Gas exchange of oxygen and carbon dioxide in the body occurs with the participation of the circulatory and respiratory systems.

The respiratory system includes:

• Airways;
• lung parenchyma, where gas exchange occurs with the help of the circulatory system;
• chest, including its bone-cartilaginous frame and neuromuscular system;
• nerve centers for the regulation of respiration.

The respiratory system provides:

• exchange of oxygen and carbon dioxide in the alveoli - alveolar ventilation;
• circulation of the lungs, including the alveoli;
• diffusion of oxygen and carbon dioxide through the alveolocapillary membrane, or airborne barrier.

Respiratory system disorders can lead to to respiratory failure- state”, characterized by the development of hypoxia and hypercapnia as a result of a violation of the gas exchange function of the lungs.

DISORDERS OF OXYGEN AND CARBON DIOXIDE METABOLISM IN LUNG ALVEOLAS

These disorders include hypo- and hypervengilation of the lungs, hypertension in the vessels of the pulmonary circulation.

Hypoventilation of the alveoli with air is characterized by a decrease in the volume of ventilation of the alveoli per unit of time, below that required by the body.

The reasons may be:

• decrease in patency respiratory tract for air due to obstruction (closing) of the lumen of the bronchi by a tumor, vomit, sinking tongue in coma, anesthesia, mucus, blood, or as a result of spasm of the bronchioles, for example, during an attack bronchial asthma, and etc.;
• a decrease in the degree of expansion of the lungs with focal confluent pneumonia, tumors of the lung parenchyma, sclerosis of the lung tissue, as well as with compression of the chest by heavy objects, for example, with blockages by earth, with pleurisy, accumulation of blood, exudate, transudate, air in the pleural cavities;
• violation of the mechanisms of regulation of respiration at the level respiratory center or its afferent and efferent pathways, which is observed with trauma to the medulla oblongata, compression of the brain with its edema or inflammation, hemorrhages in the substance of the brain, tumors of the medulla oblongata, with acute severe hypoxia various genesis and etc.

Manifestations consist in the appearance of pathological respiration - apneustic, respiration of Biot, Cheyne-Stokes, Kussmaul (Fig. 58).

Apneustic breathing(from the Greek apnoia - lack of breathing) - temporary pauses in breathing, characterized by an extended inhalation and a short exhalation.

Biot's breath manifests itself in short periods

intense breathing movements (usually 4-6), alternating with periods of apnea for several seconds.

Cheyne-Stokes breathing characterized by an increasing increase in the frequency and depth of respiratory movements, followed by their progressive decrease and the development of periods of apnea lasting 5-20 s.

Rice. 58. Types of pathological breathing.

Breath of Kussmaul manifested by rare shallow breaths and noisy exhalations, followed by a period of apnea.

Hyperventilation of the lungs is characterized by an excess of ventilation of the lungs per unit of time in comparison with that required by the body.

Causes may be inadequate artificial ventilation of the lungs, for example, concussions, hemorrhages, intracranial tumors, etc.

DISORDERS OF CIRCULATION IN THE LUNGS

Causes:

• disorders of blood flow in the vessels of small and great circle blood circulation;
• violations of lung perfusion in hypertension in the vessels of the pulmonary circulation and in violation of the outflow of blood from the lungs as a result of hypertension, mitral heart disease, pneumosclerosis, etc.

Hypotension in the vessels of the pulmonary circulation is characterized by a persistent decrease in blood pressure in them.

Causes:

• heart defects with right-to-left shunting and shunting venous blood into the arterial system, e.g. tetralogy of Fallot, valvular insufficiency pulmonary artery;
• hypovolemia of various origins, for example, with prolonged diarrhea, shock conditions, as a result of chronic blood loss, etc.;
• systemic arterial hypotension, for example, with collapse or coma.

Respiratory failure- a pathological condition in which the respiratory system does not provide the level of gas exchange necessary for the body, which is manifested by the development of hypoxemia.

The causes of hypercapnia are all of the above disorders of the gas exchange function of the lungs and extrapulmonary disorders.

DISEASES OF THE RESPIRATORY SYSTEM

The organs of the respiratory system have direct contact with the air and, therefore, are constantly exposed to the direct influence of pathogenic environmental factors. These primarily include viruses and bacteria, numerous chemical and physical irritants that enter the respiratory system along with the air. These factors cause respiratory diseases, among which the most common are acute inflammatory diseases of the trachea, bronchi and lungs, chronic nonspecific diseases lung and lung cancer.

ACUTE INFLAMMATORY DISEASES OF THE BRONCH AND LUNGS

Acute inflammatory diseases of the bronchi and lungs affect various parts of the respiratory system. Highest value among them are croupous pneumonia, bronchitis and focal bronchopneumonia.

croupous pneumonia

Croupous pneumonia- an acute infectious disease, manifested by inflammation of one or more lobes of the lungs with the obligatory involvement of the pleura in the process.

Etiology.

The causative agents are pneumococci various types, which show their effect in a previously sensitized and weakened organism.

Patho- and morphogenesis.

In the development of lobar pneumonia, which occurs within 9-11 days, four stages are distinguished: hot flush, red hepatization, gray hepatization and resolution.

high tide characterized by serous inflammation and develops in response to the multiplication of microbes in the affected lobe of the lung. During this period, the permeability of capillaries and venules increases sharply, and blood plasma and erythrocytes enter the parenchyma of the lungs. The duration of the stage is about 1 day.

Red hepatization stage characterized by the development of fibrinous lobar inflammation. The alveoli of the entire lobe are filled with erythrocytes, polynuclear leukocytes are added to them and fibrin strands fall out. The lobe of the lung increases in size, becomes red and dense, resembles liver tissue (hence the name "hepatization") - This stage lasts 2-3 days.

Rice. 59. Croupous pneumonia, gray opacity of the upper lobe of the lung.

The stage of gray hepatization.

The exudate filling the alveoli consists mainly of leukocytes and fibrin. Leukocytes phagocytize microbes. Struck lung lobe increased in size, dense, gray color. On the pleura - fibrinous exudate (Fig. 59). The stage lasts 4-6 days.

Resolution stage

At this stage, leukocyte enzymes break down fibrin, the remaining microbes are phagocytosed. A large number of macrophages appear, absorbing the remnants of fibrinous exudate. Fibrinous overlays on the pleura usually organize and turn into dense adhesions.

Complications lobar pneumonia can be pulmonary and extrapulmonary.

Pulmonary complications- abscess of the affected lobe of the lung, gangrene of the lung.

In cases where the fibrinous exudate does not dissolve, but grows into connective tissue, its organization occurs - the so-called carnification lungs. The lung becomes dense, airless, fleshy. Fibrinous inflammation of the pleura can become purulent-fibrinous, pus fills the pleural spaces and pleural empyema occurs.

Extrapulmonary complications develop with hematogenous or lymphogenous spread of infection from the lungs - purulent mediastinitis, pericarditis, endocarditis, meningitis, etc.

Death in croupous pneumonia occurs from cardiopulmonary insufficiency or from complications.

ACUTE BRONCHITIS

Etiology.

Acute bronchitis develops under the influence of various infectious agents. At the same time, a decrease in the body's resistance as a result of cooling, dusting of the inhaled air, and severe injury plays an important role.

Morphogenesis.

Usually inflammation of the bronchi and bronchioles is catarrhal in nature, but the exudate can be serous, mucous, purulent, fibrinous, or mixed. The mucous membrane of the bronchi becomes hyperemic. the amount of mucus produced increases sharply. The ciliated epithelium loses villi, sloughs off, which makes it difficult to remove mucus from the bronchi. Edema develops in the bronchial wall, it is infiltrated by lymphocytes, plasma cells, neutrophilic leukocytes. The accumulated mucus as a result of a violation of its excretion, together with the causative agents of an acute infection, descends into the underlying sections of the bronchial tree and clogs the bronchioles.

Exodus.

Acute bronchitis usually ends in recovery, the bronchial mucosa is restored. However, the course of bronchitis can become subacute and chronic, especially in the presence of disease-supporting factors (smoking).

Etiology.

Focal pneumonia(bronchopneumonia) is an island-borne inflammation of the lung tissue associated with bronchitis. The causes of focal pneumonia are usually microbes, viruses, fungi.

Pathogenesis.

The inflammatory process from the bronchi extends to the area of ​​the adjacent lung parenchyma. Sometimes focal pneumonia occurs primarily, but at the same time, the bronchus located in the zone of inflammation is also involved in the process. Depending on the size of the focus of inflammation bronchopneumonia can be:

• alveolar;
• acinous;
• lobular;
• drain lobular;
• segmental;
• intermediate.

Morphology.

Foci of inflammation most often develop in the posterior segments of the lungs. They are different sizes, dense. protrude above the cut surface of the lungs in the form of gray-red foci. The exudate is serous, sometimes serous-hemorrhagic in nature. Depending on the age of patients, there are some features of the localization and course of bronchopneumonia. So. in young children, foci of inflammation occur in the segments adjacent to the spine (II, VI, X), so pneumonia is called paravertebral. It's going well. On the contrary, in patients older than 50 years, the resorption of inflammatory foci occurs relatively slowly.

Complications: carnification of foci of inflammation, their purulent fusion and the formation of abscesses, sometimes pleurisy.

Exodus more often favorable. Death occurs when foci of inflammation become multiple and widespread. In this situation, the factors that determine the patient's condition are respiratory hypoxia and intoxication.

CHRONIC NON-SPECIFIC LUNG DISEASES

The group of chronic nonspecific lung diseases consists of several diseases of the respiratory tract, the development of which is closely related. These include Chronical bronchitis, bronchiectasis, chronic abscess, pneumosclerosis and emphysema.

Etiology.

Chronic bronchitis develops as the outcome of a protracted acute bronchitis. It can be caused by infectious agents, as well as prolonged irritation of the bronchi by physical and chemical substances.

Patho- and morphogenesis.

