Diseases of the Respiratory System

Bronchitis (brong-ki'tis) is an inflammation of the bronchi caused by irritants, such as

cigarette smoke, air pollution, or infections. The inflammation results in swelling of the
mucous membrane lining the bronchi, increased mucus production, and decreased
movement of mucus by cilia. Consequently, the diameter of the bronchi is decreased, and
ventilation is impaired. Bronchitis can progress to emphysema.
Emphysema (em-fi-se'mah) results in the destruction of the alveolar walls. Many
individuals have both bronchitis and emphysema, which are often referred to as chronic
obstructive pulmonary disease (COPD). Chronic inflammation of the bronchioles, usually
caused by cigarette smoke or air pollution, probably initiates emphysema. Narrowing of
the bronchioles restricts air movement, and air tends to be retained in the lungs. Coughing
to remove accumulated mucus increases pressure in the alveoli, resulting in rupture and
destruction of alveolar walls. Loss of alveolar walls has two important consequences. The
respiratory membrane has a decrease surface area, which decreases gas exchange, and
loss of elastic fibers decrease the ability of the lungs to recoil and expel air. Symptoms of
emphysema include shortness of breath and enlargement of the thoracic cavity. Treatment
involves removing sources of irritants (for example, stopping smoking), promoting the
removal of bronchial secretions, retraining people to breathe so that expiration of air is
maximized, and using antibiotics to prevent infections. The progress of emphysema can
be slowed, but there is no cure.
Cystic fibrosis is an inherited disease that affects the secretory cells lining the lungs,
pancreas, sweat glands, and salivary glands. The defect produces an abnormal transport
protein, resulting in decreased chloride ion secretion out of cells. Normally, the diffusion of
chloride and sodium ions out of the cells causes water to follow by osmosis. In the lungs,
the water forms a thin fluid layer over which mucus is moved by ciliated cells. In cystic
fibrosis, the decreased chloride ion diffusion results in dehydrated respiratory secretions.
The mucus is more viscous, resisting movement by cilia, and it accumulates in the lungs.
For reasons not completely understood, the mucus accumulation increases the likelihood
of infections. Chronic airflow obstruction causes difficulty in breathing, and coughing in an
attempt to remove the mucus can result in pneumothorax and bleeding within the lungs.
Once fatal during early childhood, many victims of cystic fibrosis are now surviving into
young adulthood. Future treatments could include the development of drugs that correct or
assist the normal ion transport mechanism. Alternatively, cystic fibrosis may some day be
cured through genetic engineering by inserting a functional copy of the defective gene into
a person with the disease. Research on this exciting possibility is currently underway.

Asthma (az'mah) is a disorder in which there are periodic episodes of contractions of

bronchial smooth muscle, which restricts air movement. Many cases of asthma result from
allergic responses to pollen, dust, animal dander, or other substances.
Treatment includes the use of drugs that relax the bronchiole smooth muscles and reduce
inflammation. Sometimes injections are given to reduce the sensitivity of the immune
system to the substances that stimulate an asthma attack.
Pulmonary fibrosis is the replacement of lung tissue with fibrous connective tissue,
making the lungs less elastic and breathing more difficult. Exposure to asbestos, silica, or
coal dust is the most common cause.
Lung cancer arises from the epithelium of the respiratory tract. Cancers arising from
tissues other than respiratory epithelium are not called lung cancer, even though they
occur in the lungs. Lung cancer is the most common cause of cancer death in males and
females in the United States, and almost all cases occur in smokers. Because of the rich
lymph and blood supply in the lungs, cancer in the lung can readily spread to other parts
of the lung or body. In addition, the disease is often advanced before symptoms become
severe enough for the victim to seek medical aid. Typical symptoms include coughing,
sputum production, and blockage of the airways. Treatments include removal of part or all
of the lung, chemotherapy, and radiation.

Diseases of the Upper Respiratory Tract

Strep throat is caused by a streptococcal bacteria and is characterized by inflammation of
the pharynx and by fever. Frequently, inflammation of the tonsils and middle ear are
involved. Without a throat analysis, the infection cannot be distinguished from viral causes
of pharyngeal inflammation. Current techniques allow rapid diagnosis within minutes to
hours, and antibiotics are effective in treating strep throat.
Diphtheria (dif-the're-ah) was once a major cause of death among children. It is caused
by a bacterium. A grayish membrane forms in the throat and can block the respiratory
passages totally. A vaccine against diphtheria is part of the normal immunization program
for children in the United States.
The common cold is the result of a viral infection. Symptoms include sneezing, excessive
nasal secretions, and congestion. The infection easily can spread to sinus cavities, lower
respiratory passages, and the middle ear. Laryngitis and middle ear infections are
common complications. The common cold usually runs its course to recovery in about 1
week.

