Respiratory tract

In humans, the respiratory tract is the part of the anatomy of the respiratory system involved with the process of respiration. Air is breathed in through the nose or the mouth. In the nasal cavity, a layer of mucous membrane acts as a filter and traps pollutants and other harmful substances found in the air. Next, air moves into the pharynx, a passage that contains the intersection between the oesophagus and the larynx. The opening of the larynx has a special flap of cartilage, the epiglottis, that opens to allow air to pass through but closes to prevent food from moving into the airway.

From the larynx, air moves into the trachea and down to the intersection that branches to form the right and left primary (main) bronchi. Each of these bronchi branch into secondary (lobar) bronchi that branch into tertiary (segmental) bronchi that branch into smaller airways called bronchioles that eventually connect with tiny specialized structures called alveoli that function in gas exchange.

The lungs which are located in the thoracic cavity, are protected from physical damage by the rib cage. At the base of the lungs is a sheet of skeletal muscle called the diaphragm. The diaphragm separates the lungs from the stomach and intestines. The diaphragm is also the main muscle of respiration involved in breathing, and is controlled by the sympathetic nervous system.

The lungs are encased in a serous membrane that folds in on itself to form the pleurae – a two-layered protective barrier. The inner visceral pleura covers the surface of the lungs, and the outer parietal pleura is attached to the inner surface of the thoracic cavity. The pleurae enclose a cavity called the pleural cavity that contains pleural fluid. This fluid is used to decrease the amount of friction that lungs experience during breathing.

Respiratory tract
Illu conducting passages
Conducting passages
Details
Systemrespiratory system
Identifiers
FMA265130
Anatomical terminology

Structure

Respiratory system complete en
Complete respiratory system

The respiratory tract is divided into the upper airways and lower airways. The upper airways or upper respiratory tract includes the nose and nasal passages, paranasal sinuses, the pharynx, and the portion of the larynx above the vocal folds (cords). The lower airways or lower respiratory tract includes the portion of the larynx below the vocal folds, trachea, bronchi and bronchioles. The lungs can be included in the lower respiratory tract or as separate entity and include the respiratory bronchioles, alveolar ducts, alveolar sacs, and alveoli.

The respiratory tract can also be divided into a conducting zone and a respiratory zone, based on the distinction of transporting gases or exchanging them.

The conducting zone includes structures outside of the lungs – the nose, pharynx, larynx, and trachea, and structures inside the lungs – the bronchi, bronchioles, and terminal bronchioles. The conduction zone conducts air breathed in that is filtered, warmed, and moistened, into the lungs. It represents the 1st through the 16th division of the respiratory tract. The conducting zone is most of the respiratory tract that conducts gases into and out of the lungs, but excludes the respiratory zone that exchanges gases. The conducting zone also functions to offer a low resistance pathway for airflow. It provides a major defense role in its filtering abilities.

The respiratory zone includes the respiratory bronchioles, alveolar ducts and alveoli, and is the site of oxygen and carbon dioxide exchange with the blood. The respiratory bronchioles and the alveolar ducts are responsible for 10% of the gas exchange. The alveoli are responsible for the other 90%. The respiratory zone represents the 16th through the 23rd division of the respiratory tract.

From the bronchi, the dividing tubes become progressively smaller with an estimated 20 to 23 divisions before ending at an alveolus.

Upper respiratory tract

Blausen 0872 UpperRespiratorySystem
Details of upper respiratory tract.

The upper respiratory tract, can refer to the parts of the respiratory system lying above the sternal angle (outside of the thorax),[1] above the vocal folds, or above the cricoid cartilage.[2][3] The larynx is sometimes included in both the upper and lower airways.[4] The larynx is also called the voice box and has the associated cartilage that produces sound. The tract consists of the nasal cavity and paranasal sinuses, the pharynx (nasopharynx, oropharynx and laryngopharynx) and sometimes includes the larynx.

Lower respiratory tract

The lower respiratory tract or lower airway is derived from the developing foregut and consists of the trachea, bronchi (primary, secondary and tertiary), bronchioles (including terminal and respiratory), and lungs (including alveoli).[5] It also sometimes includes the larynx.

