Slide 1

Slide 2

table 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. , 16.

Slide 3

I pharynx: ( ) tonsil: ( ) larynx: ( ) vocal cords: ( ) trachea: ( ) bronchus(pl. bronchi): ( ) bronchiole: ( ) alveolus (pl. alveoli): ( ) lung: ( ( )) pulmonary: lobe: ( ) pleura: ( ) diaphragm: ( ) mediastinum: ( ) hilum: ( ) sternum: ( )

Slide 4

Slide 5

larynx I

Slide 6

larynx III

Slide 7

larynx IV

Slide 8

Slide 9

Slide 10

Slide 11

Slide 12

tracheal epithelium

Slide 13

hilum

Slide 14

lung model

Slide 15

lower air pathway

Slide 16

Slide 17

Slide 18

Slide 19

Slide 20

Slide 21

II rib: ( ) costal: respiration: ( ) inhalation: ( ) inspiration: ( ) expiration: ( ) compliance: ( ), ( ) diffusion: ( )

Slide 22

I cough: sputum: ( ), ( ), hemoptysis: ( ), ( ) dyspnea: asphyxia: ( ) orthopnea: ( ) apnea: tachypnea: ( ) cyanosis: ( ) hypoxia: ( ) hypercapnea: ( ), ( ) hoarseness: ( ),

Slide 23

II rales: ( ) crackle: ( ) wheezing: ( ) stridor: ( ), ( )

Slide 24

lung auscultation

Slide 25

lung sound I

Slide 26

lung sound II

Slide 27

/ I tonsillitis: pharyngitis: laryngitis: bronchiolitis: chronic bronchitis: bronchiectasis: bronchial asthma: lung cancer: bronchogenic cancer: ( ) atelectasis: ( ) collapse: ( ) pulmonary emphysema: ( ) pneumonia: ( )

Slide 28

chronic bronchitis

Slide 29

bronchiectasis

Slide 30

bronchial asthma I

Slide 31

bronchial asthma II

Slide 32

bronchial asthma III

Slide 33

lung cancer I

Slide 34

lung cancer II

Slide 35

lung cancer III

Slide 36

lung cancer IV

Slide 37

atelectasis I

Slide 38

atelectasis II

Slide 39

pulmonary emphysema I

Slide 40

pneumonia I

Slide 41

Slide 42

pneumonia II

Slide 43

pneumonia III

Slide 44

pneumonia IV

Slide 45

/ II bronchopneumonia: lung abscess: ( ) pulmonary tuberculosis: ( ) endobronchial tuberculosis: ( ) MOTT (Mycobacterium other than tuberculosis): ( ) pneumoconiosis: ( ) pulmonary edema: ( ) pulmonary embolism: ( ) ( ( ) ) hyaline membrane disease: ( )

Slide 46

lung abscess I

Slide 47

lung abscess II

Slide 48

lung abscess III

Slide 49

lung abscess IV

Slide 50

pulmonary tuberculosis I

Slide 51

pulmonary tuberculosis II

Slide 52

pulmonary tuberculosis III

Slide 53

Mycobacterium tuberculosis I

Slide 54

Mycobacterium tuberculosis II

Slide 55

alveolar macrophage

Slide 56

phagocytosis of macrophage

Slide 57

pseudopodia of macrophage

Slide 58

phylogenetic tree of Mycobacterium

Slide 59

/ III DILD (diffuse interstitial lung disease): ( ) IPF (idiopathic pulmonary fibrosis): ( ) COPD (chronic obstructive pulmonary disease): ( ) fungus ball (= mycetoma): ( ) respiratory failure: ( ) ARDS (adult respiratory distress syndrome): ( )

Slide 60

diffuse interstitial lung disease I

Slide 61

diffuse interstitial lung disease II

Slide 62

DILD IPF etiology inhaled substances silicosis, asbestosis, berylliosis, hypersensitivity pneumonitis drug induced antibiotics, chemotherapeutic drug, antiarrhythmic agents connective tiss. dis. systemic sclerosis, polymyositis, dermatomyositis, systemic lupus erythematosus, rheumatoid arthritis infection atypical pneumonia, pneumocystis pneumonia (PCP), tuberculosis idiopathic sarcoidosis, idiopathic pulmonary fibrosis, Hamman-Rich syndrome malignancy lymphangitic carcinomatosis

Slide 63

chronic obstructive pulmonary disease (COPD) chronic bronchitis & emphysema airway narrowing or obstruction c.f., DILD restriction, increased lung stiffness etiology smoking, occupational exposures (coal/gold mining, Cd, welding fumes), air pollution, genetics (alpha-1- antitrypsin)

