Respiratory Disease is the term for
diseaseA disease or medical condition isan abnormal condition of an organism that impairs bodily functions, associated with specific symptoms and signs...
s of the
respiratory systemThe respiratory systems function is to allow gas exchange to all parts of the body. The space between the alveoli & the capillaries, the anatomy or structure of the exchange system, and the precise physiological uses of the exchanged gases vary depending on the organism...
. These include diseases of the
lungThe lung or pulmonary system is the essential respiration organ in air-breathing animals, including most tetrapods, a few fish and a few snails. In mammals and the more complex life forms, the two lungs are located in the chest on either side of the heart...
,
pleural cavityIn human anatomy, the pleural cavity is the body cavity that surrounds the lungs. The lungs are surrounded by the pleura, a serous membrane which folds back upon itself to form a two-layered, membrane structure. The thin space between the two pleural layers is known as the pleural space; it...
, bronchial tubes,
tracheaThe trachea, or windpipe, is a tube that connects to the pharynx or larynx, allowing the passage of air to the lungs. It is lined with pseudostratified ciliated columnar epithelium cells with mucosal goblet cells which produce mucus...
,
upper respiratory tractThe upper respiratory tract refers to the following parts of the respiratory system:* nose and paranasal sinuses* oral cavity * throat**pharynx*** genioglossus *** hyoid muscles**larynx**trachea...
and of the nerves and muscles of
breathingBreathing is the process that takes oxygen in and carbon dioxide out of the body. Aerobic organisms require oxygen to release energy via respiration, in the form of the metabolism of energy-rich molecules such as glucose...
. Respiratory diseases range from mild and self-limiting such as the
common coldAcute viral rhinopharyngitis, or acute coryza, known as an upper respiratory virus, or commonly called a cold, is a contagious, viral infectious disease of the upper respiratory system, primarily caused by rhinoviruses, or coronaviruses...
to life-threatening such as
bacterial pneumoniaBacterial pneumonia is a type of pneumonia associated with bacterial infection.-Gram positive:Streptococcus pneumoniae is the most common bacterial cause of pneumonia in all age groups except newborn infants...
or
pulmonary embolismPulmonary embolism is a blockage of the main artery of the lung or one of its branches by a substance that has travelled from elsewhere in the body through the bloodstream . Usually this is due to embolism of a thrombus from the deep veins in the legs, a process termed venous thromboembolism...
. They are a common and important cause of illness and death. In the US, people suffer 1 billion colds per year. One in seven people in the UK are affected by some form of chronic lung disease, most commonly chronic obstructive pulmonary disease and
asthmaAsthma is a predisposition to chronic inflammation of the lungs in which the airways are reversibly narrowed. Asthma affects 7% of the population of the United States, and 300 million worldwide...
.
Respiratory Disease is the term for
diseaseA disease or medical condition isan abnormal condition of an organism that impairs bodily functions, associated with specific symptoms and signs...
s of the
respiratory systemThe respiratory systems function is to allow gas exchange to all parts of the body. The space between the alveoli & the capillaries, the anatomy or structure of the exchange system, and the precise physiological uses of the exchanged gases vary depending on the organism...
. These include diseases of the
lungThe lung or pulmonary system is the essential respiration organ in air-breathing animals, including most tetrapods, a few fish and a few snails. In mammals and the more complex life forms, the two lungs are located in the chest on either side of the heart...
,
pleural cavityIn human anatomy, the pleural cavity is the body cavity that surrounds the lungs. The lungs are surrounded by the pleura, a serous membrane which folds back upon itself to form a two-layered, membrane structure. The thin space between the two pleural layers is known as the pleural space; it...
, bronchial tubes,
tracheaThe trachea, or windpipe, is a tube that connects to the pharynx or larynx, allowing the passage of air to the lungs. It is lined with pseudostratified ciliated columnar epithelium cells with mucosal goblet cells which produce mucus...
