis • Good with proper, ongoing treatment • Child may outgrow asthma • Prevention • Avoid irritants, allergens 54
- 55. Asthma • Asthma is recurrent attacks of labored breathing accompanied by 1. obstruction 2. shortness of breath 3. hypoxia 4. wheezing 55
- 56. Pulmonary Tuberculosis • Description • Slowly developing bacterial lung infection with progressive necrosis of lung tissue • Starts with phagocytosis then growths of inflamed granular-appearing tissue (granulomas) form and calcify • Calcification lesions 56 appear on x-ray
- 57. Pneumoconiosis • Description • Disease of the respiratory tract • Caused by inhalation of inorganic or organic dust particles or chemicals over prolonged period • Silicosis, asbestosis, b erylliosis, anthracosis 57
- 58. Pneumothorax (Collapsed Lung) • Description • A collection of air or fluid in the pleural cavity • Results in atelectasis; complete or partial collapse of one or both lungs • Can be spontaneous or traumatic • Caused by rupture of bleb along lung’s surface 58
- 59. Pleurisy (Pleuritis) • Description • Inflammation of the visceral and parietal pleural membranes that surround the lungs • May be primary or secondary • Associated with pleural effusion 59
- 60. Pleurisy (Pleuritis) • Etiology • Caused by infection of the pleura by bacteria, fungus, parasites, o r viruses • Can be caused by inhaled toxins or chemicals • Often secondary to pneumonia, heart failure, pulmonary= systemic lupus SLE erythmatosus. infection, neoplasm, SLE, pulm 60 onary embolism, and chest
- 61. Pleurisy (Pleuritis) • Signs and symptoms • Sharp, stabbing pain that can limit movement • Other symptoms include coughing, fever and chills, and chest pain that is greater during inspiration • Dyspnea 61
- 62. Pleurisy (Pleuritis) • Diagnostic procedures • Chest auscultation reveals pleural friction rub • Chest x-ray • CT scan or ultrasound 62
- 63. Pleurisy (Pleuritis) • Treatment • Analgesics and anti- inflammatory drugs • Bed rest • Thoracentesis 63
- 64. Pleurisy (Pleuritis) Complementary therapy • Natural analgesics and anti-inflammatory drugs Client communication • Stress need for bed rest • Apply pressure to the site of pain when coughing 64
- 65. Pleurisy (Pleuritis) • Prognosis • Good, but pleural effusion may develop • Prevention • Early treatment of respiratory infections 65
- 66. Pulmonary Embolism • Description • Mass of undissolved matter in pulmonary artery or branches • Complication of venous thrombosis 66
- 67. Pulmonary Embolism • Etiology • Generally originates in pelvic veins or deep lower- extremity veins; travels through circulatory system until it blocks pulmonary artery • At risk are those with body casts, CHF, varicose veins, polycythemia vera, thrombocytosis, neopla67 CHF = congestive heart failure. sms, postoperative clients;
- 68. Pulmonary Embolism • Signs and symptoms • Size, location of embolus determines • Dyspnea, tachypnea • Pulmonary hypertension • Substernal pain 68
- 69. Pulmonary Embolism • Signs and symptoms (cont.) • Pleuritic pain • Tachycardia • Low-grade fever • Apprehension 69
- 70. Pulmonary Embolism • Diagnostic procedures • History of predisposing condition • ECG • Chest x-ray • Pulmonary angiogram • MRI • CT scan • Auscultation 70
- 71. Pulmonary Embolism • Treatment • Maintain adequate cardiovascular and pulmonary function while clearing obstruction • Anticoagulants • Fibrinolytic therapy • Surgical management 71
- 72. Pulmonary Embolism Complementary therapy • Use of compression stockings Client communication • Instruct client to not massage or cross legs 72
- 73. Pulmonary Embolism • Prognosis • Guarded if embolism triggers pulmonary infarction; can be lethal • Prevention • Early postoperative ambulation • Anticoagulant therapy if73 at risk
- 74. Sleep Apnea • Description • An individual’s breathing at night repeatedly stops and starts • Accompanied by loud snoring 74
- 75. Sleep Apnea • Description (cont.) • Three types • Obstructive sleep apnea: throat muscles relax • Central sleep apnea: brain does not send proper signals to the muscles that control breathing • Complex apnea: combination of both 75
- 76. Sleep Apnea • Etiology • Throat muscles relax, airways narrow, and breathing temporarily stops • Brain causes individual to awaken and take a breath • Repeated incidences causes oxygen level in blood to fall • Individuals feel sleep deprived and have difficulty76 functioning all day
- 77. Sleep Apnea • Signs and symptoms • Loud snoring; hypersomnia • Observed periods of breathing cessation during sleep • Morning headache • Dry mouth; sore throat • Insomnia 77
- 78. Sleep Apnea • Diagnostic procedures • History and physical exam • Nocturnal polysomnography (sleep study) • Oximetry to measure oxygen blood level • Portable 78 cardiorespiratory
- 79. Sleep Apnea • Treatment • Continuous positive airway machine (CPAP) • Dental appliance worn at night • Uvulopalatopharyngoplast y (UPPP) • Maxillomandibular advancement 79 • Tracheostomy
- 80. Sleep Apnea Complementary therapy • Weight loss Client communication • Remind clients about losing weight, avoiding alcohol, sleeping on their side, and wearing80 their appliance
