DOCSLIB.ORG

Diagnosis and Treatment of Respiratory Illness in Children and Adults

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Diagnosis and Treatment of Respiratory Illness in Children and Adults Health Care Guideline Diagnosis and Treatment of Respiratory Illness in Children and Adults How to Cite this Document Short S, Bashir H, Marshall P, Miller N, Olmschenk D, Prigge K, Solyntjes L. Institute for Clinical Systems Improvement. Diagnosis and Treatment of Respiratory Illness in Children and Adults. Updated September 2017. ICSI Members, Sponsors and organizations delivering care within Minnesota borders, may use ICSI documents in the following ways: • ICSI Health Care Guidelines and related products (hereinafter “Guidelines”) may be used and distributed by ICSI Member and Sponsor organizations as well as organizations delivering care within Minnesota borders. The guidelines can be used and distributed within the organization, to employees and anyone involved in the organization’s process for developing and implementing clinical guidelines. • ICSI Sponsor organizations can distribute the Guidelines to their enrollees and those care delivery organizations a sponsor holds insurance contracts with. • Guidelines may not be distributed outside of the organization, for any other purpose, without prior written consent from ICSI. • The Guidelines may be used only for the purpose of improving the health and health care of Member’s or Sponsor’s own enrollees and/or patients. • Only ICSI Members and Sponsors may adopt or adapt the Guidelines for use within their organizations. • Consent must be obtained from ICSI to prepare derivative works based on the Guidelines. • Appropriate attribution must be given to ICSI on any and all print or electronic documents that reference the Guidelines. All other copyright rights for ICSI Health Care Guidelines are reserved by the Institute for Clinical Systems Improvement. The Institute for Clinical Systems Improvement assumes no liability for any use, adaptations, revisions or modifications made to ICSI Health Care Guidelines by the user or others. www.icsi.org Copyright © 2017 by Institute for Clinical Systems Improvement Health Care Guideline: Diagnosis and Treatment of Respiratory Illness in Children and Adults Main Algorithm Fifth Edition September 2017 Text in blue in this algorithm indicates a linked corresponding annotation. Patient reports some combination of symptoms: • Sore throat • Rhinorrhea • Cough • Fever • Hoarseness • Headache yes Are symptoms See immediately emergent? no Signs/symptoms of viral Signs/symptoms of strep Signs/symptoms of Signs/symptoms of acute upper-respiratory infection* pharyngitis* non-infectious rhinitis* bacterial sinusitis* • Rhinorrhea • Sudden onset of sore throat • Pruritis of the eyes, nose, • One or more of the following • Fever • Exudative tonsillitis palate, ears factors present at a point of • Cough • Tender anterior cervical • Watery rhinorrhea > 10 days after onset: • Hoarseness adenopathy • Sneezing - Facial pain or sinus pain, • Fever • Nasal congestion particularly aggravated by • Absence of rhinorrhea, • Postnasal drip postural changes or by cough, hoarseness valsalva maneuver Treatment options - Purulent nasal drainage • Comfort measures - Fever • Over-the-counter medications - Nasal congestion Do not give antibiotics See Acute Pharyngitis See Non-Infectious algorithm Rhinitis algorithm See Acute Sinusitis algorithm *See the relevant section for detailed description. Return to Table of Contents www.icsi.org Copyright © 2017 by Institute for Clinical Systems Improvement 1 Diagnosis and Treatment of Respiratory Illness in Children and Adults Fifth Edition/September 2017 Acute Pharyngitis Algorithm Text in blue in this algorithm Patient presents with indicates a linked corresponding symptoms of GAS* annotation. pharyngitis History/physical Shared decision-making Consider strep testing Do not routinely test if Centor (RADT**, throat culture, criteria < 3 or when viral features PCR***) based on clinical like rhinorrhea, cough, oral ulcers presentation and/or hoarseness are present Shared decision-making Treatment options Rapid test results yes • Symptomatic treatment show strep • Immediate antibiotics present? • Delayed antibiotics no • Symptomatic treatment Backup strep culture • Consider alternative for children Persistent no Follow-up as diagnoses infection/treatment needed failure? yes no Strep culture yes • Consider re-evaluation positive? for alternative diagnoses • Consider carrier state * Group A streptococcal ** Rapid antigen detection test *** Polymerase chain reaction Return to Table of Contents www.icsi.org Institute for Clinical Systems Improvement 2 Diagnosis and Treatment of Respiratory Illness in Children and Adults Fifth Edition/September 2017 Non-Infectious Rhinitis Algorithm Text in blue in this algorithm Patient presents with indicates a linked corresponding symptoms of non-infectious annotation. rhinitis History/physical Consider RAST* and skin yes testing when definitive Signs and symptoms no Signs and symptoms Consider referral to diagnosis is needed suggest allergic suggest structural specialist etiology? etiology? yes no * Radioallergosorbent test Treatment options Non-allergic • Education on avoidance rhinitis • Medications - Intranasal corticosteroids - Intranasal antihistamines - Oral antihistamines Treatment options - Combination intranasal • Medications antihistamines/intranasal corticosteroids - Intranasal antihistamines - Leukotriene blockers - Decongestants - Anticholinergics - Intranasal corticosteroids - Decongestants - Intranasal ipraptropium bromide • Patient education Adequate yes • Patient education Adequate yes • Follow-up as response? • Follow-up as appropriate response? appropriate no no Consider referral • Consider testing to a specialist • Consider referral to a specialist Return to Table of Contents www.icsi.org Institute for Clinical Systems Improvement 3 Diagnosis and Treatment of Respiratory Illness in Children and Adults Fifth Edition/September 2017 Acute Sinusitis Algorithm Text in blue in this algorithm indicates a linked corresponding Patient presents with annotation. symptoms suggestive of acute bacterial rhinosinusitis (ABRS) History/physical Diagnosis of ABRS Two clinical presentations where ABRS have a higher likelihood of being present: • Persistence of symptoms consistent with Does patient have no Consider alternative acute rhinosinusitis lasting 10 days or signs and symptoms diagnoses more without evidence of improvement of ABRS? • Symptoms are worsening – new onset of yes fever, headache or increase in nasal Shared discharge after a viral upper respiratory Treatment options decision-making infection that lasted 5-6 days and the patient • Symptomatic care was initially improving (double worsening - Comfort measures or double sickening) - Decongestants • Severe symptoms and high fever of 102ºF - Intranasal corticosteroids for at least 3-4 days from onset of illness • Consider immediate or delayed should not routinely be used as criteria to antibiotics based on the degree of diagnose ABRS. The diagnosis should be illness, comorbidities and after made on an individualized basis depending shared decision-making discussion on the entire clinical scenario. with patients who meet criteria for ABRS Re-evaluate • Start on antibiotic if not done Adequate • Consider changing an antibiotic no response to • Consider further evaluation and treatment? imaging yes • Consider alternative diagnoses • Consider referral to a specialist Continue plan of care and follow-up Return to Table of Contents www.icsi.org Institute for Clinical Systems Improvement 4 Diagnosis and Treatment of Respiratory Illness in Children and Adults Fifth Edition/September 2017 Table of Contents Work Group Leader Algorithms and Annotations ........................................................................................ 1-48 Sonja Short, MD Algorithm – Main .................................................................................................................1 Internal Medicine and Algorithm – Acute Pharyngitis .............................................................................................2 Pediatrics, Fairview Health Algorithm – Non-Infectious Rhinitis ...................................................................................3 Services Algorithm – Acute Sinusitis .................................................................................................4 Work Group Members Evidence Grading .................................................................................................................7 Fairview Health Services Hiba Bashir, MD Recommendations Table .................................................................................................. 