{"id":4620,"date":"2017-04-03T17:45:36","date_gmt":"2017-04-03T09:45:36","guid":{"rendered":"http:\/\/https:\/\/medicine.nus.edu.sg\/pathweb\/?page_id=4620"},"modified":"2023-04-03T12:53:30","modified_gmt":"2023-04-03T04:53:30","slug":"approach-to-respiratory-pathology","status":"publish","type":"page","link":"https:\/\/medicine.nus.edu.sg\/pathweb\/pathology-demystified\/respiratory-system\/approach-to-respiratory-pathology\/","title":{"rendered":"II. Approach to Respiratory Tract Pathology"},"content":{"rendered":"\n\n\t<p>For large and complex topics such as this, it is helpful to break it down into smaller pieces that still connect, so that everything makes sense of the Big Picture.<\/p>\n<p><strong>Here are several approaches:<\/strong><\/p>\n\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--label-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\">1. ANATOMICAL<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--icon-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\"><i>Expand<\/i><\/a>\n\t\t\t\t\t<ul>\n<li><strong>Upper respiratory tract <\/strong>(Nose, pharynx, paranasal sinuses, larynx (some include trachea too)\n<ul>\n<li>You can subdivide the conditions according to aetiology, eg. inflammatory\/infectious, neoplastic etc.<\/li>\n<li>The common and important conditions are covered well in your lecture notes and will not be further highlighted here<\/li>\n<\/ul>\n<\/li>\n<li><strong>Airways <\/strong>(trachea, bronchi, bronchioles, down to respiratory bronchioles)\n<ul>\n<li>Different conditions affect airways of different sizes, eg. bronchiectasis and chronic bronchitis (larger airways); emphysema and bronchiolitis (smaller airways) etc.<\/li>\n<li>Conditions vary according to aetiology, eg. inflammatory, neoplastic, infectious etc. and abnormalities can lead to obstruction of air flow<\/li>\n<\/ul>\n<\/li>\n<li><strong>Lung parenchyma<\/strong>\n<ul>\n<li>Alveoli, capillaries, interstitium<\/li>\n<li>In terms of function, the above form the gas exchange surface which is very important for the<strong> main function<\/strong> of the lung &#8211; absorbing oxygen and secreting carbon dioxide<\/li>\n<li><strong>Specific components of alveolar septa <\/strong>(let&#8217;s follow the direction of blood to air)\n<ul>\n<li>Capillary endothelium<\/li>\n<li>Basement membranes\n<ul>\n<li>Of capillary and alveolar wall<\/li>\n<li>Interstitial tissue (if present) &#8211; collagen, elastic, fibroblasts, smooth muscle, few chronic inflammatory cells<\/li>\n<\/ul>\n<\/li>\n<li>Alveolar epithelium (pulmonary surfactant lies on top of this)<\/li>\n<li>Alveolar macrophages (within alveolar spaces)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li><strong>Pleura<\/strong>\n<ul>\n<li>Diseases of the pleura can affect lung function as well, eg. pleural fibrosis decreasing lung expansion<\/li>\n<li>Some notable conditions: Pleural fibrosis, calcifications and plaques (eg. TB, pneumoconiosis); infections (eg. empyema); malignancy (mesothelioma &#8211; related to asbestos exposure)<\/li>\n<\/ul>\n<\/li>\n<li><strong>Blood vessels<\/strong>\n<ul>\n<li>Large to small; arteries (eg. pulmonary embolism); veins (eg. chronic venous congestion )<\/li>\n<li>Conditions can be haemodynamic (eg. pulmonary embolism, pulmonary hypertension) or inflammatory (eg. vasculitis)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--label-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\">2. AETIOLOGICAL<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--icon-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\"><i>Expand<\/i><\/a>\n\t\t\t\t\t<p>\u2022 VITAMIN C (eg. Vascular, Infectious, Toxic, etc.) &#8211; this is covered in the <strong>mindmaps at the bottom of this page.<\/strong><\/p>\n<p>Note that the mindmap is not comprehensive, and you can slot in other conditions as you read about them eg. chronic venous congestion<\/p>\n<p>\u2022 This is one of the most complete ways of categorizing lung disease, and you can take note of the anatomical component and functional aspects along the way.<\/p>\n\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--label-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\">3. FUNCTIONAL<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--icon-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\"><i>Expand<\/i><\/a>\n\t\t\t\t\t<ul>\n<li>This applies mostly to Chronic lung diseases of a non-infectious and non-neoplastic nature<\/li>\n<li>Lung disease can be classified into two main functional abnormalities:\n<ul>\n<li>Obstructive<\/li>\n<li>Restrictive<\/li>\n<\/ul>\n<\/li>\n<li>With a living patient, lung function tests are used to determine the pattern. Eg. total lung capacity and expiratory flow rate (measured by forced expiratory volume at 1 second).<\/li>\n<li>These two main patterns are caused by different conditions, with some overlaps.