1.What are the lower respiratory tracts?
The organs that make up the respiratory system are divided into two: upper and lower respiratory tracts. The nose and pharynx form the upper respiratory tract. The larynx, trachea and lungs form the lower respiratory tract. Larynx is the respiratory and vocal organ. Its structure contains cartilages connected to each other by muscles and membranes. For this reason, the larynx is always open and air passage is allowed. Trachea - Trachea is approximately 2.5 cm wide and 10-12 cm long. It is made of cartilage rings, the number of which varies between 16-20. The trachea divides into main bronchi leading to the right and left lungs. The bronchi then divide into branches leading to the lung sections, which we call lobes. The thinnest branches of the bronchi are called bronchioles. Between the trachea and alveoli, the airways branch 23 times. Lungs- This is where the respiratory system exchanges oxygen and carbon dioxide. The lungs are slightly spongy, soft, elastic and sensitive organs protected by ribs. The lungs are covered by two-layered pleural membranes. There is pleural fluid between the 2-layered membrane. Alveoli - Small, air-filled sacs that are the functional units of the lungs. Its appearance resembles a bunch of grapes. Chest Cavity - It is a truncated cone-shaped cavity made of bone and cartilage that contains the main respiratory and circulatory organs.
2.Lower respiratory tract (infections) ) What are they? Acute bronchitis / Bronchiolitis, Chronic bronchitis, COPD exacerbation, Pneumonia, Obstructive Pneumonia, that is, pneumonia due to lung cancer, developing behind the area blocked by the tumoral mass, Bronchiectasis infection, TB, that is, It is tuberculosis.
Acute bronchitis-It is acute inflammation of the large airways in the lungs. The condition, which is mostly seen in children and is characterized by inflammation of the small airways, is called acute bronchiolitis. The incidence of acute bronchitis is 5% annually. The most common lower respiratory tract infection is acute bronchitis. It is more common in winter months. Acute bronchitis occurs when a simple cold, laryngitis or pharyngitis descends into the bronchi. The causative agent of bronchitis is 90 percent viruses and less commonly bacteria.
Acute exacerbation of chronic bronchitis-If there is cough and sputum production for two consecutive years and at least three months of each year, the patient has chronic bronchitis. Chronic bronchitis is called permanent inflammation of the bronchial epithelium, that is, the bronchial membranes. There is no restriction in respiratory functions in chronic bronchitis. When the limitation in respiratory functions begins, these patients are diagnosed with COPD (chronic obstructive pulmonary disease). In chronic bronchitis or COPD, intercurrent infections, especially during the winter months, cause patients' cough and sputum to increase. Phlegm is usually colored.
Pneumonia- Pneumonia is inflammation of the lung tissue. It occurs due to various microorganisms, especially bacteria. Pneumonia is among the most common diseases that cause the most deaths all over the world and in our country. It is the fifth leading cause of death in Turkey. In particular, pneumonia can be more fatal in infants, children, the elderly, and people with another known disease. Every year, 10 to 12 million children under the age of 5 die from pneumonia in the world. 90% of these deaths occur in developing countries. Pneumonia is responsible for 48% of the deaths of babies aged 1-12 months in our country.
Tuberculosis, that is, tuberculosis- Tuberculosis disease is an infectious disease caused by a microbe called Mycobacterium tuberculosis. It is a disease. According to World Health Organization data, approximately 8.4 million people are diagnosed with this disease every year and 2 million people die due to this disease.
Bronchiectasis infection- Bronchiectasis is defined as irreversible expansion due to wall destruction in the branches of the bronchi that transmit air from the trachea to the lungs (bronchi with a diameter larger than 2 mm). This is usually caused by previous lung infections. Measles and whooping cough, which are especially severe in childhood; Apart from this, following pneumonia and pulmonary tuberculosis, bronchi enlargement, deterioration and destruction of the bronchial wall occurs in that part of the lungs. Especially in winter months, upper respiratory tract infections cause bronchiectasis infections in bronchiectasis patients, causing complaints of cough, abundant sputum and fever. It happens.
3.What are the symptoms of lower respiratory tract infections?
The most important symptom in acute bronchitis is cough. Although the condition usually improves within days, recovery may rarely take up to 2-3 weeks. While there is usually a dry cough in the beginning, there may be a small amount of sputum, which is thick in consistency, usually white in color, and sticky. Inflammation that develops in the trachea and bronchi occurs in the middle part of the chest, behind the breastbone, with pain that is increased by coughing. Sometimes milder pains can spread to the entire chest; With the strain of the respiratory muscles, breathing becomes more frequent and the cough becomes persistent. Cough duration and frequency increase in bronchitis in smokers. Fever may occur. The diagnosis of acute bronchitis is made with a good history and physical examination. Pneumonia symptoms - Pneumonia can sometimes be confused with diseases such as flu, cold and bronchitis. In such patients, if the fever rises with chills and goes up to 39-40°C, if the general condition of the patient deteriorates, if the disease is severe and lasts for a long time, if it is accompanied by dark, bloody sputum and chest pain, an investigation should be made, taking into account the possibility of pneumonia. . If patients have frequent breathing, the disease should be considered serious. Especially in children, a respiratory rate of more than 40 per minute is a very important finding and urgent application to a healthcare institution is required.
