Diseases of the Respiratory Tract

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Diseases of the Respiratory Tract
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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

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The Respiratory Tract

• Upper Respiratory Tract
• Oral Cavity
• Nasal Cavity
• Paranasal Sinuses
• Nasopharynx
• Larynx
• Lower Respiratory Tract
• Lungs (alveoli, bronchi, bronchioles)

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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

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Diseases of the Upper Airway

• Sinusitis, rhinitis
• Sinonasal papillomas
• Sinonasal cancer
• Laryngitis
• Vocal cord paralysis
• Cancer of the Larynx

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Sinusitis

• Infectious (Bacterial, viral, fungal)
• Allergic
• Signs and Symptoms
• Nasal Blockage/Obstruction (Edema)
• Sneezing
• Nasal Discharge
• Fever (viral and bacterial)

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Clouding of the sinus seen on a Radiograph
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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

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CT scan reveals the patient has a brain, two
eyeballs and a polypoid mass (Papilloma) in the
nose and sinus
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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

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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

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How to tell a

• Allergy from a
• Sinusitis from a
• Laryngitis from a
• Bronchitis from a
• Tonsillitis from a
• Pneumonia from an
• Ear Ache from a
• Flu

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NO Temp. 100 F or abovestuffy nose, sneezing

• Itchy eyes, nose, throat
• Pain around eyes,
• thick yellow nasal
• discharge

• Cat, dust, pollen allergy
• Cold plus sinusitis

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NO Temp. 100 F or abovestuffy nose, sneezing

• Cold plus otitis media
• Cold plus laryngitis

• Ear hurts
• Hoarseness
• NO
• Uncomplicated Cold

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Temp. 100 F or aboveNO Headache, chills and
sweats, rash, muscle aches, marked fatigue, cough

• Very sore throat and/or swollen neck glands

• Strep throat or tonsillitis

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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 Fluor Lyme Disease

• Flu plus bronchitis
• Flu plus pneumonia

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Diseases of the Lungs

• Chronic Obstructive Pulmonary Disease (COPD
• Pneumonias
• Granulomatous Infections
• Cancer

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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

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Pneumonia

• Bacterial and Viral Etiologies
• Filling of air spaces with edema fluid
• Requires hospitalization, antibiotics
• Symptoms
• Dyspnea
• Cough, productive or nonproductive
• Fever

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Tuberculosis

• Mycobacterium tuberculosum
• Mildly contagious, repeated exposures
• Lung Granulomas fill airspaces
• Necrosis of granulomas
• Signs and symptoms
• Productive cough
• Bloody sputum, hemoptysis
• Dyspnea

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Lung Cancer

• Bronchogenic Carcinoma
• Cigarette smoking is chief environmental risk
  factor
• Small Cell Carcinoma
• Both types metastasize
• Predispose lungs to pneumonia

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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

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Goodbye and Good Luck

• 
  Peter J.