Respiratory disease

Respiratory disease
Micrograph of an emphysematous lung; emphysema is a common respiratory disease, strongly associated with smoking. H&E stain.
Specialty	Pulmonology

Respiratory disease is a medical term that encompasses pathological conditions affecting the organs and tissues that make gas exchange difficult 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.^[1]

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.

Contents

• 
  1 Chronic respiratory disease
  


• 
  2 Restrictive lung diseases
  


• 
  3 Respiratory tract infections
  
  
  
  • 
    3.1 Upper respiratory tract infection
    
  
  
  • 
    3.2 Lower respiratory tract infection
    
  
  
  
  


• 
  4 Tumors
  
  
  
  • 
    4.1 Malignant tumors
    
  
  
  • 
    4.2 Benign tumors
    
  
  
  
  


• 
  5 Pleural cavity diseases
  


• 
  6 Pulmonary vascular disease
  


• 
  7 Neonatal diseases
  


• 
  8 Diagnosis
  


• 
  9 Epidemiology
  


• 
  10 References
  


• 
  11 External links
  

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.^[2]

Restrictive lung diseases

Age-standardised disability-adjusted life year (DALY) rates from respiratory diseases by country (per 100,000 inhabitants).

Restrictive lung diseases are a category of respiratory disease characterized by a loss of lung compliance,^[3] 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.^[4][5]

Tumors

Malignant tumors

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:

• Small cell lung cancer


• 
  Non-small cell lung cancer
  
  
  
  • Adenocarcinoma of the lung
  
  
  • Squamous cell carcinoma of the lung
  
  
  • Large cell lung carcinoma
  
  
  
  


• Other lung cancers (carcinoid, Kaposi’s sarcoma, melanoma)


• Lymphoma


• Head and neck cancer


• 
  Pleural mesothelioma, almost always 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 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

Benign tumors are relatively rare causes of respiratory disease. Examples of benign tumors are:

• Pulmonary hamartoma
  


• Congenital malformations such as pulmonary sequestration and congenital cystic adenomatoid malformation (CCAM).

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:^{[citation needed]}

• 
  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.

Neonatal diseases

Pulmonary diseases may also impact newborns, such as pulmonary hyperplasia, pulmonary interstitial emphysema (usually preterm births), and infant respiratory distress syndrome,

Diagnosis

Respiratory diseases may be investigated by performing one or more of the following tests

• 
  Biopsy of the lung or pleura


• Blood test


• Bronchoscopy


• Chest x-ray


• 
  Computed tomography scan, including high-resolution computed tomography
  


• 
  Culture of microorganisms from secretions such as sputum


• 
  Ultrasound scanning can be useful to detect fluid such as pleural effusion
  


• Pulmonary function test


• Ventilation—perfusion scan

Epidemiology

Deaths from respiratory diseases per million persons in 2012 .mw-parser-output .refbegin{font-size:90%;margin-bottom:0.5em}.mw-parser-output .refbegin-hanging-indents>ul{list-style-type:none;margin-left:0}.mw-parser-output .refbegin-hanging-indents>ul>li,.mw-parser-output .refbegin-hanging-indents>dl>dd{margin-left:0;padding-left:3.2em;text-indent:-3.2em;list-style:none}.mw-parser-output .refbegin-100{font-size:100%}

  19-125

  126-169

  170-196

  197-225

  226-275

  276-308

  309-365

  366-440

  441-593

  594-1,227

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.^[6] 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.^[7] In 2012, respiratory conditions were the most frequent reasons for hospital stays among children.^[8]

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.^[9]

Respiratory diseases (including lung cancer) are responsible for over 10% of hospitalizations and over 16% of deaths in Canada.^[10]

In 2011, respiratory disease with ventilator support accounted for 93.3% of ICU utilization in the United States.^[11]