Symptoms of Bronchiectasis Cough and sputum production are the most common symptoms. The severity of cough and the amount of sputum vary depending on the prevalence of bronchiectasis.
Enlarged bronchi that have lost their structural properties weaken the defense system of the lungs and cause frequent infections. Since it is easy for microbes to settle in this damaged area, people with bronchiectasis frequently get lung infections. Viruses or bacteria that cause simple upper respiratory tract infections in other people cause lung infections in patients with bronchiectasis. During infection periods, symptoms such as fever, increase in the amount of sputum, sputum becoming inflamed and foul-smelling yellow-green, and feeling pale and coughing up blood occur. Clubbing of fingers may occur in patients with diffuse bronchiectasis. .
Symptoms of tuberculosis diseasecan be grouped into two groups: general complaints and lung-specific complaints. General complaints are fever, night sweats, weight loss, loss of appetite and fatigue, especially in the evening. Lung-specific complaints include cough lasting more than two weeks, expectoration, coughing up variable amounts of blood, chest pain and shortness of breath. Complaints usually start mildly and progress slowly. Meanwhile, the patient spreads germs to his environment and causes more people to become infected. For this reason, it is very important for people with cough and other complaints lasting longer than two weeks to consult a health center as soon as possible.
4.For lower respiratory tract infections. Is it necessary to use antibiotics?Viruses (RSV, rhinovirus, influenzavirus, etc.) are the causative agent in 80-90% of lower respiratory tract infections in children. Likewise, viruses are the cause of 80-90% of acute bronchitis in adults. If clinical findings suggest viral infection, there is no high fever, and there are symptoms such as bronchiolitis or bronchitis, antibiotics are usually not needed. However, in the presence of bacterial infection, especially if pneumonia is suspected, antibiotics must be used. Even if a sputum culture is taken, antibiotics for the possible causative agent should be started without delay until the culture result is obtained. Again, in the presence of bronchiectasis infection, antibiotics should be started earlier. In the presence of acute bronchitis accompanied by bacterial sinusitis, which we call sinopulmonary infection, antibiotics should also be given. However, not every coughing patient is started on antibiotics. If an infection is suspected, whether it is viral or bacterial should be evaluated and antibiotic therapy should be started depending on the situation. Unnecessary use of antibiotics will lead to the development of resistant microorganisms, side effects and increased treatment costs. However, if the patient with acute bronchitis has fever that lasts for 4-6 days, has yellow or green thick sputum, is a smoker, has heart disease or diabetes, it is necessary to give antibiotics.
5.How is lower respiratory tract diseases treated? Acute Bronchitis Treatment - Treatment of acute bronchitis focuses on eliminating complaints. The first is symptomatic treatment. Control of cough is important. If bacterial infection is suspected, antibiotic treatment should be administered under physician supervision. In the presence of weakness, bed rest is required, if there is fever, the fever should be reduced and plenty of fluids should be consumed. Smoking should definitely not be used. Chronic Bronchitis Treatment - When there is an acute exacerbation in chronic bronchitis patients, antibiotics that the physician deems appropriate are usually included in the treatment, as bacteria will be added even in the presence of viral infection. Apart from this, bronchial constriction and airway edema that may occur during periods of infection are evaluated along with expectorant and expectorant drugs, and if necessary, bronchial dilators and airway edema-relieving drugs are added to the treatment. It is recommended that chronic bronchitis patients avoid contact with sick people, especially during flu epidemics, consult a physician if they have a flu infection, and get a flu vaccine every year in the fall. Staying away from smoking, not drinking and not allowing anyone to smoke is the most correct and necessary course of action to be taken to protect against chronic bronchitis and COPD.
Pneumonia Treatment- In many cases, pneumonia can be treated at home under the supervision of a physician. Severe cases, elderly patients, patients requiring oxygen therapy or intensive care support require hospitalization. Treatment varies depending on the patient. When treatment is started early and in cases that can be treated on an outpatient basis, the results are satisfactory. However, the mortality rate is high in cases of severe pneumonia with delayed diagnosis and treatment.
Treatment of Bronchiectasis - If bronchiectatic changes are seen widely in both lungs on computerized tomography, drug treatment and measures to protect the lungs are applied. Antibiotics should be used in these patients during periods of infection attacks. Apart from this, syrups that thin the phlegm and enable easy phlegm removal, and if there is bleeding due to sputum, rest and bleeding-oriented treatments should be applied. In addition, patients receiving drug treatment should be taught appropriate postural drainage (position-dependent drainage = sputum removal techniques) to remove the sputum accumulated in the dilated bronchi.
Tuberculosis treatment - Find strong drugs that are effective against the tuberculosis bacillus.
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