Title: RESPIRATORY SYSTEM DISEASES
1RESPIRATORY SYSTEM DISEASES
- According prof Ya. Bodnar
- (Frank H. Netters illustrations)
2Pneumonia
- Pneumonia is a disease, which unites the large
group of various different etiology
inflammations, pathogeny and morphological
description of respirator department of lung.
3BACTERIAL PNEUMONIAS
4VIRAL PNEUMONIAS
5OPPORTUNISTIC PNEUMONIAS
6Pneumonia
- Pneumonia is the acute infectious disease, mainly
bacterial etiology, which is characterized by the
area of defeat of lung respiratory departments
and presence of intraalveolar exudation. - ( Order of health service ministry of
Ukraine 499 from 28.10.03.)
7INFECTIOUS AGENTS CAUSING PNEUMONIA
Class Etiologic Agent Type of Pneumonia
Bacteria Streptococcus pneumoniae Streptococcus pyogenes Staphylococcus aureus Klebsiella pneumoniae Pseudomonas aeruginosa Escherichia coli Yersinia pestis Legionella pneumophila Peptostreptococcus, Peptococcus Bacteroides Fusobacterium Veillonella Legionnaires disease Aspiration (anaerobic) pneumonia Bacterial pneumonias
Actinomycetes Actinomyces israelii Nocardia asteroides Pulmonary nocardiosis Pulmonary actinomycosis
Fungi Coccidioides immitis Histoplasma capsulatum Blastomyces dermatitidis Aspergillus Phycomycetes Coccidioidomycosis Histoplasmosis Blastomycosis Aspergillosis Mucormycosis
Rickettsia Coxiella burnetii Q fever
Chlamydia Chlamydia psittaci Psittacosis Ornithosis
Mycoplasma Mycoplasma pneumoniae Mycoplasmal pneumonia
Viruses Influenza virus, adenovirus, respiratory syncytial virus, etc Viral pneumonia
Protozoa Pneumocystis carinii Pneumocystis pneumonia (plasma cell pneumonia)
8Classification of pneumonias after M.S. Molchanov
- according to etiology
- bacterial, viral, ?rnitosic, ricketsic,
mycoplasmic, mycotic, mixed, allergic,
cryptogenic etiology - according to pathogeny
- primary, secondary (hypostatic, pin (contactic),
aspiratic, traumatic, postoperative, toxic,
thermal, at the infectious diseases)
9Continuation of classification after M.S.
Molchanov
- according to clinic-morphologic manifestation
- parenchimatic (croupous (lobar) and
bronchopneumonia (lobular), interstitial. - according to localization and extension
- one-side (left- or right-side), among them
total, lobar, segmental, lobular, bilateral - according to severity of process
- heavy, middle severity, easy and abortive forms
- according to motion
- acute, protracted (more than 4 weeks).
10Classification of pneumonias
(Ministry of Health of Ukraine Order 499
28/10/03)
- Nohospital (pneumococcuss, respiratory viruses,
micoplasma) - Hospital (nosokomial) - in 2-3 days after
entering into hospital (klebsiella, hemophilic
stick, anaerobic microflora, staphylococcuss) - Aspiration
- Pneumonia in persons which have the heavy
dysimmunity ( congenital immunodeficit, AIDS-
infection, paratherapeutic immunosuppression)
11Pathogeny of pneumonias
- ?dhesing (adhesion of microorganisms into the
surface of ephithelial cells of bronchial tree
with subsequent microorganism colonization. - Disfunction of blinking mucociliary epithelium.
- Violation of mucocell hovergap.
- Secreting of biologically-active matters -
cytokines.
12Pathogeny of pneumonias
- Chemotaxis of macrophages, neutrophills and other
cells which take part in the local inflammatory
reaction - Invasion and intracellular persistence of
microorganisms with making of endo- and
exotoines - Development of clinical displays of disease.
13Risk factors
- age
- smoking, alcohol
- chronic diseases of lungs, heart, kidneys
- professional harmfulness
- immunodeficient states
- contact with birds, rodents
- trips
14Acute pneumonia
croupous P.
interstitial P.
broncho-P.