A diffuse lesion of the entire bronchial tree is characteristic. At the same time, exudative (catarrhal-mucous, catarrhal-purulent) inflammation acquires a mainly productive character over time. The mucous membrane of the bronchi in chronic bronchitis is hyperemic, all layers of the bronchial wall are infiltrated with lymphocytes, neutrophilic leukocytes, and macrophages. The epithelium gradually sloughs off. the glands atrophy, metaplasia of the ciliated epithelium into stratified squamous epithelium often occurs. Long-term inflammation in the bronchus wall leads to degeneration of muscle fibers and nerve endings, atrophy and death of the elastic framework. As a result of these changes, the peristalsis of the bronchus decreases, and it cannot perform its drainage function, i.e., remove mucus, exudate. Mucopurulent exudate stagnates in the bronchi, the microbes contained in it support inflammation. Vascular sclerosis and impaired blood supply to the bronchus cause hypoxia of its wall, which activates fibroblasts, and sclerosis increases. The walls of the bronchus expand unevenly, forming cavities in the form of bags or cylinders - bronchiectasis.

Rice. 60. Chronic purulent bronchitis with the formation of bronchiectasis. a - the lumen of the bronchus is unevenly expanded; b - necrosis and purulent fusion of the mucous membrane; c - infiltration of the bronchial wall with leukocytes; d - sclerosis of the peribronchial tissue.

This is facilitated by coughing shocks. In bronchiectasis, purulent exudate accumulates, constantly supporting inflammation of the bronchial wall. Granulation tissue develops, which, growing in the form of a polyp, can sharply narrow or completely close the lumen of the bronchus, which leads to atelectasis of the lung area (Fig. 60). In addition, lung tissue adjacent to the bronchus is involved in the inflammatory process - focal bronchopneumonia occurs. Its chronic course contributes to the development of sclerosis at the focus of inflammation, which also leads to stretching and deformation of the bronchus. Bronchiectasis becomes multiple, usually containing purulent exudate. The epithelium lining them often undergoes metaplasia into a multi-layered flat. Exacerbation of inflammation in the wall of bronchiectasis contributes to the emergence of new foci of pneumonia, and then new fields of sclerosis of the lung tissue.

emphysema

Patho- and morphogenesis.

Emphysema of the lungs increases simultaneously with the progression of sclerosis and is characterized by an increase in the volume of the alveoli and the air contained in them. Enough for a long time it has a compensatory value, as it occurs around airless foci of inflammation, atelectasis, areas of sclerosis of the lung parenchyma. Over time, the lung tissue in the foci of emphysema loses its elastic properties, the interalveolar septa are torn or sclerosed, which increases the total amount of sclerotic changes in the lungs. Pneumosclerosis develops, which is accompanied by an increase in blood pressure in the pulmonary circulation. It determines the constant increase in the load on the right parts of the heart, as a result of which they hypertrophy and develop. cor pulmonale«.

BRONCHIOECTATIC DISEASE

Bronchiectasis is characterized by a combination of bronchiectasis, pneumosclerosis, hypertension of the pulmonary circulation and " cor pulmonale". It flows with frequent exacerbations of inflammation and, accordingly, an increase in the volume of sclerosis of the lung tissue. Gradually, sclerotic changes lead to lung deformation, and then they talk about pneumocirrhosis.

Complications.

In the dynamics of the development of chronic nonspecific lung diseases, various complications may appear:

• metaplasia of the epithelium of the bronchi and bronchiectasis (often gives rise to bronchial cancer);
• bleeding from the vessels of the wall of bronchiectasis;
• lung abscess;
• secondary amyloidosis, which develops against the background of a long-term purulent inflammation in the bronchi and lung parenchyma.

Exodus. The death of patients suffering from chronic nonspecific lung diseases with the development of pneumocirrhosis and "cor pulmonale" occurs from chronic pulmonary heart failure. Bleeding from blood vessels, bronchiectasis, amyloidosis can also lead to death. internal organs, lung cancer that developed against the background of chronic bronchitis or bronchiectasis.

LUNG CANCER

Statistical studies show that in recent decades, the incidence of lung cancer has been rapidly increasing worldwide. In addition to the factors that are generally associated with the development oncological diseases, for the occurrence of lung cancer, dusting of the lungs, especially with dust containing carcinogens, is of particular importance. Smoking plays an important role in the occurrence of lung cancer. It is noted that among patients with this disease 90% are smokers. As precancerous conditions should be called metaplasia of the epithelium of the bronchi in chronic bronchitis and bronchiectasis.

Forms of lung cancer

Depending on the source of tumor growth allocate bronchogenic and alveolar cancer.

Bronchogenic cancer- the most common form in which the tumor develops from the epithelium of the bronchi. The epithelium of the alveoli of the lungs can serve as a source of alveolar cancer.

Depending on the location of the tumor, (Fig. 61):

• hilar (central) cancer emanating from the stem, lobar and initial parts of the segmental bronchi;
• peripheral cancer coming from the smaller branches of the bronchus, bronchioles and alveolar epithelium;
• mixed (massive) cancer.

In relation to the lumen of the bronchus, the tumor can grow:

• exophytic (into the lumen of the bronchus),
• endophytic (into the thickness of the bronchial wall).

Depending on the morphological features allocate:

• keratinizing squamous cell carcinoma;
• squamous nonkeratinizing cancer;
• adenocarcinoma;
• undifferentiated cancer.

Radical (central) cancer occurs most frequently (observed in 65-70% of all cases of lung cancer). Occurs in the bronchial mucosa in the form of plaques or nodules. In the future, the tumor can grow exo- or endophytically, and the cancer acquires the character endobronchial, branched, nodular or nodular-branched.

Rice. 61. Schematic representation of forms of lung cancer, a, b, c - peripheral cancer; d, e, f - central cancer.

If it grows into the lumen of the bronchus, it soon clogs the bronchus and lung atelectasis occurs, often complicated by pneumonia or abscess. In the clinical picture in this case, symptoms of pneumonia appear. If the cancer grows endophytically, it grows into the mediastinum, pericardium, and pleura. Histologically, it is the most common squamous cell carcinoma without keratinization or with keratinization. IN last case in the tumor tissue appear "cancer pearls" - areas of atypical keratinization. Often this tumor may have the structure of adenocarcinoma or undifferentiated cancer.

peripheral cancer.

This form of cancer accounts for 25-30% of all lung cancers. The tumor comes from the small bronchi, often grows expansively and does not manifest itself clinically until those; until it compresses or sprouts the bronchus. In this case, lung atelectasis and symptoms of pneumonia appear. Often, peripheral cancer germinates and colonizes the pleura, serous-hemorrhagic pleurisy occurs and the exudate compresses the lung. Histologically, in most cases, peripheral cancer has the character of adenocarcinoma, less often - squamous or undifferentiated.

Mixed (massive) cancer occurs in 2-3% of all cases of lung cancer. It has the form of a massive soft knot, occupying a large part of a lung. Histologically, such cancer has a different structure.

Metastasizes lung cancer lymphogenously in the peribronchial and bifurcation The lymph nodes. Quite quickly, hematogenous metastases to the liver, brain, vertebrae and other bones, adrenal glands join.

Death patients comes from metastases, cachexia or pulmonary complications - pneumonia, abscess, gangrene of the lung, more precise bleeding.

Organ diseases

breathing

The human respiratory apparatus consists of the nose, pharynx, larynx, trachea, bronchi and lungs.

There are upper respiratory tract, which include the nose with its adnexal cavities, the pharynx, dividing into the upper section (nasopharynx), middle and lower sections, and the larynx. The trachea, bronchi, and lungs make up the lower respiratory tract.

Breathing is automatic and controlled by the respiratory center in the medulla oblongata. In an adult, the number of breaths per minute is 16-24; in children, breathing is more frequent /

The normal physiological function of breathing can be disturbed by various disease processes in the airways or in the lung tissue itself.

Runny nose(rhinitis) - inflammation of the nasal mucosa. There are acute and chronic rhinitis.

Coryza may occur as an independent disease or be one of the signs of some infectious and allergic diseases. Predisposing factors are hypothermia, sharp temperature fluctuations. In acute rhinitis, both nasal passages are usually affected. There is a general malaise, lack of appetite, difficulty in nasal breathing. The patient sneezes, feels dryness and burning in the nose, throat and nasopharynx, sometimes the temperature rises (up to 37.5º), a large amount of watery discharge forms in the nose. Acute rhinitis can be complicated by otitis media, bronchitis and even pneumonia.

Chronic runny nose occurs as a result of often recurring acute rhinitis, purulent inflammation of the accessory cavities of the nose, after infectious diseases. External causes include prolonged exposure to various dusts, gases, etc. Signs of chronic rhinitis are the same as those of acute, but are not so pronounced.

In order to prevent the occurrence of a runny nose, one should regularly harden the body, strictly control nutrition, and carry out vitamin and climatotherapy.

Pharyngitis. Acute inflammation of the nose often extends to the nasopharynx, causing irritation of the pharyngeal mucosa, a feeling of tickling, thick or thin mucus. The glandular apparatus of the pharynx increases in size, hypertrophies. The infectious onset, having penetrated into the folds of the glands, remains in them for a long time, thus maintaining the inflammatory state.

Having turned from a protective organ into a source of infection, the lymphatic glands of the nasopharynx can lead to the development of a chronic septic process.

Laryngitis- inflammation of the mucous membrane of the larynx. There are acute and chronic laryngitis. It is manifested by fever, general malaise, the appearance of hoarseness. Patients complain of tickling, perspiration, a feeling of congestion, dryness in the throat. Cough at first dry, and later accompanied by expectoration of sputum. The sensitivity of the larynx is sharply expressed, however pain are almost absent. There is usually no difficulty in breathing.

Most often, the disease occurs with acute infections of the upper respiratory tract, influenza, measles, scarlet fever, whooping cough, etc.; its development is facilitated by general or local hypothermia, especially the inhalation of cold air through the mouth. In some cases, the disease can be complicated by bronchitis, pneumonia. In children, due to the narrowness of the larynx, shortness of breath is very often observed.

