Lecture 8

Pathophysiology of
Respiratory System
Department of Nutrition and Dietetics
College of Health Technology
3rd stage

By: Dr. Esmat Khaleqsefat

 Rhinitis
• Is inflammation of the nasal cavity and is clinically characterized by unilateral or bilateral nasal
discharge.

Classification of rhinitis

• According to the type of nasal discharge, rhinitis can be classified as:

1. Serous rhinitis: caused by mild irritants, i.e., low levels of ammonia or chlorine.
2. Catarrhal (mucous) rhinitis: caused by viral infections.
3. Purulent rhinitis: caused by pyogenic bacteria.

By: Dr. Esmat Khaleqsefat

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 Sinusitis

• Is inflammation of the paranasal sinuses.

• According to the type of inflammatory exudate, sinusitis is most commonly serous, catarrhal
or purulent.

By: Dr. Esmat Khaleqsefat

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 Nasal Polyps

• Nasal Polyps are benign mucosal overgrowths, frequently associated with allergic rhinitis. They
arise mainly from the mucous membranes of the nasal cavity and paranasal sinuses.
1. They are freely movable and non-painful.
2. Despite removal by surgery, nasal polyps are found to recur in about 70% of cases.

By: Dr. Esmat Khaleqsefat

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 Tumors of Nasal Cavity

1. Nasal carcinomas
2. Nasal osteosarcoma
3. Nasal chondrosarcoma
• Malignant tumors of the nasal cavity often metastasize.
• Some locally invasive nasal tumors may cause severe damage to the cranial nerves and brain and cause a
variety of neurological signs.

Tumor cells with abnormal mitotic figures (black Hyaline cartilage with an increased
Nasal carcinomas Nasal osteosarcoma
arrows) and tumor giant cells (arrowhead). Note the cell density and cellular atypia
presence of small lymphocytes on the left.
By: Dr. Esmat Khaleqsefat 6
 Laryngitis

• Is an inflammation of the larynx. It causes hoarse (rough) voice or disordered voice “dysphonia”
because of irritation to the vocal cords. Laryngitis is categorized as acute if it lasts less than a few
days. Otherwise it is categorized as chronic, and may last over 3 weeks.

Causes of laryngitis
1. Allergies
2. Viral, bacterial or fungal infection.
3. Excessive coughing, smoking, or alcohol consumption.
4. Use of inhaled corticosteroids for asthma treatment.

By: Dr. Esmat Khaleqsefat

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 Tracheitis
• Is an inflammation of the wind pipe (trachea).

Bacterial Tracheitis

• Bacterial tracheitis is an inflammation of the trachea that takes place due to bacterial infection
and is capable of producing airway obstruction.
• Tracheal infection by Staphylococcus aureus is considered one of the most common causes of
bacterial tracheitis and it often follows a recent viral respiratory infection.

Suppurative tracheitis
The treacheal lumen filled with suppurative exudates

By: Dr. Esmat Khaleqsefat

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 Bronchitis
• Is inflammation of the bronchi and bronchioles.

Acute Bronchitis

• Acute bronchitis is usually characterized by coughing, with or without production of sputum

[Sputum is the expectorated (coughed up) mucus].

• Acute bronchitis often occurs during the course of an acute viral illness such as the common
cold or influenza.

By: Dr. Esmat Khaleqsefat

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 Bronchitis
Chronic Bronchitis

• Is a type of chronic obstructive pulmonary disease and is characterized by the presence

of a productive cough (associated with production of sputum) that lasts for prolonged
time duration.

• Chronic bronchitis is commonly developed due to a recurrent injury of the airways

caused by inhaled irritants.
• Cigarette smoking is the most common cause, followed by air pollution and
occupational exposure to irritants.

By: Dr. Esmat Khaleqsefat

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 Pathology of the Lungs
Pneumoconiosis
• Is a general term used to describe pulmonary diseases characterized by deposition of inhaled
dust particles in the lung.
• The most common type of inhaled dust particles are the carbon (anthracosis), silica (silicosis)
and asbestos (asbestosis).

Anthracosis Black deposits are seen throughout the lung,

Black deposits are seen throughout the lung and mainly within the cytoplasm of the Interstitial
By: Dr. Esmat Khaleqsefat
in the mediastinal lymph node (black arrows). macrophages.
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 Pathology of the Lungs Pulmonary
hyperemia & congestion

• Hyperemia usually seen in acute pulmonary inflammation.

• Congestion commonly associated with left-sided heart failure.

By: Dr. Esmat Khaleqsefat

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 Pathology of the Lungs
Pulmonary Edema
• Is a very common and important pulmonary lesion characterized by accumulation of fluid in the
interstitium and alveoli.
• Pulmonary edema is generally regarded as a nonspecific lesion seen in many pulmonary and cardiac
diseases and it can be the cause of death for many illnesses.

pulmonary edema
Marked distention of the interlobular septa
By: Dr. Esmat Khaleqsefat
The alveoli are flooded with
with edematous fluid. 14
proteinaceous fluid
 Inflation Disturbances of the Lungs
A. Atelectasis

• The term “atelectasis” refers to an incomplete expansion of the lung or a portion of

the lung.