The lower respiratory tract is also called the respiratory tree or tracheobronchial tree, to describe the branching structure of airways supplying air to the lungs, and includes the trachea, bronchi and bronchioles.[6]

At each division point or generation, one airway branches into two or more smaller airways. The human respiratory tree may consist on average of 23 generations, while the respiratory tree of the mouse has up to 13 generations. Proximal divisions (those closest to the top of the tree, such as the bronchi) mainly function to transmit air to the lower airways. Later divisions including the respiratory bronchiole, alveolar ducts and alveoli, are specialized for gas exchange.

The trachea is the largest tube in the respiratory tract and consists of tracheal rings of hyaline cartilage. It branches off into two bronchial tubes, a left and a right main bronchus. The bronchi branch off into smaller sections inside the lungs, called bronchioles. These bronchioles give rise to the air sacs in the lungs called the alveoli.[8]

The lungs are the largest organs in the lower respiratory tract. The lungs are suspended within the pleural cavity of the thorax. The pleurae are two thin membranes, one cell layer thick, which surround the lungs. The inner (visceral pleura) covers the lungs and the outer (parietal pleura) lines the inner surface of the chest wall. This membrane secretes a small amount of fluid, allowing the lungs to move freely within the pleural cavity while expanding and contracting during breathing. The lungs are divided into different lobes. The right lung is larger in size than the left, because of the heart's being situated to the left of the midline. The right lung has three lobes – upper, middle, and lower (or superior, middle and inferior), and the left lung has two – upper and lower (or superior and inferior), plus a small tongue-shaped portion of the upper lobe known as the lingula. Each lobe is further divided up into segments called bronchopulmonary segments. Each lung has a costal surface, which is adjacent to the ribcage; a diaphragmatic surface, which faces downward toward the diaphragm; and a mediastinal surface, which faces toward the center of the chest, and lies against the heart, great vessels, and the carina where the two mainstem bronchi branch off from the base of the trachea.

The alveoli are tiny air sacs in the lungs where gas exchange takes place. The mean number of alveoli in a human lung is 480 million.[9] When the diaphragm contracts, a negative pressure is generated in the thorax and air rushes in to fill the cavity. When that happens, these sacs fill with air, making the lung expand. The alveoli are rich with capillaries, called alveolor capillaries. Here the red blood cells absorb oxygen from the air and then carry it back in the form of oxyhaemaglobin, to nourish the cells. The red blood cells also carry carbon dioxide (CO
2
) away from the cells in the form of carbaminohemoglobin and releases it into the alveoli through the alveolor capillaries. When the diaphragm relaxes, a positive pressure is generated in the thorax and air rushes out of the alveoli expelling the carbon dioxide.

Microanatomy

Blausen 0750 PseudostratifiedCiliatedColumnar
Respiratory epithelium

The respiratory tract is covered in epithelium, which varies down the tract. There are glands and mucus produced by goblet cells in parts, as well as smooth muscle, elastin or cartilage. Most of the epithelium (from the nose to the bronchi) is covered in ciliated pseudostratified columnar epithelium, commonly called respiratory epithelium.[10] The cilia beat in one direction, moving mucus towards the throat where it is swallowed. Moving down the bronchioles, the cells get more cuboidal in shape but are still ciliated.

Glands are abundant in the upper respiratory tract, but there are fewer lower down and they are absent starting at the bronchioles. The same goes for goblet cells, although there are scattered ones in the first bronchioles.

Cartilage is present until the small bronchi. In the trachea they are C-shaped rings of hyaline cartilage, whereas in the bronchi the cartilage takes the form of interspersed plates. Smooth muscle starts in the trachea, where it joins the C-shaped rings of cartilage. It continues down the bronchi and bronchioles, which it completely encircles. Instead of hard cartilage, the bronchi and bronchioles are composed of elastic tissue.


The lungs are made up of thirteen different kinds of cells, eleven types of epithelial cell and two types of mesenchymal cell.[11] The epithelial cells form the lining of the tracheal, and bronchial tubes, while the mesenchymal cells line the lungs.

Respiratory Tract Histological Differences

Differences in cells along the respiratory tract.

Gray964

Transverse section of tracheal tissue. Note that image is incorrectly labeled "ciliated stratified epithelium" at upper right.

