Respiratory System Disorders Questions and
answers
Review - ✅✅The primary function of the respiratory system is delivery of oxygen to the lungs and
removal of carbon dioxide from the lungs.
Upper Respiratory Tract Anatomy and Physiology - ✅✅Nose and turbinates
Sinuses
Nasopharynx
Pharynx
Tonsils
Eustachian tubes
Larynx
Rhinitis - ✅✅Inflammation of nasal mucous membrane
Acute caused by common cold, bacterial infection, presence of foreign body, drug-induced rebound
congestion (rhinitis medicamentosa).
Chronic caused by allergy, nonallergic perennial rhinitis, chronic sinusitis, and a deviated septum
Allergic rhinitis - ✅✅Caused by allergic reaction resulting in antigen-antibody reaction.
Releases large amounts of histamine
Treatment:
Identify allergens (skin testing)
Avoid exposure, if possible, to allergens
Treat with antihistamines, decongestants, intranasal antiinflammatory agents
Use saline nasal spray to reduce nasal irritation
,Allergen-antibody reaction - ✅✅Histamine is stored in small granules in most body tissues, and is
released in response to an allergic reaction.
Reacts with H1 receptors in the area and arterioles and capillaries in the region dilate, allowing
increased blood flow to the area resulting in redness.
Capillaries become more permeable , resulting in outward passage of fluid into the extracellular spaces
resulting in edema.
Nasal, lacrimal, and bronchial secretions are released.
If large amounts of histamine are released (severe reaction), arteriolar dilatation causes drop in BP,
flushing and edema of skin, itching (urticaria) develops.
Constriction and spasm of bronchial tubes make respiratory effort more difficult (dyspnea), and copious
amounts of pulmonary and gastric secretions are released.
Common cold - ✅✅Limited to relieving symptoms of rhinitis, pharyngitis and laryngitis.
Antihistamines are of some benefit
Analgesics, antipyretics, expectorants, antitussive agents also beneficial, depending on cold symptoms
Laryngitis may benefit from cool mist
Rhinitis medicamentosa - ✅✅Prevention is best treatment
Withdraw topical decongestant
Nasal steroid solutions also can be used
Can taper use one nostril at a time
Antihistamines (H1 receptor antagonists) - ✅✅Drug of choice in treating allergic rhinitis
Administered orally and distributed systemically, reduce the symptoms of nasal itching, sneezing,
rhinnorhea, lacrimation, and conjunctival itching.
Do not reduce nasal congestion
, Anti-inflammatory agents - ✅✅Administered intranasally are used to treat nasal symptoms resulting
from mild to moderate allergic rhinitis.
Not used for treatment of cold as symptoms are resolving before effectiveness is reached.
Agents used are corticosteroids and cromolyn sodium.
EPISTAXIS - ✅✅- Hemorrhage of the nares or nostrils.
- May be unilateral (most common) or bilateral.
- May be primary in nature, as a result of drying of the mucous membranes or from local irritation or
trauma.
- May be secondary to controlled hypertension or coagulopathies.
- Hemorrhage of the nares or nostrils and may stem from dry nasal mucosa, local irritation, trauma, or
hypertension.
EPISTAXIS (cont) - ✅✅- Treat to maintain airway, stop bleeding, identify cause, prevent recurrence.
- Firm pressure on the nares or nasal packing may be needed.
- Diffuse vascularity and proximity to the surface make the nares very susceptible to hemorrhage.
- Hypovolemic shock can occur with significant blood loss.
EPISTAXIS Management - ✅✅Immediate attention is required for signs of airway obstruction,
aspiration or hypovolemic shock.
Goals of treatment are to maintain airway, stop bleeding, identify the cause and prevent recurrence.
Firm nares pressure for 5 minutes, if bleeding continues, have the patient blow their nose and resume
pressure for 10 minutes.