8-9 Allergy/Immunology Foreword Danielle Olmschenk, PharmD Pharmacy Introduction ...................................................................................................................10 HealthPartners Scope and Target Population .........................................................................................10 Peter Marshall, PharmD Aims ..............................................................................................................................10 Pharmacy Implementation Recommendation Highlights ..............................................................11 Mayo Clinic Annotations .................................................................................................................. 12-48 Nathaniel Miller, MD 1. Initial Presentation ............................................................................................. 12-13 Family Medicine 2. Viral Upper-Respiratory
Load more

Recommended publications
  • Infections of the Respiratory Tract
    F70954-07.qxd 12/10/02 7:36 AM Page 71 Infections of the respiratory 7 tract the nasal hairs and by inertial impaction with mucus- 7.1 Pathogenesis 71 covered surfaces in the posterior nasopharynx (Fig. 11). 7.2 Diagnosis 72 The epiglottis, its closure reflex and the cough reflex all reduce the risk of microorganisms reaching the lower 7.3 Management 72 respiratory tract. Particles small enough to reach the tra- 7.4 Diseases and syndromes 73 chea and bronchi stick to the respiratory mucus lining their walls and are propelled towards the oropharynx 7.5 Organisms 79 by the action of cilia (the ‘mucociliary escalator’). Self-assessment: questions 80 Antimicrobial factors present in respiratory secretions further disable inhaled microorganisms. They include Self-assessment: answers 83 lysozyme, lactoferrin and secretory IgA. Particles in the size range 5–10 µm may penetrate further into the lungs and even reach the alveolar air Overview spaces. Here, alveolar macrophages are available to phagocytose potential pathogens, and if these are overwhelmed neutrophils can be recruited via the This chapter deals with infections of structures that constitute inflammatory response. The defences of the respira- the upper and lower respiratory tract. The general population tory tract are a reflection of its vulnerability to micro- commonly experiences upper respiratory tract infections, bial attack. Acquisition of microbial pathogens is which are often seen in general practice. Lower respiratory tract infections are less common but are more likely to cause serious illness and death. Diagnosis and specific chemotherapy of respiratory tract infections present a particular challenge to both the clinician and the laboratory staff.
    [Show full text]
  • Bronchiolitis
    6 Sand Hill Road, Suite 102 Flemington, NJ 08822 PHONE 908-782-6700 FAX 908-788-5861 hunterdonpediatrics.org BRONCHIOLITIS Bronchiolitis is an infection of the small breathing tubes (bronchioles) that lead to the lung. Bronchiolitis is not the same as bronchitis, which is an infection in the large breathing tubes (bronchi). Bronchiolitis is usually seen in infants and young toddlers. It is not usually seen in older children or adults. A virus causes bronchiolitis. The most common virus is RSV (respiratory syncytial virus). Since RSV infection does not usually result in immunity, people can get it again; however, beyond the age of two, RSV usually causes just a bad cold. RSV is very contagious and spreads rapidly through childcare groups and families from October through April. Some studies suggest that babies who get RSV are more likely to have asthma in the future. Also, people with asthma who get RSV infection may trigger an asthma attack. Babies with RSV have severe nasal congestion, usually followed by a worsening cough. There may be a mild fever at the beginning of the illness. Signs of trouble with RSV include: ● Poor feeding/decreased urine output ● Rapid breathing ● Grunting sound with breathing ● Tightening of chest or stomach muscles with breathing ● Wheezing (high pitched whistling sound with breathing out) ● Blue tint around mouth or fingers/toes ● Fever lasting more than two days, or over 104 The vast majority of patients with bronchiolitis recover well. Certain children are especially likely to have trouble with bronchiolitis: ● Infants under two months of age ● Infants who were premature and have not reached their “due date” yet ● Patients with lung diseases like cystic fibrosis or bronchopulmonary dysplasia (BPD) ● Patients with severe heart disease ● Patients with AIDS or other immunity problems ● Patients on chemotherapy or with organ transplants Treatment for bronchiolitis is mostly supportive; that is, treatment is aimed at helping the patient breathe better.