,
upper respiratory tractThe upper respiratory tract refers to the following parts of the respiratory system:* nose and paranasal sinuses* oral cavity * throat**pharynx*** genioglossus *** hyoid muscles**larynx**trachea...
and of the nerves and muscles of
breathingBreathing is the process that takes oxygen in and carbon dioxide out of the body. Aerobic organisms require oxygen to release energy via respiration, in the form of the metabolism of energy-rich molecules such as glucose...
. Respiratory diseases range from mild and self-limiting such as the
common coldAcute viral rhinopharyngitis, or acute coryza, known as an upper respiratory virus, or commonly called a cold, is a contagious, viral infectious disease of the upper respiratory system, primarily caused by rhinoviruses, or coronaviruses...
to life-threatening such as
bacterial pneumoniaBacterial pneumonia is a type of pneumonia associated with bacterial infection.-Gram positive:Streptococcus pneumoniae is the most common bacterial cause of pneumonia in all age groups except newborn infants...
or
pulmonary embolismPulmonary embolism is a blockage of the main artery of the lung or one of its branches by a substance that has travelled from elsewhere in the body through the bloodstream . Usually this is due to embolism of a thrombus from the deep veins in the legs, a process termed venous thromboembolism...
. They are a common and important cause of illness and death. In the US, people suffer 1 billion colds per year. One in seven people in the UK are affected by some form of chronic lung disease, most commonly chronic obstructive pulmonary disease and
asthmaAsthma is a predisposition to chronic inflammation of the lungs in which the airways are reversibly narrowed. Asthma affects 7% of the population of the United States, and 300 million worldwide...
. Respiratory disease is responsible for over 10% of hospitalizations and over 16% of deaths in Canada.
The study of respiratory disease is known as
pulmonologyIn medicine, pulmonology is the specialty that deals with diseases of the lungs and the respiratory tract. It is called chest medicine and respiratory medicine in some countries and areas...
. 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.
Diagnostic tests
Respiratory diseases may be investigated by performing one or more of the following tests
- Chest x-ray
In medicine, a chest radiograph, commonly called a chest x-ray , is a projection radiograph of the chest used to diagnose conditions affecting the chest, its contents, and nearby structures...
- Pulmonary function test
- Computed tomography scan
- Culture of microorganisms
A microbiological culture, or microbial culture, is a method of multiplying microbial organisms by letting them reproduce in predetermined culture media under controlled laboratory conditions. Microbial cultures are used to determine the type of organism, its abundance in the sample being tested,...
from secretions such as sputum
- Bronchoscopy
Bronchoscopy is a technique of visualizing the inside of the airways for diagnostic and therapeutic purposes. An instrument is inserted into the airways, usually through the nose or mouth, or occasionally through a tracheostomy. This allows the practitioner to examine the patient's airways for...
- Biopsy
A biopsy is a medical test involving the removal of cells or tissues for examination. It is the removal of tissue from a living subject to determine the presence or extent of a disease. The tissue is generally examined under a microscope by a pathologist, and can also be analyzed chemically...
of the lung or pleura
- Ventilation - perfusion scan
A ventilation/perfusion lung scan, also called a V/Q lung scan, is a type of medical imaging used to evaluate the circulation of air and blood within a patient's lungs. The ventilation part of the test looks at the ability of air to reach all parts of the lungs, while the perfusion part evaluates...
- Ultrasound
Diagnostic sonography is an ultrasound-based diagnostic imaging technique used to visualize subcutaneous body structures including tendons, muscles, joints, vessels and internal organs for possible pathology or lesions. Obstetric sonography is commonly used during pregnancy and is widely...
scanning can be useful to detect fluid such as pleural effusionPleural effusion is excess fluid that accumulates in the pleural cavity, the fluid-filled space that surrounds the lungs. Excessive amounts of such fluid can impair breathing by limiting the expansion of the lungs during inhalation.-Types of fluids:...
Treatment
Treatment of respiratory disease depends on the particular disease being treated, the severity of disease and the patient. Lifestyle factors such as regular exercise and healthy nutrition are important in preventing and treating respiratory disease. Vaccination can prevent some respiratory diseases. In addition, the following treatments are often used for respiratory diseases:
- Medication, often given in an inhaled form
- Corticosteroids
Glucocorticoids are a class of steroid hormones that bind to the glucocorticoid receptor , which is present in almost every vertebrate animal cell...
