The respiratory system
Peter Kopelman, Dame Jane Dacre in Handbook of Clinical Skills, 2019
Respiratory diseases often lead to hospital admission, and patients with chronic obstructive pulmonary disease may require repeated admissions for infective exacerbations. Smoking remains the single most important cause of respiratory disease despite greater awareness of the dangers of cigarette smoking and health warnings placed in advertisements and on cigarette packets. The nasal cavities form the first part of the respiratory passage and extend from the anterior nares or nostrils to the nasopharynx. The nares are lined with respiratory epithelium, with some olfactory epithelium. The respiratory tract includes the nose, nasopharynx and larynx, extending down into the alveoli to include the blood supply. A history of childhood asthma, pneumonia or whooping cough is sometimes relevant to the later development of chest symptoms in an adult. Chest injuries and previous pneumonia may explain changes seen on a chest X-ray.
Tests of the mucociliary apparatus, inflammation and cystic fibrosis
Glenis K. Scadding, Valerie J Lund in Investigative Rhinology, 2004
Method The patient is asked to blow their nose. Under direct vision, using small forceps (Figure 7.1), a quarter tablet of saccharin is placed on the medial border of the inferior turbinate about 1 cm back from the anterior edge. The patient is asked to sit quietly without sneezing, sniffing, snorting, eating or drinking. They should swallow approximately once a minute and report as soon as any taste is experienced. The nature of the taste is not specified so that the patient can be asked about the quality of the sensation when reporting. A possible variation is to employ saccharin which has been dyed with Evans blue, so that this can be looked for in the nasopharynx.
Respiratory System
David Sturgeon in Introduction to Anatomy and Physiology for Healthcare Students, 2018
This chapter shows that oxygen from the atmosphere diffuses from a high concentration in the alveoli to a lower concentration in pulmonary circulation. The respiratory system consists of the airways, the lungs, the muscles of respiration and the areas of the nervous system which control the rate and depth of ventilation. The airways are divided into the upper and lower respiratory tract at the larynx. Air enters the larynx through the epiglottis which protects the glottis and lower respiratory tract when swallowing occurs. The upper respiratory tract consists of the nasal cavity, the mouth and the pharynx. Air is inhaled through the nose and is filtered, warmed and humidified as it passes through the nasal conchae and makes its way to posterior chamber of the nasal cavity and the upper part of the pharynx – the nasopharynx. The pharynx, oral cavity and nasal cavity also act as resonating chamber that helps to provide the distinctive sound quality of the voice.
Endoscopic Examination of the Nasopharynx
Published in Acta Oto-Laryngologica, 1979
Endoscopic examination of the nasopharynx is a simple and rapid procedure. The inspection can be made through the nose. This method is recommended for screening. If abnormalities of the nasopharynx are disclosed and are to be studied in detail, and particularly if such abnormalities are to be documented photographically, it is necessary to inspect them through the oropharynx while the soft palate is drawn forward. It is possible under direct vision to take representative biopsy specimens, and it is easy to take photographs for the purpose of documentation, comparison and education. This procedure can to a great extent replace diagnostic excision of tissue from the nasopharynx under general anaesthesia. Especially with a view to early diagnosis of malignant disease of the nasopharynx, it is important to extend the use of this method, which can be performed with little discomfort to the patient.
Endotoxin Liberation and Invasivity of Neisseria meningitidis
Published in Scandinavian Journal of Infectious Diseases, 1984
Bjørg Marit Andersen, Otto Solberg
The relationship between endotoxin liberation and invasiveness was studied in 50 strains of Neisseria meningitidis isolated from blood or cerebrospinal fluid (CSF) of 16 patients with invasive disease, from nasopharynx of 9 patients with upper respiratory tract symptoms, and from nasopharynx and rectum (1, serogroup W-135) in 25 persons examined for venereal disease. Meningococci varied in their ability to liberate endotoxin. Free endotoxin was partly a function of growth and seemed to be associated with certain properties of the individual strain. Strains isolated from patients with invasive disease liberated significantly more endotoxin than strains isolated from the venereal group (p < 0.002). All 16 invasive strains were sulfonamide resistant, against 5/9 strains from patients with upper respiratory disease symptoms and only 4/25 strains from the venereal group. The difference between the invasive group and the venereal group was significant (p < 0.002). Serogroup A, B, C meningococci liberated significantly more endotoxin than non-A, B, C strains (p = 0.01), and serogroup A, B, C strains isolated from nasopharynx tended to have a higher endotoxin release than non-A, B, C strains isolated from the same place (not significant). Serogroup B meningococci were most frequently isolated both from patients with invasive disease and from the nasopharynx of the persons examined for venereal disease. Serogroup B meningococci had significantly more free endotoxin when isolated from blood or CSF than when isolated from nasopharynx of presumably healthy persons (p = 0.002).
Lymphoepithelioma of the Nasopharynx: Cervical Adenopathy Diagnosed Late
Published in Acta Oto-Laryngologica, 1967
G. Everberg, K.-E. Sjölin, I. Ørntoft
A case of nasopharyngeal lymphoepithelioma in a 16-year-old boy is reported. Ten months elapsed from the first manifestation, swelling of the cervical lymph nodes, until the diagnosis was made. The first biopsy from the nasopharynx was negative. Four biopsies from the cervical nodes were negative. All the findings indicated infection, until the second biopsy from the nasopharynx disclosed the true nature of the disease. The 4 negative cervical-node biopsies are remarkable. The most likely explanation is lymphoid overgrowth of the cancer tissue. The necessity of continuing to remove biopsies from swollen cervical nodes as well as from the nasopharynx is emphasized, all the more so as the disease is amenable to radiotherapy, if it is diagnosed in time.