Mosby’s PATHOLOGY Lesson 10.1 Objective Massage · PDF fileDefine upper respiratory tract infections and Define upper respiratory tract ... Discuss the vascular disorders and include

Chapter 10Chapter 10

Respiratory PathologiesRespiratory Pathologies

Mosby’s PATHOLOGY

for Massage Therapists

Copyright © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.2

Copyright © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.2

Lesson 10.1 ObjectiveLesson 10.1 Objective

�� Discuss anatomic structures and physiologic Discuss anatomic structures and physiologic

processes related to the respiratory system.processes related to the respiratory system.

3Copyright © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.

3

Respiratory SystemRespiratory System

�� Functions:Functions:

�� Exchange of gasesExchange of gases

�� Regulates blood pHRegulates blood pH

�� Provides sense of smellProvides sense of smell

�� Filters incoming airFilters incoming air

�� Produces soundsProduces sounds

�� Eliminates some water and heatEliminates some water and heat


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Respiratory System Respiratory System (cont(cont’’d.)d.)

From Salvo S: From Salvo S: Massage therapy; principles and practice,Massage therapy; principles and practice, eded 3, St. Louis, 2007, Saunders.3, St. Louis, 2007, Saunders.


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From From VidicVidic B, Suarez FR: B, Suarez FR: Photographic atlas of the human body,Photographic atlas of the human body, St. Louis, 1984, Mosby.St. Louis, 1984, Mosby.

�� LungsLungs

�� Separate organsSeparate organs

�� Rests on the Rests on the

diaphragmdiaphragm

�� Right lung has 3 Right lung has 3

lobes; left lung lobes; left lung

has 2 lobeshas 2 lobes


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�� Oxygen diffuses Oxygen diffuses

from alveoli into from alveoli into

blood blood

�� Carbon dioxide Carbon dioxide

diffuses from blood diffuses from blood

to alveoli to alveoli



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�� Pulmonary ventilation Pulmonary ventilation –– Air movement into Air movement into

and out of lungsand out of lungs

�� consists of inspiration and expirationconsists of inspiration and expiration


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Lesson 10.2 ObjectivesLesson 10.2 Objectives

�� Define upper respiratory tract infections and Define upper respiratory tract infections and

list appropriate massage considerations.list appropriate massage considerations.

�� Discuss lower respiratory tract infections and Discuss lower respiratory tract infections and

list appropriate massage considerations. list appropriate massage considerations.


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Upper Respiratory Tract Upper Respiratory Tract

InfectionsInfections

�� Common coldCommon cold

�� SinusitisSinusitis

�� PharyngitisPharyngitis

�� LaryngitisLaryngitis

�� InfluenzaInfluenza

�� Infectious mononucleosisInfectious mononucleosis


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Common ColdCommon Cold

�� Acute inflammation of the upper respiratory tract Acute inflammation of the upper respiratory tract

mucosamucosa

�� Usually confined to the nose and throatUsually confined to the nose and throat

�� Massage is contraindicatedMassage is contraindicated


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SinusitisSinusitis

�� Inflammation of the Inflammation of the paranasalparanasal sinus sinus mucosaemucosae

�� Massage is contraindicated during acute Massage is contraindicated during acute

episodes; otherwise, avoid prone position if episodes; otherwise, avoid prone position if

pressure of face rest causes pain or in cases of pressure of face rest causes pain or in cases of

breathing difficulty breathing difficulty



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PharyngitisPharyngitis

�� Inflammation of the pharynxInflammation of the pharynx

�� Also called sore throat Also called sore throat

�� Strep throat: Strep throat: pharyngitispharyngitis due to Streptococcus due to Streptococcus

bacteriabacteria

�� Massage is contraindicated if caused by Massage is contraindicated if caused by

infectious agentinfectious agent


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LaryngitisLaryngitis

�� Inflammation of the Inflammation of the

larynx often resulting in larynx often resulting in

loss of voiceloss of voice

�� Massage is Massage is

contraindicated if due to contraindicated if due to

infectious diseaseinfectious diseaseFrom From DamjanovDamjanov I, Linder J: I, Linder J: Pathology: a color atlas,Pathology: a color atlas, St. St.

Louis, 2000, Mosby.Louis, 2000, Mosby.


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InfluenzaInfluenza

�� Viral upper respiratory tract infectionViral upper respiratory tract infection

�� Can extend into the lower respiratory tractCan extend into the lower respiratory tract

�� Massage is contraindicatedMassage is contraindicated


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Infectious MononucleosisInfectious Mononucleosis

�� Viral respiratory infection Viral respiratory infection

caused by EBV; can also caused by EBV; can also

be caused by CMVbe caused by CMV


contraindicatedcontraindicated

Courtesy Dr. M. Sherlock. In Courtesy Dr. M. Sherlock. In ZitelliZitelli BJ, Davis HW: BJ, Davis HW: Atlas of Atlas of

pediatric physical diagnosis, pediatric physical diagnosis, eded 3, St. Louis, 1997, Mosby.3, St. Louis, 1997, Mosby.


