upper Respiratory track

The Upper Respiratory Tract

The upper respiratory tract includes the organs involved in breathing air from the outside environment into the lungs. The major structures of the upper respiratory tract include:

Nose: The nose filters, warms, and humidifies the air that is breathed in. It contains hairs and mucus that trap foreign particles and pathogens. The nasal passages also produce mucus and fluids that moisten the air.
Nasal cavity: The nasal cavity is the hollow space inside the nose. It is lined with mucous membranes and cilia that help trap and expel foreign materials. The nasal cavity also warms and moisturizes the air before it enters the rest of the respiratory system.
Sinuses: The sinuses are air-filled cavities located in the skull. They help insulate and protect the skull, and also produce mucus that moistens the nasal cavity. The sinuses are located behind the forehead, between the eyes, and alongside the nasal cavity.
Pharynx: The pharynx, or throat, is a passageway for air and food. It is located behind the nasal cavity and soft palate and in front of the esophagus. The pharynx transports air from the nose to the larynx and lungs. It helps warm and moisten the air.
Epiglottis: The epiglottis is a flap of cartilage located behind the tongue. It closes over the trachea when swallowing to prevent food from entering the lungs. When breathing, the epiglottis opens to allow air to flow into the trachea and lungs.
Trachea: The trachea, or windpipe, transports air from the mouth and nose to the lungs. It passes through the neck and splits into the bronchial tubes that enter the lungs. The trachea cleans, warms, and moistens the air before it enters the lungs.
Larynx: The larynx, or voice box, is located just below the pharynx. It contains the vocal cords, which produce sound for speech. The larynx also produces coughing to clear the respiratory tract. It assists in controlling the flow of air into the lungs.

The upper respiratory tract works together to filter, warm, and humidify air that is breathed in from the environment before it enters the lungs. Keeping the organs of the upper respiratory tract healthy helps ensure good respiratory function and overall health.

Transcript:-
Upper respiratory tracted infections involve the infection and inflammation in the respiratory mucosa, starting from the nose to the lower respiratory tract, but do not include the alveoli. These are mostly due to viral origin, but it is important to differentiate them from bacterial origin and super infections as they need other forms of therapy to counteract them.

The upper respiratory tract includes the sinuses, nasal passages. Pharynx and the larynx. The term upper respiratory tracted infections, U R I, includes a range of conditions like common cold rhinitis, pharyngitis, laryngitis, epiglottitis, and tracheitis. Of which Epiglottitis is a life-threatening condition. Most U R I are seen throughout the year, but incidents is more during winter and when the humidity is low, only epiglottitis doesn't show a seasonal variation.

U R I are generally caused by viruses and sometimes by bacteria. Viral infection may lead to a subsequent development of bacterial infection. There are more than 200 viruses that account for U R I and include rhinoviruses, coronaviruses, aino viruses. And Cox viruses. Epiglottitis is typically a bacterial infection and is caused by hemophilus influenza, type B hib streptococcus, a streptococcus pneumonia, and Moraxella Kahala.

The risk factors for U R I include close proximity to infected persons smoking, active and passive, lowered immune levels, anatomical changes such as facial dysmorphism, nasal polyps, et cetera. Colonization by a potential pathogen such as streptococcus A. The spread of infection is generally through person to person contact. That is when an infected person's hand comes in contact with the other person's hand. There is a spread of infection. And from there, if the person touches his nose or eyes, it enters the body. It can also enter the body as droplets that arise when an infected person coughs or sneezes. Once the virus or the bacteria enters the body, it is resisted by the host by a variety of defense mechanism.

The hairy lining of the nose mucosal coat of the upper respiratory tract. The angle between posterior nose to pharynx and affiliated cells in the respiratory tract act as physical barriers in improv, providing defense against the entry of pathogens deep into the respiratory. The adenoids and the tonsils provide immune response for pathogens, immunoglobulins, macrophages, neutrophils, eosinophils, monocytes, reach the area of infection and provide an immune response.