    [Show full text]
  • Respiratory Syncytial Virus Bronchiolitis in Children DUSTIN K
    Respiratory Syncytial Virus Bronchiolitis in Children DUSTIN K. SMITH, DO; SAJEEWANE SEALES, MD, MPH; and CAROL BUDZIK, MD Naval Hospital Jacksonville, Jacksonville, Florida Bronchiolitis is a common lower respiratory tract infection in infants and young children, and respiratory syncytial virus (RSV) is the most common cause of this infection. RSV is transmitted through contact with respiratory droplets either directly from an infected person or self-inoculation by contaminated secretions on surfaces. Patients with RSV bronchiolitis usually present with two to four days of upper respiratory tract symptoms such as fever, rhinorrhea, and congestion, followed by lower respiratory tract symptoms such as increasing cough, wheezing, and increased respira- tory effort. In 2014, the American Academy of Pediatrics updated its clinical practice guideline for diagnosis and man- agement of RSV bronchiolitis to minimize unnecessary diagnostic testing and interventions. Bronchiolitis remains a clinical diagnosis, and diagnostic testing is not routinely recommended. Treatment of RSV infection is mainly sup- portive, and modalities such as bronchodilators, epinephrine, corticosteroids, hypertonic saline, and antibiotics are generally not useful. Evidence supports using supplemental oxygen to maintain adequate oxygen saturation; however, continuous pulse oximetry is no longer required. The other mainstay of therapy is intravenous or nasogastric admin- istration of fluids for infants who cannot maintain their hydration status with oral fluid intake. Educating parents on reducing the risk of infection is one of the most important things a physician can do to help prevent RSV infection, especially early in life. Children at risk of severe lower respiratory tract infection should receive immunoprophy- laxis with palivizumab, a humanized monoclonal antibody, in up to five monthly doses.
    [Show full text]
  • Tonsillopharyngitis - Acute (1 of 10)
    Tonsillopharyngitis - Acute (1 of 10) 1 Patient presents w/ sore throat 2 EVALUATION Yes EXPERT Are there signs of REFERRAL complication? No 3 4 EVALUATION Is Group A Beta-hemolytic Yes DIAGNOSIS Streptococcus (GABHS) • Rapid antigen detection test infection suspected? (RADT) • roat culture No TREATMENT EVALUATION No A Supportive management Is GABHS confi rmed? B Pharmacological therapy (Non-GABHS) Yes 5 TREATMENT A EVALUATE RESPONSEMIMS Supportive management TO THERAPY C Pharmacological therapy • Antibiotics Poor/No Good D Surgery, if recurrent or complicated response response REASSESS PATIENT COMPLETE THERAPY & REVIEW THE DIAGNOSIS© Not all products are available or approved for above use in all countries. Specifi c prescribing information may be found in the latest MIMS. B269 © MIMS Pediatrics 2020 Tonsillopharyngitis - Acute (2 of 10) 1 ACUTE TONSILLOPHARYNGITIS • Infl ammation of the tonsils & pharynx • Etiologies include bacterial (group A β-hemolytic streptococcus, Haemophilus infl uenzae, Fusobacterium sp, etc) & viral (infl uenza, adenovirus, coronavirus, rhinovirus, etc) pathogens • Sore throat is the most common presenting symptom in older children TONSILLOPHARYNGITIS 2 EVALUATION FOR COMPLICATIONS • Patients w/ sore throat may have deep neck infections including epiglottitis, peritonsillar or retropharyngeal abscess • Examine for signs of upper airway obstruction Signs & Symptoms of Sore roat w/ Complications • Trismus • Inability to swallow liquids • Increased salivation or drooling • Peritonsillar edema • Deviation of uvula
    [Show full text]
  • The Common Cold.Pdf
    PATIENT TEACHING AID The Common Cold PERFORATION ALONG TEAR Everyone has experienced the misery of the common Rhinovirus Infection cold. A cold causes familiar symptoms such as a runny nose, sore throat, congestion, postnasal drip, and cough. For most sufferers, these symptoms are annoying, but not serious. Cold symptoms gradually improve and disappear over 7 to 10 days without complications. Colds are viral infections, so treatment with an antibiotic is not helpful. The best treatment for a cold is rest, fluids, and nonprescription medicines to help relieve symptoms. Although there is no vaccine to prevent colds, the spread of cold viruses can be slowed by frequent hand washing and avoiding close contact with those suffering from a cold. ILLUSTRATION: KRISTEN WIENANDT MARZEJON 2016 MARZEJON WIENANDT KRISTEN ILLUSTRATION: Copyright Jobson Medical Information LLC, 2016 continued MEDICAL PATIENT TEACHING AID Antibiotics Should Not Be Used to Treat a Cold Colds are caused by a variety of viruses, most commonly rhinoviruses. These viruses are highly contagious, and they are spread through the air or when someone is in contact with an infected person or contaminated object. There is no good evidence that exposure to cold or being overheated © Jobson Medical Information LLC, 2016 LLC, Information Medical Jobson © increases the risk of contracting a cold. Although most Wash your hands thoroughly and frequently colds occur in the winter months, some viruses that cause to prevent the spread of cold viruses. colds are more common in the fall or spring. Infants and young children are more prone to colds, as are people with weakened immunity.