Function

Most of the respiratory tract exists merely as a piping system for air to travel in the lungs, and alveoli are the only part of the lung that exchanges oxygen and carbon dioxide with the blood.

Respiration

Respiration is the rhythmical process of breathing, in which air is drawn into the alveoli of the lungs via inhalation and subsequently expelled via exhalation. When a human being inhales, air travels down the trachea, through the bronchial tubes, and into the lungs. The entire tract is protected by the rib cage, spine, and sternum. In the lungs, oxygen from the inhaled air is transferred into the blood and circulated throughout the body. Carbon dioxide (CO2) is transferred from returning blood back into gaseous form in the lungs and exhaled through the lower respiratory tract and then the upper, to complete the process of breathing.

Unlike the trachea and bronchi, the upper airway is a collapsible, compliant tube. As such, it has to be able to withstand suction pressures generated by the rhythmic contraction of the diaphragm that sucks air into the lungs. This is accomplished by the rhythmic contraction of upper airway muscles, such as the genioglossus (tongue) and the hyoid muscles. In addition to rhythmic innervation from the respiratory center in the medulla oblongata, the motor neurons controlling the muscles also receive tonic innervation that sets a baseline level of stiffness and size.

The diaphragm is the primary muscle that allows for lung expansion and contraction. Smaller muscles between the ribs, the external intercostals, assist with this process.

Defences against infection

The epithelial lining of the upper respiratory tract is interspersed with goblet cells that secrete a protective mucus. This helps to filter waste, which is eventually either swallowed into the highly acidic stomach environment or expelled via spitting. The epithelium lining the respiratory tract is covered in small hairs called cilia. These beat rhythmically out from the lungs, moving secreted mucus foreign particles toward the laryngopharynx upwards and outwards, in a process called the mucociliary escalator. In addition to keeping the lower respiratory tract sterile, they prevent mucus accumulation in the lungs. Macrophages in the alveoli are part of the immune system which engulf and digest any inhaled harmful agents.

Hair in the nostrils plays a protective role, trapping particulate matter such as dust.[12] The cough reflex expels all irritants within the mucus membrane to the outside. The airways of the lungs contain rings of muscle. When the passageways are irritated by some allergen, these muscles can constrict.

Clinical significance

The respiratory tract is a common site for infections.

Infection

Upper respiratory tract infections are probably the most common infections in the world.

The respiratory system is very prone to developing infections in the lungs. Infants and older adults are more likely to develop infections in their lungs, because their lungs are not as strong in fighting off these infections. Most of these infections used to be fatal, but with new research and medicine, they are now treatable. With bacterial infections, antibiotics are prescribed, while viral infections are harder to treat, but still curable.

The common cold/flu is the most common cause for the upper respiratory tract infection, which can cause more serious illness that can develop in the lower respiratory tract. Pneumonia is the most common, and frequent lower respiratory tract infection. This can be either viral, bacterial, or fungal. This infection is very common, because pneumonia can be airborne, and when you inhale this infection in the air, the particles enter the lungs and move into the air sacs. This infection quickly develops in the lower part of the lung, and fills the lung with fluid, and excess mucus. This causes difficulty in breathing, and coughing as the lower respiratory tract tries to get rid of the fluid in the lungs. You can be more prone to developing this infection if you have asthma, flu, heart disease, or cancer[8]

Bronchitis is another common infection that takes place in the lower respiratory tract. It is an inflammation of the bronchial tubes. There are two forms of this infection: acute bronchitis, which is treatable and can go away without treatment, or chronic bronchitis, which comes and goes, but will always affect one's lungs. Bronchitis increases the amount of mucus that is natural in your respiratory tract. Chronic bronchitis is common in smokers, because the tar from smoking accumulates over time, causing the lungs to work harder to repair themselves.[8]

Tuberculosis is one of many other infections that occurs in the lower respiratory tract. You can contract this infection from airborne droplets, and if inhaled you are at risk of this disease. This is a bacterial infection which deteriorates the lung tissue resulting in coughing up blood.[8] This infection is deadly if not treated.