- Bronchodilators
- Antibiotics
- Anticoagulants
- Cancer chemotherapy
Chemotherapy, in its most general sense, is the treatment of disease by chemicals especially by killing micro-organisms or cancerous cells. In popular usage, it refers to antineoplastic drugs used to treat cancer or the combination of these drugs into a cytotoxic standardized treatment regimen...
- Immune suppressants
- Physiotherapy
- Oxygen
Oxygen Oxygen Oxygen (acid, literally "sharp", from the taste of acids) and -γενής (-genēs) (producer, literally begetter) is the element with atomic number 8 and represented by the symbol O...
- Mechanical ventilation
In medicine, mechanical ventilation is a method to mechanically assist or replace spontaneous breathing.This may involve a machine called a ventilator or the breathing may be assisted by a physician or other suitable person compressing a bag or set of bellows...
- Liquid ventilation (or Liquid breathing
Liquid breathing is a postulated form of respiration in which a normally air-breathing organism breathes an oxygen-rich liquid , rather than breathing air. In theory, liquid breathing could assist in the treatment of patients with severe pulmonary or cardiac trauma, especially in pediatric cases...
)
- Surfactant Replacement Therapy
- Radiotherapy
- Surgery
- Removal of a cancer e.g. lobectomy, pneumonectomy
- Pleurodesis
Pleurodesis is a medical procedure in which the pleural space is artificially obliterated.-Uses:Pleurodesis is done to prevent recurrence of pneumothorax or pleural effusion. It can be done chemically or surgically.-Chemical:...
- Lung volume reduction surgery
- Lung transplantation
Lung transplantation is a surgical procedure in which a patient's diseased lungs are partially or totally replaced by lungs which come from a donor...
- Artificial lung
An artificial lung is a prosthetic device that is implanted into the body to replace the biological lung. It is different from a heart-lung machine in that it is internal and designed to take over the functions of the lungs for long periods of time rather than on a temporary basis.Recent...
Respiratory diseases
Respiratory diseases can be classified in many different ways; by the organ involved, by the pattern of symptoms or by the cause of the disease.
Obstructive lung diseases
Obstructive lung diseaseObstructive lung disease is a category of respiratory disease characterized by airway obstruction.MeSH includes the following in this category:* Asthma* Bronchitis* Chronic obstructive pulmonary disease...
s are diseases of the lung where the bronchial tubes become narrowed making it hard to move air in and especially out of the lung.
Restrictive lung diseases
Restrictive lung diseaseRestrictive lung diseases are a category of respiratory disease characterised by a loss of lung compliance, causing incomplete lung expansion and increased lung stiffness.-Pathophysiology:...
s (also known as interstitial lung diseases) are a category of
respiratory diseaseRespiratory Disease is the term for diseases of the respiratory system. These include diseases of the lung, pleural cavity, bronchial tubes, trachea, upper respiratory tract and of the nerves and muscles of breathing. Respiratory diseases range from mild and self-limiting such as the common cold to...
characterized by a loss of
lung compliancePulmonary compliance is the ability of the lungs to stretch during a change in volume relative to an applied change in pressure....
, causing incomplete lung expansion and increased lung stiffness. E.g. in infant respiratory distress syndrome (IRDS)
Respiratory tract infections
Infections can affect any part of the respiratory system. They are traditionally divided into upper respiratory tract infections and lower respiratory tract infections.
Upper respiratory tract infection
The most common
upper respiratory tract infectionUpper respiratory tract infections, , are the illnesses caused by an acute infection which involves the upper respiratory tract: nose, sinuses, pharynx or larynx.-Signs and symptoms:...
is the
common coldAcute viral rhinopharyngitis, or acute coryza, known as an upper respiratory virus, or commonly called a cold, is a contagious, viral infectious disease of the upper respiratory system, primarily caused by rhinoviruses, or coronaviruses...
however, infections of specific organs of the upper respiratory tract such as
sinusitisSinusitis is a condition consisting of infection or inflammation of the paranasal sinuses, which may or may not be as a result of infection, from bacterial, fungal, viral, allergic or autoimmune issues...