The duration of the disease is from several days to several weeks. With poor treatment, acute laryngitis can become chronic. Medical treatment is carried out by a doctor. An important point is the observance of the voice mode (loud conversation, shouting is prohibited). Hot and spicy food is excluded. Plentiful warm drink, mustard plasters, cans on the chest and back are recommended. With frequently recurring laryngitis, warm rubdowns are shown at night, cool in the morning in order to strengthen the body.

Tracheitis. Acute inflammation of the tracheal mucosa most often occurs after a cold (cooling), after inhalation of dust or irritating gases and vapors, such as sulphurous, nitric acid. These thermal, mechanical and chemical stimuli reduce the resistance of the respiratory mucosa. Microbes commonly found in the respiratory tract (pneumococci, micrococci, less often streptococci, etc.) cause and maintain inflammation.

Inflammatory swelling of the mucous membrane of the trachea irritates the sensory nerves of the mucous membrane, and from the first day of the disease there is a cough. At first it is dry, often paroxysmal, then a little viscous vitreous mucus is separated with a cough, and after a few days the cough becomes softer and mucopurulent sputum is easily excreted in large quantities. With tracheitis, the patient feels scratching, burning, soreness behind the sternum, aggravated by coughing.

Due to a strong cough, chest pains may occur from overexertion of the muscles of the chest. At the beginning of the disease, general weakness, weakness, and a decrease in appetite are observed. The temperature is normal or increased to 38º in the first days.

The patient should be protected from the effects of cold, smoke and other adverse factors. Diaphoretic treatment works well: at night, a warmly sheltered patient is given three to four glasses of hot tea or raspberry infusion, lime blossom. Warm compresses, dry cups relieve pain and cough; mustard plasters on the sternum reduce the feeling of soreness with tracheitis.

Bronchitis- an inflammatory disease of the bronchi caused by viruses and microbes. Adenoids, foci of infection in the form of sinusitis, chronic tonsillitis increase the risk of the disease. The factor predisposing to the development of the disease is hypothermia, so the peak incidence of bronchitis occurs in the cold season. In most cases, bronchitis manifests itself as an acute respiratory viral infection and is the result of the spread of the inflammatory process from the pharynx, nasopharynx to the bronchi. The main symptom of bronchitis is a cough, which at first is dry, obsessive. With frequent, persistent coughing, pain behind the sternum, in the chest, is possible. After four or five days, the cough becomes more rare, soft, wet, and sputum appears. With the appearance of sputum, the patient's well-being improves: excruciating attacks of coughing and chest pain disappear.

Bronchitis may be accompanied by more pronounced inflammation of the bronchial mucosa, its swelling, the release of a large amount of mucus, leading to narrowing of the bronchi, their spasm and blockage. In this case, not only large and medium, but also small bronchi are affected. The patient's well-being is significantly disturbed, there is a frequent wet cough, difficulty in exhaling, shortness of breath at rest. Breathing in this case becomes whistling, audible at a distance.

Chronical bronchitis. Chronic inflammation of the bronchial mucosa can develop after repeated acute bronchitis, with chronic catarrh of the nose and throat, with prolonged inhalation of dust (for example, in masons, millers), with chronic diseases of the lungs and heart.

The most persistent symptoms of bronchitis are coughing, sputum production and wheezing heard in the lungs. Chronic bronchitis develops gradually and exacerbates during the cold season. Initially, the cough occurs only in the morning, with coughing a small amount of viscous sputum. Over time, the cough intensifies, often becomes paroxysmal, worries the patient not only during the day, but also at night. The amount of sputum gradually increases; at first it is mucous, then it acquires a mucopurulent character.

Chronic bronchitis, continuing for many years, eventually causes significant changes in the lungs and in the general condition of the patient. The inflammatory process affects not only the mucous membrane, but also extends to the entire wall of the bronchus and the lung tissue surrounding it. The walls of the bronchi, due to the development of connective tissue in them, become more pliable. Under the influence of frequent cough shocks, as well as wrinkling of the connective tissue around the bronchi, in some places a protrusion of the bronchial wall and their expansion (bronchiectasia) is formed. At the same time, the elasticity of the lung tissue decreases, and lung expansion develops. Prolonged cough and expansion of the lungs create difficulties for blood flow in the pulmonary circulation; the work of the right ventricle of the heart increases, and over time, its fatigue and weakening occurs.

In order to reduce the phenomena of bronchitis and stop the progression of the disease, it is necessary to eliminate the harmful factors that contribute to the development of bronchitis (smoking, dust, cooling), and to treat the disease that causes or maintains bronchitis (upper respiratory tract inflammation, bronchial asthma, cardiac decompensation).

The condition of patients is improved by a long stay in the warm season in the fresh air. A good result is given by climatic treatment in the south, on the Black Sea coast. With bronchitis with abundant sputum, a warm, dry or mountain climate is indicated.

Bronchial asthma. Bronchial asthma is a chronic disease manifested by attacks of suffocation. Suffocation is caused by a sudden narrowing of the lumen of the small bronchi due to contraction of their muscles and swelling of the mucous membrane. Bronchial asthma usually begins at a young age. The development of asthma is sometimes preceded by chronic bronchitis, pneumonia, influenza, neuropsychic shocks. In many patients with asthma, an attack occurs when you smell a certain smell, inhale some kind of dust (hay, feathers, wool, etc.); some have attacks only at home, while others may disappear with a move to another area. Bronchial asthma refers to allergic diseases. An allergic condition is characterized by an increased sensitivity of the body to any substance or microbe, the introduction of which into the body, even in negligible amounts (for example, by inhalation), causes an excessively strong reaction. In bronchial asthma, inhalation of substances to which the patient is sensitive causes a sharp reaction from the nervous system; irritation of nuclei vagus nerve and its pulmonary branches causes spasm of the muscles of the small bronchi and an asthma attack.

During an attack, the patient must be calmed, freed from clothing that constrains his chest, and the room is ventilated. Treatment of patients with bronchial asthma outside of an attack is reduced to the elimination of factors that cause an attack, and to reduce the hypersensitivity and excitability of the body. Useful stay of patients in the open air. Climatic treatment is carried out on the seashore or in the mountains, provided there is a complete absence of dust, including flower dust.

Emphysema is a disease caused by loss of elasticity of the lung tissue. The lung with emphysema is constantly in a state of inhalation, since the elastic fibers in the lungs have lost the ability to contract. The emphysematous lung has a larger than normal volume. The diseases that cause emphysema are primarily bronchitis and peribronchitis. Whooping cough, bronchial asthma, tuberculosis and a number of other diseases accompanied by coughing, as well as toxic effects on the lung tissue itself, on its elastic elements, can lead to the development of emphysema. The main symptom of emphysema is shortness of breath. The latter appears during physical exertion and reaches a high degree due to the fact that the lungs are not able to cover the demands for oxygen made by the body. The course of emphysema is chronic. Emphysema can develop early in life, but it usually occurs in middle age and especially in old age. Emphysema occurs, as a rule, in old age. Patients under normal conditions can live long and even work with relatively large emphysema. Patients with emphysema eventually develop heart failure. Chronic emphysema is an incurable disease due to significant and irreversible anatomical changes in the lung tissue and chest.

Pneumonia- an infectious disease of the lungs. It is caused by various microbes: pneumococci, staphylococci and other bacteria and viruses. Inflammation of the lungs develops not only when microbes enter the oral cavity and upper respiratory tract from the surrounding air: when hypothermia, microbes that are constantly in the oral cavity and on the mucous membrane of the upper respiratory tract become pathogenic and can also cause illness. Pneumonia is not only a local lesion of the respiratory system, but also a general disease of the whole organism.

The initial manifestations of the disease coincide with the signs of an acute respiratory disease - a runny nose, cough, headache, and lethargy appear. Body temperature may remain normal, but more often at the onset of the disease it rises to 37.5-37.8º, and even more in the future. It may fluctuate during the day with a decrease in the morning and an increase in the evening. Sometimes the onset of pneumonia is sudden, acute, accompanied by a rise in body temperature from the first hours of illness. The patient's appetite decreases, thirst appears, loose stools, vomiting are possible. A characteristic sign of pneumonia is shortness of breath, the respiratory rate increases to 70-80 per minute. When breathing, the wings of the nose swell, the muscles of the chest tense.

Frequent diseases of acute respiratory viral infections, bronchitis, prolonged pneumonia create conditions for the development of chronic inflammation of the lungs, which proceeds in waves, with periodically occurring exacerbations. One of the constant signs of chronic pneumonia may be cough and sputum (mucopurulent, profuse). The patient coughs, the cough may disturb him at night in bed or in the morning, in some patients it is persistent and prolonged. There may be short rises in temperature. The latent course of exacerbations, the indistinctness of signs contribute to the fact that sometimes the patient's condition is incorrectly assessed, they are not considered sick. With delayed treatment, chronic pneumonia can lead to disability. Proper treatment and care can only be provided in a hospital setting. The systematic hardening of the body is important for the prevention of the disease. In the prevention of illness in children, the fight against SARS plays an important role; special attention is required for children with adenoids, chronic tonsillitis, inflammation of the paranasal sinuses, often suffering from bronchitis.

Literature

Vasilenko V.Kh. Internal illnesses. M., 1996.

Smoleva E.V. Nursing in therapy with a course in primary care. Rostov-on-Don, 2006.

Big medical encyclopedia. M., 1989.

Reference book of the physician-therapist. M., 1993.

The respiratory system is one of the most important "mechanisms" of our body. It not only fills the body with oxygen, participating in the process of respiration and gas exchange, but also performs a number of functions: thermoregulation, voice formation, smell, air humidification, hormone synthesis, protection from environmental factors, etc.

At the same time, the organs respiratory system perhaps most often encountered various diseases. Every year we endure acute respiratory viral infections, acute respiratory infections and laryngitis, and sometimes we struggle with more serious bronchitis, tonsillitis and sinusitis.

