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Respiratory Pathophysiology: B. Pimentel, M.D. University of Makati College of Nursing

The document discusses respiratory pathophysiology, including transmission of respiratory infections through aspiration of oropharyngeal flora, inhalation of infectious aerosols, and hematogenous or direct spread. It describes risk factors like age and underlying conditions. Typical pneumonias usually involve Streptococcus pneumoniae and have a sudden onset, while atypical pneumonias like Mycoplasma pneumoniae are more gradual in onset and involve extrapulmonary symptoms. Aspiration of gastric contents can cause chemical pneumonitis.

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124 views12 pages

Respiratory Pathophysiology: B. Pimentel, M.D. University of Makati College of Nursing

The document discusses respiratory pathophysiology, including transmission of respiratory infections through aspiration of oropharyngeal flora, inhalation of infectious aerosols, and hematogenous or direct spread. It describes risk factors like age and underlying conditions. Typical pneumonias usually involve Streptococcus pneumoniae and have a sudden onset, while atypical pneumonias like Mycoplasma pneumoniae are more gradual in onset and involve extrapulmonary symptoms. Aspiration of gastric contents can cause chemical pneumonitis.

Uploaded by

Doc Jacque
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
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Respiratory Pathophysiology

B. Pimentel, M.D.
University Of Makati
College of Nursing
Respiratory Infections - Pneumonia

TRANSMISSION Microbial pathogens may enter the lung


by one of several routes

 Aspiration of Organisms That Colonize the


Oropharynx
 Most pulmonary pathogens originate in the
oropharyngeal flora
 Aspiration of these pathogens is the most common
mechanism for the production of pneumonia
Asthma

 Chronic inflammatory disease of airways


 Increased responsiveness of the
tracheobronchial tree
 Manifested physiologically by a widespread
narrowing of the air passages
 Clinically by paroxysms of dyspnea, cough, and
wheezing
 Relieved spontaneously or as a result of therapy
Respiratory Infections - Pneumonia

 Inhalation of Infectious Aerosols


 Transmission of an infectious agent in the form of an
aerosol is particularly efficient
 Particles >10 um in diameter are deposited mostly in
the nose and upper airways
 Particles <5 um in diameter (also called airborne droplet
nuclei) and containing one or perhaps two
microorganisms fail to settle out by gravity but rather
remain suspended in the atmosphere
Respiratory Infections - Pneumonia

 Hematogenous Dissemination from an


Extrapulmonary Site
 Usually with Staphylococcus aureus
 Disseminates hematogenously to the lungs in patients
(such as intravenous drug users) who have either right-
or left-sided bacterial endocarditis
 Patients with intravenous catheter infections
Respiratory Infections - Pneumonia

 Direct Inoculation and Contiguous


Spread
 Result of either tracheal intubation or stab
wounds to the chest
 As contiguous spread from an adjacent site
of infection
Age Risk Factors
 Chlamydia trachomatis and respiratory syncytial virus are
common among infants < 6 months of age
 H. influenzae among children 6 months to 5 years of age
 M. pneumoniae, C. pneumoniae, and hantavirus among
young adults
 H. influenzae and M. catarrhalis among elderly individuals
with chronic lung disease
 L. pneumophila among elderly persons, smokers, and
persons with compromised cell-mediated immunity, renal
or hepatic failure, diabetes, or systemic malignancy
Typical vs. Atypical Pneumonias
 Typical pneumonia syndrome is usually caused by
the most common bacterial pathogen in
community-acquired pneumonia, S. pneumoniae
 Atypical pneumonia is classically produced by M.
pneumoniae
Clinical Manifestation

 The "typical" pneumonia syndrome


 Sudden onset of fever
 Cough
 Purulent sputum
 Shortness of breath
 Pleuritic chest pain
 Signs of pulmonary consolidation
 dullness, increased fremitus, bronchial breath sounds,
and rales
Clinical Manifestation
 The "atypical" pneumonia syndrome
 More gradual onset
 Dry cough
 Shortness of breath
 Rales
 Prominence of extrapulmonary symptoms
 Headache, myalgias, fatigue, sore throat, nausea,
vomiting, and diarrhea
 Abnormalities on chest radiographs despite
minimal signs of pulmonary involvement
Aspiration Pneumonia and Anaerobic
Lung Abscess

 Aspiration of a sufficient volume of gastric acid 


chemical pneumonitis
 Acute dyspnea
 Wheezing
 Hypoxemia
 Infiltrates on chest radiographs

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