ASSIGNMENT

ONLINE ASSIGNMENT

Topic: LUNG DISEASES

PREPARED BY
VINOD P H
DEPT. OF NATURAL SCIENCE
S N T C NEDUNGANDA

INTRODUCTION
The chest contains two lungs, one lung on the right side
of the chest, the other on the left side of the chest. Each
lung is made up of sections called lobes. The lung is soft

and protected by the ribcage. The purposes of the lungs

are to bring oxygen (abbreviated O2), into the body and to
remove carbon dioxide (abbreviated CO2). Oxygen is a
gas that provides us energy while carbon dioxide is a
waste product or "exhaust" of the body.
The cone-shaped lungs are sponge-like organs that fill the chest cavity
and make up most of the lower respiratory tract. Their most important
job is providing oxygen to capillaries so they can oxygenate blood.
Each lung is divided into lobes. The right lung has three, but the left
lung has only two, thus allowing room to accommodate the heart.
Together, the lungs tissue surface is almost 40 times greater than the
bodys outer surface, making the lungs (together) one of the largest
organs in the body.
Each lung houses a bronchial tree, which gets its name from the intricate
network of air passages that supply the lungs with air. The air-filled sacs
in the lungs called alveoli resemble grape clusters. White blood cells
known as macrophages, located inside each alveolus, ingest and destroy
airborne irritants that enter the lungs. After you exhale, the lungs stay
partly inflated because of a fluid called surfactant that is produced by
special cells and secreted within the alveoli. Surfactant contains fatty
proteins and helps to prevent lung infections.
Suffering from a respiratory disorder is one of the most common reasons
for doctor visits in industrialized countries, where the air is filled with
chemicals, pollutants, dust, pollen, bacteria, and viruses. The billions of
microorganisms bacteria, viruses, and fungi in the air you breathe
can enter the lungs, and they make respiratory infections quite common.
Some infections, such as the common cold or sinusitis, affect the upper

respiratory tract. Others, such as bronchitis and pneumonia, affect the

lower respiratory tract

Acute bronchitis
Acute bronchitis is an infection of the the bronchi - the large airways.
Acute bronchitis is common and is usually due to infection with a virus.
Infection with a germ (a bacterial infection) is a less common cause

Symptoms of acute bronchitis

The main symptom is cough. You may also develop a high temperature
(fever), headache, cold symptoms and aches and pains. Symptoms
typically peak after 2-3 days and then gradually clear. However, it
commonly takes 2-3 weeks for the cough to go completely after the
other symptoms have gone. This is because inflammation in the airways
caused by the infection may take some time to settle.
Symptoms are a nonproductive or mildly productive cough accompanied
or preceded by URI symptoms, usually by > 5 days. Subjective dyspnea
results from chest pain or tightness with breathing, not from hypoxia.
Signs are often absent but may include scattered rhonchi and wheezing.
Sputum may be clear, purulent, or occasionally contain blood. Sputum
characteristics do not correspond with a particular etiology (ie, viral vs
bacterial). Mild fever may be present, but high or prolonged fever is
unusual and suggests influenza or pneumonia.
On resolution, cough is the last symptom to subside and often takes 2 to
3 wk or even longer to do so.