We will talk about the features of diseases of the respiratory system, the causes of their occurrence and types in today's article.

Why do diseases of the respiratory system occur?

Diseases of the respiratory system are divided into four types:

• infectious- they are caused by viruses, bacteria, fungi that enter the body and cause inflammatory diseases of the respiratory system. For example, bronchitis, pneumonia, tonsillitis, etc.
• allergic- appear due to pollen, food and household particles, which provoke a violent reaction of the body to some allergens, and contribute to the development of respiratory diseases. For example, bronchial asthma.
• Autoimmune diseases of the respiratory system occur when the body fails, and it begins to produce substances directed against own cells. An example of such an impact is idiopathic hemosiderosis of the lungs.
• hereditary- a person is predisposed to the development of certain diseases at the gene level.

Contribute to the development of diseases of the respiratory system and external factors. They do not directly cause the disease, but they can provoke its development. For example, in a poorly ventilated room, the risk of getting ARVI, bronchitis or tonsillitis increases.

Often, this is why office workers get sick with viral diseases more often than others. If air conditioning is used in offices in the summer instead of normal ventilation, then the risk of infectious and inflammatory diseases also increases.

Another mandatory office attribute - a printer - provokes the occurrence of allergic diseases of the respiratory system.

The main symptoms of diseases of the respiratory system

You can identify a disease of the respiratory system by the following symptoms:

• cough;
• pain;
• dyspnea;
• suffocation;
• hemoptysis

Cough is a reflex protective reaction of the body to the mucus accumulated in the larynx, trachea or bronchi. By its nature, cough is different: dry (with laryngitis or dry pleurisy) or wet (with chronic bronchitis, pneumonia, tuberculosis), as well as constant (with inflammation of the larynx) and periodic (with infectious diseases - SARS, influenza).

Coughing may cause pain. Pain also accompanies those suffering from diseases of the respiratory system when breathing or a certain position of the body. It may vary in intensity, localization and duration.

Shortness of breath is also divided into several types: subjective, objective and mixed. Subjective appears in patients with neurosis and hysteria, objective occurs with emphysema and is characterized by a change in the rhythm of breathing and the duration of inhalation and exhalation.

Mixed shortness of breath occurs with pneumonia, bronchogenic lung cancer, tuberculosis and is characterized by an increase in respiratory rate. Also, shortness of breath can be inspiratory with difficulty in inhaling (diseases of the larynx, trachea), expiratory with difficulty exhaling (with bronchial damage) and mixed (pulmonary embolism).

Choking is the most severe form of shortness of breath. Sudden seizures choking can be a sign of bronchial or cardiac asthma. With another symptom of diseases of the respiratory system - hemoptysis - when coughing, blood is released with sputum.

Allocations can appear with lung cancer, tuberculosis, lung abscess, as well as with diseases of cardio-vascular system(heart defects).

Types of diseases of the respiratory system

In medicine, there are more than twenty types of diseases of the respiratory system: some of them are extremely rare, while others we encounter quite often, especially during cold seasons.

Doctors divide them into two types: diseases of the upper respiratory tract and diseases of the lower respiratory tract. Conventionally, the first of them are considered easier. These are mainly inflammatory diseases: ARVI, acute respiratory infections, pharyngitis, laryngitis, rhinitis, sinusitis, tracheitis, tonsillitis, sinusitis, etc.

Diseases of the lower respiratory tract are considered more serious, as they often occur with complications. These are, for example, bronchitis, bronchial asthma, pneumonia, chronic obstructive pulmonary disease (COPD), tuberculosis, sarcoidosis, pulmonary emphysema, etc.

Let us dwell on the diseases of the first and second groups, which are more common than others.

Angina

Angina, or acute tonsillitis, is an infectious disease that affects the palatine tonsils. The bacteria that cause sore throats are especially active in cold and damp weather, so most often we get sick in autumn, winter and early spring.

You can get a sore throat by airborne or alimentary routes (for example, when using one dish). Particularly susceptible to angina are people with chronic tonsillitis - inflammation of the palatine tonsils and caries.

There are two types of angina: viral and bacterial. Bacterial - a more severe form, it is accompanied by severe sore throat, enlarged tonsils and lymph nodes, fever up to 39-40 degrees.

The main symptom of this type of angina is a purulent plaque on the tonsils. The disease is treated in this form with antibiotics and antipyretics.

Viral angina is easier. The temperature rises to 37-39 degrees, there is no plaque on the tonsils, but cough and runny nose appear.

If you start treating viral sore throat in time, you will be on your feet in 5-7 days.

Symptoms of angina: Bacterial - malaise, pain when swallowing, fever, headache, white plaque on the tonsils, enlarged lymph nodes; viral - sore throat, temperature 37-39 degrees, runny nose, cough.

Bronchitis

Bronchitis is an infectious disease accompanied by diffuse (affecting the entire organ) changes in the bronchi. Bacteria, viruses, or the occurrence of atypical flora can cause bronchitis.

Bronchitis is of three types: acute, chronic and obstructive. The first is cured in less than three weeks. A chronic diagnosis is made if the disease manifests itself for more than three months a year for two years.

If bronchitis is accompanied by shortness of breath, then it is called obstructive. With this type of bronchitis, a spasm occurs, due to which mucus accumulates in the bronchi. the main objective treatment - relieve spasm and remove accumulated sputum.

Symptoms: the main one is cough, shortness of breath with obstructive bronchitis.

Bronchial asthma

Bronchial asthma is a chronic allergic disease in which the walls of the airways expand and the lumen narrows. Because of this, a lot of mucus appears in the bronchi and it becomes difficult for the patient to breathe.

Bronchial asthma is one of the most common diseases and the number of people suffering from this pathology is increasing every year. In acute forms of bronchial asthma, life-threatening attacks may occur.

Symptoms of bronchial asthma: cough, wheezing, shortness of breath, suffocation.

Pneumonia

Pneumonia is an acute infectious and inflammatory disease that affects the lungs. The inflammatory process affects the alveoli - the end part of the respiratory apparatus, and they are filled with fluid.

The causative agents of pneumonia are viruses, bacteria, fungi and protozoa. Pneumonia is usually severe, especially in children, the elderly, and those who already had other infectious diseases before the onset of pneumonia.

If symptoms appear, it is best to consult a doctor.

Symptoms of pneumonia: fever, weakness, cough, shortness of breath, chest pain.

Sinusitis

Sinusitis is an acute or chronic inflammation of the paranasal sinuses, there are four types:

• sinusitis - inflammation of the maxillary sinus;
• frontal sinusitis - inflammation of the frontal paranasal sinus;
• ethmoiditis - inflammation of the cells of the ethmoid bone;
• sphenoiditis - inflammation of the sphenoid sinus;

Inflammation in sinusitis can be unilateral or bilateral, with damage to all the paranasal sinuses on one or both sides. The most common type of sinusitis is sinusitis.

Acute sinusitis can occur with acute rhinitis, influenza, measles, scarlet fever and other infectious diseases. Diseases of the roots of the four rear upper teeth can also provoke the appearance of sinusitis.

Sinusitis symptoms: fever, nasal congestion, mucous or purulent discharge, deterioration or loss of smell, swelling, pain when pressing on the affected area.

Tuberculosis

Tuberculosis is an infectious disease that most often affects the lungs, and in individual cases genitourinary system, skin, eyes and peripheral (visible) lymph nodes.

Tuberculosis comes in two forms: open and closed. With an open form of mycobacterium tuberculosis, there is in the patient's sputum. This makes it contagious to others. With a closed form, there are no mycobacteria in the sputum, so the carrier cannot harm others.

The causative agents of tuberculosis are mycobacteria, transmitted by airborne droplets when coughing and sneezing or talking with the patient.

But you don't necessarily get infected through contact. The likelihood of infection depends on the duration and intensity of contact, as well as the activity of your immune system.

Symptoms of tuberculosis: cough, hemoptysis, fever, sweating, deterioration in performance, weakness, weight loss.

Chronic obstructive pulmonary disease (COPD)

Chronic obstructive pulmonary disease is a non-allergic inflammation of the bronchi that causes them to narrow. Obstruction, or more simply, deterioration of patency, affects the normal gas exchange of the body.

COPD occurs as a result of an inflammatory reaction that develops after interaction with aggressive substances (aerosols, particles, gases). The consequences of the disease are irreversible or only partially reversible.

Symptoms of COPD: cough, sputum, shortness of breath.

The diseases listed above are just a few. big list diseases affecting the respiratory system. We will talk about the diseases themselves, and most importantly their prevention and treatment, in the following articles of our blog.

For updates, we will send interesting materials about health directly to your mail.

When writing this article, materials from the books were used: "Guide to Pulmonology" edited by N.V. Putova, G.B. Fedoseev. 1984; "Guidelines for Clinical Pulmonology" G.V. Trubnikov. 2001; as well as materials from articles posted on the Internet, in particular, from Wikipedia, from the article "Infections of the upper respiratory tract" on the Yod.ru website; from the article "Diseases of the upper respiratory tract" on the site Nedug.ru; from the article "Diseases of the respiratory system" on the site medside.ru; from the article "Tuberculosis of the respiratory organs" on the site nozdorovie.ru; from articles in the Home Doctor reference book on the SuperCook.ru website; from Professor Park Jae Woo's book "Your Own Su Jok Doctor" and other articles posted on the Internet, as well as my personal medical experience.
Respiratory diseases (DOD) - the most common pathology that people face and come to see a doctor. There are many diseases of the respiratory system, but all of them, to one degree or another, disrupt the respiratory function of a person and reduce the quality of his life. Each disease has its own symptoms and its specific approach to treatment. This article is for those who want to understand these issues and understand them correctly. This article describes the AODs that are most common in our lives.

nasal cavity is divided into two halves by a cartilaginous septum. On her inner surface there are three winding passages through which air passes into the nasopharynx. The glands of the mucous membrane of the nasal cavity secrete mucus, which moisturizes the inhaled air. In the nose, the air is warmed in the cold season. Dust particles and microbes in the inhaled air linger on the moist mucous membrane and are neutralized by mucus and leukocytes.