- 81. Sleep Apnea • Prognosis • Complicated because not all treatments are successful and many clients stop trying • Prevention • No prevention except weight loss, avoiding alcohol, sleeping on the side, and keeping nasal 81 passages open
- 82. Lung Cancer • Description • Various malignant neoplasms • Appears in trachea, bronchi, air sacs of lungs • Leading cause of cancer deaths in both sexes • Two major types • Non–small-cell (more common; slower growth, spread) • Small cell 82
- 83. Lung Cancer • Etiology • 87% caused directly or indirectly by smoking • Radon gas: second leading cause • Long-term exposure to asbestos, uranium, arsen ic, some petroleum products 83
- 84. Lung Cancer • Signs and symptoms • Early stage, no symptoms • Smoker’s cough • Hoarseness • Weight loss 84
- 85. Lung Cancer • Signs and symptoms (cont.) • Wheezing • Chest pain • Dyspnea • Hemoptysis 85
- 86. Lung Cancer • Diagnostic procedures • Chest x-ray • Sputum cytology • Fiberoptic bronchoscopy • Tissue biopsy 86
- 87. Lung Cancer • Diagnostic procedures (cont.) • Helical low-dose CT scan can detect small tumors • Blood tests • CT scan and MRI 87
- 88. Lung Cancer • Treatment • Combination of surgery, radiation, chem otherapy • Photodynamic therapy for small tumors 88
- 89. Lung Cancer Complementary therapy • Acupuncture and massage • Hypnosis, yoga, and meditation Client communication • Follow-up care essential • Regular check-ups • Refer to cancer support 89 systems
- 90. Lung Cancer • Prognosis • Despite diagnostic advances, overall survival rate has changed little during last 30 years • Prevention • Stop smoking • Avoid other irritants 90
- 91. Sudden Infant Death Syndrome • Description • Unexpected and unexplained death of an apparently healthy infant usually ages 10 to 12 weeks • Death most often occurs while sleeping • Occurs more often in 91 males than females and
- 92. Sudden Infant Death Syndrome • Etiology • Unknown • Possibilities include mechanical suffocation, prolonged apnea, lack of vitamin B complex, unknown virus, immunological abnormalities, defect in respiratory mucosa, or 92 abnormal larynx
- 93. Sudden Infant Death Syndrome • Signs and symptoms • None • Infant does not cry out or struggle • When found may be cyanotic and have blood- tinged sputum 93
- 94. Sudden Infant Death Syndrome • Diagnostic procedures • Diagnosis of SIDS is exclusionary • An autopsy rules out other causes of death 94
- 95. Sudden Infant Death Syndrome • Treatment • None • Emotional support for parents 95
- 96. Sudden Infant Death Syndrome Complementary therapy • None Client communication • Referral for grief counseling • SIDS support systems • Teach parents to place 96 infants on their backs for
- 97. Sudden Infant Death Syndrome • Prognosis • It is believed that children are no longer at risk past age 1 • Prevention • Home monitoring devices • Placing infants on their backs to sleep 97
- 98. Sudden Infant Death Syndrome • Children are at the most risk for SIDS at age 1. 1 year 2. 10 to 12 weeks 3. 12 to 15 weeks 4. under 2 months 98
- 99. Acute Tonsillitis • Description • Inflammation of a tonsil, usually the palatine tonsils • May be acute or chronic 99
- 100. Acute Tonsillitis • Etiology • Most frequently caused by Streptococcus pyogenes or Staphylococcus aureus • Common complication of pharyngitis 100
- 101. Acute Tonsillitis • Signs and symptoms • Sudden onset of chills • High-grade fever • Mild to severe sore throat • Malaise 101
- 102. Acute Tonsillitis • Signs and symptoms (cont.) • Headache • Dysphagia • Tonsillar hypertrophy and abscess 102
- 103. Acute Tonsillitis • Diagnostic procedures • Physical examination • Throat culture to detect bacteria • Blood test may reveal leukocytosis 103
- 104. Acute Tonsillitis • Treatment • Antibiotics • Saline gargle • Analgesics • Antipyretics • Tonsillectomy 104
- 105. Acute Tonsillitis Complementary therapy • Fluid diet with diluted juices and warm broths Client communication • Remind clients to take all antibiotics 105
- 106. Acute Tonsillitis • Prognosis • Usually good, but complications of otitis media, mastoiditis, and sinusitis • Prevention • None 106
- 107. Thrush • Description • Yeast infection of the mucus membrane lining the mouth and tongue • Commonly seen in infants and diabetics, in long- term antibiotic use, chemotherapy treatments, and those with HIV or AIDS 107
- 108. Croup • Description • Acute, severe inflammation and obstruction of the upper respiratory tract • Occurs most frequently between age 3 months and 3 years • Treated symptomatically 108
- 109. Credits Publisher: Margaret Biblis Acquisitions Editor: Andy McPhee Developmental Editors: Yvonne Gillam, Julie Munden Backgrounds: Joseph John Clark, Jr. Production Manager: Sam Rondinelli Manager of Electronic Product Development: Kirk Pedrick Electronic Publishing: Frank Musick The publisher is not responsible for errors of omission or for consequences from application of information in this presentation, and makes no warranty, expressed or implied, in regard to its content. Any practice described in this presentation should be applied by the reader in accordance with professional standards of care used with regard to the unique circumstances that may apply in each situation. 109