Lung cancer

Some of these cancers have environmental causes such as smoking. When a tobacco product is inhaled, the smoke paralyzes the cilia, causing mucus to enter the lungs. Frequent smoking, over time causes the cilia hairs to die and can no longer filter mucus. Tar from the smoke inhaled enters the lungs, turning the pink-coloured lungs black. The accumulation of this tar could eventually lead to lung cancer, or chronic obstructive pulmonary disease.[5]

Chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is a common lower respiratory disease that can be caused by exposure to harmful chemicals, or prolonged use of tobacco. This disease is chronic and progressive, the damage to the lungs is irreversible and eventually fatal. COPD destroys the alveoli, and lung tissue which makes breathing very difficult, causing shortness of breath, hyperventilation, and raised chest. The decreased number of alveoli causes loss of oxygen supply to the lungs, and an increased accumulation of carbon dioxide. There are two types of COPD: primary and secondary. Primary COPD can be found in younger adults. This type of COPD deteriorates the air sacs, and lung mass. Secondary COPD can be found in older adults who smoke or have smoked and have a history of bronchitis. Older terms for COPD are emphysema and chronic bronchitis.[5]

Asthma

The bronchi are the main passages to the right and left lungs. These airways carry the oxygen to the bronchioles inside the lungs. Inflammation of the bronchii and bronchioles can cause them to swell up, which could lead to an asthma attack. This results in wheezing, tightness of the chest and severe difficulty in breathing. There are different types of asthma that affect the functions of the bronchial tubes. Allergies can also set off an allergic reaction, causing swelling of the bronchial tubes; as a result, the air passage will swell up, or close up completely.[8]

See also

References

  1. ^ I. Edward Alcamo; John Bergdahl (29 July 2003). Anatomy Coloring Workbook. The Princeton Review. pp. 238–. ISBN 978-0-375-76342-7. Retrieved 26 April 2010.
  2. ^ Ronald M. Perkin; James D Swift; Dale A Newton (1 September 2007). Pediatric hospital medicine: textbook of inpatient management. Lippincott Williams & Wilkins. pp. 473–. ISBN 978-0-7817-7032-3. Retrieved 26 April 2010.
  3. ^ Jeremy P. T. Ward; Jane Ward; Charles M. Wiener (2006). The respiratory system at a glance. Wiley-Blackwell. pp. 11–. ISBN 978-1-4051-3448-4. Retrieved 26 April 2010.
  4. ^ Sabyasachi Sircar (2008). Principles of medical physiology. Thieme. pp. 309–. ISBN 978-3-13-144061-7. Retrieved 26 April 2010.
  5. ^ a b c "Bronchial Anatomy". Retrieved 5 Mar 2014.
  6. ^ "Tracheobronchial tree | Radiology Reference Article". Radiopaedia. Retrieved 7 September 2017.
  7. ^ a b c Page 81 in Robert M. Kacmarek, Steven Dimas & Craig W. Mack (2013). Essentials of Respiratory Care. Elsevier Health Sciences. ISBN 978-032327778-5.
  8. ^ a b c d e "Human Respiratory System". Archived from the original on 2008-10-15. Retrieved 5 Oct 2008.
  9. ^ Ochs, M; et al. (1 January 2004). "The number of alveoli in the human lung". American Journal of Respiratory and Critical Care Medicine. 169 (1): 120–4. doi:10.1164/rccm.200308-1107OC. PMID 14512270.
  10. ^ Moore EJ, Feliciano DV, Mattox KL (2004). Trauma. New York: McGraw-Hill, Medical Pub. Division. p. 545. ISBN 0-07-137069-2. Retrieved 2008-06-15.
  11. ^ "Cellular structure, function and organization in the lower respiratory tract". Retrieved 5 Oct 2008.
  12. ^ Blaivas, Allen J. (29 June 2012). "Anatomy and function of the respiratory system". Penn State Hershey Medical Center. Retrieved 2017-09-20.
ANOTHER syndrome

ANOTHER syndrome consists of alopecia, nail dystrophy, ophthalmic complications, thyroid dysfunction, hypohidrosis, ephelides and enteropathy, and respiratory tract infections. This is an autosomal recessive variant of ectodermal dysplasia.

Adenovirus infection

Adenovirus infections most commonly cause illness of the respiratory system; however, depending on the infecting serotype, they may also cause various other illnesses and presentations.

