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Respiratory Tract Conditions

The respiratory tract consists of an upper and lower section and conditions include the common cold.

Respiratory Tract (RT)

The respiratory tract consists of an upper and lower section1.

The upper respiratory tract (URT) is from the nose to the vocal cords (larynx) 1.

The lower respiratory tract (LRT) is from the windpipe (trachea) to the lungs1.

Functions2

  • Breathing
  • Gas exchange, supplying the body with oxygen and removing carbon dioxide
  • Fighting infection through small hairs and mucus that form part of the RT
  • Air vibrating the vocal cords creates sound, which enables speech
  • The chemical sensation of smelling
  • The prevention of choking through cough reflexes

What can go wrong?2

  • The RT is prone to viral, bacterial and fungal infections
  • Environmental factors such as smoke and substances that cause pollution can be problematic
  • Allergic reactions can result from sensitivity to substances that cause discomfort to the body
  • Can be affected by inflammation – when the body becomes red, swollen, hot and experiences pain
  • Can be affected when the body’s immune system attacks healthy cells (autoimmune conditions)
  • Physical injury

Common conditions of the RT2, 3, 4:

URT

  • Common cold
  • Blocked nose (rhinitis)
  • Blocked sinuses (sinusitis)
  • Sore throat (pharyngitis)
  • An infection of the vocal cords (laryngitis)
  • Flu
  • Breathing in foreign substances
  • Ear infection

LRT

The inflammation of the mucous membrane in the bronchial tubes of the lungs, typically causing coughing (acute bronchitis).
The inflammation of one or both of the lungs, caused by bacterial or viral infections (pneumonia).
A combination of the above (bronchopneumonia)
Tuberculosis (TB)

Obstructive lung conditions

The following make it difficult to exhale all of the air in the lungs:

Asthma
Lung cancer

Chronic obstructive pulmonary diseases (COPD)

Chronic bronchitis
Damaged and enlarged air sacs of the lungs causing breathlessness (emphysema).

Signs and symptoms of URT conditions5

  • Coughing
  • Sneezing
  • Blocked and/or runny nose
  • Sore throat
  • Fever
  • Watery eyes
  • Earache

Signs and symptoms of LRT conditions6

  • Coughing up mucus or blood
  • Fever
  • Shortness of breath
  • Excessive sweating
  • Fatigue
  • Unintentional weight loss

Prevention

  • Good hygiene
  • Frequent hand washing
  • Flu vaccination
  • Pneumococcal vaccination (against pneumonia)
  • No smoking
  • Wear a mask when working with chemicals, pollutants or toxins

A cough can tell a lot! 8

The nature of a cough can provide insights into the possible causes and treatment required.

Dry cough

Associated with irritation or a tickly throat
Usually caused by an infection of the URT
Possibly an early sign of a LRT infection
Found in smokers or individuals suffering from asthma
Often gets worse at night, when one is intensely agitated or in high temperatures

Wet cough

Associated with a tight chest and breathing difficulties
Comprised of mucus and phlegm
The purpose is to remove fluid from the LRT
Usually worse in the mornings
Common causes include infections and asthma

Croup cough

Experienced by children
Accompanied by a “barking” sound
Usually caused by viral infections

Whooping cough

Also occurs in children
Associated with frequent coughing fits, after which the child can be left breathless

Nature (wet or dry)
Is it worse in the mornings or evenings?
Is it accompanied by mucus, phlegm or blood?
Duration
Is it worsened by heat, cold or exercise?
Colour of the expelled saliva and mucus (sputum)
Medical history and medication that you are on
Any recent travelling

Diagnosis3, 9

Usually based on:

  • Medical history
  • Clinical examination
  • Signs and symptoms

In some cases additional tests may be required, such as:

  • Blood tests
  • Culturing micro-organisms from sputum
  • Chest X-ray
  • Ultrasound
  • Pulmonary function test

Management11

The treatment method will depend on the cause of the RT condition and may involve:

  • Antibiotics, antiviral or antifungal medication in the event of an infection
  • Anti-histamines in the case of an allergy
  • Corticosteroids in the event of inflammation or auto-immune conditions
  • Anti-asthmatics and bronchodilators to open up airways during asthma

Therapeutic treatment, also aimed at managing symptoms:

  • Pain medication if indicated
  • Medicine used to relieve a blocked nose
  • Medicine to thin out mucus, making it easier to release
  • Cough suppressants if the cough interferes with daily activities or sleep
  • Medicine to loosen mucus, which encourages coughing
  • Combination of the prior two
  • Physiotherapy and steam inhalation

Medical References

Marianne Belleza, RN, Respiratory System Anatomy and Physiology, Nurseslabs, May 2, 2017 Kim Ann Zimmermann, Respiratory System: Facts, Function and Diseases, Live Science, February 12, 2018 John Hansen-Flaschen David V. Bates, Respiratory disease, Encyclopaedia Britannica, 2013 Dr Hana Omer, Respiratory system diseases, presentation 2015 Sherif B. Mossad, Upper Respiratory Tract Infections, Cleveland Centre for Continuing Education, August 2013 Pramod Kerkar, MD, FFARCSI, Causes & Symptoms of Lower Respiratory Tract Infection, ePainAssist, Jul 20, 2017 Małgorzata Maciaszek, M.D., Prevention of respiratory system diseases, StethoMe, 2018 Kathleen Kenny, PharmD, RPh, Cough: Navigating the Classifications, November 13, 2015 Atul Lawrence, Acute Respiratory Distress Syndrome, Medical Surgical Nursing, Dec 27, 2013 Francesco De Blasio, Cough management: a practical approach, BioMed Central, Oct 10, 201