The mucous membrane of the respiratory tract is lined with ciliated epithelium, which has cilia that can contract. Reduction of the cilia removes mucus and dust particles and microbes adhering to it from the nasal cavity to the outside. This does not happen when air enters the body through the mouth. You need to breathe through your nose. Through nasopharynx air enters the throat.

Larynx has the appearance of a funnel and is formed by cartilage. The entrance to the larynx during swallowing food is closed by the epiglottis, the thyroid cartilage. Through the larynx, air from the pharynx enters the trachea.

Trachea or windpipe- This is a tube about 10 cm long and 15 - 18 mm in diameter, formed by cartilaginous half rings. The posterior wall of the trachea is membranous, adjacent to the esophagus.

The trachea divides into 2 bronchi. They enter the left and right lungs. In them, the bronchi branch out, forming a bronchial tree.

On the terminal bronchial branches are the smallest pulmonary vesicles - alveoli, with a diameter of 0.15 - 0.25 mm and a depth of 0.06 - 0.3 mm, filled with air. The walls of the alveoli are lined with a single layer squamous epithelium, covered with a film of a substance - surfactan, preventing them from falling off. The alveoli are permeated with a dense network of capillaries. Gas exchange occurs through their walls.

The lungs are covered with a membrane - pulmonary pleura, which passes into the parietal pleura, which lines the inner wall of the chest cavity. The narrow space between the pulmonary and parietal pleura forms a gap filled with pleural fluid. The gap is called the pleural cavity. The pleural fluid facilitates the sliding of the pleura during respiratory movements.

The main causes of AOD:

2. External allergens: household allergens, domestic mites, pet allergens, yeast and mold spores, plant pollen, insect allergens.

3. Occupational factors, such as evaporation of steel during electric welding, nickel salts.

4. Some medications, such as antibiotics, sulfonamides.

5. Food allergens.

6. Polluted air, which may contain high concentrations of certain chemical compounds at work and at home.

7. Unfavorable climatic conditions that are poorly tolerated by individuals.

8. Active and passive smoking.

The provocative factors of ASD are:

1. Frequent use of alcohol, drug-containing substances.

2. Chronic human diseases, foci of chronic infection that weaken the immune system.

3. Burdened heredity, creating a predisposition to ZOD.
With ZOD, there are characteristic symptoms that may accompany these diseases.

ZOD symptoms.

Dyspnea. It is divided into subjective, objective and mixed.

Subjective shortness of breath- a subjective feeling of labored breathing, occurs during bouts of hysteria, neurosis and chest sciatica.

Objective dyspnea- characterized by a change in the frequency, depth or rhythm of breathing, as well as the duration of inhalation and exhalation.

With ZOD, dyspnea is usually mixed, that is, there are subjective and objective components. The frequency of respiration increases more often. This is observed in pneumonia, bronchogenic lung cancer, pulmonary tuberculosis. Shortness of breath can be both with a normal respiratory rate and with its decrease.

According to the difficulty of one or another phase of breathing, shortness of breath happens: - inspiratory when breathing is difficult, more often with diseases of the trachea and larynx;

-expiratory when exhalation is difficult, with bronchial diseases; - mixed, it is difficult to inhale and exhale with pulmonary embolism.

A severe form of shortness of breath is suffocation that occurs with pulmonary edema, with cardiac and bronchial asthma.

In bronchial asthma, an asthma attack occurs as a result of a spasm of the small bronchi and is accompanied by a difficult long and noisy exhalation.

With cardiac asthma, suffocation occurs due to a weakening of the left side of the heart, often turning into pulmonary edema and is manifested by a sharp difficulty in breathing.

Shortness of breath can be:

- physiological that occurs with increased physical activity;

- pathological, with diseases of the respiratory system, cardiovascular and hematopoietic systems, with poisoning by certain poisons.

Cough- a complex reflex act that occurs as a protective reaction when mucus accumulates in the larynx, trachea and bronchi or when a foreign body enters them.

Dust particles and mucus exhaled with air in a small amount are removed from the lumen of the bronchi by the ciliated epithelium. However, with inflammation of the bronchial mucosa, the secret irritates the nerve endings and causes a cough reflex. The most sensitive reflexogenic zones are located in the places of branching of the bronchi, in the area of ​​the bifurcation of the trachea and in the area of ​​the larynx. But a cough can also be caused by irritation of the reflexogenic zones of the nasal mucosa, pharynx and pleura.

The cough can be dry, without sputum production, or wet, with sputum production.

Dry cough happens with laryngitis, dry pleurisy, compression of the main bronchi by bifurcation lymph nodes (lymphogranulomatosis, tuberculosis, cancer metastases). Bronchitis, pulmonary tuberculosis, pneumosclerosis, lung abscess, bronchogenic lung cancer give at first dry cough, then wet with sputum.

Moist cough with sputum is characteristic of chronic bronchitis, pneumonia, tuberculosis, oncological diseases of the respiratory system.

In inflammatory diseases of the bronchi, larynx, bronchogenic lung cancer, some forms of tuberculosis, cough is usually permanent.
With influenza, SARS, pneumonia, coughing periodically worries.

With a strong and prolonged cough, for example, with whooping cough, in addition to coughing, vomiting may occur, since excitation from the cough center in the brain is transmitted to the vomiting center.

Loud, barking cough happens with whooping cough, compression of the trachea by a retrosternal goiter or tumor, damage to the larynx, hysteria.

Silent cough (cough) may be in the first stage of croupous pneumonia, with dry pleurisy, in initial stage pulmonary tuberculosis.

Hemoptysis- Excretion of blood with sputum during coughing.

Hemoptysis can be in diseases of the lungs and airways: bronchi, trachea, larynx, and in diseases of the cardiovascular system.

Hemoptysis occurs with pulmonary tuberculosis, lung cancer, viral pneumonia, abscess and gangrene of the lungs, bronchiectasis, actinomycosis, with viral tracheitis and laryngitis, with influenza.

Cardio - vascular diseases that can cause hemoptysis: heart defects (mitral valve stenosis) create stagnation of blood in the pulmonary circulation; thrombosis or embolism of the pulmonary artery and the subsequent development of pulmonary infarction.

Bleeding may be subtle, with streaks of blood or diffuse staining of sputum.

Bleeding can be pronounced: with tuberculous caverns of the lungs, bronchiectasis, decay of a lung tumor, pulmonary infarction. Such bleeding is accompanied by a strong cough.

Scarlet blood in sputum is found in pulmonary tuberculosis, bronchogenic cancer, bronchiectasis, lung actinomycosis, and pulmonary infarction.

With croupous pneumonia, the blood is "rusty" due to the breakdown of red blood cells.

pain associated with ZOD may have different localization. Pain in the chest wall is more often localized, aching or stabbing, intense and prolonged, may increase with deep breathing, coughing, lying on the affected side, with movements of the trunk. They may depend on damage skin (trauma, erysipelas, shingles), muscles (trauma, inflammation - myositis), intercostal nerves (thoracic sciatica), ribs and costal pleura (tumor metastases, fractures, periostitis).

In diseases of the respiratory system, chest pain may be associated with irritation of the pleura, especially the costal and diaphragmatic ones. There are sensory nerve endings in the pleura, but none in the lung tissue. Pain associated with the pleura occurs when it is inflamed (dry pleurisy), subpleural inflammation of the lungs (croupous pneumonia, lung abscess, tuberculosis), lung infarction, with tumor metastases in the pleura or the development of a primary tumor in the pleura, with trauma (spontaneous pneumothorax, injury, rib fracture) subphrenic abscess and acute pancreatitis.

Localization of pain depends on the location of the painful focus.

With dry pleurisy, the pain is one-sided and occurs in the left or right half of the chest. With inflammation of the diaphragmatic pleura, pain may be in the abdomen and may be similar to pain in acute cholecystitis, pancreatitis, appendicitis.

In diseases of the heart and blood vessels, the pain is localized in the region of the heart or behind the sternum, it can be pressing, squeezing.

In neuroses, the pain in the region of the heart is stabbing. The pain does not change its intensity with deep breathing, coughing, and is not associated with trunk movements.

With tumors in the mediastinum, constant, intense pain can be behind the sternum. Retrosternal pain can be with a hernia of the esophageal opening of the diaphragm, with a stomach ulcer, a tumor of the fundus of the stomach, cholelithiasis.

Dear readers, if you or the people around you have at least one of the above signs, you need to contact your local general practitioner to find out the reasons for their appearance.

Diagnosis of ZOD.

In the process of diagnosis, the doctor gets acquainted with the patient's complaints, examines and examines him using palpation, percussion (tapping), auscultation (listening)

When examining the respiratory system the doctor determines the respiratory rate. In an adult healthy person, the number of respiratory movements is 16 - 20 per 1 minute, in a newborn 40 - 45 per 1 minute. In a dream, breathing becomes less frequent 12 - 14 in 1 minute. During physical exertion, emotional arousal, after abundant intake food, the respiratory rate increases.

With percussion the doctor determines the decrease in the amount of air in the lungs with inflammation, edema or fibrosis. In patients with emphysema, the amount of air in the lungs increases. Percussion defines the boundaries of the lungs.

For diagnostic purposes, the doctor may prescribe instrumental, hardware, laboratory tests. The most informative and mandatory are X-ray methods for examining the respiratory organs. X-rays, x-rays are used chest, tomography of the respiratory organs and fluorography.

Fluoroscopy and radiography determine the transparency of the lung fields, foci of compaction (infiltrates, pneumosclerosis, neoplasms), cavities in the lung tissue, foreign bodies of the trachea and bronchi, the presence of fluid or air in pleural cavity, adhesions of the pleura.