Cat flu

Cat flu is the common name for a feline upper respiratory tract disease. While feline upper respiratory disease can be caused by several different pathogens, there are a few symptoms that they have in common.Avian Flu can also infect cats, but "cat flu" is generally a misnomer, since it usually does not refer to an infection by an influenza virus. Instead, it is a syndrome, a term referring to patients displaying a number of symptoms that can be caused by one or more of these infectious agents (pathogens):

Feline herpes virus causing feline viral rhinotracheitis (cat common cold, this is the disease that is closely similar to cat flu)

Feline calicivirus—(cat respiratory disease)

Bordetella bronchiseptica—(cat kennel cough)

Chlamydophila felis—(chlamydia)In South Africa the term cat flu is also used to refer to canine parvovirus. This is misleading, as transmission of the canine parvovirus rarely involves cats.

Dhauti

Dhauti is an important part of the Shatkarma (sometimes known as Shatkriya), the yogic system of body cleansing techniques. It is intended mainly to the cleaning of the digestive tract in its full length but it affects also the respiratory tract, external ears and eyes. According to Gheranda Samhita, it is divided into four parts: Antar (internal) dhauti, Danta (teeth) dhauti, Hrid (cardiac or chest region) dhauti and Moola shodhana (rectal cleansing).

Antar Dhauti is further divided into four parts: Vatsara, Varisara, Agnisara, Bahishkrit.

Danta Dhauti: Danta Mula, Jivha Mula, Karna Randha, Kapola Randha.

Hrid Dhauti: Danda Dhauti, Vaman Dhauti, Vastra Dhauti

Human orthopneumovirus

Human orthopneumovirus, formerly Human respiratory syncytial virus (HRSV), is a syncytial virus that causes respiratory tract infections. It is a major cause of lower respiratory tract infections and hospital visits during infancy and childhood. A prophylactic medication, palivizumab, can be employed to prevent HRSV in preterm (under 35 weeks gestation) infants, infants with certain congenital heart defects (CHD) or bronchopulmonary dysplasia (BPD), and infants with congenital malformations of the airway. Treatment is limited to supportive care, including oxygen therapy and more advanced breathing support with CPAP or nasal high flow oxygen, as required.

In temperate climates there is an annual epidemic during the winter months. In tropical climates, infection is most common during the rainy season.

In the United States, 60% of infants are infected during their first HRSV season, and nearly all children will have been infected with the virus by 2–3 years of age. Of those infected with RSV, 2–3% will develop bronchiolitis, necessitating hospitalization. Natural infection with HRSV induces protective immunity which wanes over time—possibly more so than other respiratory viral infections—and thus people can be infected multiple times. Sometimes an infant can become symptomatically infected more than once, even within a single HRSV season. Severe HRSV infections have increasingly been found among elderly patients. Young adults can be re-infected every five to seven years, with symptoms looking like a sinus infection or a cold (infections can also be asymptomatic).

Lower respiratory tract infection

Lower respiratory tract infection (LRTI), while often used as a synonym for pneumonia, can also be applied to other types of infection including lung abscess and acute bronchitis. Symptoms include shortness of breath, weakness, fever, coughing and fatigue.

There are a number of symptoms that are characteristic of lower respiratory tract infections. The two most common are bronchitis and edema. Influenza affects both the upper and lower respiratory tracts.

Antibiotics are the first line treatment for pneumonia; however, they are not effective or indicated for parasitic or viral infections. Acute bronchitis typically resolves on its own with time.

In 2015 there were about 291 million cases. These resulted in 2.74 million deaths down from 3.4 million deaths in 1990. This was 4.8% of all deaths in 2013.

Bronchitis describes the swelling or inflammation of the bronchial tubes. Additionally, bronchitis is described as either acute or chronic depending on its presentation and is also further described by the causative agent. Acute bronchitis can be defined as acute bacterial or viral infection of the larger airways in healthy patients with no history of recurrent disease. It affects over 40 adults per 1000 each year and consists of transient inflammation of the major bronchi and trachea. Most often it is caused by viral infection and hence antibiotic therapy is not indicated in immunocompetent individuals. Viral bronchitis can sometimes be treated using antiviral medications depending on the virus causing the infection, and medications such as anti-inflammatory drugs and expectorants can help mitigate the symptoms. Treatment of acute bronchitis with antibiotics is common but controversial as their use has only moderate benefit weighted against potential side effects (nausea and vomiting), increased resistance, and cost of treatment in a self-limiting condition. Beta2 agonists are sometimes used to relieve the cough associated with acute bronchitis. In a recent systematic review it was found there was no evidence to support their use.Acute Exacerbations of Chronic Bronchitis (AECB) are frequently due to non-infective causes along with viral ones. 50% of patients are colonised with Haemophilus influenzae, Streptococcus pneumoniae or Moraxella catarrhalis. Antibiotics have only been shown to be effective if all three of the following symptoms are present: increased dyspnea, increased sputum volume and purulence. In these cases 500 mg of Amoxycillin orally, every 8 hours for 5 days or 100 mg doxycycline orally for 5 days should be used.