,
tonsillitisTonsillitis is an infection of the tonsils and will often, but not necessarily, cause a sore throat and fever.-Types:There are 3 main types of tonsillitis: acute, subacute and chronic. Acute tonsillitis can either be bacterial or viral in origin. Subacute tonsillitis is caused by the bacterium...
,
otitis mediaOtitis media is inflammation of the middle ear, or middle ear infection.Otitis media occurs in the area between the ear drum and the inner ear, including a duct known as the eustachian tube. It is one of the two categories of ear inflammation that can underlie what is commonly called an earache,...
,
pharyngitisPharyngitis is an inflammation of the throat or pharynx. In most cases it is painful and the initial infection can extent for a lengthy time period, and is often referred to as a sore throat....
and
laryngitisLaryngitis is an inflammation of the larynx. It causes hoarse voice or the complete loss of the voice because of irritation to the vocal folds . Dysphonia is the medical term for Laryngitis and other vocal disorders....
are also considered upper respiratory tract infections.
Lower respiratory tract infection
The most common lower respiratory tract infection in is
pneumoniaPneumonia is an inflammatory illness of the lung. Frequently, it is described as lung parenchyma/alveolar inflammation and abnormal alveolar filling with fluid ....
, a lung infection. Pneumonia is usually caused by bacteria, particularly
Streptococcus pneumoniaeStreptococcus pneumoniae, or pneumococcus, is Gram-positive, alpha-hemolytic, bile soluble aerotolerant anaerobe and a member of the genus Streptococcus. A significant human pathogenic bacterium, S...
in Western countries. Worldwide,
tuberculosisTuberculosis is a common and often deadly infectious disease caused by mycobacteria...
is an important cause of pneumonia. Other pathogens such as viruses and fungi can cause pneumonia for example
severe acute respiratory syndromeSevere Acute Respiratory Syndrome is a respiratory disease in humans which is caused by the SARS coronavirus . There has been one near pandemic to date, between the months of November 2002 and July 2003, with 8,096 known infected cases and 774 deaths worldwide being listed in the World Health...
and
pneumocystis pneumoniaPneumocystis pneumonia or pneumocystosis is a form of pneumonia, caused by the yeast-like fungus Pneumocystis jirovecii. This pathogen is specific to humans...
. A pneumonia may develop complications such as a lung abscess, a round cavity in the lung caused by the infection or an empyema, the spread of the infection to the
pleural cavityIn human anatomy, the pleural cavity is the body cavity that surrounds the lungs. The lungs are surrounded by the pleura, a serous membrane which folds back upon itself to form a two-layered, membrane structure. The thin space between the two pleural layers is known as the pleural space; it...
.
Respmaka bwisit
15% of all cancer diagnoses and 29% of all cancer deaths. The majority of respiratory system cancers are attributable to smoking
tobaccoTobacco is an agricultural product processed from the leaves of plants in the genus Nicotiana. It can be consumed, used as an organic pesticide, and in the form of nicotine tartrate it is used in some medicines. In consumption it most commonly appears in the forms of smoking, chewing, snuffing, or...
.
The major types of respiratory system cancer are:
- Small cell lung cancer
- Non-small cell lung cancer
- Adenocarcinoma
- Large cell undifferentiated carcinoma
- Other lung cancers (carcinoid
Carcinoid is a slow-growing type of neuroendocrine tumour, originating in the cells of the neuroendocrine system....
, Kaposi’s sarcoma, melanomaMelanoma is a malignant tumor of melanocytes which are found predominantly in skin but also in the bowel and the eye . It is one of the less common types of skin cancer but causes the majority of skin cancer related deaths. Melanocytes are normally present in skin, being responsible for the...
)
- Lymphoma
Lymphoma is a cancer that begins in the lymphocytes of the immune system and presents as a solid tumor of lymphoid cells. They often originate like balls in lymph nodes, presenting as an enlargement of the node...
