RESPIRATORY SYSTEM DISEASES

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RESPIRATORY SYSTEM DISEASES

• According prof Ya. Bodnar
• (Frank H. Netters illustrations)

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Pneumonia

• Pneumonia is a disease, which unites the large
  group of various different etiology
  inflammations, pathogeny and morphological
  description of respirator department of lung.

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BACTERIAL PNEUMONIAS
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VIRAL PNEUMONIAS
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OPPORTUNISTIC PNEUMONIAS
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Pneumonia

• 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.)

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INFECTIOUS 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)
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Classification 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)

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Continuation 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).

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Classification 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)

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Pathogeny 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.

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Pathogeny 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.

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Risk factors

• age
• smoking, alcohol
• chronic diseases of lungs, heart, kidneys
• professional harmfulness
• immunodeficient states
• contact with birds, rodents
• trips

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Acute pneumonia
croupous P.
interstitial P.
broncho-P.
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Etiology 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.

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Croupous pneumonia
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Morphogeny 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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Carnification of lungs.Abscesses in lungs
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Bronchopneumonia

• 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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• 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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Interstitial 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).

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Interstitial pneumonia
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Chronic Obstructive Pulmonary Disease
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Bronchitis

• 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.

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Bronchitis

• acute
  chronic

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Acute 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.

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Acute bronchitis
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acute bronchitis
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Chronic 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).

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Chronic Bronchitis
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chronic bronchitis
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Cystic Fibrosis
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Emphysema 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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Emphysema
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Bubble (bullous) emphysema of lungs
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Asthma
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Adult Respiratory Distress Syndrome
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Pulmonary Embolism
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Cancer of lung
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Lung Cancer
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Small-Cell Lung Cancer
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Non-Small-Cell LungCancer
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Lung CancerExtrapulmonaryManifestations
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MetastaticMalignancyto the Lung
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• Thank you for attention!