Lung

The lungs are the primary organs of the respiratory system in humans and many other animals including a few fish and some snails. In mammals and most other vertebrates, two lungs are located near the backbone on either side of the heart. Their function in the respiratory system is to extract oxygen from the atmosphere and transfer it into the bloodstream, and to release carbon dioxide from the bloodstream into the atmosphere, in a process of gas exchange. Respiration is driven by different muscular systems in different species. Mammals, reptiles and birds use their different muscles to support and foster breathing. In early tetrapods, air was driven into the lungs by the pharyngeal muscles via buccal pumping, a mechanism still seen in amphibians. In humans, the main muscle of respiration that drives breathing is the diaphragm. The lungs also provide airflow that makes vocal sounds including human speech possible.

Humans have two lungs, a right lung and a left lung. They are situated within the thoracic cavity of the chest. The right lung is bigger than the left, which shares space in the chest with the heart. The lungs together weigh approximately 1.3 kilograms (2.9 lb), and the right is heavier. The lungs are part of the lower respiratory tract that begins at the trachea and branches into the bronchi and bronchioles, and which receive air breathed in via the conducting zone. The conducting zone ends at the terminal bronchioles. These divide into the respiratory bronchioles of the respiratory zone which divide into alveolar ducts that give rise to the microscopic alveoli, where gas exchange takes place. Together, the lungs contain approximately 2,400 kilometres (1,500 mi) of airways and 300 to 500 million alveoli. Each lung is enclosed within a pleural sac that contains pleural fluid which allows the inner and outer walls to slide over each other whilst breathing takes place, without much friction. This sac also divides each lung into sections called lobes. The right lung has three lobes and the left has two. The lobes are further divided into bronchopulmonary segments and pulmonary lobules. The lungs have a unique blood supply, receiving deoxygenated blood from the heart in the pulmonary circulation for the purposes of receiving oxygen and releasing carbon dioxide, and a separate supply of oxygenated blood to the tissue of the lungs, in the bronchial circulation.

The tissue of the lungs can be affected by a number of diseases, including pneumonia and lung cancer. Chronic obstructive pulmonary disease includes chronic bronchitis and emphysema, and can be related to smoking or exposure to harmful substances such as coal dust, asbestos fibres and crystalline silica dust. Diseases such as bronchitis can also affect the respiratory tract. Medical terms related to the lung often begin with pulmo-, from the Latin pulmonarius (of the lungs) as in pulmonology, or with pneumo- (from Greek πνεύμων "lung") as in pneumonia.

In embryonic development, the lungs begin to develop as an outpouching of the foregut, a tube which goes on to form the upper part of the digestive system. When the lungs are formed the fetus is held in the fluid-filled amniotic sac and so they do not function to breathe. Blood is also diverted from the lungs through the ductus arteriosus. At birth however, air begins to pass through the lungs, and the diversionary duct closes, so that the lungs can begin to respire. The lungs only fully develop in early childhood.

Mucus

Mucus ( MEW-kəs) is a polymer. It is a slippery aqueous secretion produced by, and covering, mucous membranes. It is typically produced from cells found in mucous glands, although it may also originate from mixed glands, which contain both serous and mucous cells. It is a viscous colloid containing inorganic salts, antiseptic enzymes (such as lysozymes), immunoglobulins, and glycoproteins such as lactoferrin and mucins, which are produced by goblet cells in the mucous membranes and submucosal glands. Mucus serves to protect epithelial cells (that line the tubes) in the respiratory, gastrointestinal, urogenital, visual, and auditory systems; the epidermis in amphibians; and the gills in fish, against infectious agents such as fungi, bacteria and viruses. Most of the mucus produced is in the gastrointestinal tract.