Diseases of the Lower Respiratory Tract

Laryngitis (lar-in-ji'tis) is an inflammation of the larynx, especially the vocal cords, and
bronchitis (brong-ki'tis) is an inflammation of the bronchi. Bacterial or viral infection can
move from the upper respiratory tract to cause laryngitis or bronchitis. Bronchitis is also
often caused by continually breathing air containing harmful chemicals, such as those
found in cigarette smoke.
Whooping cough (pertussis) is a bacterial infection. The infection causes a loss of cilia
of the respiratory epithelium. Mucus accumulates, and the infected person attempts to
cough up the mucous accumulations. The coughing can be severe. A vaccine for
whooping cough is part of the normal vaccination procedure for children in the United
States.
Tuberculosis (tu-ber'ku-lo'sis) is caused by a tuberculosis bacterium. In the lung, the
tuberculosis bacteria forms lesions called tubercles. The small lumps contain
degenerating macrophages and tuberculosis bacteria. An immune reaction is directed
against the tubercles, which causes the formation of larger lesions and inflammation. The
tubercles can rupture, releasing bacteria that infect other parts of the lung or body.
Recently, a strain of the tuberculosis bacteria has developed that is resistant to treatment,
and there is concern that tuberculosis will again become a widespread infectious disease.
Pneumonia (nu-mo'ne-ah) refers to many infections of the lung. Most pneumonias are
caused by bacteria, but some result from viral, fungal, or protozoan infections. Symptoms
include fever, difficulty in breathing, and chest pain. Inflammation of the lungs results in
the accumulation of fluid within alveoli (pulmonary edema) and poor inflation of the lungs
with air. A protozoal infection that results in pneumocystosis pneumonia is rare, except in
persons who have a compromised immune system. This type of pneumonia has become
one of the infections commonly suffered by persons who have AIDS.
Flu (influenza) is a viral infection of the respiratory system and does not affect the
digestive system as is commonly assumed. Flu is characterized by chills, fever, headache,
and muscular aches, in addition to respiratory symptoms. There are several strains of flu
viruses. The mortality rate from flu is approximately 1%, and most of those deaths are
among the very old and very young. During a flu epidemic the infection rate is so rapid
and the disease is so widespread that the the total number of deaths is substantial, even
though the percentage of deaths is relatively low. Flu vaccines can provide protection
against the flu.
A number of fungal diseases, such as histoplasmosis (his'to-plaz-mo'sis) and
coccidioidomycosis (kok-sid-e-oy'do-mi-ko'sis), affect the respiratory system. The fungal

spores usually enter the respiratory system through dust particles. Spores in soil and
feces of certain animals make the rate of infection higher in farm workers and in
gardeners. The infections usually result in minor respiratory infections, but in some cases
they can cause infections throughout the body.

Diseases of the Circulatory System

The following is a compact list of circulatory system diseases.

Heart Diseases
Heart is the major and most important element of circulatory system. The pathology
or diseases that affect the physiological functions of the heart are as follows:

Angina
Angina is commonly referred to as chest pain in layman terms and referred to as the
sharp and shooting pain that is severe in intensity and develop when the blood
supply to the heart muscles is altered as a result of ischemia. The pain is usually felt
to the left of sternum or in epigastrium and radiates to neck, arms, and back
(especially concentrated at the scapular region). It may persist up to 5-15 min. The patients should be
taken immediately to the hospital as it is usually a warning sign of impending heart attack. It is usually
relieved by rest, nitroglycerin and oxygen administration.

Cardiomyopathy
Cardiomyopathy is the disease of the heart muscles that may lead to enlarged, thick or rigid heart
muscles. It can be acquired or inherited in nature and causes weakening of the heart muscles especially

of the ventricles. If left untreated; it may spreads to involve upper chambers of heart. As cardiomyopathy
worsens it can cause scarring and weakening of the heart muscles resulting in congestive heart failure
and even death.

