CP

• - URT
• - Lung parenchma (connective and supportive tissue) pneumonia, TB

• - Bronchiectasis
• - Lung abscess

- common cold

- like those of the common cold

- the upper respiratory tract

- droplet transmission

• - infection and inflammation of the nasopharyngeal mucosa
• - extension of the infection beyonf the NP- pneumonia, bronchitis, otis media

- highly infectious actue viral illness caused by the influenza virus

• - pyrexia- fever
• - headache
• - myalgia- aches
• - malasie- feeling sick
• - fatigue and lethargy

• - highly infectious
• - droplet spread
• - still a major cause of morbidity and mortality
• - high risk- age, comorbidities, immune compromised, resp disease

• - supportive
• - preventative

• - epiglottitis- inflammation of the supraglottic region
• - laryngotracheobronchitis- croup, inflam of the subglottic region
• - pertussis- whooping cough, viral infection, characteristic cough

• - protect airway
• - humidification
• - antibiotics
• - inhaled adrenaline
• - corticosteroids
• - minimal handling
• - respiratory support as needed
• Physio- CI in acute phase but later only if there is specific lung pathology

• - bronchiolitis
• - pneumonia
• -  PCP- classic pneuonia of aids
• -legionella
• - lung abscess
• - bronchiectasis
• - TB
• - 

- inflammation of the bronchioles

• - most common LFT disease in childhood
• - usually caused by RSV (respsinovirus)
• - aerosol or direct transmission

• - inflamm of bronchioles by viral pathogen
• - necrosis of the epithelium- sloughs into airway
• - airway oedma
• - increased mucous production
• - obstruction to small airways- air trapping or collapse, pneumonia/ consolidation

• - fever
• - resp distress
• - cough and secretions
• - ausc signs
• 0 CXR may show consolidation

• medical
• - humidification with or without O2
• - ventilatory support needed
• - ABs i f secondary infection
• - medications- antiviral

• Physio
• - not indicated in acute stage
• - later in the disease course only if specific lung pathology and excessive secretions- only when u should handle them

• - INFLAMMATORY PROCESS AFFECTING THE LUNG PARENCHYMA- GAS EXCHANGE portion of the lung
• - significant world wide cause of morbidity and mortality

• - Nosocomial/ Hospital acquired (HAP)
• - Community acquired (CAP)
• - Health associated (HCAP)

• - typical vs atypical
• - bacteria- streptococuss, staphylococcus, klebsiella, pseudomonas, haemophillus, legionella
• - viruses: influenz, RSV
• - mycoplasma pneumoniae: small organisms which escapes isolation by standard tests
• - chicken pox
• - rubella- measles
• - fungal- aspergillus (in soil), histoplasmosa, candida
• - aspiration- alcoholics, people with poor conciousness, foreign substances into resp tract, URT secretions, gastric secretions, often anaerobic microbes- abcess, arapneumonic effusions
• - repeated pneumonia- suggestes aspiration, obstruction of bronchus eg Ca, perm lung damage

• -poor resp defences
• - extremes of age- children and elderly
• - respdisease acute or chronic eg COPD
• - other chronic disease eg DM
• - debilitated
• - malnourished
• - immunocompromised
• - hospital pts
• - ETOH/ Drugs

• -infetion of lung parenchyma with pathogen
• -filling of alvoli- fluid, secretions, RBCs, white blood cells, macrophages
• - consolidation of lung- poor alveolar ventilation, VQ mismatch, hypoxaemia

• - cosolidation stage- initial stage
• - resoution stage- break up of alveolar consolidation, may become productive

• - fever increase WCC
• - flu like symptoms- my/arthralgia, malaise, headache, N&V
• - pleural pain
• - cough- dry/ productive
• - increased RR and HR
• - ausc- BBS, crackles, reduced BS
• - CXR- vary, consol
• - ABGS- hypoxameia
• - sputum culture

• - perm damage to lung
• - bronchiectasis, lung abscess
• - pleural effusion- parapneumonic (in pleural space), empyema (puss)
• - sepsis and multiorgan failure
• - resp failure

• - hospital admission
• - antibiotics
• - fluid management
• - analgesics
• - oxygen therapy to mantain PaO2
• - other supportive therapy as needed
• PHYSIO
• - percs and vibes postural drainage in the resolution phase