Bony fish, hagfish, snails, slugs, and some other invertebrates also produce external mucus. In addition to serving a protective function against infectious agents, such mucus provides protection against toxins produced by predators, can facilitate movement and may play a role in communication.

Neoplasm

A neoplasm is a type of abnormal and excessive growth, called neoplasia, of tissue. The growth of a neoplasm is uncoordinated with that of the normal surrounding tissue, and it persists growing abnormally, even if the original trigger is removed. This abnormal growth usually (but not always) forms a mass. When it forms a mass, it may be called a tumor.

ICD-10 classifies neoplasms into four main groups: benign neoplasms, in situ neoplasms, malignant neoplasms, and neoplasms of uncertain or unknown behavior. Malignant neoplasms are also simply known as cancers and are the focus of oncology.

Prior to the abnormal growth of tissue, as neoplasia, cells often undergo an abnormal pattern of growth, such as metaplasia or dysplasia. However, metaplasia or dysplasia does not always progress to neoplasia. The word is from Ancient Greek νέος- neo ("new") and πλάσμα plasma ("formation", "creation").

Peritonsillar abscess

Peritonsillar abscess (PTA), also known as a quinsy, is pus due to an infection behind the tonsil. Symptoms include fever, throat pain, trouble opening the mouth, and a change to the voice. Pain is usually worse on one side. Complications may include blockage of the airway or aspiration pneumonitis.They are typically due to infection by a number of types of bacteria. Often it follows streptococcal pharyngitis. They do not typically occur in those who have had a tonsillectomy. Diagnosis is usually based on the symptoms. Medical imaging may be done to rule out complications.Treatment is by removing the pus, antibiotics, sufficient fluids, and pain medication. Steroids may also be useful. Admission to hospital is generally not needed. In the United States about 3 per 10,000 people per year are affected. Young adults are most commonly affected.

Pharyngitis

Pharyngitis is inflammation of the back of the throat, known as the pharynx. It typically results in a sore throat and fever. Other symptoms may include a runny nose, cough, headache, and a hoarse voice. Symptoms usually last 3–5 days. Complications can include sinusitis and acute otitis media. Pharyngitis is a type of upper respiratory tract infection.Most cases are caused by a viral infection. Strep throat, a bacterial infection, is the cause in about 25% of children and 10% of adults. Uncommon causes include other bacteria such as gonorrhea, fungus, irritants such as smoke, allergies, and gastroesophageal reflux disease. Specific testing is not recommended in people who have clear symptoms of a viral infection, such as a cold. Otherwise, a rapid antigen detection test (RADT) or throat swab is recommended. Other conditions that can produce similar symptoms include epiglottitis, thyroiditis, retropharyngeal abscess, and occasionally heart disease.NSAIDs, such as ibuprofen, can be used to help with the pain. Numbing medication, such as topical lidocaine, may also help. Strep throat is typically treated with antibiotics, such as either penicillin or amoxicillin. If steroids are useful in acute pharyngitis, other than possibly in severe cases, is unclear.About 7.5% of people have a sore throat in any 3-month period. Two or three episodes in a year are not uncommon. This resulted in 15 million physician visits in the United States in 2007. Pharyngitis is the most common cause of a sore throat. The word comes from the Greek word pharynx meaning "throat" and the suffix -itis meaning "inflammation".

Respiratory disease

Respiratory disease, or respiratory tract disease, is a medical term that encompasses pathological conditions affecting the organs and tissues that make gas exchange difficult in air-breathing animals. They include conditions of the respiratory tract including the trachea, bronchi, bronchioles, alveoli, pleurae, pleural cavity, and the nerves and muscles of respiration. Respiratory diseases range from mild and self-limiting, such as the common cold, to life-threatening diseases such as bacterial pneumonia, pulmonary embolism, acute asthma and lung cancer.The study of respiratory disease is known as pulmonology. A doctor who specializes in respiratory disease is known as a pulmonologist, a chest medicine specialist, a respiratory medicine specialist, a respirologist or a thoracic medicine specialist.

