Transcript Diseases of the Respiratory Tract

Diseases of the
Respiratory Tract
The MIND Paradigm
• M = metabolic diseases
– Hormonal, nutritional, compromised organ systems
• I = inflammatory diseases
– Trauma, reactive, Infection, immunologic
• N = neoplastic diseases
– Benign, premalignant, malignant
• D = developmental diseases
– Disorders of growth & embryologic defects
The Respiratory Tract
• Upper Respiratory Tract
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Oral Cavity
Nasal Cavity
Paranasal Sinuses
Nasopharynx
Larynx
• Lower Respiratory Tract
– Lungs (alveoli, bronchi, bronchioles)
Definitions
• Pulmonary function tests – physiologic tests
that measure the airway space capacities
• Dyspnea – shortness of breath
• Stridor – closing off of vocal cords
• Productive cough – bring up phlegm
• Nonproductive cough – dry hack
• Hemoptysis – coughing up blood
Diseases of the Upper Airway
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Sinusitis, rhinitis
Sinonasal papillomas
Sinonasal cancer
Laryngitis
Vocal cord paralysis
Cancer of the Larynx
Sinusitis
• Infectious (Bacterial, viral, fungal)
• Allergic
• Signs and Symptoms
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Nasal Blockage/Obstruction (Edema)
Sneezing
Nasal Discharge
Fever (viral and bacterial)
Clouding of the sinus seen on a
Radiograph
Sinonasal Polyps
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Arise from respiratory epithelium
Growths with narrow stalk (pedunculated)
Papillary pattern of growth (papillomas)
Nasal Obstruction
Visualization
– Direct in the nasal cavity
– Detected with Radiographs of the sinonasal region
• Certain types can undergo cancerous change
CT scan reveals the patient has a brain,
two eyeballs and a polypoid mass
(Papilloma) in the nose and sinus
Sinonasal Carcinoma
• Malignant tumors of respiratory
epithelium
• In the antrum, may invade into the
mouth through the palate
• Associated numbness of the maxilla
• Often fatal
Laryngitis
• Overuse of vocal cords (shouting, yelling, singing
loudly, talking naughty)
• Trauma
• Viral or Bacterial infection of throat and vocal
cords
• Allergic
• Signs and symptoms:
– Hoarseness
– Sore throat
– Fever when infectious
How to tell a
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Allergy
Sinusitis
Laryngitis
Bronchitis
Tonsillitis
Pneumonia
Ear Ache
Flu
from a
from a
from a
from a
from a
from an
from a
NO Temp. 100 F or above
stuffy nose, sneezing
Itchy eyes, nose, throat
Cat, dust, pollen allergy
Pain around eyes,
thick yellow nasal
discharge
Cold plus sinusitis
NO Temp. 100 F or above
stuffy nose, sneezing
• Ear hurts
• Hoarseness
NO
• Uncomplicated Cold
• Cold plus otitis media
• Cold plus laryngitis
Temp. 100 F or above
NO Headache, chills and sweats, rash,
muscle aches, marked fatigue, cough
• Very sore throat
and/or swollen neck
glands
• Strep throat or
tonsillitis
Temp. 100 F or above
Headache, chills and sweats, rash,
muscle aches, marked fatigue, cough
• Wheezing, coughing
up gray-yellow
phlegm
• Painful breathing
and/or coughing up
rust-colored phlegm
NO
• Uncomplicated Flu
or Lyme Disease
• Flu plus bronchitis
• Flu plus pneumonia
Diseases of the Lungs
• Chronic Obstructive Pulmonary
Disease (COPD
• Pneumonias
• Granulomatous Infections
• Cancer
COPD
• Loss of airway space
• Major underlying causes
– Bronchitis (smoking)
– Emphysema (smoking)
– Asthma (allergy, familial, anxiety)
• Signs and Symptoms:
– Wheezing (asthma)
– Productive cough (bronchitis)
– Dyspnea (shortness of breath)
• Cannot walk up a staircase without resting
• Sleep with many pillows
Pneumonia
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Bacterial and Viral Etiologies
Filling of air spaces with edema fluid
Requires hospitalization, antibiotics
Symptoms:
– Dyspnea
– Cough, productive or nonproductive
– Fever
Tuberculosis
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Mycobacterium tuberculosum
Mildly contagious, repeated exposures
Lung Granulomas fill airspaces
Necrosis of granulomas
Signs and symptoms:
– Productive cough
– Bloody sputum, hemoptysis
– Dyspnea
Lung Cancer
• Bronchogenic Carcinoma
– Cigarette smoking is chief
environmental risk factor
• Small Cell Carcinoma
• Both types metastasize
• Predispose lungs to pneumonia
Dental Implications
• Upper tract diseases may cause maxillary pain,
mimicking toothache
• Antral tumors may involve the palate
• Infections can be transmitted in the dental
operatory setting
• COPD and other pulmonary diseases with dyspnea
require frequent uprighting of patient
• Asthmatics – keep inhalers in easy reach
• Oxygen tank for pulmonary emergencies
Goodbye and Good Luck
Peter J.