Tomography- layered x-ray examination of the lungs to determine the exact localization of tumors, small inflammatory infiltrates, cavities.

Bronchography- X-ray examination of the bronchi by introducing a contrast agent into the lumen of the bronchi. This is how bronchiectasis, abscesses, cavities in the lungs, narrowing of the lumen of the bronchus by a tumor are detected.

Fluorography of the chest organs is very important informative method X-ray examination and allows you to identify respiratory diseases at various stages. Fluorography is carried out for the entire population once a year. Do not do fluorography for pregnant women and children under 15 years of age.

Endoscopic research methods - bronchoscopy and thoracoscopy.

Bronchoscopy- visual examination of the trachea and bronchi with the help of an optical device of a bronchofibroscope in order to identify purulent processes, tumors, foreign bodies and allows you to remove these foreign bodies from the bronchi.

Thoracoscopy- visual examination of the pleural cavity with a thoracoscope device, while bleeding, adhesions (unions) are detected, the device separates them.

Methods of functional diagnostics make it possible to identify respiratory failure before the appearance of its first symptoms, to establish the dynamics of its change during the development of the disease and under the influence of its treatment.

For this, they carry out spirography, which determines the volume of the lungs and the intensity of pulmonary ventilation.

Measurement of lung volumes.

Tidal volume- the volume of inhaled and exhaled air during normal breathing, normally 300 - 900 ml.

expiratory reserve volume- the volume of air that a person can exhale if, after a normal exhalation, makes a maximum exhalation, it is equal to 1500 - 2000 ml.

Inspiratory reserve volume- the volume of air that a person can inhale, if after a normal breath he takes a maximum breath, it is equal to 1500 - 2000 ml.

Vital capacity of the lungs- is the sum of the reserve inhalation and exhalation and is approximately 3700 ml.

Residual volume- the volume of air remaining in the lungs after maximum exhalation is 1000 - 1500 ml.

Total lung capacity- the sum of respiratory, reserve and residual volumes and is equal to 5000 - 6000 ml.

All these volumes are determined by spirography.

Studies of the intensity of pulmonary ventilation determine the volume of respiration (approximately 5000 ml), the maximum ventilation of the lungs (respiratory limit), the respiratory reserve (normally it is 15-20 times more than the minute volume of respiration). All these tests determine the capabilities of a person when performing a difficult task. physical work and in diseases of the respiratory system.

Ergospirography- a method that allows you to determine the amount of work that a person can do without the appearance of signs of respiratory failure.

Blood gas studies determine the presence and ratio of carbon dioxide and oxygen in the blood.

Sputum examination- allows you to establish the nature of the pathological process in the respiratory organs in the respiratory organs and determine its cause.

Examination of the pleural fluid- is carried out with inflammatory changes in the pleural cavity, with violations of blood and lymph circulation in the chest, with diseases of the lungs and mediastinum.

Upper respiratory tract: nasal cavity, paranasal sinuses, pharynx, larynx.

Lower respiratory tract: trachea, bronchi, bronchioles.

Diseases of the upper respiratory tract (URT diseases) usually infectious nature. These are viral, bacterial, fungal, protozoal infections. Most URT infections are viral.

People who are prone to allergic reactions allergic rhinitis. It develops under the influence of various allergens - plant pollen, mites, animal hair, house dust etc. There are acute and chronic forms of allergic rhinitis. In chronic rhinitis, the nutrition of the nasal mucosa is disturbed. It can give complications, sinusitis develops (sinusitis, frontal sinusitis).

Sinusitis- inflammation of the maxillary (maxillary) paranasal sinus. It develops under the influence of viruses, bacteria that enter the paranasal sinus through the blood or nasal cavity. Patients are concerned about discomfort and pain in and around the nose. The pain intensifies in the evening, often there is a headache. The pain may radiate to the eye on the side of the inflamed sinus.

Angina- an acute infectious disease in which the palatine tonsils become inflamed, but the lingual tonsil may also become inflamed. Regional submandibular and anterior cervical lymph nodes become inflamed, enlarged and become dense. The infectious agent multiplies on the tonsils and can spread to other organs, causing complications of the disease.

If the pathogens are streptococci, then immunity is impaired. The disease begins with a general feeling of weakness, chills, headache. There is pain when swallowing, aching joints. The body temperature rises to 39 degrees and above. Gradually, the pain in the throat intensifies. Submandibular lymph nodes increase, become painful. There is redness of the palatine arches, uvula, tonsils. These are the signs catarrhal angina.

Pus may be in the lacunae of the tonsils. This lacunar angina.

There is an unpleasant smell from the mouth ( halitosis) due to excretion of waste products pathogenic flora and products of the inflammatory process.

Patients develop a growing sore throat, difficulty swallowing. The body temperature rises to 39 - 40 degrees, chills are possible. There is weakness, headache. The lymph nodes are enlarged. From a mouth an unpleasant smell. There may be trismus - the inability to open the mouth, which makes it difficult to examine. In case of paratonsillar abscess emergency hospitalization to the hospital for its opening and drainage.

Laryngitis can be acute or chronic.

Chronic laryngitis is divided into chronic catarrhal and chronic hypertrophic.

Laryngotracheitis- a variant of the development of the disease, in which inflammation of the larynx is accompanied by inflammation initial department trachea.

In acute laryngitis, the mucous membrane is sharply reddened, edematous. There may be purple-red dots of hemorrhages on it, which occur with complicated influenza. The voice becomes hoarse, up to its complete loss. Perhaps difficulty in breathing due to narrowing of the edematous glottis. Patients complain of dryness, perspiration, scratching in the throat. There is a dry cough with sputum difficult to separate. Sometimes there is pain when swallowing, headache, slight fever. Cough may be accompanied by nausea and vomiting.

With a false croup, an attack of the disease occurs unexpectedly, at night during sleep. The child wakes up covered in sweat, restless, his breathing becomes noisy and labored, his lips turn blue, his cough is barking. After 20-30 minutes, the child calms down and falls asleep. Body temperature remains normal or rises slightly. Seizures may be repeated. When symptoms appear false croup The child must be urgently admitted to the hospital.

Chronic laryngitis develops as a result of repeatedly recurring acute laryngitis or prolonged inflammatory processes in the nose, paranasal sinuses and pharynx. Chronic laryngitis often develops in teachers as occupational disease. Contribute to the disease smoking, alcohol abuse, voice strain.

At chronic laryngitis patients complain of hoarseness, fatigue voices, sore throat, coughing, tightness. With an exacerbation of the inflammatory process, all these phenomena increase.

Treatment of diseases of the upper respiratory tract appointed by the doctor after examining the patient.

Those with upper respiratory tract infections are usually not hospitalized, treatment is prescribed at home. Treatment should be comprehensive, adequate. Etiotropic therapy is prescribed - drugs that eliminate the cause of the disease. In most cases, antibiotics are prescribed that are effective against a specific pathogen.

In diseases of the viral nature of ARVI, influenza, the appointment of antibiotics in the first days of the disease is not indicated. In these cases, antiviral drugs are prescribed - interferon-containing or interferon-stimulating drugs (anaferon, aflubin, oscillococcin, rimantadine, cycloferon, viferon - suppositories, genferon - suppositories, fluferon - nasal drops). These drugs are prescribed for acute rhinitis x, acute rhinosinusitis, acute nasopharyngitis in the first days of illness, they are immunomodulators.

If the symptoms of acute rhinitis, rhinosinusitis do not go away and continue for more than 7 days, antibiotics are prescribed. These include amoxicillin, azithromycin, lincomycin, amoxiclav, ciprofloxacin, clarithromycin, unidox solutab, cephalexin, azalide, ceftriaxone, etc. Antibiotics are prescribed only by a doctor.

In the absence of an effect from the treatment of acute rhinosinusitis for 3 days and with the progression of its symptoms (bursting headache in the nose and around it, the presence of purulent discharge from the nose and drainage of discharge along the back of the pharynx, an increase in body temperature to 37.5 - 38 degrees ) to the patient, after radiography of the paranasal sinuses, the otolaryngologist performs a puncture of the inflamed paranasal sinus (maxillary, frontal) to clear it of mucus and pus. If necessary, such a patient is hospitalized.

To improve nasal breathing, decongestants are prescribed vasoconstrictor drugs: oxymetazoline hydrochloride - nose drops, phenylpropanolamine hydrochloride, etc.

Diseases of the lower respiratory tract (LDP Diseases).

Tracheitis- inflammation of the mucous membrane of the trachea, can be acute and chronic. It develops under the influence of viral, bacterial and viral - bacterial infections. Inflammation can be under the influence of physical and chemical factors. The inflammatory process, as a rule, descends from the top down from the nasal cavity, pharynx, larynx into the trachea.

Patients develop edema of the mucous membrane of the trachea, dry paroxysmal cough appears, hoarse voice, labored breathing. Coughing fits can give headache. Cough appears more often in the morning and at night, body temperature rises slightly, malaise appears.

Incorrectly treated or untreated acute tracheitis can become chronic.

Bronchitis may be acute or chronic.

Acute bronchitis (BO)- acute inflammation of the bronchial mucosa. Caused by viruses, bacteria, can occur under the influence of physical (dry hot air in the metallurgical industry) and chemical factors (nitrogen oxides, sulfur dioxide, varnishes, paints, etc.). Smoking, cooling, alcohol abuse, chronic inflammatory diseases of the nasopharynx, chest deformities predispose to the disease.

With adequate treatment acute symptoms subside by 3-4 days and completely disappear by 7-10 days. Accession of bronchospasm leads to a protracted course and contributes to the development of chronic bronchitis. There were no significant changes in blood tests and X-ray examination of the lungs.

BO treatment. Bed rest, heavy drinking, non-steroidal anti-inflammatory drugs (aspirin, paracetamol, ibuprofen), vitamins C, E, A (antioxidants), adaptogens (tinctures of ginseng, magnolia vine, eleutherococcus, etc.) with a decrease in temperature - mustard plasters, jars on the chest. Expectorants are prescribed for dry unproductive cough– libexin, warmed inhalation mineral water, a solution of baking soda, eucalyptus oil.

