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Transcript
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 – – – – – 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 • • • • • • Sinusitis, rhinitis Sinonasal papillomas Sinonasal cancer Laryngitis Vocal cord paralysis Cancer of the Larynx Sinusitis • Infectious (Bacterial, viral, fungal) • Allergic • Signs and Symptoms – – – – Nasal Blockage/Obstruction (Edema) Sneezing Nasal Discharge Fever (viral and bacterial) Clouding of the sinus seen on a Radiograph Sinonasal Polyps • • • • • 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 • • • • • • • • 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 • • • • Bacterial and Viral Etiologies Filling of air spaces with edema fluid Requires hospitalization, antibiotics Symptoms: – Dyspnea – Cough, productive or nonproductive – Fever Tuberculosis • • • • • 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.