Rheumatic Heart Disease

It is an inflammatory condition that mainly involves cardiac valves as a result of chronic history of
untreated or poorly managed rheumatic fever. The condition is mainly associated with strep-throat
infection that may lead to obstruction of the heart valves or insufficiency as a result of auto-immune
destruction.

Arrhythmia
An arrhythmia is an abnormal rate or rhythm of the heartbeat. It can beat too fast, too slow, or with an
irregular rhythm. If the heart beat is fast it is called as tachycardia and if is too slow, it is referred to as
bradycardia. Generally mild arrhythmias are harmless, but if left poorly managed, the rhythm
abnormalities may prove life threatening.

Congenital Heart Defects

Congenital heart defects are abnormalities in the morphological or physiological functioning of the heart
that are present at the time of birth. The primary cause is the incomplete or abnormal development of
the fetal heart during the early weeks of pregnancy. The exact aetiology is unknown but it can be
associated with genetic disorders, such as Down syndrome or use of certain drugs by pregnant mommy
during pregnancy. It is not possible to prevent congenital heart defect but there are many treatments to
manage the cardiac defects early in the neonatal period to prevent complications.

Vascular Diseases
Vascular diseases are referred to as disorders of blood vessels.

Hypertension
Hypertension is the most common vascular disorder that has become the leading cause of morbidity
and mortality in all parts of the world. Hypertension occurs when the heart pump blood through the
narrow vessels as a result of atherosclerosis or stiffening of arteries due to aging or inherited vascular
conditions. The pumping through the narrowed vessel consistently increases the systolic and diastolic
pressure above normal reference range. Increased work load of heart leads to damaged tissues and
increases the risk of cardiac diseases, kidney diseases, aneurysms and stroke.

Aortic Aneurysm
It is the abnormal dilatation of the aorta leading to the weakening of the walls. Large or fast growing
aortic aneurysm can rupture that can lead to severe pain; massive internal bleeding and even death if
not treated immediately.

Atherosclerosis

Atherosclerosis is a chronic vascular disease that may remain asymptomatic for many years leading to
the hardening of the arteries due to the accumulation of fat, cholesterol, and other substances in the
arterial walls. The condition usually affects medium and large arteries. If untreated the condition may
lead to complete occlusion of the vessel leading to cessation of blood supply to the heart or brain.
Smoking, alcohol, diabetes, cholesterol and hypertension increase the risk of atherosclerosis.

Deep Vein Thrombosis

Development of a blood clot as a result of stasis of blood or hypercoaguable state like pregnancy,
Protein C and S deficiency and other factors in the deep veins of the leg is referred to as deep vein
thrombosis. In most situations, the thrombus is asymptomatic and concealed but may also present with
mild to moderate pain, discoloration and swelling in the affected area of leg. It usually develops during
periods of prolonged immobility like orthopedic or spinal surgery, and hypercoagulable states. The most
dreadful complication of DVT is the dislodgment of thrombus that may block pulmonary vessels leading
to pulmonary embolism.

Polyarteritis Nodosa
It is a serious inflammatory disease of unknown etiology affecting small to medium sized arteries, but
latest research suggests a possible association with hepatitis B infection. Polyarteritis Nodosa is
characterized by muscle and joint aches, fever, night sweats, fatigue, and weight loss. Treatment
modalities are mostly dependent on the extent of the illness, and the parts of the body involved. Most
commonly used drugs are corticosteroids and other immunosuppressive therapies.

Coronary Artery Disease

Coronary artery disease (CAD) is one of the common vascular diseases marked by accumulation of
atherosclerotic plaque in the coronary blood vessels. As the plaque thickens, secondary changes may
take place like enlargement of size and calcification that may lead to complete occlusion of lumen of the
coronary artery, resulting in inadequate supply of oxygen to the heart muscle.

Peripheral Vascular Disease

Peripheral Vascular Disease is also called peripheral artery disease. It is a vascular disorder marked by
obstruction of large arteries of the legs and hands. It causes either acute or chronic ischemia due to
atherosclerosis or inflammatory processes.

Hypercholesterolemia
Hypercholesterolemia refers to high cholesterol level. There are mainly two types of cholesterol, one is
low-density lipoproteins (LDL) that is not good for the body and other is high-density lipoproteins (HDL)
that is considered good quality cholesterol because of its cardio-protective properties. Elevated LDL
levels increase the risk for heart diseases and stroke.