Respiratory diseases can be classified in many different ways, including by the organ or tissue involved, by the type and pattern of associated signs and symptoms, or by the cause of the disease.

Respiratory tract infection

Respiratory tract infection (RTI) refers to any of a number of infectious diseases involving the respiratory tract. An infection of this type is normally further classified as an upper respiratory tract infection (URI or URTI) or a lower respiratory tract infection (LRI or LRTI). Lower respiratory infections, such as pneumonia, tend to be far more serious conditions than upper respiratory infections, such as the common cold.

Retropharyngeal abscess

Retropharyngeal abscess (RPA) is an abscess located in the tissues in the back of the throat behind the posterior pharyngeal wall (the retropharyngeal space). Because RPAs typically occur in deep tissue, they are difficult to diagnose by physical examination alone. RPA is a relatively uncommon illness, and therefore may not receive early diagnosis in children presenting with stiff neck, malaise, difficulty swallowing, or other symptoms listed below. Early diagnosis is key, while a delay in diagnosis and treatment may lead to death. Parapharyngeal space communicates with retropharyngeal space and an infection of retropharyngeal space can pass down behind the esophagus into the mediastinum. RPAs can also occur in adults of any age.

RPA can lead to airway obstruction or sepsis – both life-threatening emergencies. Fatalities normally occur from patients not receiving treatment immediately and suffocating prior to knowing that anything serious was wrong.

Subacute thyroiditis

Subacute thyroiditis is a form of thyroiditis that can be a cause of both thyrotoxicosis and hypothyroidism. It is uncommon and can affect individuals of both sexes, occurring three times as often in women than in men. and people of all ages. The most common form, subacute granulomatous, or de Quervain's, thyroiditis manifests as a sudden and painful enlargement of the thyroid gland accompanied with fever, malaise and muscle aches. Indirect evidence has implicated viral infection in the etiology of subacute thyroiditis. This evidence is limited to preceding upper respiratory tract infection, elevated viral antibody levels, and both seasonal and geographical clustering of cases. There may be a genetic predisposition. Nishihara and coworkers studied the clinical features of subacute thyroiditis in 852 mostly 40- to 50-year-old women in Japan. They noted seasonal clusters (summer to early autumn) and most subjects presented with neck pain. Fever and symptoms of thyrotoxicosis were present in two thirds of subjects. Upper respiratory tract infections in the month preceding presentation were reported in only 1 in 5 subjects. Recurrent episodes following resolution of the initial episode were rare, occurring in just 1.6% of cases. Laboratory markers for thyroid inflammation and dysfunction typically peaked within one week of onset of illness.

Tracheal tumor

A tracheal tumor is a tumor primarily presenting in the trachea. It may be benign or malignant. 80% of all tracheal tumors are malignant. Among these, the most common are the squamous-cell carcinoma and the adenoid cystic carcinoma.

Tracheitis

Tracheitis is an inflammation of the trachea.

Although the trachea is usually considered part of the lower respiratory tract, in ICD-10 tracheitis is classified under "acute upper respiratory infections".

Upper respiratory tract infection

An upper respiratory tract infection (URTI) is an illness caused by an acute infection, which involves the upper respiratory tract, including the nose, sinuses, pharynx, or larynx. This commonly includes nasal obstruction, sore throat, tonsillitis, pharyngitis, laryngitis, sinusitis, otitis media, and the common cold. Most infections are viral in nature, and in other instances, the cause is bacterial. URTIs can also be fungal or helminthic in origin, but these are far less common.In 2015, 17.2 billion cases of URTIs are estimated to have occurred. As of 2014, they caused about 3,000 deaths, down from 4,000 in 1990.

Vitamin D and respiratory tract infections

A link between vitamin D and respiratory tract infections has been hypothesised. According to the hypothesis, vitamin D deficiency may predispose to infection. Evidence supporting the hypothesis derives from some scientific studies and the observation that outbreaks of respiratory infections occur predominantly during months associated with lower exposure to the sun. Evidence against the hypothesis has also been reported. The Institute of Medicine concluded in a 2011 report that the existing data were "not consistently supportive of a causal role" for the vitamin in reducing the risk of infection.

Anatomy of the lower respiratory tract
Respiratory tree
Lungs
Respiration
Control
Lung volumes
Circulation
Interactions
Insufficiency

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