It is possible to use the inhaler "Ingalipt". In severe bronchitis, the doctor may prescribe antibiotics, bronchodilators, antihistamines.

Bronchitis chronic (BC)- long-term, irreversible damage to all large, medium and small bronchi. Bronchitis is considered chronic if the cough continues for at least two years. three months in a year.

HD is associated with long-term irritation of the bronchial mucosa by various harmful factors(smoking, inhalation of dusty air polluted with smoke, oxides of carbon, sulfur, nitrogen and other harmful chemical compounds) and is provoked by an infection (viruses, fungi, bacteria). Pathology of the upper respiratory tract and hereditary predisposition play a negative role.

The onset of HD is gradual: cough in the morning with mucous sputum. Then the cough comes on at night and during the day, worse in damp and cold weather. Sputum during periods of exacerbation becomes muco-purulent or purulent. Shortness of breath appears. HD can be simple uncomplicated, purulent and purulent-obstructive. Hard breathing, dry rales are heard over the lungs. On x-ray examination, there may be no changes in the lungs, and further pneumosclerosis develops. In blood tests, during an exacerbation, the number of leukocytes increases. The diagnosis is confirmed by bronchoscopy and spirography.

BH treatment. During an exacerbation, the doctor prescribes antibiotics, expectorants, bronchodilators (broncholitin, alupent, asthmapent, eufillin, theophylline, etc.), sputum thinners (bromhexine, bisolvon), inhalation solutions baking soda, table salt, drinking plenty of water. It is possible to conduct therapeutic bronchoscopy. Effective breathing exercises, physiotherapy treatment. At home, you can use jars, mustard plasters, circular warming compresses.

Causes:

Various microorganisms - bacteria, viruses, mycoplasmas, fungi;

Chemical and physical factors - impact on the lungs of chemicals, thermal factors, radioactive radiation;

Allergic reactions in the lungs;

Manifestation systemic diseases- leukemia, collagenosis, vasculitis.

Pathogens penetrate into the lung tissue through the bronchi, through the blood or lymph.

The condition of such patients is severe. There is redness of the face, cyanosis. Herpetic eruptions often appear on the lips and nose. Breathing quickens, becomes shallow. The affected half of the chest lags behind the healthy one in the act of breathing. Increased or weakened breathing, crepitus (sound of alveoli disintegrating), pleural friction rub are heard. The pulse is quickened, blood pressure is reduced. In the blood - an increase in the number of leukocytes, an acceleration of ESR. On x-ray examination - darkening of the affected lobe of the lung or part of it.

A cough appears or intensifies, which may be dry or with mucopurulent sputum. The body temperature rises to 38 - 39 degrees. There may be pain in the chest when coughing and inhaling. Breathing can be enhanced vesicular and bronchial, medium and fine bubbling rales are heard. With confluent pneumonia, several small inflammatory foci merge into larger ones. The condition of patients deteriorates sharply, there is severe shortness of breath, cyanosis, and a lung abscess may develop.

X-ray examination revealed foci of inflammatory infiltration in the lung tissue. In blood tests, leukocytosis, accelerated ESR.

Treatment of pneumonia. Mild pneumonia can be treated at home, but most patients require hospitalization. In the midst of illness, bed rest. A diet with a sufficient amount of vitamins - antioxidants (A, E, C), drinking plenty of water. The attending physician prescribes antibiotics and other antibacterial drugs, conducts detoxification, immunostimulating treatment. In the future, as the condition improves, the phenomena of intoxication are eliminated, exercise therapy, physiotherapy, and reflexotherapy are prescribed.

Chronic pneumonia (PC)- recurrent inflammation of the same localization with damage to all structural elements of the lungs and the development of pneumosclerosis. PC is characterized by a periodic increase in body temperature, usually to subfebrile numbers, cough with mucopurulent sputum, sweating, dull pain in the chest on the affected side. Harsh breathing, moist small bubbling rales are heard. If chronic bronchitis and pulmonary emphysema join, shortness of breath appears.

During x-ray examination, foci of pneumonic infiltration in combination with fields of pneumosclerosis, inflammation and deformation of the bronchi, may be bronchiectasis. In blood tests during exacerbation of the disease - leukocytosis, shift of the leukocyte formula to the left, acceleration of ESR.

PC treatment in the period of exacerbation, it is carried out as in acute focal pneumonia. Out of the exacerbation phase, exercise therapy is indicated, sanatorium - resort treatment.

Causes: decrease in general and local immunity due to foreign bodies, mucus, vomit in the bronchi and lungs drunkenness, after a convulsive seizure, during unconscious state. Contributing factors: chronic diseases ( diabetes, blood diseases), violations of the drainage function of the bronchi, long-term use glucocorticoids, cytostatics, immunosuppressants.

It mainly occurs in middle-aged men who abuse alcohol. The onset of the disease is acute: chills, fever, chest pain. After a breakthrough of pus, a large amount of purulent sputum is released into the bronchus, sometimes with an admixture of blood and an unpleasant odor.

At first, weakened breathing is heard over the affected area, after the breakthrough of the abscess - bronchial breathing, moist rales. As a result of treatment, a favorable result may occur, after 1-3 months a thin-walled cyst or pneumosclerosis will form. With an unfavorable outcome, the abscess becomes chronic.

X-ray examination in the initial period reveals a massive darkening, after the breakthrough of the abscess - a cavity with a liquid level in it. Bronchoscopy reveals inflammation of the bronchial wall associated with the abscess. In the blood test - leukocytosis, shift of the leukocyte formula to the left, acceleration of ESR.

Treatment of acute lung abscess. Improvement of the drainage function of the bronchi (bronchodilators, expectorants, inhalations, repeated therapeutic bronchoscopy). When the abscess is located in the lower lobes - drainage by position, the foot end of the bed is raised by 20 - 30 cm. Antibiotics in large doses, immunity stimulation - high-calorie nutrition, proteins, vitamins, levomisole, T - activin, antistaphylococcal plasma, gamma - globulin, hemosorption, plasmapheresis. With inefficiency conservative treatment after 2 - 3 months - surgical treatment.

chronic lung abscess- a long-term suppurative process of the lung, which is an unfavorable outcome of an acute lung abscess. It proceeds with exacerbations and remissions.

During periods of remission - cough with a small amount of sputum, there may be hemoptysis, a slight increase in body temperature, sweating, shortness of breath during exercise.

During periods of exacerbations (cooling, viral infection), body temperature rises, the amount of sputum discharge increases, harsh or bronchial breathing, wet rales over the abscess zone.

On x-ray examination - a cavity in the lungs with a level of fluid in it, surrounded by a zone of inflammation. During bronchoscopy, pus is released from the draining bronchus. In the blood - a decrease in hemoglobin, leukocytosis during an exacerbation, a shift in the leukocyte formula to the left, an acceleration of ESR.

Treatment of chronic lung abscess- conservative: antibiotics, therapeutic bronchoscopy, stopping the exacerbation. Surgery- excision of the affected area of ​​the lung.

Non-specific allergens provoke bronchospasm:

- flower pollen field herbs, trees;

House dust, pet hair;

Food allergens (eggs, fish, citrus fruits, milk);

Medications (some antibiotics, sulfonamides, etc.);

Mechanical and chemical substances (metal, wood, silicate, cotton dust, vapors of acids, alkalis, fumes);

Physical and meteorological factors (changes in temperature, air humidity, fluctuations in barometric pressure, the Earth's magnetic field);

Allergens of ticks, insects, animals;

Nervous-psychic influences.

The basis of the disease is hereditary, congenital or acquired defects in the sensitivity of the bronchi.

There are 2 forms of bronchial asthma: infectious-allergic and atopic with attacks of suffocation of varying intensity.

May develop status asthmaticus, when there is resistance to bronchodilator therapy, cough does not bring relief, sputum does not separate. The status can occur with severe allergies, with an overdose of sympathomimetic drugs (Berotek, Asthmopent, Alupent, etc.), with a sharp withdrawal of glucocorticoids. In the absence of adequate intensive care status can be fatal.

Diagnosis of BA is based on typical asthma attacks with difficult expiration, an increase in the number of eosinophilic leukocytes in the blood and sputum, and allergic tests.

BA treatment. In atopic asthma, elimination of contact with the allergen. If the allergen is known and associated with household items (carpets, flowers), pets (wool allergy), occupational factors, food, then avoiding contact with the allergen can completely eliminate asthma attacks. If you are allergic to plant pollen, specific substances contained in the air, a change of residence will help achieve a positive result.

For desensitization (decrease in sensitivity to allergens), without exacerbation, treatment is carried out with bronchodilators (eufillin, theofedrin), expectorants (thermopsis, mukaltin, ledum, coltsfoot), antihistamines, intal, zaditen, aerosols for inhalation (berotek, berodual, asthmapent, salbutamol, etc.).

With an exacerbation of the inflammatory process, the doctor prescribes antibiotics. In severe cases, glucocorticoid hormones, plasmapheresis, hemosorption are prescribed - methods of "gravitational surgery" that cleanse the blood of antigen-antibody immune complexes that cause asthma attacks. Physiotherapy is widely used different kinds reflexology. Recommended sanatorium - resort treatment.

Bronchiectasis disease (BED) - an acquired disease characterized by a chronic suppurative process of irreversibly altered (dilated, deformed) bronchi, mainly in lower sections lungs.

They get sick mainly in childhood and young age, more often men. Exacerbations of BEB are more common in spring and autumn.

A cough appears with purulent sputum, which is discharged after a night's sleep, and in a "drainage position", in which sputum flows better from the affected bronchi. There may be hemoptysis and pulmonary bleeding. Shortness of breath on exertion, cyanosis. Various moist rales are heard, which decrease after coughing.