Diagnosis
Clinical evaluation

 Sometimes chest x-ray to exclude other disorders

Diagnosis is based on clinical presentation. Testing is usually
unnecessary. However, patients who complain of dyspnea should have
pulse oximetry to rule out hypoxemia. Chest x-ray is done if findings
suggest serious illness or pneumonia (eg, ill appearance, mental status
change, high fever, tachypnea, hypoxemia, crackles, and signs of
consolidation or pleural effusion). Elderly patients are the occasional
exception, as they may have pneumonia without fever and auscultatory
findings, presenting instead with altered mental status and tachypnea.
Sputum Gram stain and culture usually have no role. Nasopharyngeal
samples can be tested for influenza and pertussis if these disorders are
clinically suspected (eg, for pertussis, persistent and paroxysmal cough
after 10 to 14 days of illness, only sometimes with the characteristic
whoop and/or retching, exposure to a confirmed casesee also Pertussis
: Diagnosis).
Cough resolves within 2 wk in 75% of patients. Patients with persistent
cough should undergo a chest x-ray. Evaluation for noninfectious causes,
including postnasal drip and gastroesophageal reflux disease, can usually
be done clinically. Differentiation of cough-variant asthma may require
pulmonary function testing.
Symptom relief (eg, acetaminophen, hydration, possibly
antitussives)
Inhaled -agonist or anticholinergic for wheezing
Acute bronchitis in otherwise healthy patients is a major reason that
antibiotics are overused. Nearly all patients require only symptomatic
treatment, such as acetaminophen and hydration. Evidence supporting

efficacy of routine use of other symptomatic treatments, such as

antitussives, mucolytics, and bronchodilators, is weak. Antitussives
should be considered only if the cough is interfering with sleep (see
Treatment). Patients with wheezing may benefit from an inhaled 2
-agonist (eg, albuterol) or an anticholinergic (eg, ipratropium) for a few
days. Oral antibiotics are typically not used except in patients with
pertussis or during known outbreaks of bacterial infection. A macrolide
such as azithromycin 500 mg po once, then 250 mg po once/day for 4
days or clarithromycin 500 mg po bid for 14 days is given.

Pneumonia
Pneumonia is an infection in one or both lung. It can be caused by fungi,
bacteria, or viruses. Pneumonia causes inflammation in your lungs air
sacs, or alveoli. The alveoli fill with fluid or pus, making it difficult to
breathe.
Symptoms of pneumonia can range from mild to life-threatening. The
severity of your pneumonia usually depends on:
the cause of your inflammation

 the type of organism causing your infection

your age
your general health
There are five major types of pneumonia. They are:
Bacterial Pneumonia

Bacterial pneumonia can affect anyone at any age. It can develop

on its own or after a serious cold or flu. The most common cause
of bacterial pneumonia is Streptococcus pneumoniae. Bacterial
pneumonia can also be caused by Chlamydophila
pneumonia or Legionella pneumophila. Pneumocystis jiroveci
pneumonia is sometimes seen in those who have weak immune
systems due to illnesses like AIDS or cancer.
Viral Pneumonia
In most cases, respiratory viruses can cause pneumonia, especially in young
children and the elderly. Pneumonia is usually not serious and lasts a short
time. However, the flu virus can cause viral pneumonia to be severe or fatal.
Its especially harmful to pregnant women or individuals with heart or lung
issues. Invading bacteria can cause complications with viral pneumonia.
Mycoplasma Pneumonia

Mycoplasma organisms are not viruses or bacteria, but they have

traits common to both. They are the smallest agents of disease that
affect humans. Mycoplasmas generally cause mild cases of
pneumonia, most often in older children and young adults.

Other Types of Pneumonia

Many additional types of pneumonia affect immune-compromised

individuals. Tuberculosis and Pneumocystis carinii pneumonia

(PCP) generally affect people with suppressed immune systems,

such as those who have AIDS. In fact, PCP can be one of the first
signs of illness in people with AIDS.
Less common types of pneumonia can also be serious. Pneumonia
can be caused by inhaling food, dust, liquid, or gas, as well as by
various fungi.

Symptoms
The general symptoms of bacterial pneumonia can develop quickly and
may include:
chest pain
shaking chills
fever
dry cough
wheezing
muscle aches
nausea
vomiting
rapid breathing
rapid heartbeat
difficulty breathing
Diagnosis

Physical Exam

Crackling and bubbling sounds in the chest during inhalation are usually
indicators of pneumonia. Wheezing may also be present. Your doctor
may also have trouble hearing normal breathing sounds in different areas
of your chest.
Diagnostic Tests
Chest X-rays can be used to determine if infection is present in your
lungs. However, chest X-rays wont show your type of pneumonia.
Blood tests can provide a better picture of the type of pneumonia. Also,
blood tests are necessary to see if the infection is in your bloodstream

