ANATOMY AND

PATHOPHYSIOLOGY –
RESPIRATORY DISORDERS
DR. ROSEMARIE C. SANTOS
 PNEUMONIA

•A C U T E P N E U M O N I A I S A N
INFLAMMATION OF THE LUNG THAT CAN
B E C A U S E D B Y A VA R I E T Y O F
O R G A N I S M S , M O S T C O M M O N LY
BACTERIA & VIRUSES
 PNEUMONIA

Instead of rapidly infecting large regions of the lung, the virus causing COVID-19 sets up
shop in multiple small areas of the lung. It then hijacks the lungs' own immune cells and
uses them to spread across the lung over a period of many days or even weeks, like
multiple wildfires spreading across a forest. As the infection slowly moves across the lung, it
leaves damage in its wake and continuously fuels the fever, low blood pressure and
damage to the kidneys, brain, heart and other organs in patients with COVID-19.
 ALVEOLAR PNEUMONIA OR
AIR SPACE PNEUMONIA
• EXEMPLIFIED BY PNEUMOCOCCAL PNEUMONIA,
IS PRODUCED BY AN ORGANISM THAT CAUSES
AN INFLAMMATORY EXUDATES THAT REPLACES
AIR IN THE ALVEOLI.
• INFLAMMATION SPREADS FROM ONE ALVEOLI TO
T H E N E S T B Y WAY O F C O M M U N I C AT I N G
CHANNELS & IT MAY INVOLVE PULMONARY
SEGMENTS OR AN ENTIRE LOBE.
ALVEOLAR PNEUMONIA OR
AIR SPACE PNEUMONIA
 BRONCHOPNEUMONIA

• TYPIFIED BY STAPHYLOCOCCAL INFECTION, IS PRIMARILY

AN INFLAMMATION THAT ORIGINATES IN THE BRONCHI OR
THE BRONCHIOLAR MUCOSA & SPREADS TO ADJACENT
ALVEOLI
• BECAUSE ALVEOLI SPREAD OF THE INFECTION IN THE
PERIPHERAL AIR SPACE IS MINIMAL, THE INFLAMMATION
TENDS TO PRODUCE SMALL PATCHES OF CONSOLIDATION
• B R O N C H I A L I N F L A M M AT I O N C A U S I N G A I R WA Y
OBSTRUCTION LEADS TO ATELECTASIS (COLLAPSED LUNG)
W/ LOSS OF LUNG VOLUME
BRONCHOPNEUMONIA
 ANTHRAX

•CAUSED BY THE SPORELIKE MICROBE

KNOWN AS BACILLUS ANTHRACIS
• CONSIDERED A HIGHLY VOLATILE MICROBE
BECAUSE OF ITS TRANSMISSION & HIGHLY
FATALITY RATE
• ORGANISM CAN SURVIVE FOR DECADES IN
THE SOIL IN EXTREME CONDITIONS (HEAT &
ANTHRAX
 TUBERCULOSIS (TB)
•C A U S E D B Y M Y C O B A C T E R I U M
TUBERCULOSIS, A ROD-SHAPED BACTERIUM
W/ A PROTECTIVE WAXY COAT THAT PERMITS
IT TO LIVE OUTSIDE THE BODY FOR A LONG
TIME
• TB SPREADS MAINLY BY DROPLETS IN THE
AIR, W/C ARE PRODUCED IN HUGE NUMBERS
BY THE COUGHING PATIENT
 TUBERCULOSIS (TB)

• ORGANISMS MAY BE INHALED FROM

SPUTUM THAT HAS DRIED & TURNED
INTO DUST
• RAPIDLY KILLED BY DIRECT SUNLIGHT
BUT MAY SURVIVE A LONG TIME IN THE
DARK
 PRIMARY TUBERCULOSIS

