Disorders of lungs are divided in different categories for better understanding:-

1. Obstructive lung disorders

These are characterized by the blockage of the airflow through the airways . The obstruction may be acute or chronic. Different types of disorders under this category are:

a. Bronchitis- The bronchitis is acute when the secondary bacterial infection of bronchi which is proceeded by common flu or influenza makes the measles and whooping cough complicated in children.

Chronic bronchitis is when an individual has cough for the gap of 3 months in 2 continuous years. It is a inflammatory disease from prolonged irritation of bronchial epithelium. It becomes worse due to damp or cold conditions.

Causes:– viruses, cigarette smoking, dust, air pollution, toxic gases etc.

Treatment:- Cough suppressants and expectorants, Bronchodilators , Anti- allergy medications, antihistamines, Nonsteroidal anti-inflammatories ( NSAIDs)

b. Asthma- It is a common inflammatory disease of the airways which is associated with over-reactivity of airway smooth muscle. The mucous membrane and muscle layer of bronchi becomes thick; and the mucous glands enlarge, which reduces the airflow in the lower respiratory tracts. There are two types of asthma:

• Atopic asthma:- when children and young adults have hypersensitivity towards pollen, dust, fungi, feather pillows etc.
• non-atopic asthma is the chronic inflammation of upper respiratory tract.

Causes:- cold, flu, sinus, bronchitis, emotional stress, exposure to allergic viruses.

Treatment:- beta-agonists, anticholinergics(dilate the airways), mast cell stabilizers etc.

c. Bronchiectasis- It is a permanent abnormal dilation of bronchi and bronchioles. It is associated with chronic bacterial infection; and sometimes occurs in patient already suffering from bronchopneumonia, bronchial tumor etc.

Causes:- damage to the large walls of airways, infection, immune diseases, autoimmune diseases etc.

Treatment:- antibiotics, bronchoconstrictors, lung transplant

2. Lung infections

a. Pneumonia- This means infection of alveoli. This occurs when the pulmonary mechanism for defence fails; and is unable to prevent the inhaled microbes and also those coming with blood from reaching lungs.

• Lobar pneumonia is the infection in 1 or more lobes which leads to the watery inflammatory substance in the alveoli.
• Bronchopneumonia is a infection which spreads from the bronchioles to the alveoli.

Causes:-  bacteria, fungi, viruses, cigarette smoking, alcohol consumption.

Treatment:– antibiotics, antifungals, antivirals, analgesics, cough suppressants

b. Lung abscess- This is common pus formation or dying of  cells within the lungs. The sources are:- if pneumonia is not treated properly, as a result of trauma, due to infection in the adjacent structures like oesophagus, spine etc.

After the treatment, it may be completely cured or may have some complications like: chronic pus formation, erosion of pulmonary blood vessels.

Causes:- consuming infected material (microorganisms) from mouth and enters the lungs.

Treatment:-  antibiotics, surgery

c. Tuberculosis (TB)- It is a major health problem all over the world, especially where HIV is very common.  The microbes are spread through inhalation. Pulmonary TB is of two types:

• primary TB: initially it occurs in the apex of lungs. The inflammatory cells including macrophages and lymphocytes are enlist in the defence.
• Secondary TB: this is usually due to reactivation of disease from latent bacteria surviving primary TB. The infection now is much likely to progress further than it was in the primary stage; with more destruction of lung tissues.

Causes:-  bacteria that spread from person(suffering from TB) to different person during coughing, sneezing etc.

Treatment:- antibiotics

3. Lung collapse

The collapse affected the whole lung or the part of lung depends on how much the lung is affected. Without showing obvious symptoms, one part of lu g can be out of function.

Causes:– there are four main causes-

• absorption collapse(obstruction of an airway)- the amount of lung affected depends upon the size of the obstructed airway passage. Just below the obstruction, the air is trapped and absorbed; the lung collapses and the secretion gets collected there.
• impaired surfactant function- premature babies may be unable to expand there lungs by their own respiratory efforts; because their lungs are too immature to produce surfactant. That’s why these babies  are kept on ventilator until they produce surfactant by their own mechanism.
• Pressure collapse- when the air and water enter the pleural cavity, the negative  pressure becomes greater that positive pressure and the lung collapses.
• alveolar hypoventilation- In the normal individual breathing quietly at rest, there are always some collapsed lobules within the lung because of low tidal volume.

4. Lung tumors

Malignant tumors of lung are:

a. Bronchial carcinoma– The tumors usually develops in a main bronchus, hence forming large friable mass that project in the lumen of the blood vessel; sometimes causes obstruction. As the tumor grows, it may destroy the blood vessels.

b. Pleural mesothelioma– these cases are linked to the exposure to asbestos (silicate minerals) dust. This tumor develop after 3 months of more of exposure to the silicate minerals. In very rare cases, the patient suffering from this tumor are completely cured.

Causes:- smoking cigarette and too much consumption of alcohol, tabacco etc.

Treatment:- immunotherapy drugs( helps immune system fight cancer), targeted therapy(reduces the multiple growing cancer cell)

Multiple choice questions(MCQs)

1. What is asthma?
A. blockage of airflow B. spreading of microbes across lungs
C. lung collapse D. obstruction of blood vessels
2. Which of the following is not the treatment of pneumonia?
A. analgesics B. antibiotics
C. antifungals D. bronchoconstrictors
3. Which of the following is the cause of lung collapse?
A. absorption collapse B. pressure collapse
C. unable to form surfactant D. all of the above
4. Match the following cause and its disorder-
A. bronchitis 1. Toxic gases
B. TB 2. bronchitis
C. asthma 3. Spreading of bacteria from one person to another
D. lung abscess 4. Consuming infected material
5. What happens during TB?
A. blockage of airflow B. spreading of microbes across lungs
C. lung collapse D. obstruction of blood vessels
6. Which of the following comes under lung tumors?
A. asthma B. pneumonia
C. tuberculosis D. none of the above
7. What happens during lung abscess?
A. formation of pus B. blockage of airflow
C. dying of lung cells D. both A and C
8. Which of the following statement is not true?
A. Asthma is of two types
B. bronchiectasis is abnormal constriction of bronchi
C. TB does not always happens in lungs, it occurs in joints, lymph nodes etc also
D. bronchial carcinoma is a malignant tumor
9. What is the treatment for Bronchiectasis?
A. antibiotics B. bronchoconstrictors
C. diuretics D. both A and B
10. Which lung disorder is caused due to the exposure to silicate minerals?
A. asthma B. bronchitis
C. lung collapse D. pleural mesothelioma

ANSWERS:-

1. blockage of airflow
2. bronchoconstrictors
3. all of the above
4. a – 1 b – 3 c – 2 d – 4
5. spreading of microbes across lungs
6. none of the above
7. both A and C
8. bronchiectasis is abnormal constriction of bronchi
9. both A and B
10. pleural mesothelioma

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REFERENCE:- Ross and Wilson-Anatomy and physiology in health and illness;  12^th edition; page no.-: 263-272.