    [Show full text]
  • SEPTOPLASTY SURGICAL INFORMED CONSENT the Nasal
    .SEPTOPLASTY SURGICAL INFORMED CONSENT The nasal septum is the wall inside your nose that divides it into two separate nasal passages. It is made of cartilage and bone. In a healthy nose, there is usually nearly equal airflow on both sides. Sometimes, the nasal septum is crooked or twisted. This condition is called a deviated nasal septum, and it can be caused by trauma to the nose, or patients can be born this way. The primary problem with a deviated nasal septum is nasal blockage, either on one or both sides. This nasal blockage can also contribute to nosebleeds, sinus infections, and often worsens obstructive sleep apnea. Occasionally, a deviated septum can be associated with a specific type of headache. A deviated septum can be surgically repaired with an operation called a septoplasty. This is typically done through a closed approach, which takes about one hour. More complicated or severely deviated septa may require an open approach, which can take up to 2-3 hours. In either case, septoplasty surgery is done under general anesthesia. It is an outpatient procedure so patients will be discharged home the same day. Some patients have multiple causes of nasal obstruction. Aside from a deviated septum, other reasons for a stuffy nose include chronic sinusitis, turbinate hypertrophy, nasal polyps, or nasal valve collapse. In these cases, septoplasty surgery may be performed in conjunction with other procedures such as endoscopic sinus surgery, turbinate reduction, or insertion of alar batten or spreader grafts. These procedures are discussed in their own individual sections on our website. Your physician will discuss what surgery is most appropriate for you.
    [Show full text]
  • Intranasal Ipratropium Bromide Reduced Rhinorrhea and Improved Cold Symptoms
    /:*-..= S Evid Based Med: first published as 10.1136/ebm.1996.1.205 on 1 December 1996. Downloaded from Intranasal ipratropium bromide reduced rhinorrhea and improved cold symptoms Hayden FG, Diamond L, Wood PB, 0.06% in a buffered salt solution (P = 0.003). {This 17% absolute dif- KortsDC, Wecker MT. Effectiveness (2 sprays/nostril [84 u,g] 3 times/d ference in improvement between the and safety of intranasal ipratropium for 4 d) (n = 137), the same nasal ipratropium and placebo groups bromide in common colds. A ran- spray without ipratropium in = 137), means that 6 patients (95% CI, 4 to domized, double-blind, placebo- or no medication (n = 137). No cold 16) would need to be treated with controlled trial. Ann Intern Med. medications other than analgesics ipratropium (rather than placebo) for 1996JullS;12S:89-91. and antitussives were allowed. 4 days to result in improvement for 1 additional patient; the relative risk Main outcome measures improvement was 26%, CI 9% to Objective 47%* }. Rates of nasal dryness (12% To determine whether intxanasal ipra- The main outcome measure was a vs 4%), blood-tinged mucus (17% vs tropium bromide is effective and safe global assessment of overall improve- 4%), and headache (9% vs 2%) were for reducing common cold symptoms. ment (report by patients of being better or much better). Rhinorrhea greater in the ipratropium group than Design was monitored in the clinic hourly in the placebo group. 6-day, randomized, double-blind, for the first 6 hours on day 1 and Conclusion placebo-controlled trial. hourly for 3 hours on day 2.