• TRADITIONALLY BEEN CONSIDERED A

DISEASE OF CHILDREN & YOUNG ADULTS
WITH THE DRAMATIC DECREASE IN THE
PREVALENCE OF TB
PRIMARY TUBERCULOSIS
• ANTEROPOSTERIOR CHEST RADIOGRAPH OF
A YOUNG PATIENT WHO PRESENTED TO THE
EMERGENCY DEPARTMENT (ED) WITH COUGH
AND MALAISE. THE RADIOGRAPH SHOWS A
CLASSIC POSTERIOR SEGMENT RIGHT UPPER
LOBE DENSITY CONSISTENT WITH ACTIVE
TUBERCULOSIS. THIS WOMAN WAS ADMITTED
TO ISOLATION AND STARTED EMPIRICALLY ON
A 4-DRUG REGIMEN IN THE ED.
TUBERCULOSIS WAS CONFIRMED ON SPUTUM
TESTING. IMAGE COURTESY OF REMOTE
MEDICINE (REMOTEMEDICINE.ORG).
 SECONDARY
TUBERCULOSIS
• R E A C T I VAT I O N O F O R G A N I S M S F R O M
P R E V I O U S LY D O R M A N T T U B E R C L E I S
T E R M E D A S E C O N D A RY L E S I O N O R
REINFECTION TB AT TIMES TUBERCULOSIS
BACILLUS MAY REMAIN INACTIVE FOR MANY
YEARS
• BEFORE A SECONDARY LESION DEVELOPS,
OFTEN BECAUSE OF A DECREASE OF THE
 RESPIRATORY SYNCYTIAL
VIRUS
• VIRUS ATTACKS THE LOWER RESPIRATORY TRACT &
C A U S E S N E C R O S I S O F T H E R E S P I R AT O R Y
EPITHELIUM OF THE BRONCHI & BRONCHIOLES, W/C
LEADS TO BRONCHIOLITHS
• THE NECROTIC MATERIAL & E D E M A F R O M T H E
INFECTION CAUSE BRONCHIAL OBSTRUCTION
• BRONCHIOLITHS PRODUCES BRONCHIAL SPASM, &
INTERSTITIAL PNEUMONIA OCCURS AS A RESULT OF
THE OBSTRUCTION
 CHRONIC OBSTRUCTIVE
PULMONARY DISEASE (COPD)
• INCLUDES SEVERAL CONDITIONS IN W/C
CHRONIC OBSTRUCTION OF THE AIRWAY
LEADS TO AN INEFFECTIVE EXCHANGE
O F R E S P I R AT O RY G A S E S & M A K E S
BREATHING DIFFICULT
 CHRONIC BRONCHITIS
• CHARACTERIZED BY EXCESSIVE TRACHEOBRONCHIAL
MUCUS PRODUCTION LEADING TO THE OBSTRUCTION OF
SMALL AIRWAYS
• CHRONIC INFLAMMATION OF THE BRONCHI LEADS TO
SEVERE COUGHING W/ THE PRODUCTION OF SPUTUM;
BRONCHITIS MAY BE
• COMPLICATION OF RESPIRATORY INFECTION OR THE
RESULT OF LONG-TERM EXPOSURE TO AIR POLLUTION OR
CIGARETTE SMOKING
CHRONIC BRONCHITIS
 ANTRHRACOSIS (COAL
WORKER’S
PNEUMOCONIOSIS)
• C O A L M I N E R S , E S P E C I A L LY T H O S E W O R K I N G W /
A N T H R A C I T E ( H A R D C O A L ) , H AV E I N C R E A S E D
SUSCEPTIBILITY TO DEVELOPMENT OF PNEUMOCONIOSIS
FROM INHALATION OF HIGH CONCENTRATIONS OF COAL
DUST
• A N T H R A C I T E C O L L E C T S I N T H E WA L L S O F T H E
RESPIRATORY BRONCHIOLES, CAUSING WEAKENED &
DILATION
• DEPOSITION OF ANTHRACITE PARTICLES CHANGES THE
LUNG TISSUE TO A DARK COLOR, LEADING TO THE NAME
ANTRHRACOSIS (COAL
WORKER’S
PNEUMOCONIOSIS)
 PNEUMOTHORAX

•PRESENCE OF AIR IN THE PLEURAL

C AV I T Y, R E S U LT S I N A PA RT I A L O R
COMPLETE COLLAPSE OF THE LUNG
PNEUMOTHORAX
 PLEURAL EFFUSION
• ACCUMULATION OF FLUID IN THE PLEURAL SPACE IS
NONSPECIFIC FINDING THAT MAY BE CAUSED BY A WIDE
VARIETY OF PATHOLOGIC PROCESSES
• MOST COMMON CAUSES INCLUDE CONGESTIVE HEART
FAILURE, PULMONARY EMBOLISM, INFECTION (ESPECIALLY
TB), PLEURISY, NEOPLASTIC DISEASE, & CONNECTIVE
TISSUE DISORDERS
• P L E U R A L E F F U S I O N C A N A L S O B E T H E R E S U LT O F
ABDOMINAL DISEASE SUCH AS A RECENT SURGERY,
ASCITES, SUBPHRENIC ABSCESS, & PANCREATITIS
PLEURAL EFFUSION