Diseases of the respiratory system

Dr. M.A.S
Diseases of the respiratory system
Principles of respiratory insufficiency
The principal function of the respirator system are:
1- Gas exchange in which oxygen is transferred from the
environment to the
blood and carbon dioxide is moved in the opposite
direction.
2- Role in thermoregulation in most species, acid-base
regulation in concert with the kidney.
3- The metabolism of metabolically active substances,
including nitric oxide.
4- Role in immune response to inhaled immunogens and
pathogens.
5- Capillaries in the lungs of the farm animal species and
horses also possess intravascular macrophages, which are
important as a reticuloendothelial organ in the processing
of antigens.
Failure of gas exchange, and the resultant hypoxia and
hypercapnia, is responsible for most of the clinical signs of
respiratory disease and for respiratory failure, the terminal event
of fatal cases. Death due to respiratory failure is due to hypoxia.
Hypoxia
Failure of the tissues to receive an adequate supply of oxygen it
is associated with failure of different organ systems, different
diseases, and have fundamentally different pathophysiological
mechanisms.
Diseases of the respiratory system
Dr. M.A.S
Hypoxic (or hypoxemic) hypoxia
It is occurs when there is inadequate oxygenation of blood
(hypoxemia) and is usually associated with disease of the
respiratory tract or other causes of hypoventilation.
Anemic hypoxia
it is occurs when there is a deficiency of hemoglobin per unit
volume of blood (anemia).
Circulatory hypoxia
it is occurs as a result of inadequate delivery of oxygen to tissue
because of inadequate perfusion of tissues by blood.
Histotoxic anoxia
it is occurs when oxygen deliver to tissue is adequate because
both oxygen content of arterial blood and blood flow are
appropriate, but the tissue is unable to utilize oxygen.
Compensatory mechanisms of respiratory insufficiency
Occurs as both short-term and long-term events. Short-term
compensatory mechanisms for low arterial oxygen tension or
oxygen deliver to tissues occur within seconds to minutes and
include respiratory, cardiovascular and behavioral responses.
Stimulation of respiratory
centers in the medulla oblongata by low arterial oxygen tension
and high arterial carbon dioxide tension an increase in respirator
minute volume mediated by an increase in tidal volume and
respirator frequency. Stimulates an increase in cardiac output,
mainly as a result of increased heart rate and to a lesser extent
by an increase in stroke volume. Splenic contraction, in those
species such as the horse in which the spleen is an important
reservoir of red blood cells, increases both blood volume and
hemoglobin concentration' thereby increasing the oxygen carry
capacity of blood. Hypoxemia also causes animals to attempt to
Diseases of the respiratory system
Dr. M.A.S
decrease their oxygen requirement by decreasing physical
activity, including moving and eating.
Longer-term compensatory mechanisms include an increase
in erythropoietin secretion by the kidney with subsequent
increases in bone marrow production of red blood cells and an
increase in hemoglobin concentration in blood. This
polycythemia increases the oxygen carrying capacity of blood.
Principal manifestations of respiratory insufficiency
1- Abnormalities in the rate, depth, or ease of breathing
2- Lethargy or exercise intolerance
3- abnormal posture
4- abnormal lung sounds
5-abnormal respiratory noises
6- Coughing
7- Cyanosis
8-Nasal discharge
9- Epistaxis and hemoptysis
Abnormalities in the rate, depth, or breathing
Polypnea\ is a rate of breathing that is faster than observed in
clinically normal animals of the same species.
Tachypnea\ an increased rate of breathing, although with the
implication that breathing is shallow.
Hyperpnea\ is an abnormal increase in the rate and depth of
breathing but the breathing is not labored and is not associated
with signs from which one could infer represent distress on the
part of the animal.
Diseases of the respiratory system
Dr. M.A.S
Dyspnea
It is a term used to describe labored or difficult breathing in
animals that also display some signs of distress, such as anxious
expression, unusual posture or stance, or unusual behavior.
Expiratory dyspnea
It is prolonged and forceful expiration, usually associated with
diffuse or advanced obstructive lower airway disease.

Inspiratory dyspnea
It is prolonged and forceful inspiration due to obstruction of the
extra thoracic airways, such as with laryngeal obstruction or
collapse of the cervical trachea.
POSTURE
Animals with respiratory disease, often adopt an unusual posture
and are rarely recumbent except in the terminal
stages of the disease. Animals in severe respiratory distress will
stand with the head and neck held low and extended. Animals,
except horses, will often have open-mouthed breathing. Cattle
with severe respiratory distress and open-mouth breathing will
often drool large quantities of saliva - probably a consequence
of decreased frequency of swallowing as the animal labors to
breath. The positioning of the legs is often abnormal. Severely
affected animals will usually stand with elbows abducted.