    [Show full text]
  • Allergic/Non-Allergic Rhinitis
    Tips to Remember: Rhinitis Do you have a runny or stuffy nose that doesn't seem to go away? If so, you may have rhinitis, which is an inflammation of the mucous membranes of the nose. Rhinitis is one of the most common allergic conditions in the United States, affecting about 40 million people. It often coexists with other allergic disorders, such as asthma. It is important to treat rhinitis because it can contribute to other conditions such as sleep disorders, fatigue and learning problems. There are two general types of rhinitis: Allergic rhinitis is caused by substances called allergens. Allergens are often common, usually harmless substances that can cause an allergic reaction in some people. Causes • When allergic rhinitis is caused by common outdoor allergens, such as airborne tree, grass and weed pollens or mold, it is called seasonal allergic rhinitis, or "hay fever." • Allergic rhinitis is also triggered by common indoor allergens, such as animal dander (dried skin flakes and saliva), indoor mold or droppings from cockroaches or dust mites. This is called perennial allergic rhinitis. Symptoms • Sneezing • Congestion • Runny nose • Itchiness in the nose, roof of the mouth, throat, eyes and ears Diagnosis If you have symptoms of allergic rhinitis, an allergist/immunologist can help determine which specific allergens are triggering your reaction. He or she will take a thorough health history, and then test you to determine if you have allergies. Skin tests or Blood (RAST) tests are the most common methods for determining your allergic triggers. Treatment Once your allergic triggers are determined, your physician or nurse will work with you to develop a plan to avoid the allergens that trigger your symptoms.
    [Show full text]
  • Allergic Fungal Airway Disease Rick EM, Woolnough K, Pashley CH, Wardlaw AJ
    REVIEWS Allergic Fungal Airway Disease Rick EM, Woolnough K, Pashley CH, Wardlaw AJ Institute for Lung Health, Department of Infection, Immunity & Inflammation, University of Leicester and Department of Respiratory Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK J Investig Allergol Clin Immunol 2016; Vol. 26(6): 344-354 doi: 10.18176/jiaci.0122 Abstract Fungi are ubiquitous and form their own kingdom. Up to 80 genera of fungi have been linked to type I allergic disease, and yet, commercial reagents to test for sensitization are available for relatively few species. In terms of asthma, it is important to distinguish between species unable to grow at body temperature and those that can (thermotolerant) and thereby have the potential to colonize the respiratory tract. The former, which include the commonly studied Alternaria and Cladosporium genera, can act as aeroallergens whose clinical effects are predictably related to exposure levels. In contrast, thermotolerant species, which include fungi from the Candida, Aspergillus, and Penicillium genera, can cause a persistent allergenic stimulus independent of their airborne concentrations. Moreover, their ability to germinate in the airways provides a more diverse allergenic stimulus, and may result in noninvasive infection, which enhances inflammation. The close association between IgE sensitization to thermotolerant filamentous fungi and fixed airflow obstruction, bronchiectasis, and lung fibrosis suggests a much more tissue-damaging process than that seen with aeroallergens. This review provides an overview of fungal allergens and the patterns of clinical disease associated with exposure. It clarifies the various terminologies associated with fungal allergy in asthma and makes the case for a new term (allergic fungal airway disease) to include all people with asthma at risk of developing lung damage as a result of their fungal allergy.