BEB treatment. Conservative: antibiotics, bronchodilators, sputum thinners, exercise therapy, chest massage. Physiotherapy is prescribed in the absence of elevated body temperature and hemoptysis. With limited lesions of the lobe and segment of the lung, surgical intervention is performed.

Causes of IL: surgical interventions, postpartum period, heart failure, fractures of long bones, malignant tumors, prolonged bed rest.

The closure of the lumen of the vessel by a thrombus leads to an increase in pressure in the pulmonary artery system and contributes to hemorrhage into the lung tissue. Attachment of a microbial infection causes inflammation of this area (pneumonia).

Manifestations of IL depend on the caliber and number of blood vessels closed by a thrombus. Massive thromboembolism can be fatal.

Thrombus in the pulmonary artery

The most common signs of IL are: sudden onset or suddenly increased shortness of breath, chest pain, pale gray skin tone, cyanosis, rhythm disturbances (tachycardia, atrial fibrillation, extrasystole), lowering blood pressure, fever, cough with mucous or bloody sputum, hemoptysis. A pleural friction rub, fine bubbling rales may be heard.

X-ray examination is determined by the expansion of the root of the lung, the triangular shadow of infarct pneumonia, signs of pleurisy. For diagnosis, angiopulmonography, lung scintigraphy is used.

IL treatment. Urgent hospitalization. Fibrinolytic agents: streptokinase, streptodecase, fibrinolysin, heparin, reopoliglyukin, eufillin, antibiotics. After elimination of life-threatening symptoms, treatment is carried out according to the treatment regimen for pneumonia.

The basis is an increase in pressure in the pulmonary circulation. There are acute (within a few hours, days), subacute (within a few weeks, months), chronic (over many years) development of cor pulmonale.

They lead to it:

Diseases affecting the lung tissue (chronic obstructive bronchitis, pulmonary emphysema, pneumosclerosis, pulmonary infarction, extensive pneumonia);

Changes in the musculoskeletal system that provides ventilation of the lungs ( severe forms curvature of the spine);

Primary lesions of the pulmonary vessels.

In acute and subacute cor pulmonale, the symptoms are characteristic of infarct pneumonia. Signs of insufficiency of the right parts of the heart are growing, the neck veins swell, the liver is enlarged.

In chronic pulmonary heart - shortness of breath, cyanosis, an increase in the number of erythrocytes, hemoglobin in the blood, a slowdown in ESR.

For diagnosis, changes in the electrocardiogram of the right heart, X-ray data characteristic of pulmonary infarction, are important.

LS treatment. Treatment of acute and subacute LS is the treatment of pulmonary embolism. Treatment of chronic LS includes cardiac, diuretics, heparin, hirudin, leeches, bloodletting, oxygen therapy, limitation of physical activity.

Pleurisy - inflammation of the pleura, a membrane lining the chest cavity from the inside and covering the lungs. In this case, a fibrinous plaque is formed on the surface of the pleura or an effusion (liquid) in its cavity. Pleurisy is always secondary. This is a complication or manifestation of many diseases.

The causative agents of pleurisy can be Mycobacterium tuberculosis, pneumococci, staphylococci and other bacteria, viruses and fungi. They penetrate the pleura through the blood, lymph, with injuries of the chest, fractures of the ribs. Pleurisy can be caused by rheumatism, systemic lupus erythematosus, neoplasms, thrombosis, and pulmonary embolism.

Pleurisy is dry (fibrinous) and exudative (effusion).

With dry pleurisy- the main symptom is pain in the side, aggravated by inhalation, coughing, decreases in the position on the affected side. Breathing is rapid, superficial, a pleural friction rub is auscultated (reminiscent of the creaking of snow). With dry diaphragmatic pleurisy, there may be pain in the abdomen, as with cholecystitis or appendicitis. Sometimes there is painful hiccups, pain when swallowing. There are no changes in X-ray examination, and in blood tests they are minimal.

An x-ray examination reveals an effusion in the pleural cavity. The study of the pleural fluid obtained during the puncture allows you to determine the cause of pleurisy.

Pleurisy treatment. Bed rest. Appointment of antibiotics, anti-inflammatory, desensitizing, analgesic drugs.

At effusion pleurisy a puncture is performed to remove fluid from the pleural cavity, while it is possible to introduce medicines- antibiotics, antiseptics, anticancer drugs, glucocorticoids. During the recovery period - physiotherapy, exercise therapy.

Symptoms. Cough with bloody sputum, chest pain. In an advanced stage, repeated pneumonia and bronchitis. Early forms are oligosymptomatic, they are detected during an x-ray examination, therefore it is necessary to undergo an annual fluorographic examination, especially for people over 40 years of age and smokers. Lung cancer can be central, growing from the bronchus, and peripheral, from the lung tissue itself. Lung cancer metastasizes to the lymph nodes of the root of the lung, in the later stages - to the liver, supraclavicular lymph nodes, brain and other organs.

Diagnosis is based on X-ray examination (X-ray, lung tomography), bronchoscopy with tumor biopsy.

Lung Cancer Treatment chemotherapy, radiation, surgery.

Emphysema (EP)- damage to the lung tissue, accompanied by a change in the wall of the alveoli and expansion of the alveoli of the lungs.

EL is primary, developing without previous lung disease, and secondary, against the background of obstructive bronchitis.

Predispose to the development of EL: disorders of the microcirculation of the vessels of the lungs, congenital deficiency of the enzyme alpha-1 trypsin, gaseous substances (cadmium compounds, nitrogen oxides, etc.), tobacco smoke, dust particles in the inhaled air. There is an increase in pressure in the lungs, the stretching of the alveoli increases.

EL is characterized by shortness of breath, barrel-shaped chest, low mobility of the chest during inspiration, widening of the intercostal spaces, swelling of the supraclavicular regions, and decreased breathing. Patients exhale with closed lips. Shortness of breath on slight exertion and at rest. Primary EL develops more often in men of middle and young age. Secondary EL - more often in the elderly, cor pulmonale develops.

An x-ray examination determines the low standing of the diaphragm, a decrease in its mobility, and increased transparency of the lung fields. On the spirogram, the function of external respiration is impaired.

EL treatment. Categorical cessation of smoking, avoid contact with industrial hazards, limit physical activity. Special breathing exercises are shown to strengthen the respiratory muscles. Breathing with maximum involvement of the diaphragm. Oxygen therapy with carboxytherapy is indicated.

Pulmonary tuberculosis is an infectious disease caused by Mycobacterium tuberculosis (Koch's rods).

The disease is transmitted by airborne droplets, which allows it to spread rapidly. In this case, mycobacteria enter the lungs. Pulmonary tuberculosis is the most common form of tuberculosis. A person suffering from pulmonary tuberculosis becomes a source and carrier of infection. You can get infected in any public place. According to statistics, the probability of developing tuberculosis in a healthy person is 4-6%.
Symptoms of pulmonary tuberculosis.

The first symptoms of pulmonary tuberculosis are hardly noticeable. Often the disease is confused with other diseases of the respiratory system - pneumonia, bronchitis. The main symptom of pulmonary tuberculosis is weight loss. After infection, a person can dramatically lose weight by 10 kilograms. Then there is fatigue, sweating, irritability.

With the development of the disease, cough and chest pain appear when inhaling. Cough dry or with a small amount of mucous or mucopurulent sputum.

There may be a small amount of blood in the sputum. The destruction of the walls of large vessels by the tuberculous process can give pulmonary bleeding.

The development of the tuberculous process is accompanied by shortness of breath, which can be during physical exertion and even at rest. Tuberculosis toxins cause dystrophy of the heart muscle, cardiac activity is weakened. The pulse becomes frequent, weak. Due to hemoptysis and pulmonary bleeding, anemia develops.

The diagnosis of this dangerous disease is made only by a doctor. X-ray examination is necessary to determine the disease. Also, for the diagnosis of pulmonary tuberculosis, sputum is examined for the presence of tuberculosis microbacteria. Tuberculosis can be indicated by a positive Mantoux test. In some cases, a blood test is taken for reliability.

Classification of pulmonary tuberculosis.

With a cold stimulate the nose correspondence points. They are located on the palmar and plantar surfaces of the fingers in the middle of the nail phalanges.

For sore throat affect the correspondence points of the larynx, palatine tonsils. In the standard correspondence system, the palatine tonsils are outside the projection of the corners of the mouth, the correspondence of the larynx is in the center of the upper phalanx of the thumb.

To eliminate cough it is necessary to stimulate the correspondence points of the trachea, bronchi, lungs, and larynx.

To lower body temperature stimulate painful points

After the massage, the painful correspondence points must be warmed up with a wormwood cigar. If there is no wormwood cigar, then a well-dried regular cigarette can be used. Its end is set on fire and with pecking movements "up - down" the points warm up until a persistent pleasant heat appears.

After warming up, plant seeds can be put on the correspondence points and fixed with a plaster for one day. For this, seeds of radish, black pepper, buckwheat, peas, beets, lemon, etc. are suitable. After a day, if necessary, the seeds should be replaced with new ones.

For sore throat and loss of voice you can make an alcohol or honey compress on the first phalanx of the thumb, corresponding to the neck in the standard matching system. To do this, wrap the phalanx with a gauze napkin moistened with vodka or smeared with honey. Put a piece of polyethylene on top, then cotton wool and fix them with a bandage.

Well, you can use the old folk recipe: for the treatment of SARS, soak your feet in hot water. And also steam and brushes. It will be very effective for treating the symptoms of SARS.

During the period of increasing incidence of viral infections excellent tool their prevention will be the heating of energy points on the hands and feet.

Compliance systems can make alcohol or vodka compresses, compresses from honey, wraps from leaves of cabbage, birch steamed with boiling water. To do this, the thumb and the area at its base (thenar) are wrapped with a gauze napkin soaked in vodka or smeared with honey, compress paper is applied on top, a little cotton wool, and fixed with a bandage so that the compress fits snugly against the skin. The duration of such a compress is 6 - 10 hours (you can leave it overnight).