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F.A. Davis: Advantage –Upper and Lower Respiratory Tract Disorders (11.16.15)
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Upper and Lower
Respiratory Tract
Disorders
The respiratory system is an interconnected network of organs, tissues, and pathways that work together to help you breathe.
It has two distinct sections—the upper respiratory tract and the lower respiratory tract.
Cutaway figure appears on the screen. The script calls for the various labels to appear at the
VO says “disorders of the upper respiratory tract”. However, that doesn’t currently appear
in the script dialogue they’ve provided.
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F.A. Davis: Advantage –Upper and Lower Respiratory Tract Disorders (11.16.15)
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Not only is the respiratory system connected internally, it is connected to the external environment
through the air we breathe. Exposure to the external environment accounts for many of the disorders of
this system.
Let’s travel within the respiratory tract as it journeys through our external environment.
New screen. Man emerges from a house and walks forward, breathing in paricles. As he
does, his lungs appear and we can see the particles going into them.
The man walks past other figures, also breathing in particles.
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F.A. Davis: Advantage –Upper and Lower Respiratory Tract Disorders (11.16.15)
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When we encounter the rhinovirus, we are likely to suffer from acute rhinitis, or the common cold...
...and its common symptom of green or yellow nasal discharge.
As the man continues walking, a rhino w/ flag enters from the rest, charging towards him.
As the rhino passes the man, the camera pans closer. A green drop of mucus falls from his
nose and he wipes it with a handkerchief.
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F.A. Davis: Advantage –Upper and Lower Respiratory Tract Disorders (11.16.15)
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Rhinitis can also result from allergies. Although, in this case, clear nasal discharge occurs.
Allergies, bacteria, viruses, and fungi can all cause sinusitis, or inflammation of the sinus cavities.
The man continues past several trees, which emit pollen. The man sneezes and a clear drop
of mucus forms on his nose. He wipes it with a tissue.
The man continues walking towards a cave, with label.
Sound: Sneeze.
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Facial pain and headaches are common symptoms.
The man walks through the cave, holding his head in pain. Funguses, viruses and bacteria are
visible on the walls.
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Moving along the upper respiratory tract, we encounter the tonsils. Tonsillitis is inflammation of the
tonsils.
The man exits the cave and walks down the hill across the labeled bridge.
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With tonsillitis, swallowing becomes very difficult, as the tonsils become reddened and enlarged.
The next structure along our journey is the epiglottis, which is a flap that covers the trachea to prevent
food from entering.
On the other side of the bridge, the man stops in front of a lemonade stand. He holds his
throat and nods “no” as the kid offers him a lemonade.
The man continues past an open garage. The labeled door lowers as he walks by.
Sound: Garage door closing.
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F.A. Davis: Advantage –Upper and Lower Respiratory Tract Disorders (11.16.15)
Epiglottitis, inflammation of the epiglottis, is a life-threatening event, as the air passage may become
blocked.
The camera pans in as the man turns. The garage door swells, bulging out of the door frame
as an ambulance enters from the left as the VO says “life threatening”.
Sound: Ambulance siren
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Often this narrowed passageway appears as a “steeple sign” on X-ray.
The man turns back and continues walkins as the ambulance passes him. He passes an xray
with an image of steeple sign.
Sound: Ambulance siren passing and fading.
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F.A. Davis: Advantage –Upper and Lower Respiratory Tract Disorders (11.16.15)
Pharyngitis is inflammation of the throat, the common “sore throat”.
Although most commonly caused by viruses, it may also be caused by the bacteria Streptococcus
pyogenes and result in strep throat.
The man continues towards a dark alley. The figure of a mugger emerges from a corner.
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Resolution of an S. pyogenes infection is crucial, as progression may lead to scarlet fever, rheumatic
fever, or glomerulonephritis.
Pan closer to the man’s head. The labels appear as the VO mentions them.
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Now, let’s continue our journey into the lower respiratory tract, in which we may encounter
bronchitis, pneumonia, or tuberculosis.
Bronchitis is inflammation of the bronchioles, most commonly due to viral infection. The bronchioles
become obstructed by mucous and leukocytes.
Pull back. The man is now descending stairs, past signs on the wall.
As the bottom of the stairs, the man continues on into the tunnels.
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F.A. Davis: Advantage –Upper and Lower Respiratory Tract Disorders (11.16.15)
Wheezing and production of red sputum may occur.
In the tunnel. There are mucus and leukocytes on the walls. The man coughs, spraying red
sputum into a handkercheif.
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Pneumonia is the result of inflammation and the alveolar air spaces filling with fluid.
Bacteria, viruses, and fungi, especially in immunocompromised individuals, may cause pneumonia.
The man continues through the tunnel. There are now pockets in the sides, with are filling
with fluid on the bottoms and bacteria and fungi on the sides.
Sound: Wheezing, then a cough
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Streptococcus pneumoniae is the most common cause of community-acquired pneumonia...
...whereas infection with Staphylococcus aureus is most common in hospital-acquired forms.
The man emerges from the tunnel. He shakes hands with a couple of people on the sidewalk.
The label appears above.
The man heads towards a hospital entrance. The label appears on the left.
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Ventilator-associated pneumonia may also occur
Now, let’s talk about the most common infectious disease in the world: Tuberculosis.
Bacterial pneumonia may also develop as a secondary infection following a virus such as influenza. .
New screen. A map of the world appears and circles with “TB” in them pop up all over the
map.
New screen. The man is now in bed, on a ventilator. As the VO mentions bacterial
pnuemonia, a calendar appears on the upper right. The first page, labeled “Viral Infection”
is visible, then the page flips to reveal the next page, indicating the passage of time.
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Page 13
Tuberculosis is transmitted through the inhalation of airborne droplets of Mycobacterium tuberculosis. Once inhaled, the bacteria settle in the lungs.
White blood cells are unable to kill the organism, but are able to wall off the infection, resulting in a
lesion, known as a tubercle.
New screen. A woman now walks down the street, breathing in TB particles.
As the immune system attempts to destroy the bacteria, damage to the lung’s tissue results...
The woman walks past white blood cells, walling off a space. She passes a black xray screen,
with shows an xray of her lung, with tubercles visible.
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F.A. Davis: Advantage –Upper and Lower Respiratory Tract Disorders (11.16.15)
As the immune system attempts to destroy the bacteria, damage to the lung’s tissue results, causing a
cheese-like appearance known as caseous necrosis.
The woman turns towards us. Her lungs become visible, riddled with holes.
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Clinical signs of tuberculosis include chronic cough, hemoptysis, and weight loss. Up to 20% of
patients with active tuberculosis, however, may present with no symptoms.
Back to the map of the world. Several of the circles are highlighted, showing the percentage
of people who don’t show TB symptoms.
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