• - classic pneumonia of AIDS
• - pneumocystis pneumonia
• - it is a fungus causiing infection in immunocompromised pts
• - diagnosed by analysis of sputum

• - supportive
• - pharmacological
• - usually non productive therefore often no need for physio

- a localised collection of pus withing a caviated necrotic lesion in the lung parenchyma

• Anaerobic bacteria invading lung
• - bacteriodes
• - normally inhabit GIT and mouth
• - colonize gums (poor hygeine)
• - enter the lungs via aspiration
• Associated with
• - ETOH
• - Loss of consciousness
• - dysphagia

• Causes:
• - other bacteria invading lung eg E. coli
• - bronchial obstuction with secondary infection
• - vascular obstruction eg PE
• - interstitial lung disease
• - blood born infection- sepsis
• - infective bullae (bubble thing)
• - transdiaphragmatic spread

• - as for pneumonia in the early stages- lung consolidation
• - progression to tissue necrosis and destruction of tissue- cavity formation
• - cavity filled with air and infected material
• - may be encapsulated in a yogenic membrane- fibrosis, inflammatory, granu;lation tissue
• - may rupture into a bronchus into the pleural cavity- bronchopleural fistula, empyema, drainage of fluid
• - compression of surrounding lung

• - as for pneumonia
• - systemic signs
• - cough with purulent secretions
• - hasmoptysis
• - loss of weight
• - CXR/ CT findings- cavity, airfluid levels

• medical
• - antibiotics
• - biopsy
• - supportive therapy
• - surgery
• Physio
• - postural drainage may be required if abcess is draining
• - affected area uppermost- gravity assisted

anatomically defined by chronic, irreversible dilation and distortion of the bronchi caaused by inflam destruction of the mm and elastic components of bronchial walls

• incidence in developed countrie unknow- low
• - less overcrowding
• - better hygiene
• - high immunisation rates
• - better nutrition
• - access health care
• - prevalance in indigenous aust and pacific isalnders- highest in the world

• - idiopathic
• - acquired
•  -chronic lung infection
•   - pneumonia, CF
•   - chronic aspiration
•  - subsequent to childhood infections
•  - immunodeficiency
•  - may also occur distal to obstructed bronchus- foreign body, lymph node
• - congenital- kartagener's syndrome, primary ciliary diskinesia, hypogammaglobulinemia
• - associated with other diseases- often autoimmune- RA, chron's disease

• - initialinsult and then ongoing inflam response
• - damage and destruction to airway- cartilage, smooth mm, elastin, blood vessels
• - reduced effectiveness of MCC- pooling of secretions, further infection and lung damage
• - small airways closure- may lead to gas trapping or alveolar collapse
• - scarring of fibrosis of airways
• - both obstructive and restrictive
• - local or diffuse

• - cylindrical
• - varicose
• - cystic/ saccular

- dialated bronchi which fail to taper

• - irregular dilation
• - like varicose veins

- bronchi dialated and ending in cysts

• - cough with secretions
• - ausc- crackles and wheezes
• - ABGs, PFTS
• - CXR- tramlines, ring like shadows, outlines of thickened and dilated bronchi
• - CT- HRCT (high resp CT) gold standard diagnostic tool, dilated airways, no tapering

• - increased cough with more secretions, change colour
• - haemoptysis
• - signs of resp compromise
• - ausc crackles, wheezes
• - pleutric pain
• - cxr- increased consolidation, secretions in bronchi, cysts etc
• do tend to cough up blood due to erroded blood vessels

• - secretion clearance
• - antibiotics
• - resp medications as appropriate
• - vaccinations
• - pulm rehab

• Acute- ABs- may be IV, other supportive treatment
• Surgery- remove affected lobes

• - effective clearance- PD, P&V, ACBT, PEP< FLutter
• - self management and edu
• - exercise training and rehab

• - infectious disease caused by myocobacterium TB
• - particularly affects the lungs
• - one of the oldest disease known to affect human
• - old term consumption

• - > 5 mill new cases reported to WHO each yr
• - 95% from developing countries
• - under reported, 9 million estimated new cases per yr
• - 15-20million
• - 2 million die each 
• - incidence stable or slightlydecling

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• - aerobic
• - thrive off areas of high O2
• - doesnt cahnge colour with acid stains
• - dropplet transmission
• - can remain in air for several hours

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