RESP 2 (Pneumonia) Flashcards
Breathing Requirements - What are they?
Patent Airways - impaired by tongue, swelling, mucous, fluid, foreign bodies, bronchiolar constriction, insufficient surfactant
Adequate Alveolar gaseous exchange - as above plus anything that impairs respiratory membrane function or blood supply (infections)
What affects Gas Exchange?
- concentration of gases (high eltitude etc)
- rate of gas sxchange (respiratory rate)
- alveolar patency/surface area (hyaline disease in newborns)
- Compliance of the lungs (scarring oedema)
- airway resistance (asthma, COPD)
Infections of the lung
- what
- defences
Normal lung is free of organisms: defence mechanisms
Micro-organisms gain access via aspiration of commensals from oropharyna, inhalation of contaminated aerosols, blood spread (rare)
Defences
normally we clear this bacteria (columnar cilia, sneezing or blowing, macrophages)
How do our defence mechanisms become impaired?
- Loss of suppression of cough reflex
- injury to mucociliary process
- interference with teh phagocytic bacterial action of alveolar macrophages
- pulmonary congestion and oedema
- accumulation of secretions
Defence impairment
LOSS OR SUPPRESSION OF COUGH REFLEX
- leads to coma
- anaestjesoa
- neuromuscular disorders
- drugs
- chest pain (some will not cough because of this pain)
Defence Impairment
Injury to mucociliary apparatus
- Impairment in function or destruction of ciliated epithelium (cigarette smoke, inhalation of gases, viral diseases, bacterial pathogens, cystic fibrosis)
Impairment of lung defence:
Interference with phagocytic or bacterial action of alveolar macrophages
- alcohol
- tobacco smoke
- anoxia
- 02 intoxication
Impairment of lung defence
Accumulation of secretions
- Cystic Fibrosis
- Bronchial obstruction “stasis is the basis”
Common Cold
What does that affect?
Mostly affects the nasopharynx, swelling and secretion.
Inflammation of..
- nasolacrimal duct - watery eyes
- nasal cavity - sinusitis
- auditory tube - middle ear probs
- larynx - hoarsness
Caused by rhinovirus mostly (can survive 5 hours on skin and durfaces - ususally this is the way to catch it)
Pneumonia
Inflammation of the lung caused by infectious agents
There are 2 types
Broncho
Lombar
Usually affects LOWER LOBES (gravity)
What are the CAUSATIVE AGENTS of PNEUMONIA
Influenced by
- age of person
- underlying respiratory diseases
- immunocompromisation
- travel, animal, occupational contact
Common:
- strep. pneumonia, mycoplasma pneumoniae
- If Co-Morbidity - strep pneumoniar, haemophilus influenzaw
Often HOSPITAL ACQUIRED
Often in IMMUNOCOMPROMISED PEOPLE
- post transplant
- AIDS
Bacteria - mycobacterium spp, nocardia
Fungi - aspergillus
Viruses: Cytomegalovirus, Herpes Simplex
Pneumonia: Management
Antibiotic treatment - firstly broad spectrum then tailored to specific organism
2 TYPES OF PNEUMONIA
LOBAR AND BRONCHOPNEUMONIA
LOBAR PNEUMONIA
What bacteria causes it?
** LARGE portion of a lobe or entire lobe**
- Organisms gain entry ti abd soread through distal air spaces
- MOST COMMONLY FROM STREP PNEUMONIAE
LOBAR PNEUMONIA
Clinical Features
CLINICAL FEATURES
- sudden onset
- rapid rise in temperature
- anorexia, headache, arthalgia
- localised pleuritic type pain
- cough which starts out to be short
LOOKS LIKE - One part of the lung is white
with BRIGHT RED blood cessels, air spaces FULL of cells (neutrophils, fibrin, oedema - AI)