Atelectasis Most of the alveoli are collapsed (non-

Some parts of the left lungs appear collapsed expanded) especially within the upper
(non-expanded). part of the section.
By: Dr. Esmat Khaleqsefat
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 Pulmonary Emphysema

• Pulmonary emphysema is an inflation disturbance of the lungs characterized by

enlargement of the air spaces due to irreversible expansion of the alveoli or destruction of
the alveolar walls.

• Pulmonary emphysema may give rise to labored breathing and an increased susceptibility
to infection.

By: Dr. Esmat Khaleqsefat 19

 Pneumonitis

• Is a general term that refers to inflammation of lung tissue. It is caused by:

1. Infection of the lung (pneumonia) by various infectious agents (viruses, bacteria, fungi or
parasites).
2. Smoking
3. Radiation
4. Adverse reaction to medications and inhalant agents.

By: Dr. Esmat Khaleqsefat

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 Pneumonia

• The term “pneumonia” refers to lung infection caused by bacteria, viruses, fungi or parasites.

Stages of pneumonia

• Four stages of pneumonia are classically described:

1. Congestion
2. Red hepatization gross appearance of redness and solidification (consolidation) of the pulmonary
parenchyma.
3. Gray hepatization
The lungs still appear consolidated, but grossly the color is paler and the cut surface is drier.
4. Resolution

By: Dr. Esmat Khaleqsefat

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 Types of Pneumonia
A. Suppurative bronchopneumonia (Lobular pneumonia)

• Is a suppurative inflammation of the bronchi and lungs usually caused by bacterial infections.

Suppurative Bronchopneumonia Suppurative

Purulent exudate (pus) can be seen within bronchopneumonia
the airways
By: Dr. Esmat Khaleqsefat
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 Types of Pneumonia
B. Lobar pneumonia (fibrinous pneumonia)

• It is characterized by lobar distribution affecting mainly the lower lobes of the lung and is caused by
aerogenous infection with certain bacteria or by aspiration of harsh materials.

Lobar pneumonia
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 Types of Pneumonia
C. Interstitial Pneumonia
• Is a type of pneumonia characterized by diffuse or patchy thickening of the inter-alveolar septa
widely distributed throughout the lungs.

Interstitial Pneumonia
By: Dr. Esmat Khaleqsefat
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 Types of Pneumonia
D. Granulomatous pneumonia
• Is a type of pneumonia characterized by a slow (chronic)
course and formation of granulomatous non-exudative
lesions with random distribution throughout the pulmonary
tissue.

• Granulomatous pneumonia is a characteristic lesion of

aerogenous or hematogenous infections caused by certain
bacteria e.g., Mycobacterium tuberculosis and fungi.

Granulomatous pneumonia

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By: Dr. Esmat Khaleqsefat
 Types of Pneumonia
E. Aspiration pneumonia

• Is inflammation of the lungs and bronchi that takes

place due to aspiration of foreign materials,
particularly the vomits (gastric contents following
vomiting).

Aspiration pneumonia
By: Dr. Esmat Khaleqsefat
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 Pathology of the Thoracic (Pleural) Cavity
Hydrothorax

• Hydrothorax is the accumulation of abnormal quantities of

transudation (serous) fluid in thoracic cavity.

• Common causes of hydrothorax include:

1. Heart failure
2. Lymphatic obstruction
3. Hypoproteinemia (due to starvation and interstitial diseases
of the liver and kidney).

Hydrothorax

By: Dr. Esmat Khaleqsefat

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 Pathology of the Thoracic (Pleural) Cavity
Hemothorax

• Is the presence of free blood in thoracic cavity. It is caused by:

1. Severe trauma or penetrating wound into the lungs
2. Rupture of a major blood vessel

Hemothorax

By: Dr. Esmat Khaleqsefat

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 Pathology of the Thoracic (Pleural) Cavity
Chylothorax

• Is the presence of abnormal quantities of free lymph (chyle) in the

thoracic cavity and it is caused by rupture of a major lymphatic
duct due to thoracic trauma, iatrogenic disorder and neoplasia.

Chylothorax
Presence of free lymph in the pleural cavity
resulting in severe compressive atelectasis of
the left lung

By: Dr. Esmat Khaleqsefat

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 Pathology of the Thoracic (Pleural) Cavity
Pyothorax (pleural empyema)
• Is the accumulation of a purulent exudate (pus) in the thoracic
cavity due to infection with pyogenic bacteria.

Pleuritis (pleurisy)

• Pleuritis or pleurisy is the inflammation of pleura and it can

occur alone or in combination with pneumonia
(pleuropneumonia).

By: Dr. Esmat Khaleqsefat

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