- Head and neck cancer
The term head and neck cancer refers to a group of biologically similar cancers originating from the upper aerodigestive tract, including the lip, oral cavity , nasal cavity, paranasal sinuses, pharynx, and larynx. Most head and neck cancers are squamous cell carcinomas, originating from the...
- Mesothelioma
Mesothelioma is a form of cancer that is almost always caused by exposure to asbestos. In this disease, malignant cells develop in the mesothelium, a protective lining that covers most of the body's internal organs...
, usually caused by exposure to asbestos dust.
In addition, since many cancers spread via the bloodstream and the entire cardiac output passes through the lungs, it is common for cancer metastases to occur the lung.
Breast cancerBreast cancer is a cancer that starts in the breast, usually in the inner lining of the milk ducts or lobules. There are different types of breast cancer, with different stages , aggressiveness, and genetic makeup. With best treatment, 10-year disease-free survival varies from 98% to 10%...
may invade directly through local spread, and through lymph node metastases. After metastasis to the
liverHepatic tumors are tumors or growths on or in the liver . These growths can be benign or malignant...
, colon cancer frequently metastasizes to the lung.
Prostate cancerProstate cancer is a form of cancer that develops in the prostate, a gland in the male reproductive system. The cancer cells may metastasize from the prostate to other parts of the body, particularly the bones and lymph nodes. Prostate cancer may cause pain, difficulty in urinating, problems...
, germ cell cancer and
renal cell carcinomaRenal cell carcinoma is a kidney cancer that originates in the lining of the proximal convoluted tubule, the very small tubes in the kidney that filter the blood and remove waste products. RCC is the most common type of kidney cancer in adults, responsible for approximately 80% of cases...
may also metastasize to the lung.
Treatment of respiratory system cancer depends on the type of cancer. Surgery (usually removal of part of the lung, a
lobectomyLobectomy means surgical excision of a lobe. This may refer to a lobe of the lung, a lobe of the thyroid , or a lobe of the brain ....
or an entire lung, a
pneumonectomyA pneumonectomy is a surgical procedure to remove a lung. Removal of just one lobe of the lung is specifically referred to as a lobectomy, and that of a segment of the lung as a wedge resection ....
), chemotherapy and radiotherapy are all used. The chance of surviving lung cancer depends on the cancer stage at the time the cancer is diagnosed and is only about 14-17% overall. In the case of metastases to the lung, treatment can occasionally be curative but only in certain, rare circumstances.
Benign tumors
Benign tumors are relatively rare causes of respiratory disease. Examples of benign tumors are:
- Pulmonary hamartoma
A hamartoma is a benign, focal malformation that resembles a neoplasm in the tissue of its origin. This is not a malignant tumor, and it grows at the same rate as the surrounding tissues. It is composed of tissue elements normally found at that site, but which are growing in a disorganized mass...
- Congenital malformations such as pulmonary sequestration
A pulmonary sequestration, also known as a bronchopulmonary sequestration or a cystic lung lesion, is a medical condition where a piece of tissue that develops into lung tissue is not attached to the pulmonary blood supply and does not communicate with the other lung tissue. Often it gets its blood...
and congenital cystic adenomatoid malformationCongenital cystic adenomatoid malformation is a congenital disorder similar to bronchopulmonary sequestration. In CCAM, usually an entire lobe of lung is replaced by a non-working cystic piece of abnormal lung tissue. This abnormal tissue will never function as normal lung tissue.In most cases the...
(CCAM).
Pleural cavity diseases
Pleural cavity diseases include
empyemaPleural empyema is an accumulation of pus in the pleural cavity. Most pleural empyemas arise from an infection within the lung , often associated with parapneumonic effusions. There are three stages: exudative, fibrinopurulent and organizing. In the exudative stage, the pus accumulates...
and
mesotheliomaMesothelioma is a form of cancer that is almost always caused by exposure to asbestos. In this disease, malignant cells develop in the mesothelium, a protective lining that covers most of the body's internal organs...
which are mentioned above.
A collection of fluid in the pleural cavity is known as a
pleural effusionPleural effusion is excess fluid that accumulates in the pleural cavity, the fluid-filled space that surrounds the lungs. Excessive amounts of such fluid can impair breathing by limiting the expansion of the lungs during inhalation.-Types of fluids:...