Normal and abnormal breathing sounds

Normal breath sounds are louder on inspiration than on
expiration because inspiration is active with more rapid airflow,
whereas expiration is passive in normal animals and associated
with lower rates of airflow.
Diseases of the respiratory system
Dr. M.A.S
Increased loudness of breath sounds is heard in normal animals
with increased respiratory rate and depth of respiration. This can
occur for physiological reasons such as exercise, excitement or a
high environmental temperature.
Decreased loudness an almost complete absence of breath
sounds
occurs in pleural effusion or pneumothorax and Space-
occupying masses in lung.
Abnormal breath sounds
it is include crackles and wheezes. Crackles are discontinuous
sounds and wheezes are continuous sounds.
Crackles
Abnormal lung sounds described as crackles, popping or
bubbling sound. Crackles may thus be caused by the presence of
exudate and secretions in the airways, and edematous bronchial
mucosa. Crackling lung sounds are also audible in cattle with
interstitial pulmonary emphysema.
Wheezes
It is continuous whistling, squeaking sounds caused by
vibrations of airways or air passing through a narrowed airway.
Inspiratory wheezing suggests obstruction of the upper
airways, usually extra thoracic.
Expiratory wheezing usually indicates intrathoracic airway
obstruction such as bronchoconstriction with or without distal
airways that are narrowed.
Pleuritic friction sounds are a combination of continuous and
discontinuous sounds produced by the rubbing together of
inflamed parietal and visceral pleura. The sound is loud, coarse
and usually not influenced by coughing.
Diseases of the respiratory system
Dr. M.A.S
Absence of lung sounds occurs when the breath sounds are
reflected at the interface between the lung and thoracic wall by
the presence of a medium such as a space-occupying mass, fluid
or air.
Respiratory noises
Sneezing
It is a sudden, involuntary, noisy expiration through the nasal
cavities caused reflex by irritation of the nasal mucosae.
Sneezing occurs in rhinitis and obstruction of the nasal cavities.
Stridor
It is an inspiratory stenotic sound originating from a reduction in
the caliber of the larynx, as occurs in laryngeal edema and
abscess.
Stertor or snoring
It is a deep guttural sound on inspiration originating from
vibrations of pharyngeal mucosa. Snoring is often intermittent,
depending on the animal's posture.
Wheezing
It is a high-pitched sound made by a flowing through a narrow
lumen, such as a stenotic or inflamed nasal cavity
Roaring
It is occur during exercise and is caused by air passing through a
larynx with a reduced lumen, e.g. laryngeal hemiplegia in
horses.
Expiratory grunting
Diseases of the respiratory system
Dr. M.A.S
It is a clearly audible grunting noise synchronous with
expiration. It is most common in cattle with diffuse pulmonary
disease.

Snuffling, bubbling or rattling sounds

It may be audible over the trachea or base of the lungs when
there is an accumulation of secretion, or exudate, in the nasal
cavities, larynx or trachea. These · are most clearly audible on
inspiration.
Cough
A cough is an explosive expiration of air from the lungs. It is
initiated by reflex stimulation of the cough center in the medulla
oblongata by irritation of sensory receptors in one of various
organs, especially the respiratory tract.
The purpose of coughing is to remove the excess mucus,
inflammatory products or foreign material from the respiratory
tract distal to the larynx. Coughing indicates the existence of
primary or secondary respiratory disease.
Cyanosis
It is a bluish discoloration of the skin, conjunctivae and visible
mucosae caused by an increase in the absolute amount of
reduced hemoglobin in the blood. It can occur only when the
hemoglobin concentration of the blood is normal or nearly so,
and when there is incomplete oxygenation of the hemoglobin.
Cyanosis is classified as central or peripheral. Central cyanosis
is present when arterial oxygen saturation is below normal with
concentration of deoxygenated hemoglobin exceeding 4-5 g/dL.
Diseases of the respiratory system
Dr. M.A.S
Peripheral cyanosis occurs when there is localized desaturation
of blood despite arterial oxygen saturation being normal.
Nasal discharge
Excessive or abnormal nasal discharge is usually an indication
of respiratory tract disease.
Unilateral or bilateral.
Nasal discharges may originate from lesions in the nasal
cavities, congenital defects of the hard palate such as cleft palate
in the newborn, paranasal sinuses, guttural pouch in the horse,
pharynx, larynx, trachea and lungs. Diseases of the esophagus
and stomach that cause dysphagia and regurgitation or vomiting
can also cause a nasal discharge stained with feed material.

Epistaxis and Hemoptysis

It is in most instances a result of disease of the mucosae of the
upper respiratory tract but it may originate anywhere in the
upper or lower respiratory tract.
Hemoptysis is the coughing up of blood. The blood usually
originates from hemorrhage in the lower respiratory tract.
Principles of treatment and control of respiratory tract
disease
0 Ensure adequate oxygenation of blood and excretion of carbon
dioxide.
o Relieve pulmonary inflammation.
o Effectively treat infectious causes of respiratory disease.
o Relieve bronchoconstriction.
o Supportive care to minimize demands for respiratory gas
transport.
Diseases of the respiratory system
Dr. M.A.S