References

1. 
   ^ 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. PMID 27286184..mw-parser-output cite.citation{font-style:inherit}.mw-parser-output .citation q{quotes:"""""""'""'"}.mw-parser-output .citation .cs1-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/thumb/6/65/Lock-green.svg/9px-Lock-green.svg.png")no-repeat;background-position:right .1em center}.mw-parser-output .citation .cs1-lock-limited a,.mw-parser-output .citation .cs1-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/thumb/d/d6/Lock-gray-alt-2.svg/9px-Lock-gray-alt-2.svg.png")no-repeat;background-position:right .1em center}.mw-parser-output .citation .cs1-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/thumb/a/aa/Lock-red-alt-2.svg/9px-Lock-red-alt-2.svg.png")no-repeat;background-position:right .1em center}.mw-parser-output .cs1-subscription,.mw-parser-output .cs1-registration{color:#555}.mw-parser-output .cs1-subscription span,.mw-parser-output .cs1-registration span{border-bottom:1px dotted;cursor:help}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/thumb/4/4c/Wikisource-logo.svg/12px-Wikisource-logo.svg.png")no-repeat;background-position:right .1em center}.mw-parser-output code.cs1-code{color:inherit;background:inherit;border:inherit;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;font-size:100%}.mw-parser-output .cs1-visible-error{font-size:100%}.mw-parser-output .cs1-maint{display:none;color:#33aa33;margin-left:0.3em}.mw-parser-output .cs1-subscription,.mw-parser-output .cs1-registration,.mw-parser-output .cs1-format{font-size:95%}.mw-parser-output .cs1-kern-left,.mw-parser-output .cs1-kern-wl-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right,.mw-parser-output .cs1-kern-wl-right{padding-right:0.2em}
   


2. 
   ^ "WHO | Chronic respiratory diseases (CRDs)".
   


3. 
   ^ Sharma, Sat. "Restrictive Lung Disease". Retrieved 2008-04-19.
   


4. 
   ^ "Respiratory Disease & Oral Health". unitedconcordia.com.
   


5. 
   ^ American Academy of Periodontology, kpmjkk 2008
   


6. 
   ^ "National Institutes of Health – common cold". Archived from the original on 2008-10-01. Retrieved 2008-05-07.
   


7. 
   ^ 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.
   


8. 
   ^ 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.
   


9. 
   ^ "British Lung Foundation - Facts about ukinnam respiratory disease". Archived from the original on 2008-05-16. Retrieved 2008-04-19.
   


10. 
    ^ "Public Health Agency of Canada - Centre for Chronic Disease Prevention and Control Chronic Respiratory Diseases". Archived from the original on 2008-04-11. Retrieved 2008-05-06.
    


11. 
    ^ Barrett ML, Smith MW, Elizhauser A, Honigman LS, Pines JM (December 2014). "Utilization of Intensive Care Services, 2011". HCUP Statistical Brief #185. Rockville, MD: Agency for Healthcare Research and Quality.
    

External links

Classification	D ICD-10: J00-J99 ICD-9-CM: 460-519 MeSH: D012140

Wikimedia Commons has media related to Diseases and disorders of the respiratory system.

v t e Diseases of the respiratory system (J, 460–519)
Upper RT (including URTIs, common cold)	Head sinuses Sinusitis nose Rhinitis Vasomotor rhinitis Atrophic rhinitis Hay fever Nasal polyp Rhinorrhea nasal septum Nasal septum deviation Nasal septum perforation Nasal septal hematoma tonsil Tonsillitis Adenoid hypertrophy Peritonsillar abscess Neck pharynx Pharyngitis Strep throat Laryngopharyngeal reflux (LPR) Retropharyngeal abscess larynx Croup Laryngomalacia Laryngeal cyst Laryngitis Laryngopharyngeal reflux (LPR) Laryngospasm vocal folds Laryngopharyngeal reflux (LPR) Vocal fold nodule Vocal fold paresis Vocal cord dysfunction epiglottis Epiglottitis trachea Tracheitis Laryngotracheal stenosis
Lower RT/lung disease (including LRTIs)	Bronchial/ obstructive acute Acute bronchitis chronic COPD Chronic bronchitis Acute exacerbations of chronic bronchitis Acute exacerbation of COPD Emphysema) Asthma (Status asthmaticus Aspirin-induced Exercise-induced Bronchiectasis unspecified Bronchitis Bronchiolitis Bronchiolitis obliterans Diffuse panbronchiolitis Interstitial/ restrictive (fibrosis) External agents/ occupational lung disease Pneumoconiosis Aluminosis Asbestosis Baritosis Bauxite fibrosis Berylliosis Caplan's syndrome Chalicosis Coalworker's pneumoconiosis Siderosis Silicosis Talcosis Byssinosis Hypersensitivity pneumonitis Bagassosis Bird fancier's lung Farmer's lung Lycoperdonosis Other ARDS Combined pulmonary fibrosis and emphysema Pulmonary edema Löffler's syndrome/Eosinophilic pneumonia Respiratory hypersensitivity Allergic bronchopulmonary aspergillosis Hamman-Rich syndrome Idiopathic pulmonary fibrosis Sarcoidosis Obstructive or restrictive Pneumonia/ pneumonitis By pathogen Viral Bacterial Pneumococcal Klebsiella) Atypical bacterial Mycoplasma Legionnaires' disease Chlamydiae Fungal Pneumocystis Parasitic noninfectious Chemical/Mendelson's syndrome Aspiration/Lipid By vector/route Community-acquired Healthcare-associated Hospital-acquired By distribution Broncho- Lobar IIP UIP DIP BOOP-COP NSIP RB Other Atelectasis circulatory Pulmonary hypertension Pulmonary embolism Lung abscess
Pleural cavity/ mediastinum	Pleural disease Pleuritis/pleurisy Pneumothorax/Hemopneumothorax Pleural effusion Hemothorax Hydrothorax Chylothorax Empyema/pyothorax Malignant Fibrothorax Mediastinal disease Mediastinitis Mediastinal emphysema
Other/general	Respiratory failure Influenza SARS Idiopathic pulmonary haemosiderosis Pulmonary alveolar proteinosis