. This may be due to fluid shifting from the bloodstream into the pleural cavity due to conditions such as congestive heart failure and cirrhosis. It may also be due to inflammation of the pleura itself as can occur with infection, pulmonary embolus, tuberculosis, mesothelioma and other conditions.
A
pneumothoraxIn medicine , a pneumothorax is a potential medical emergency wherein air or gas is present in the pleural cavity. A pneumothorax can occur spontaneously. It can also occur as the result of disease or injury to the lung, or due to a puncture to the chest wall...
is a hole in the pleura covering the lung allowing air in the lung to escape into the pleural cavity. The affected lung “collapses” like a deflated balloon. A
tension pneumothoraxA tension pneumothorax is a life-threatening condition that results from a progressive deterioration and worsening of a simple pneumothorax, associated with the formation of a one-way valve at the point of a rupture in the lung...
is a particularly severe form of this condition where the air in the pleural cavity cannot escape, so the pneumothorax keeps getting bigger until it compresses the heart and blood vessels, leading to a life threatening situation.
Pulmonary vascular diseases
Pulmonary vascular diseases are conditions that affect the
pulmonary circulationPulmonary circulation is the portion of the cardiovascular system which carries oxygen-depleted blood away from the heart, to the lungs, and returns oxygenated blood back to the heart...
. Examples of these conditions are
- Pulmonary embolism
Pulmonary embolism is a blockage of the main artery of the lung or one of its branches by a substance that has travelled from elsewhere in the body through the bloodstream . Usually this is due to embolism of a thrombus from the deep veins in the legs, a process termed venous thromboembolism...
, a blood clotThrombosis is the formation of a blood clot inside a blood vessel, obstructing the flow of blood through the circulatory system. When a blood vessel is injured, the body uses platelets and fibrin to form a blood clot, because the first step in repairing it is to prevent loss of blood...
that forms in a vein, breaks free, travels through the heart and lodges in the lungs (thromboembolism). Large pulmonary emboli are fatal, causing sudden death. A number of other substances can also embolise to the lungs but they are much more rare: fat embolismA fat embolism is a type of embolism that is often caused by physical trauma.-Causes:Fat emboli can occur whenever there is a chance for fat to enter the circulatory system, such as during surgery or trauma...
(particularly after bony injury), amniotic fluid embolism (with complications of labour and delivery), air embolismAn air embolism, or more generally gas embolism, is a physiological condition caused by gas bubbles in a vascular system. The most common context is a human body, in which case it refers to gas bubbles in the bloodstream...
(iatrogenic).
- Pulmonary arterial hypertension, elevated pressure in the pulmonary arteries. It can be idiopathic
Idiopathic is an adjective used primarily in medicine meaning arising spontaneously or from an obscure or unknown cause. From Greek ἴδιος, idios + πάθος, pathos , it means approximately "a disease of its own kind."...
or due to the effects of another disease, particularly COPD. This can lead to strain on the right side of the heart, a condition known as cor pulmonaleCor pulmonale or pulmonary heart disease is a change in structure and function of the right ventricle of the heart as a result of a respiratory disorder. Right ventricular hypertrophy is the predominant change in chronic cor pulmonale, whereas in acute cases, dilation dominates...
.
- Pulmonary edema
Pulmonary edema , or oedema , is fluid accumulation in the lungs. It leads to impaired gas exchange and may cause respiratory failure. It is due to either failure of the heart to remove fluid from the lung circulation or a direct injury to the lung parenchyma...
, leakage of fluid from capillaries of the lung into the alveoli (or air spaces). It is usually due to congestive heart failure.
- Pulmonary hemorrhage, inflammation and damage to capillaries in the lung resulting in blood leaking into the alveoli. This may cause blood to be coughed up. Pulmonary hemorrhage can be due to auto-immune disorders such as Wegener's Granulomatosis
Wegener's granulomatosis is a form of vasculitis that affects the lungs, kidneys and other organs. Due to its end-organ damage, it can be a serious disease that requires long-term immunosuppression. It is named after Dr...
and oodpasture's