Cardiopulmonary Pathology Lecture 5 PDF

Pharos University in Alexandria Faculty of Physical Therapy Pathology II PTBA - 333 Cardiopulmonary Pathology Lecture 5 Dr /Maha Abubakr Feissal MD clinical hematopathology Lecturer Review of Anatomy & Physiology Review of Anat...

Pharos University in Alexandria Faculty of Physical Therapy Pathology II PTBA - 333 Cardiopulmonary Pathology Lecture 5 Dr /Maha Abubakr Feissal MD clinical hematopathology Lecturer Review of Anatomy & Physiology Review of Anatomy & Physiology  Upper Respiratory Tract Respiratory Mucosa Pharynx – lined with ciliated mucus – 3 parts: Nasopharynx, Oropharynx, producing cells Laryngopharynx – purifies air – Tonsils(3 pairs) – is contiguous with all structures pharyngeal (adenoids) Nose palatine – Paranasal sinuses lingual frontal, maxillary, sphenoid, – Eustachian (auditory) tubes open ethmoid into nasopharynx lighten skull equalizes pressure between sound resonant chambers middle ear & the outside – conchae (3 pairs) Larynx warm & humidify air – composed of pieces of cartilage – lacrimal ducts Thyroid cartilage= Adam’s – olfactory receptors apple – epiglottis & glottis  Lower Respiratory Tract Trachea – composed of C- shaped cartilaginous rings – called windpipe Bronchi, Bronchioles, Alveolar Duct, Alveoli – gas exchange occurs in alveoli – occurs via Passive Diffusion – Respiratory Membrane 2 cell layers thick » surfactant = reduces surface tension to keep alveoli distended » lining of alveolus (alveolar epithelium) » lining of capillary ( capillary endothelium)  Lungs & Pleura – Right lung = 3 lobes; left lung = 2 lobes – lower part of lung resting on diaphragm = Base of lung – upper part of lung under clavicle = Apex of lung – pleura = serous membrane (i.e. secretes some fluid) parietal pleura lines thoracic cavity visceral pleura lines organs (viscera) – Mechanics of Breathing – air moves by differences in air pressure – Inspiration » active process; get contraction of diaphragm & external intercostal muscles » results in increase in size of chest cavity – Expiration » passive process with normal expiration » active process with forced expiration; get contraction of abdominal & internal intercostal muscles » results in decrease in size of chest cavity which increases pressure & forces air out  Manifestations of Pulmonary Disease Sneezing = reflex response to irritation of upper respiratory tract Coughing = reflex response to irritation of lower respiratory tract Sputum production – If yellowish- green ------ infection – If rusty ------- blood + pus = pneumococcal pneumonia – If bloody , called “hemoptysis” ---- usually frothy --- seen in pulm. Edema Also seen in pulm. TB & cancer – Large amounts & foul = bronchiectasis – Thick & sticky = asthma, cystic fibrosis Breathing patterns – dyspnea , wheezing, stridor Breath sounds – Normal, rales, rhonchi, decreased breath sounds Dyspnea --- discomfort feeling when can’t get enough air – Orthopnea = dyspnea lying down Cyanosis --- not a reliable early indicator of hypoxia  Respiratory System Diseases General Outline Infectious diseases COPD (chronic obstr. pulm. dis) – Upper – Emphysema URI – Chronic bronchitis Croup Restrictive lung diseases Epiglottitis Flu (Influenza) – Chest wall abnormalities – Lower – Connective tissue abnormalities Bronchiolitis (RSV) Pneumoconioses Pneumonia Vascular disorders SARS – Pulmonary edema TB – Pulmonary embolism Fungal diseases Expansion disorders Obstructive lung diseases – Atelectasis – Cystic fibrosis – Pleural effusion – Cancer – Pneumothorax – Aspiration pneumonia – Resp. distress syndrome – Asthma Infant adult  Question-1 1. Which of the following are primary components of the upper airway? a. nose, oral cavity, pharynx b. larynx, trachea, and bronchic. c. nose, oral cavity, larynx and trachead. d. nose, oral cavity, pharynx, larynx, and trachea  Feed back A- The nose, oral cavity, and pharynx are the primary structures that compose the upper airway B. The trachea and bronchi and subglottic portion of the larynx are located in the lower airway C. The trachea and subglottic part of the larynx are located in the lower airway. D. The trachea and subglottic portion of the larynx are located in the lower airway Answer is A.  Question 2 2. Which of the following is NOT a primary function of the nose? a. conduct gas and food to lower airway b. humidfy inspired gas c. filter the inspired gas d. warm the inspired gas  Feed back A The nose serves as passageway for gas, not food, to the lower airway. B The nose humidifies,, warms, and filters the inspired gas. C. The nose humidifies, warms, and filters the inspired gas. D. The nose humdifies, warms, and filters the inspired gas. Answer is A  Manifestations of Pulmonary Disease Sneezing = reflex response to irritation of upper respiratory tract Coughing = reflex response to irritation of lower respiratory tract Sputum production – If yellowish- green ------ infection – If rusty ------- blood + pus = pneumococcal pneumonia – If bloody , called “hemoptysis” ---- usually frothy --- seen in pulm. Edema Also seen in pulm. TB & cancer – Large amounts & foul = bronchiectasis – Thick & sticky = asthma, cystic fibrosis Breathing patterns – dyspnea , wheezing, stridor Breath sounds – Normal, rales, rhonchi, decreased breath sounds Dyspnea --- discomfort feeling when can’t get enough air – Orthopnea = dyspnea lying down Cyanosis --- not a reliable early indicator of hypoxia Dr Maha Abubakr