upper and lower respiratory tract disorders and...the man exits the cave and walks down the hill...

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F.A. Davis: Advantage –Upper and Lower Respiratory Tract Disorders (11.16.15)

Upper and LowerRespiratory Tract

Disorders

The respiratory system is an interconnected network of organs, tissues, and pathways that work to-gether to help you breathe.

It has two distinct sections—the upper respiratory tract and the lower respiratory tract.

Cutaway figure appears on the screen. The script calls for the various labels to appear at the VO says “disorders of the upper respiratory tract”. However, that doesn’t currently appear in the script dialogue they’ve provided.



Not only is the respiratory system connected internally, it is connected to the external environment through the air we breathe. Exposure to the external environment accounts for many of the disorders of this system.

Let’s travel within the respiratory tract as it journeys through our external environment.

New screen. Man emerges from a house and walks forward, breathing in paricles. As he does, his lungs appear and we can see the particles going into them.

The man walks past other figures, also breathing in particles.



When we encounter the rhinovirus, we are likely to suffer from acute rhinitis, or the common cold... ...and its common symptom of green or yellow nasal discharge.

As the man continues walking, a rhino w/ flag enters from the rest, charging towards him. As the rhino passes the man, the camera pans closer. A green drop of mucus falls from his nose and he wipes it with a handkerchief.



Rhinitis can also result from allergies. Although, in this case, clear nasal discharge occurs. Allergies, bacteria, viruses, and fungi can all cause sinusitis, or inflammation of the sinus cavities.

The man continues past several trees, which emit pollen. The man sneezes and a clear drop of mucus forms on his nose. He wipes it with a tissue.

The man continues walking towards a cave, with label.

Sound: Sneeze.



Moving along the upper respiratory tract, we encounter the tonsils. Tonsillitis is inflammation of the tonsils.

Facial pain and headaches are common symptoms.

The man walks through the cave, holding his head in pain. Funguses, viruses and bacteria are visible on the walls. The man exits the cave and walks down the hill across the labeled bridge.



With tonsillitis, swallowing becomes very difficult, as the tonsils become reddened and enlarged. The next structure along our journey is the epiglottis, which is a flap that covers the trachea to prevent food from entering.

The man continues past an open garage. The labeled door lowers as he walks by.On the other side of the bridge, the man stops in front of a lemonade stand. He holds his throat and nods “no” as the kid offers him a lemonade.

Sound: Garage door closing.



Often this narrowed passageway appears as a “steeple sign” on X-ray.Epiglottitis, inflammation of the epiglottis, is a life-threatening event, as the air passage may become blocked.

The man turns back and continues walkins as the ambulance passes him. He passes an xray with an image of steeple sign.The camera pans in as the man turns. The garage door swells, bulging out of the door frame

as an ambulance enters from the left as the VO says “life threatening”.

Sound: Ambulance sirenSound: Ambulance siren passing and fading.



Pharyngitis is inflammation of the throat, the common “sore throat”.

Although most commonly caused by viruses, it may also be caused by the bacteria Streptococcus pyogenes and result in strep throat.

The man continues towards a dark alley. The figure of a mugger emerges from a corner.

Resolution of an S. pyogenes infection is crucial, as progression may lead to scarlet fever, rheumatic fever, or glomerulonephritis.

Pan closer to the man’s head. The labels appear as the VO mentions them.



Now, let’s continue our journey into the lower respiratory tract, in which we may encounter bronchitis, pneumonia, or tuberculosis.

Pull back. The man is now descending stairs, past signs on the wall.

Bronchitis is inflammation of the bronchioles, most commonly due to viral infection. The bronchioles become obstructed by mucous and leukocytes.

As the bottom of the stairs, the man continues on into the tunnels.



Wheezing and production of red sputum may occur. Pneumonia is the result of inflammation and the alveolar air spaces filling with fluid. Bacteria, viruses, and fungi, especially in immunocompromised individuals, may cause pneumonia.

In the tunnel. There are mucus and leukocytes on the walls. The man coughs, spraying red sputum into a handkercheif.

The man continues through the tunnel. There are now pockets in the sides, with are filling with fluid on the bottoms and bacteria and fungi on the sides.Sound: Wheezing, then a cough



Streptococcus pneumoniae is the most common cause of community-acquired pneumonia... ...whereas infection with Staphylococcus aureus is most common in hospital-acquired forms.

The man emerges from the tunnel. He shakes hands with a couple of people on the sidewalk.The label appears above.

The man heads towards a hospital entrance. The label appears on the left.



Ventilator-associated pneumonia may also occur

Bacterial pneumonia may also develop as a secondary infection following a virus such as influenza. .

Now, let’s talk about the most common infectious disease in the world: Tuberculosis.

New screen. The man is now in bed, on a ventilator. As the VO mentions bacterial pnuemonia, a calendar appears on the upper right. The first page, labeled “Viral Infection” is visible, then the page flips to reveal the next page, indicating the passage of time.

New screen. A map of the world appears and circles with “TB” in them pop up all over the map.



Tuberculosis is transmitted through the inhalation of airborne droplets of Mycobacterium tuberculo-sis. Once inhaled, the bacteria settle in the lungs.

White blood cells are unable to kill the organism, but are able to wall off the infection, resulting in a lesion, known as a tubercle.

As the immune system attempts to destroy the bacteria, damage to the lung’s tissue results...New screen. A woman now walks down the street, breathing in TB particles.

The woman walks past white blood cells, walling off a space. She passes a black xray screen, with shows an xray of her lung, with tubercles visible.



As the immune system attempts to destroy the bacteria, damage to the lung’s tissue results, causing a cheese-like appearance known as caseous necrosis.

Clinical signs of tuberculosis include chronic cough, hemoptysis, and weight loss. Up to 20% of patients with active tuberculosis, however, may present with no symptoms.

The woman turns towards us. Her lungs become visible, riddled with holes. Back to the map of the world. Several of the circles are highlighted, showing the percentage of people who don’t show TB symptoms.

upper and lower respiratory tract disorders and...the man exits the cave and walks down the hill...

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