Epistaxis that persists may require nasal packing (sometimes accompanied by epinephrine) or
cauterization with silver nitrate sticks.
answers
Review - ✅✅The primary function of the respiratory system is delivery of oxygen to the lungs and
removal of carbon dioxide from the lungs.
Upper Respiratory Tract Anatomy and Physiology - ✅✅Nose and turbinates
Sinuses
Nasopharynx
Pharynx
Tonsils
Eustachian tubes
Larynx
Rhinitis - ✅✅Inflammation of nasal mucous membrane
Acute caused by common cold, bacterial infection, presence of foreign body, drug-induced rebound
congestion (rhinitis medicamentosa).
Chronic caused by allergy, nonallergic perennial rhinitis, chronic sinusitis, and a deviated septum
Allergic rhinitis - ✅✅Caused by allergic reaction resulting in antigen-antibody reaction.
Releases large amounts of histamine
Treatment:
Identify allergens (skin testing)
Avoid exposure, if possible, to allergens
Treat with antihistamines, decongestants, intranasal antiinflammatory agents
Use saline nasal spray to reduce nasal irritation
,Allergen-antibody reaction - ✅✅Histamine is stored in small granules in most body tissues, and is
released in response to an allergic reaction.
Reacts with H1 receptors in the area and arterioles and capillaries in the region dilate, allowing
increased blood flow to the area resulting in redness.
Capillaries become more permeable , resulting in outward passage of fluid into the extracellular spaces
resulting in edema.
Nasal, lacrimal, and bronchial secretions are released.
If large amounts of histamine are released (severe reaction), arteriolar dilatation causes drop in BP,
flushing and edema of skin, itching (urticaria) develops.
Constriction and spasm of bronchial tubes make respiratory effort more difficult (dyspnea), and copious
amounts of pulmonary and gastric secretions are released.
Common cold - ✅✅Limited to relieving symptoms of rhinitis, pharyngitis and laryngitis.
Antihistamines are of some benefit
Analgesics, antipyretics, expectorants, antitussive agents also beneficial, depending on cold symptoms
Laryngitis may benefit from cool mist
Rhinitis medicamentosa - ✅✅Prevention is best treatment
Withdraw topical decongestant
Nasal steroid solutions also can be used
Can taper use one nostril at a time
Antihistamines (H1 receptor antagonists) - ✅✅Drug of choice in treating allergic rhinitis
Administered orally and distributed systemically, reduce the symptoms of nasal itching, sneezing,
rhinnorhea, lacrimation, and conjunctival itching.
Do not reduce nasal congestion
, Anti-inflammatory agents - ✅✅Administered intranasally are used to treat nasal symptoms resulting
from mild to moderate allergic rhinitis.
Not used for treatment of cold as symptoms are resolving before effectiveness is reached.
Agents used are corticosteroids and cromolyn sodium.
EPISTAXIS - ✅✅- Hemorrhage of the nares or nostrils.
- May be unilateral (most common) or bilateral.
- May be primary in nature, as a result of drying of the mucous membranes or from local irritation or
trauma.
- May be secondary to controlled hypertension or coagulopathies.
- Hemorrhage of the nares or nostrils and may stem from dry nasal mucosa, local irritation, trauma, or
hypertension.
EPISTAXIS (cont) - ✅✅- Treat to maintain airway, stop bleeding, identify cause, prevent recurrence.
- Firm pressure on the nares or nasal packing may be needed.
- Diffuse vascularity and proximity to the surface make the nares very susceptible to hemorrhage.
- Hypovolemic shock can occur with significant blood loss.
EPISTAXIS Management - ✅✅Immediate attention is required for signs of airway obstruction,
aspiration or hypovolemic shock.
Goals of treatment are to maintain airway, stop bleeding, identify the cause and prevent recurrence.
Firm nares pressure for 5 minutes, if bleeding continues, have the patient blow their nose and resume
pressure for 10 minutes.
Epistaxis that persists may require nasal packing (sometimes accompanied by epinephrine) or
cauterization with silver nitrate sticks.