15Etiology of croupous pneumonia
- in 95 cases caused by pneucoccus, rarer
diplobatsil, streptococcus, staphilcoccus A cold
which reduces immunobiological reactivity comes
forward a procatarxis. Illness arises up often in
persons with alcoholism, avitaminosises, cardiac
insufficiency, chronic overstrain.
16Croupous pneumonia
17Morphogeny of croupous pneumonia
- The morphological changes at croupous pneumonia
test a certain evolution, which enables to select
a few stages of process (R. Rokytanskyy) - stage
of congesting (from 12 hours to 3 days), stage of
red hepatisation (1-3 days), stage of grey
hepatisation (2-6 days), stage of resolution.
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20Carnification of lungs.Abscesses in lungs
21Bronchopneumonia
- A term bronchopneumonia pneumonia (lobular
pneumonia) unite the lungs fevers different
originally, and the general line of which there
is localization of primary process in bronchial
tubes. From here inflammation passes to pulmonary
tissue and can be limited in the acinus, lobulus,
segment or lobe.
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23- In most cases reason of bronchopneumonia is a
bronchogenic (aerogene) infection, however can be
the haematogenic and lymphogenic ways of
infecting. A process begins from bronchiolus and
passes to alveolar ducts. A peribronchitis can
join to the bronchitis. The process passes from
peribronchial tissue to the neighbouring
alveoluses (peribronchial pneumonia).
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26Interstitial pneumonia
- Interstitial pneumonia spreads mainly on
interstitial tissue. At this case the
insignificant accumulation of exsudate appears in
the road clearance of alveoluses. Interstitial
pneumonia belongs to the atypical forms. Meets at
viral infections, croupous pneumonia. A process
begins from a bronchitis with next distribution
of process by lymphatic ways (lymphangitis) or
vasculitis (systemic lupus erithematosus).
27Interstitial pneumonia
28Chronic Obstructive Pulmonary Disease
29Bronchitis
- Distinguish a acute and chronic bronchitis
(bronchitis acute, bronchitis chronic). - Among the etiologic factors of acute inflammation
of bronchial tubes of primary value give to the
viruses and bacteria which cause the respirators
diseases. From physical factors select the
pathogenic action of dry or cold air, dust, from
chemical is breathing in tobacco smoke, chlorine
steam, nitrogen oxides. The inherited insolvency
of barrier mechanisms of mucus, insufficiency of
cellular (phagocytosis) and humural (IgA)
protective factors of local value, assists to
development of bronchitis.
30Bronchitis
31Acute bronchitis
- It can be independent nosology unit or secondary
display of row of other illnesses (croupous
pneumonia, uremia). Almost all forms of catarrhal
inflammation develop in mucus bronchial tubes
serosal, festering, fibrin, fibrin-hemorragic,
mucous. Destruction of mucus membrane with ulcers
development is possible sometimes.
32Acute bronchitis
33acute bronchitis
34Chronic inflammation of bronchial tubes
- Shows up in such forms
- a) a chronic mucous or purulent catarrh with
atrophy of mucus plate, cystophorous regeneration
of glands and metaplasia of prismatic epithelium
into multi-layered flat - b) chronic productive inflammation with polypuses
formation by granulation tissue (polypal chronic
bronchitis) - c) deformation of bronchial tube at ripening of
granulation tissue, excrescence of connecting
tissue in a muscular layer, sclerosis and atrophy
of mucus membrane (deforming chronic bronchitis).
35Chronic Bronchitis
36chronic bronchitis
37Cystic Fibrosis
38Emphysema of lungs
- Emphysema of lungs (emphysema pulmonum) is the
pathosis of pulmonary tissue, which is
characterized by enhanceable (?) maintenance in
her air.
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41Emphysema
42Bubble (bullous) emphysema of lungs
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44Asthma
45Adult Respiratory Distress Syndrome
46Pulmonary Embolism
47Cancer of lung
48Lung Cancer
49Small-Cell Lung Cancer
50Non-Small-Cell LungCancer
51Lung CancerExtrapulmonaryManifestations
52MetastaticMalignancyto the Lung
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