Slide 64

alpha-1-antitrypsin (A1AT) serine protease inhibitor inhibiting a wide variety of protease in its absence, elastase is free to break down elastin -> the decreased elasticity of the lungs -> COPD (emphysema) 394 amino acids the gene is located on the long arm of 14 th chromosome

Slide 65

fungus ball (mycetoma, aspergilloma)

Slide 66

Slide 67

adult respiratory distress syndrome (ARDS)

Slide 68

ARDS case June 2June 4 16:27June 5 01:40 young woman just back from West Africa with fever and 1.7 % P. falcifarum parasitemia

Slide 69

/ IV pleurisy: ( ) pleural effusion: ( ) empyema (= pyothorax): ( ) hemothorax: ( ) pneumothorax: ( ) mediastinitis: ( ) paragonimiasis: ( )

Slide 70

pleural space

Slide 71

pleurisy (pleuritis)

Slide 72

empyema (pyothorax)

Slide 73

hemothorax

Slide 74

pneumothorax I

Slide 75

pneumothorax II 38 y/o male in skate board accident

Slide 76

pneumothorax III

Slide 77

tension pneumothorax

Slide 78

lung collapse by TP

Slide 79

needle thoracostomy

Slide 80

Slide 81

Slide 82

Paragonimus westermani (adult) I

Slide 83

P. westermani (adult) II

Slide 84

P. westermani (egg)

Slide 85

/ I tonsillectomy: ( ) tracheostomy: ( ) pneumonectomy: ( ) lobectomy: ( ) (( ) ) thoracotomy: ( ) thoracostomy: ( ) decortication: ( ) (( ) ) pleuropneumonectomy: PFT (pulmonary function test): bronchoscopy: ( ) tuberculin test (= Mantoux test):

Slide 86

Slide 87

tracheostomy tube

Slide 88

tracheostomy done

Slide 89

lung surgery

Slide 90

Slide 91

anterolateral thoracotomy

Slide 92

median sternotomy

Slide 93

thoracostomy

Slide 94

3 bottle system of chest drainage

Slide 95

chest drainage system

Slide 96

bronchoscopy

Slide 97

rigid bronchoscope

Slide 98

flexible bronchoscope

Slide 99

bronchoscopy II

Slide 100

Slide 101

tuberculin test (Mantoux test)

Slide 102

hypersensitivity reaction

Slide 103

tuberculin test (+) result

Slide 104

Slide 105

/ II endotracheal intubation: ( ) thoracentesis: ( ) chest tube: ( ) PCNA (PerCutaneous Needle Aspiration): ( ) postural drainage: ( ) AFB (acid fast bacilli): ( ), ( )

Slide 106

Slide 107

endotracheal tube & laryngoscope

Slide 108

endotracheal intubation

Slide 109

Slide 110

thoracentesis set

Slide 111

thoracentesis

Slide 112

chest tube insertion

Slide 113

chest tubes

Slide 114

percutaneous needle aspiration

Slide 115

Slide 116

postural drainage

Slide 117

Slide 118

Hans Christian Gram, 1853-1938

Slide 119

Gram (+) & (-) species Staphylococcus aureusEscherichia coli

Slide 120

Slide 121

mycobacterium species (AFB)

Slide 122

acid-fast staining

Slide 123

acid fast stained M. tuberculosis

Slide 124

acid fast stain (+) & (-) species

Slide 125

acid fast stained cryptosporidia

Slide 126

Slide 127

device for pulmonary function test

Slide 128

pulmonary function test

Slide 129

lung volumes

Slide 130

results for pulmonary function test volume-time curveflow-volume loop

Slide 131

Slide 132

Slide 133

typical results of disease on spirometry

Slide 134

Slide 135

variable results of spirometry

Slide 136

V/Q ratio

Slide 137

normal values about blood gas exchange Blood gas values (ranges) from healthy persons at rest. - Normal mean tensions for mixed venous blood and for alveolar air are shown below. PaO2 : 10-13 kPa (75-95 mmHg) PaCO2:4.8-6 kPa (36-45 mmHg), Base Excess:Zero, pH :7.35-7.45 (ie,[H+] = 35-44 nM) PAO2 :10 - 13.3 kPa (75-100 mmHg) PACO2 :4.8-6 kPa (36-45 mmHg). Mean: 5.3 kPa (40 mmHg), Mean PvO2 :6 kPa (45 mmHg) Mean PvCO2 :6.1 kPa (46 mmHg)

Slide 138

respiratory failure Type 1 (hypoxemic)Type 2 (hypercapnic) PaO2PaO2 low (