Inflammatory cytokines help in regulating the immune response. Viruses undergo many mutations to counter the host response and develop resistance, which poses serious challenges to the immune system. Bacterial pathogens may also release toxins, proteases, and bacterial adherence factors, and may develop a capsule to counter the phagocytes.

The incubation time before the appearance of symptoms vary for vial and bacterial pathogens. One to five days for rhino viruses. One to four days for influenza viruses, seven to 10 days for pertussis, one to 10 days for diphtheria, and around seven days for respiratory sensational virus. The inflammatory response to infection by the immune system causes symptoms such as erythema, edema, localized swelling and fever.

The infection might spread from the site of origin to deeper areas and cause infection and inflammation in those area. Symptoms of viral nasopharyngitis. Begin two to three days after inoculation and lasts about a week. Congestion with nasal blockage, difficulty in breathing and sneezing. Sore throat with aphagia or dysphagia. Dry mouth and halitosis due to oral breathing. Cough, headache, myalgia and fever along with nausea, vomiting and diarrhea may be seen.

Erythema and edema may be observed. Severe nasal discharge. Which is typically clear initially later turning white, yellow or green. Tonsil hypertrophy and anterior cerv, lymph adenopathy may be seen. Conjunctivitis may be present with adenoviruses. The signs and symptoms of bacterial nasopharyngitis are very similar to viral infection, and it is difficult to assess the difference between viral and bacterial infections, although some characteristics include the persistence of symptoms beyond 10 days.

And usually distinguished by the absence of cough, rhino ear, and conjunctivitis. Bacterial rhinosinusitis generally develops following viral sinusitis and is characterized by the persistence of symptoms beyond seven to 10 days. Most of the symptoms are similar to that of viral. However, the discharge is generally more curent. The patient is often febrile and has facial pain. Epiglottitis is more common in children between one to five years. It is characterized by presence of sore throat and drooling, ophia or dysphagia, dysphonia, or loss of voice, dyspnea, or shortness of breath, dry cough or no cough, fever. Malaise, tenderness on palpation over the laryngeal area, cervical lymph adenopathy, inspiratory, strider on oscultation over the anterior traia, laryngitis, and tracheitis generally begin with nasopharyngitis.

Fever, myalgia and malaise are usually seen. Other symptoms observed include dyspnea, odynophagia, or dysphagia, hoarseness of voice, dry cough, which is like barking time in children. Classical whoop sound in Wiki cough and severe dry cough. In adults, the severity of cough can sometimes cause sub conjunctival hemorrhage or rib fractures causing pinpoint tenderness.

Lymph adenopathy in inspiratory strider. On Oscultation over the anterior tracko, the signs and symptoms of sinusitis are similar to that of common cold with nasal obstruction and discharge, sneezing, facial tenderness, headache, and swelling over the affected sinus area. There may be also generalized malaise, cough, fever, and chills.

There is inflammation of the nasal mucus membrane. Nasal discharge is usually purulent and colored. There is increase in pain associated with head movements and bending forward. Otitis media is the persistent pain in the ear that is affected. Other signs and symptoms of upper respiratory tract infection are generally present. Fever may or may not be seen. Reduced hearing ability is observed. The timan membrane is inflamed and the areas of the middle. Cannot be visualized clearly in bacterial, fario, tonsillitis. Patients will usually have fever, halitosis, difficulty, and pain with swallowing and sore throat.

The airway is obstructed and mouth breathing and sleep apnea are quite common. Generalized malaise is a common feature. There is usually a change in voice. Children are usually affected by this condition on examination. Inflammation of the tonsils with or without exudates may be seen. Tenderness of cervical lymph nodes may be observed. Examination will help in ruling out fario tonsillitis due to viral origin, in which case the appearance of the consular area will be different. The skin and the mucosa should be checked to see if the person is dehydrated.

