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Ch. 12 Disorders
disorders of the upper respiratory, bronchial, lung, and pleural cavity.
Terms in this set (22)
Acute viral infection of infants and children with obstruction of the larynx, barking cough, and stridor. The most common causative agents are influenza viruses or respiratory syncytial virus (RSV)
Acute infection of the throat and upper respiratory tract caused by the diphtheria bacterium (Corynebacterium).
Inflammation occurs, and a leather, opaque membrane (Greek diphthera, leather membrane) forms in the pharynx and trachea.
Immunity to diphtheria (by production of antibodies) is induced by the administration of weakened toxins (antigens) beginning between the sixth and eighth weeks of life. These injections usually are given as combination vaccines with pertussis and tetanus toxins and so are called DPT injections.
Nosebleed. Epistaxis is a Greek word meaning a dropping. It commonly results from irritation of nasal mucous membranes, trauma, vitamin K deficiency, clotting abnormalities, or hypertension.
Whooping cough; highly contagious bacterial infection of the pharynx, layrnx, and trachea caused by Bordetella pertussis. Pertussis is characterized by paroxysmal (violent, sudden) spasms of coughing that ends in a loud "whooping" inspiration.
Chronic bronchial inflammatory disorder with airway obstruction due to bronchial edema and constriction and increased mucus production.
Associated signs and symptoms of asthma are dyspnea, wheezing, and cough. Etiology can involve allergy or infection. Triggers to asthmatic attacks include exercise, strong odors, cold air, stress, allergens, (e.g., dust, molds, pollens, foods), and medications (aspirin, beta-blockers).
Asthma treatments are:
*Anti-inflammatory agents inhaled (long-term control with glucocorticoids)
*Bronchodilators -- quick-relief control (such as Albuterol)
*Leukotriene blockers reduce inflammatory symptoms with inhaled medications such as Singulair.
*Trigger avoidance with patient education.
Other conditions, such as gastroesophageal reflux disease (GERD), sinusitis, or allergic rhinitis, or certain medications can impede asthma control.
Chronic dilation of a bronchus secondary to infection.
This condition is caused by chronic infection with a loss of elasticity of the bronchi. Secretions puddle and do not drain normally. Signs and symptoms are cough, fever, and expectoration of foul-smelling, purulent (pus-containing) sputum. Treatment is palliative (noncurrative) and includes antibiotics, mucolytics, and bronchodilators, respiratory therapy, and surgical resection if other therapies are not effective.
Inflammation of bronchi persisting over a long time; type of chronic obstructive pulmonary disease (COPD).
Infection and cigarette smoking are etiologic factors. Signs and symptoms include excessive secretion of often infected mucus, a productive cough, and obstruction of respiratory passages. Chronic bronchitis, asthma, and emphysema (lung disease in which air exchange at the alveoli is severely impaired) are components of chronic obstructive pulmonary disease (COPD).
Cystic Fibrosis (CF)
Inherited disorder of exocrine glands resulting in thick mucous secretions in the respiratory tract that do not drain normally.
The exocrine glands affected are the pancreas (insufficient secretion of enzymes resulting in poor growth), sweat glands (abnormal salt production), and epithelium (lining cells) of the respiratory tract. Chronic airway obstruction, infection, bronchiectasis, and respiratory failure are the end result. Therapy includes replacement of pancreatic enzymes and treatment of pulmonary obstruction and infection.
The gene responsible of cystic fibrosis is known, and person carrying the gene may be identified. There is no known cure, although lung transplantation can extend life and restore lung function.
Collapsed lung; incomplete expansion of alveoli.
In atelectasis, the bronchioles and alveoli (pulmonary parenchyma) resemble a collapsed balloon. Common causes of atelectasis include poor inspiratory effort after surgery, blockage of a bronchus or smaller bronchial tube by secretions, tumor, and chest wounds that permit air, fluid or blood to accumulate in the pleural cavity. Acute atelectasis requires removal of the underlying cause (tumor, foreign body, mucous plug) and therapy to open airways. Respiration also can be limited by pain.
Hyperinflation of air sacs with destruction of alveolar walls.
Loss of elasticity and the breakdown of alveolar walls result in expiratory flow limitation. There is a strong association between cigarette smoking and emphysema. As a result of the destruction of lung parenchyma, including blood vessels, to pump blood. This leads to right ventricular hypertrophy and right heart failure (cor pulmonale).
Emphysema and chronic bronchitis are both forms of COPD.
Malignant tumor arising from the lungs and the bronchi.
This group of cancers, often associated with cigarette smoking, is the most frequent fatal malignancy. Lung cancers are divided into two general categories: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC).
Non-Small Cell Lung Cancer:
Accounts for 90% of lung cancers and comprises two main types: adenocarcinoma (derived from mucus-secreting cells), and squamous cell carcinoma (derived from the lining cells of the upper airway). When lung cancer is diagnosed, physicians assess the stage of the tumor (determined by its size and location, including any distant areas of spread) to prepare a protocol for treatment.
For localized tumors, surgery may be curative. Staging of NSCLC by assessing mediastinal lymph nodes is critical. If nodes are negative, a patient is a good candidate for surgery. If nodes are positive, multimodality treatment (chemotherapy and irradiation), with or without surgery, is an option. Doctors treat metastatic disease (to liver, brain, and bones) with chemotherapy and radiation therapy.
In nonsmokers, NSCLC may be caused by a mutation (change) in lung tissue. This mutation invovlves an epidermal growth factor receptor (EGFR), which is sensitive to treatment with EGFR inhibitors (Iressa and Tarceva). This is an example of targeted drug therapy for cancer.
Small Cell Lung Cancer:
derives from small, round ("oat" cells) cells found in pulmonary epithelium. It grows rapidly early in its course and quickly spreads outside the lung. Palliative treatment includes surgery, radiation therapy, and chemotherapy.
Abnormal condition caused by dust in the lungs, with chonic inflammation, infection, and bronchitis.
Various forms are named according to the type of dust particle inhaled: anthracosis -- coal (anthrac/o) dust (black lung disease); asbestosis -- asbestos (asbest/o) particles (in shipbuilding and construction trades); silicosis -- silica (silic/o = rock) or glass (grinders disease).
Acute inflammation and infection of alveoli, which fill with pus or products of the inflammatory reaction.
Etiologic agents are pneumococci, staphylococci, and other bacteria, fungi, or viruses. Infection damages alveolar membranes so that an exudate (fluid, blood cells, and debris) consolidates the alveoli (sacs become "glued" together, making air exchange less effective). An infiltrate is a fluid-filled area within the lungs as seen on a chest x-ray or CT scan.
Lobar pneumonia involves an entire lobe of a lung.
Community-acquired pneumonia results from a contagious respiratory infection, caused by a variety of viruses and bacteria (especially Mycoplasma bacteria). It usually is treated at home with oral antibiotics.
Bronchopneumonia, common in infants and the elderly, involves patchy consolidation (abscesses) in the lung parenchyma. Treatment includes appropriate antibiotics and, if necessary, oxygen and mechanical ventilation.
hospital-acquired pneumonia or nosocomial pneumonia is acquired during hospitalization (Greek nosokomeion means hospital).
Aspiration pneumonia is caused by material, such as food or vomitus, lodging in bronchi or lungs. It is a danger to the elderly, Alzheimer disease patients, stroke victims, and people with dysphagia.
Large collection of pus (bacterial infection) in the lungs.
Fluid in the air sacs and bronchioles.
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