<\/li>\n<\/ul>\n<p><strong>Refer to \u00a0&#8220;Mindmaps: Obstructive vs Restrictive Lung Diseases&#8221; &#8211; at the bottom of this page<\/strong><\/p>\n<h3>\n\t\tMINDMAPS: LUNG DISEASES 1 AND 2 \n\t<\/h3>\n\t<p>If you can&#8217;t play the video, watch it here on YouTube:\u00a0<a href=\"https:\/\/youtu.be\/DFjTGSrFP8o\" target=\"_blank\" rel=\"noopener\">https:\/\/youtu.be\/DFjTGSrFP8o<\/a><\/p>\n\t<iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/188257870\" width=\"640\" height=\"483\" frameborder=\"0\" webkitallowfullscreen mozallowfullscreen allowfullscreen><\/iframe>\n\t<p>If you can&#8217;t play the video, watch it here on YouTube:\u00a0<a href=\"https:\/\/youtu.be\/MF3edGtlYCA\" target=\"_blank\" rel=\"noopener\">https:\/\/youtu.be\/MF3edGtlYCA<\/a><\/p>\n\t<iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/188091220\" width=\"640\" height=\"483\" frameborder=\"0\" webkitallowfullscreen mozallowfullscreen allowfullscreen><\/iframe>\n<h3>\n\t\tMINDMAPS: OBSTRUCTIVE VS RESTRICTIVE DISEASES 1 and 2\n\t<\/h3>\n\t<p>If you can&#8217;t play the video, watch it here on YouTube:\u00a0<a href=\"https:\/\/youtu.be\/UZj023LXWPQ\" target=\"_blank\" rel=\"noopener\">https:\/\/youtu.be\/UZj023LXWPQ<\/a><\/p>\n\t<iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/188091241?title=0&#038;byline=0&#038;portrait=0\" width=\"640\" height=\"481\" frameborder=\"0\" webkitallowfullscreen mozallowfullscreen allowfullscreen><\/iframe><br \/>\n\t<p>If you can&#8217;t play the video, watch it here on YouTube:\u00a0<a href=\"https:\/\/youtu.be\/c47HyvdGzeI\" target=\"_blank\" rel=\"noopener\">https:\/\/youtu.be\/c47HyvdGzeI<\/a><\/p>\n\t<iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/188257944?title=0&#038;byline=0&#038;portrait=0\" width=\"640\" height=\"480\" frameborder=\"0\" webkitallowfullscreen mozallowfullscreen allowfullscreen><\/iframe><br \/>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/pathology-demystified\/respiratory-system\/respiratory-function\/\" target=\"_self\" role=\"button\" rel=\"noopener\">\n\t\t\t\t\t\t\tI. Function\n\t\t\t\t\t<\/a>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/pathology-demystified\/respiratory-system\/approach-to-respiratory-pathology\/\" target=\"_self\" role=\"button\" rel=\"noopener\">\n\t\t\t\t\t\t\tII. Approaches to Respiratory Pathology\n\t\t\t\t\t<\/a>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/pathology-demystified\/respiratory-system\/clinical-manifestations-of-respiratory-diseases\/\" target=\"_self\" role=\"button\" rel=\"noopener\">\n\t\t\t\t\t\t\tIII. Clinical Manifestations of Respiratory Disease\n\t\t\t\t\t<\/a>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/pathology-demystified\/respiratory-system\/media-library\/\" target=\"_self\" role=\"button\" rel=\"noopener\">\n\t\t\t\t\t\t\tIV. Respiratory Tract: Talking Pots and Slides\n\t\t\t\t\t<\/a>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/pathology-demystified\/respiratory-system\/respiratory-quiz\/\" target=\"_self\" role=\"button\" rel=\"noopener\">\n\t\t\t\t\t\t\tV. Respiratory Tract: Quiz &#8211; Two Mystery Cases\n\t\t\t\t\t<\/a>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/pathology-demystified\/respiratory-system\/respiratory-one-page-summary\/\" target=\"_self\" role=\"button\" rel=\"noopener\">\n\t\t\t\t\t\t\tRespiratory Tract One Page Summary\n\t\t\t\t\t<\/a>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/pathology-demystified\/respiratory-system\/\" target=\"_self\" role=\"button\" rel=\"noopener\">\n\t\t\t\t\t\t\tRespiratory Tract Chapter Home\n\t\t\t\t\t<\/a>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/pathology-demystified\/\" target=\"_self\" role=\"button\" rel=\"noopener\">\n\t\t\t\t\t\t\tPathology Demystified\n\t\t\t\t\t<\/a>\n\n","protected":false},"excerpt":{"rendered":"<p>For large and complex topics such as this, it is helpful to break it down into smaller pieces that still connect, so that everything makes sense of the Big Picture. Here are several approaches: 1. ANATOMICAL Expand Upper respiratory tract (Nose, pharynx, paranasal sinuses, larynx (some include trachea too) You can subdivide the conditions according [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":4607,"menu_order":0,"comment_status":"open","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-4620","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>NUS Pathweb<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/pathology-demystified\/respiratory-system\/approach-to-respiratory-pathology\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:description\" content=\"For large and complex topics such as this, it is helpful to break it down into smaller pieces that still connect, so that everything makes sense of the Big Picture. 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