The diagnosis of U R I is undertaken after a careful history and proper examination of the signs and symptoms is done. If necessary. Further diagnostic tests are ordered to confirm on the diagnosis or to help inciting therapy. Testing is also warranted in cases persisting over a period of two weeks with progressive symptoms, viral identification if warranted.

Is done by obtaining a nasal swab or aspirate and subjected to immunofluorescence antigen or polymer's chain reaction. P C R assays Rapid test kits are useful in giving a diagnosis of influenza. This kind of testing is helpful when targeted therapy is necessary in treatment as in influenza H S V and E B V infections.

Bacterial identification is done by obtaining a culture by a swab or aspirate. The method varies according to the infected site. These are usually helpful in infections caused by group a, strepto cockeye or eria gonorrhea. Certain rapid test kits are also available to identify group A, strepto Cockeye.

The W B C count is generally high in patients with U R I. With presence of atypical lymphocytes, lymphocytosis, or lymphopenia imaging studies are not usually performed in routine and uncomplicated cases. They are sometimes performed in patients with persistent or progressive symptoms. In cases of persistent rhino sinusitis, sinus imaging is performed to study the anatomy. In cases of suspected spread of infection to deeper areas, computed tomography, CT scan is performed to obtain a clearer picture. R I is used when fungal sinusitis or tumor is suspected. Neck imaging is generally used to rule out epiglottitis X-ray findings usually show a swollen epiglottis.

Radiographic studies are generally of limited use in cases of laryngitis and tracheitis. Laryngoscopy is sometimes performed in cases of suspected epiglottitis. This is also used to obtain samples for blood culture in Laryn Tracheitis. Although there are chances of contamination of the samples by upper airway flora, sinus puncture and aspiration is sometimes performed in cases of persistent rhino sinusitis.

Most of the U R I are self-limiting and do not require specific care and only need symptomatic treatment. However, some conditions such as epiglottitis and ln tracheitis with possible airway compromise need emergency medical attention. In cases of epiglottitis and laryn tracheitis, the patient is monitored for respiratory co. And oxygen humidified is administered accordingly. Antibiotics as necessary are administered and IV fluids are administered to counter volume deficits in cases of Laryn, tracheitis, Emmic, epinephrine. Is inhaled to bring about dilatation of the airways and to reduce mucosal inflammation. Surgery may be necessary in cases of spread of infection to the deeper areas.

It is also necessary in cases of persistent sinus infection or in cases of a fungal infection of the sin. Or spread of infection to the deeper areas. In cases of repeated streptococci infections, tonsillectomy may be considered symptomatic. Treatment is usually the mainstay of treatment in most U R I, bacterial infections of the ears. Sinuses and group A streptococci. Infections of the pharynx and tonsils and epiglottitis require antimicrobial therapy. Antimicrobial agents include amoxicillin, amoxicillin, cla, penicillin.

Erythromycin, Cephyl, Ceia, ceftriaxone, et cetera. Anticholinergic agents such as IRO bromide help in reducing the mucus in the lungs and in relaxation of the bronch. AIC agonists such as epinephrine help in reducing mucosal inflammation and bring about dilatation of the airways. Antihistamines, such as diphenhydramine and chlorpheniramine help help in regulating bronchial construction.

Mucosal secretions and edema. Corticosteroids such as dexamethasone, help in reducing the inflammation and thus bring down edema. Decongestion, such as pseudo efrin, oxymetazoline, and phenylephrine. Bring about vasos. By stimulating alpha adrenergic receptors and thus relieve nasal symptoms, antitussives, such as codeine are used to help relieve cough.

Antipyretics and analgesics are used to relieve the symptoms of fever and my alg. Spread of U R I can be prevented by following a few simple steps, like frequent washing of hands and avoiding contact of unwashed hands to the eyes and nostrils, regular cleaning of surfaces with a disinfectant to reduce the presence of pathogens in the environ. Reduced contact between patients and the others. Avoiding closed and crowded environments, especially in Cold Seasons. Immunization against diphtheria, pertussis, influenza, and hib.