v t e Certain conditions originating in the perinatal period / fetal disease (P, 760–779)
Maternal factors and complications of pregnancy, labour and delivery	.mw-parser-output .nobold{font-weight:normal} placenta: Placenta praevia Placental insufficiency Twin-to-twin transfusion syndrome chorion/amnion: Chorioamnionitis umbilical cord: Umbilical cord prolapse Nuchal cord Single umbilical artery
Length of gestation and fetal growth	Small for gestational age/Large for gestational age Preterm birth/Postmature birth Intrauterine growth restriction
Birth trauma	scalp Cephalhematoma Chignon Caput succedaneum Subgaleal hemorrhage Brachial plexus lesion Erb's palsy Klumpke paralysis
By system	Respiratory Intrauterine hypoxia Infant respiratory distress syndrome Transient tachypnea of the newborn Meconium aspiration syndrome pleural disease Pneumothorax Pneumomediastinum Wilson–Mikity syndrome Bronchopulmonary dysplasia Cardiovascular Pneumopericardium Persistent fetal circulation Haemorrhagic and hematologic disease Vitamin K deficiency Haemorrhagic disease of the newborn HDN ABO Anti-Kell Rh c Rh D Rh E Hydrops fetalis Hyperbilirubinemia Kernicterus Neonatal jaundice Velamentous cord insertion Intraventricular hemorrhage Germinal matrix hemorrhage Anemia of prematurity Digestive Ileus Necrotizing enterocolitis Meconium peritonitis Integument and thermoregulation Erythema toxicum Sclerema neonatorum Nervous system Perinatal asphyxia Periventricular leukomalacia Musculoskeletal Gray baby syndrome muscle tone Congenital hypertonia Congenital hypotonia
Infectious	Vertically transmitted infection Neonatal infection Congenital rubella syndrome Neonatal herpes simplex Mycoplasma hominis infection Ureaplasma urealyticum infection Omphalitis Neonatal sepsis Group B streptococcal infection Neonatal conjunctivitis
Other	Miscarriage Perinatal mortality Stillbirth Infant mortality Neonatal withdrawal

v t e Respiratory physiology
Respiration	breath inhalation exhalation respiratory rate respirometer pulmonary surfactant compliance elastic recoil hysteresivity airway resistance bronchial hyperresponsiveness constriction dilatation mechanical ventilation
Control	pons pneumotaxic center apneustic center medulla dorsal respiratory group ventral respiratory group chemoreceptors central peripheral pulmonary stretch receptors Hering–Breuer reflex
Lung volumes	VC FRC Vt dead space CC PEF calculations respiratory minute volume FEV1/FVC ratio Lung function tests spirometry body plethysmography peak flow meter nitrogen washout
Circulation	pulmonary circulation hypoxic pulmonary vasoconstriction pulmonary shunt
Interactions	ventilation (V) Perfusion (Q) Ventilation/perfusion ratio V/Q scan zones of the lung gas exchange pulmonary gas pressures alveolar gas equation alveolar–arterial gradient hemoglobin oxygen–haemoglobin dissociation curve (Oxygen saturation 2,3-BPG Bohr effect Haldane effect) carbonic anhydrase (chloride shift) oxyhemoglobin respiratory quotient arterial blood gas diffusion capacity (DLCO)
Insufficiency	high altitude oxygen toxicity hypoxia

Authority control	NARA: 10640996 NDL: 00566505

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