    [Show full text]
  • Influenza (PDF)
    INFLUENZA Outbreaks of influenza, or “flu”, typically occur every winter. Colds may occur at any time of year with seasonal peaks occurring in fall and spring. Influenza is a respiratory illness usually caused by infection with one of two influenza viruses – influenza A or influenza B. Outbreaks of influenza (flu) typically occur every winter. Influenza is characterized by an abrupt onset of fever, chills, headache, body aches, and lack of energy accompanied by respiratory symptoms, most frequently cough and sore throat. Most people are largely recovered in one week, although many feel fatigued for several weeks. Serious complications of flu, such as pneumonia, however, can occur, especially if the body’s defenses are weakened by age or disease. Influenza is spread by inhaling the influenza virus which is usually carried on tiny, invisible water droplets in the air generated by coughs and sneezes. Hand-to-hand contact as well as contact with infected secretions on a hard surface may also cause transmission of the virus. Each year influenza viruses change and new vaccines are made to combat the particular strains that are expected to cause illness that year. The flu vaccine may reduce the chance of getting the flu by 60-80%, and lessen the severity of illness in the person who does get the flu. According to the Centers for Disease Control (CDC), everyone 6 months or order should get a yearly flu vaccine. The following people are at high risk for complications of flu and are especially urged to get vaccinated: Individuals with chronic heart or lung problems that have required regular medical follow-up or hospitalization during the last year.
    [Show full text]
  • The Respiratory System
    Respiratory Rehabilitation Program The Respiratory System Every cell in the body needs oxygen to survive. The respiratory system provides a way for oxygen to enter the body. It also provides a way for carbon dioxide, the waste product of cells, to leave the body. The respiratory system is made up of 2 sections: the upper respiratory tract and the lower respiratory tract mouth and nose larynx or voice box trachea The Upper Respiratory Tract Mouth and Nose Air enters the body through your mouth and nose. The air is warmed, moistened and filtered by mucous secretions and hairs in the nose. Larynx or Voice Box The larynx sits at the top of the trachea. It contains your vocal cords. Each time you breathe in or inhale, the air passes through the larynx, down the trachea and into the lungs. When you breathe out or exhale, the air moves from your lungs, up your trachea and out through your nose and mouth. When you speak, the vocal cords tighten up and move closer together. Air from the lungs is forced between them and causes them to vibrate. This produces sound. Your tongue, lips and teeth form words out of these sounds. Trachea The trachea is the tube that connects the mouth and nose to your lungs. It is also called the windpipe. The Lower Respiratory Tract Inside Lungs Outside Lungs bronchial tubes alveoli diaphragm (muscle) Bronchial Tubes The trachea splits into 2 bronchial tubes in your lungs. These are called the left bronchus and right bronchus. The bronchus tubes keep branching off into smaller and smaller tubes called bronchi.
    [Show full text]
  • RESPIRATORY TRACT INFECTIONS Peter Zajac, DO, FACOFP, Author Amy J
    OFP PATIENT EDUCATION HANDOUT RESPIRATORY TRACT INFECTIONS Peter Zajac, DO, FACOFP, Author Amy J. Keenum, DO, PharmD, Editor • Ronald Januchowski, DO, FACOFP, Health Literacy Editor HOME MANAGEMENT INCLUDES: • Drinking plenty of clear fuids and rest. Vitamin-C may help boost your immune system. Over-the-counter pain relievers such as acetaminophen and ibuprofen can be helpful for fevers and to ease any aches. Saline (salt) nose drops, lozenges, and vapor rubs can also help symptoms when used as directed by your physician. • A cool mist humidifer can make breathing easier by thinning mucus. • If you smoke, you should try to stop smoking for good! Avoid second-hand smoking also. • In most cases, antibiotics are not recommended because they are only effective if bacteria caused the infection. • Other treatments, that your Osteopathic Family Physician may prescribe, include Osteopathic Manipulative Therapy (OMT). OMT can help clear mucus, Respiratory tract infections are any relieve congestion, improve breathing and enhance comfort, relaxation, and infection that affect the nose, sinuses, immune function. and throat (i.e. the upper respiratory tract) or airways and lungs (i.e. the • Generally, the symptoms of a respiratory tract infection usually pass within lower respiratory tract). Viruses are one to two weeks. the main cause of the infections, but • To prevent spreading infections, sneeze into the arm of your shirt or in a tissue. bacteria can cause some. You can Also, practice good hygiene such as regularly washing your hands with soap and spread the infection to others through warm water. Wipe down common surfaces, such as door knobs and faucet handles, the air when you sneeze or cough.
    [Show full text]