PATHOPHYSIOLOGY OF PNEUMONIA The respiratory system is an intricate arrangement of spaces and passageways that conduct air from outside

of the body. The role of the lungs is to take oxygen into the body, which we need for our cells to live and function properly, and to help us get rid of carbon dioxide, which is a waste product.

Pneumonia is an inflammation of the lung parenchyma that is caused by a microbial agent. Bacteria commonly enter the lower airway but do not cause pneumonia in the presence of an intact host defence mechanism. When pneumonia does occur, it is caused by various microorganisms,

including bacteria, mycobacteria, chlamydiae, mycoplasma, fungi, parasites and viruses. Mycoplasma pneumonia occurs most often in older children and young adults and is spread by infected respiratory droplets through person-person contact. Viruses is the most common in infants and children.

According to Brunner and Suddarths, upper airway characteristics normally prevent potentially infectious particles from reaching the normally sterile lower respiratory tract. Thus, patients with pneumonia caused by infectious agents often have an acute or chronic underlying disease that impairs host defences. Pneumonia arises from normally present flora in a patient whose resistance has been altered, or it results from aspiration of flora present in the oropharynx. It may also result from bloodborne organisms that enter the pulmonary circulation and are trapped in the pulmonary capillary bed, becoming a potential source of pneumonia.

Pneumonia often affects both ventilation and diffusion. An inflammatory reaction can occur in the aveoli, producing an exudates that interferes with the diffusion of oxygen and carbon dioxide. White blood cell, mostly neutrophils, also migrate into the aveoli and fill the normally air-containing spaces. Areas of the lung are not adequately ventilated because of secretions and mucosal edema that

cause partial occlusion of the bronchi or aveoli, with a resultant decrease in alveolar oxygen tension. Bronchospasm may also occur in patients with reactive airway disease. Because of hypoventilation, a ventilation-perfusion mismatch occurs in the affected area of the lung. Venous blood entering the pulmonary circulation passes through the underventilated area and exits to the left side of the heart poorly oxygenated. The mixing of oxygenated and unoxygenated or poorly oyygenated blood eventually results in arterial hypoxemia.

Pneumonia is named for the way in which a person gets the infection or for the pathogen that causes it. The classifications of pneumonia are Community-Acquired Pneumonia, occurs outside of hospitals and other health care settings. Most people get CAP by breathing in germs (especially while sleeping) that live in the mouth, nose, or throat. CAP is the most common type of pneumonia. HospitalAcquired Pneumonia, some people catch pneumonia during a hospital stay for another illness. Health Care-Associated Pneumonia, patients also may get pneumonia in other health care settings, such as nursing homes, dialysis centers, and outpatient clinics; and Aspiration Pneumonia which can occur if you inhale food, drink, vomit, or saliva from your mouth into your lungs. This may happen if something disturbs your normal gag reflex, such as a brain injury, swallowing problem, or excessive use of alcohol or drugs.