Asthma
Asthma is a chronic disease involving the airways in the lungs. These
airways, or bronchial tubes, allow air to come in and out of the lungs.
If you have asthma your airways are always inflamed. They become
even more swollen and the muscles around the airways can tighten when
something triggers your symptoms. This makes it difficult for air to
move in and out of the lungs, causing symptoms such as coughing,
wheezing, shortness of breath and/or chest tightness.
For many asthma sufferers, timing of these symptoms is closely related
to physical activity. And, some otherwise healthy people can develop
asthma symptoms only when exercising. This is called exercise-induced
bronchoconstriction (EIB), or exercise-induced asthma (EIA). Staying
active is an important way to stay healthy, so asthma shouldn't keep you
on the sidelines. Your physician can develop a management plan to keep
your symptoms under control before, during and after physicial activity.
People with a family history of allergies or asthma are more prone to
developing asthma. Many people with asthma also have allergies. This is
called allergic asthma.

Occupational asthma is caused by inhaling fumes, gases, dust or other

potentially harmful substances while on the job.
Childhood asthma impacts millions of children and their families. In
fact, the majority of children who develop asthma do so before the age
of five.

Symptoms
Asthma symptoms vary from person to person. You may have infrequent
asthma attacks, have symptoms only at certain times such as when
exercising or have symptoms all the time.
Asthma signs and symptoms include:
Shortness of breath
Chest tightness or pain
Trouble sleeping caused by shortness of breath, coughing or
wheezing
A whistling or wheezing sound when exhaling (wheezing is a
common sign of asthma in children)
Coughing or wheezing attacks that are worsened by a respiratory
virus, such as a cold or the flu
Diagnosis

Allergy testing to find out which allergens affect you, if any.

A test to measure how sensitive your airways are. This is called a
bronchoprovocation test. Using spirometry, this test repeatedly
measures your lung function during physical activity or after you

receive increasing doses of cold air or a special chemical to breathe

in.
A test to show whether you have another condition with the same
symptoms as asthma, such as reflux disease, vocal cord
dysfunction, or sleep apnea.
A chest x ray or an EKG (electrocardiogram). These tests will help
find out whether a foreign object or other disease may be causing
your symptoms.

Tuberculosis
Tuberculosis, MTB, or TB (short for tubercle bacillus), in
the past also called phthisis, phthisis pulmonalis, or
consumption, is a widespread, infectious disease caused
by various strains of mycobacteria, usually
Mycobacterium tuberculosis. Tuberculosis typically
attacks the lungs, but can also affect other parts of the
body. It is spread through the air when people who have
an active TB infection cough, sneeze, or otherwise
transmit respiratory fluids through the air. Most infections
do not have symptoms, known as latent tuberculosis.
About one in ten latent infections eventually progresses
to active disease which, if left untreated, kills more than
50% of those so infected

Symptoms of TB disease depend on where in the body the TB bacteria

are growing. TB bacteria usually grow in the lungs (pulmonary TB). TB
disease in the lungs may cause symptoms such as
a bad cough that lasts 3 weeks or longer
pain in the chest
coughing up blood or sputum (phlegm from deep inside the lungs)

Symptoms
weakness or fatigue
weight loss
no appetite
chills
fever
sweating at night

Symptoms of TB disease in other parts of the body depend on the area

affected.
People who have latent TB infection do not feel sick, do not have any
symptoms, and cannot spread TB to others.
Diagnosis

During the physical exam, your doctor will check your lymph nodes for
swelling and use a stethoscope to listen carefully to the sounds your
lungs make while you breathe.
The most commonly used diagnostic tool for tuberculosis is a simple
skin test, though blood tests are becoming more commonplace. A small
amount of a substance called PPD tuberculin is injected just below the
skin of your inside forearm. You should feel only a slight needle prick.
Within 48 to 72 hours, a health care professional will check your arm for
swelling at the injection site. A hard, raised red bump means you're
likely to have TB infection. The size of the bump determines whether
the test results are significant.

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