Respiratory disease is a medical term that encompasses pathological conditions affecting the organs and tissues that make gas exchange possible in higher organisms, and includes conditions of the upper respiratory tract, trachea, bronchi, bronchioles, alveoli, pleura and pleural cavity, and the nerves and muscles of breathing. Respiratory diseases range from mild and self-limiting, such as the common cold, to life-threatening entities like 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.
Chronic respiratory disease
Chronic respiratory diseases (CRDs) are diseases of the airways and other structures of the lung. They are characterized by a high inflammatory cell recruitment (neutrophil) and/or destructive cycle of infection, (e.g. mediated by Pseudomonas aeruginosa). Some of the most common are asthma, chronic obstructive pulmonary disease, and acute respiratory distress syndrome. CRDs are not curable; however, various forms of treatment that help dilate major air passages and improve shortness of breath can help control symptoms and increase the quality of life for people with the diseases.
Restrictive lung diseases
Restrictive lung diseases are a category of respiratory disease characterized by a loss of lung compliance, causing incomplete lung expansion and increased lung stiffness, such as in infants with respiratory distress syndrome.
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 infection is the common cold. However, infections of specific organs of the upper respiratory tract such as sinusitis, tonsillitis, otitis media, pharyngitis and laryngitis are also considered upper respiratory tract infections.
Lower respiratory tract infection
The most common lower respiratory tract infection is pneumonia, an infection of the lungs which is usually caused by bacteria, particularly Streptococcus pneumoniae in Western countries. Worldwide, tuberculosis is an important cause of pneumonia. Other pathogens such as viruses and fungi can cause pneumonia for example severe acute respiratory syndrome and pneumocystis pneumonia. A pneumonia may develop complications such as a lung abscess, a round cavity in the lung caused by the infection, or may spread to the pleural cavity.
Poor oral care may be a contributing factor to lower respiratory disease. New research suggests bacteria from gum disease travel through airways and into the lungs.
Malignant tumors of the respiratory system, particularly primary carcinomas of the lung, are a major health problem responsible for 15% of all cancer diagnoses and 30% of all cancer deaths. The majority of respiratory system cancers are attributable to smoking tobacco.
The major histological types of respiratory system cancer are:
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 within the lung. Breast cancer may invade directly through local spread, and through lymph node metastases. After metastasis to the liver, colon cancer frequently metastasizes to the lung. Prostate cancer, germ cell cancer and renal cell carcinoma may also metastasize to the lung.
Treatment of respiratory system cancer depends on the type of cancer. Surgical removal of part of a lung (lobectomy, segmentectomy, or wedge resection) or of an entire lung pneumonectomy), along with 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 to some extent on the histology, 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 are relatively rare causes of respiratory disease. Examples of benign tumors are:
Pleural cavity diseases
Pleural cavity diseases include pleural mesothelioma which are mentioned above.
A collection of fluid in the pleural cavity is known as a pleural effusion. 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 pneumothorax 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 pneumothorax 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 disease
Pulmonary vascular diseases are conditions that affect the pulmonary circulation. Examples are:
- Pulmonary embolism, a blood clot 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 (travel through the blood stream) to the lungs but they are much more rare: fat embolism (particularly after bony injury), amniotic fluid embolism (with complications of labour and delivery), air embolism (iatrogenic - caused by invasive medical procedures).
- Pulmonary arterial hypertension, elevated pressure in the pulmonary arteries. Most commonly it is idiopathic (i.e. of unknown cause) but it can be 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 pulmonale.
- Pulmonary edema, 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 granulomatosis with polyangiitis and Goodpasture's syndrome.
Pulmonary diseases may also impact newborns, such as pulmonary hyperplasia, pulmonary interstitial emphysema (usually preterm births), and infant respiratory distress syndrome,
Respiratory diseases may be investigated by performing one or more of the following tests
Respiratory disease is a common and significant cause of illness and death around the world. In the US, approximately 1 billion "common colds" occur each year. A study found that in 2010, there were approximately 6.8 million emergency department visits for respiratory disorders in the U.S. for patients under the age of 18. In 2012, respiratory conditions were the most frequent reasons for hospital stays among children.
In the UK, approximately 1 in 7 individuals are affected by some form of chronic lung disease, most commonly chronic obstructive pulmonary disease, which includes asthma, chronic bronchitis and emphysema.
Respiratory diseases (including lung cancer) are responsible for over 10% of hospitalizations and over 16% of deaths in Canada.
In 2011, respiratory disease with ventilator support accounted for 93.3% of ICU utilization in the United States.
- ^Sengupta, Nandini; Sahidullah, Md; Saha, Goutam (August 2016). "Lung sound classification using cepstral-based statistical features". Computers in Biology and Medicine. 75 (1): 118–129. doi:10.1016/j.compbiomed.2016.05.013.
- ^Sharma, Sat. "Restrictive Lung Disease". Retrieved 2008-04-19.
- ^"Respiratory Disease & Oral Health". unitedconcordia.com.
- ^American Academy of Periodontology, kpmjkk 2008
- ^"National Institutes of Health – common cold". Retrieved 2008-05-07.
- ^Wier, L. M.; Hao, Y.; Owens, P.; Washington, R. (May 2013). "Overview of Children in the Emergency Department, 2010". HCUP Statistical Brief #157. Agency for Healthcare Research and Quality. Rockville, MD.
- ^Witt WP, Wiess AJ, Elixhauser A (December 2014). "Overview of Hospital Stays for Children in the United States, 2012". HCUP Statistical Brief #186. Rockville, MD: Agency for Healthcare Research and Quality.
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Respiration is the process of taking in and using oxygen. There are
three different phases of respiration: external respiration, internal
respiration, and cellular respiration. External respiration is the intake of
oxygen from the environment and the release of carbon dioxide. In internal
respiration, oxygen is carried to the cells and carbon dioxide is carried away
from the cells. In cellular respiration, oxygen is used in chemical reactions
within the cells.
Some Diseases of the respiratory system are: bronchial asthma, the common
cold, and diphtheria.
Bronchial asthma is a disease in which the bronchial passages are made
smaller and swelling of the mucous lining causes blockage of breathing, usually
due to dust, animal fur or feathers, or pollen. Many people have asthma which
is caused by allergies, called extrinsic asthma, usually suffer from hay fever.
Non allergic asthma, which adults usually have, is called intrinsic asthma.
Intrinsic asthma is usually caused by respiratory infections and emotional
upsets. A typical asthma attack begins with coughing, wheezing, and shortness
of breath. Some people have dry coughing as the only symptom. Attacks usually
last only a couple hours. An attack may happen again in hours to even years
after the first attack.
Asthma attacks can be treated and prevented by the use of drugs. Albuterol
or terbutaline, which can bring relief within minutes, is the usual treatment.
The common cold is another disease of the respiratory system. The cold
affects the mucous membranes of the nose and throat. It causes nasal
congestion, sore throat, and coughing. A cold usually lasts up to an average
of seven days. There is no known cure for the common cold yet.
Diphtheria is another respiratory disease that, most of the time, affects
children. The disease enters the body through the nose and mouth and attack the
mucous membrane where they multiply and secrete a powerful poison. The heart and
central nervous system are damaged by the poison and it can lead to death.
Toxoids, which are given to infants during the first year of life, are
harmless forms of the diphtheria poison which immunize the children against
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