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Lower Respiratory Tract InfectionsLower Respiratory Tract Infections

�� PleurisyPleurisy

�� PneumoniaPneumonia

�� TuberculosisTuberculosis


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PleurisyPleurisy

�� Inflammation of pleural Inflammation of pleural

membranes; usually membranes; usually

from a secondary from a secondary

diseasedisease


contraindicated contraindicated


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PneumoniaPneumonia

�� Lung infection; usually Lung infection; usually

bacterial bacterial

�� Massage is contraindicated; Massage is contraindicated;

in some instances, clientin some instances, client’’s s

physician may approve physician may approve

postural drainage while postural drainage while

client is recovering client is recovering

From From DamjanovDamjanov I: I: Pathology for the health professions,Pathology for the health professions, eded 3, St. Louis, 2006, Saunders.3, St. Louis, 2006, Saunders.


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Postural DrainagePostural Drainage


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Postural DrainagePostural Drainage

�� Obtain medical Obtain medical

clearanceclearance

�� PercussPercuss and vibrate and vibrate

back and rib cage back and rib cage

for up to 5 for up to 5 minsmins

�� Use intervals of 30Use intervals of 30--

45 seconds, pausing 45 seconds, pausing

5 seconds between 5 seconds between

intervalsintervals


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TuberculosisTuberculosis

�� Bacterial lung infection Bacterial lung infection

transmitted by inhalation transmitted by inhalation

of infected dropletsof infected droplets

�� Postpone massage until Postpone massage until

4th wk from start of 4th wk from start of

treatment; massage is treatment; massage is

contraindicated during contraindicated during

secondary TB secondary TB

Modified from Gould B: Modified from Gould B: PathophysiologyPathophysiology for the health professions,for the health professions,

eded 2, Philadelphia, 2002, WB Saunders.2, Philadelphia, 2002, WB Saunders.


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Lesson 10.3 ObjectivesLesson 10.3 Objectives

�� List chronic obstructive pulmonary diseases along List chronic obstructive pulmonary diseases along

with appropriate massage considerations.with appropriate massage considerations.

�� Identify types and causes of Identify types and causes of pneumoconiosespneumoconioses..

�� Discuss the vascular disorders and include Discuss the vascular disorders and include

appropriate massage considerations. appropriate massage considerations.

�� Define the expansion disorder and appropriate Define the expansion disorder and appropriate

massage considerations.massage considerations.


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Lesson 10.3 Objectives Lesson 10.3 Objectives (cont(cont’’d.)d.)

�� Discuss the immune disorder featured in this Discuss the immune disorder featured in this

chapter and include appropriate massage chapter and include appropriate massage

considerations.considerations.

�� Contrast and compare a common cold to hay Contrast and compare a common cold to hay

fever.fever.

�� Delineate the muscles of respiration.Delineate the muscles of respiration.


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Chronic Obstructive Pulmonary Chronic Obstructive Pulmonary

DiseasesDiseases

From From DamjanovDamjanov I: I: Pathology for the healthPathology for the health--related professions,related professions, eded 2, Philadelphia, 2000, WB Saunders.2, Philadelphia, 2000, WB Saunders.


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Diseases Diseases (cont(cont’’d.)d.)

Pink PuffersPink Puffers Blue BloatersBlue Bloaters



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Diseases Diseases (cont(cont’’d.)d.)

�� AsthmaAsthma

�� BronchitisBronchitis

�� EmphysemaEmphysema

�� PneumoconiosisPneumoconiosis

�� BronchiectasisBronchiectasis

�� Cystic fibrosisCystic fibrosis

�� Obstructive sleep apneaObstructive sleep apnea


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AsthmaAsthma

�� Chronic, inflammatory Chronic, inflammatory

disorder characterized disorder characterized

by bronchial obstruction by bronchial obstruction

in susceptible persons in susceptible persons

�� Avoid allergens and Avoid allergens and

triggers; have triggers; have

medications handy if medications handy if

needed needed

From Frazier MS, From Frazier MS, DrzymkowskiDrzymkowski JW: JW: Essentials of human diseases and Essentials of human diseases and

conditions,conditions, eded 2, Philadelphia, 2000, WB Saunders.2, Philadelphia, 2000, WB Saunders.


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BronchitisBronchitis

�� Inflammation of Inflammation of

bronchial mucosa bronchial mucosa

with resultant with resultant

swelling and swelling and

mucous mucous

hypersecretionhypersecretion


contraindicated in contraindicated in

acute casesacute cases

Courtesy Courtesy RolinRolin Graphics. In Graphics. In ThibodeauThibodeau GA, Patton KT: GA, Patton KT: Anatomy and physiology,Anatomy and physiology, eded 4, St. Louis, 1999, Mosby.4, St. Louis, 1999, Mosby.


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EmphysemaEmphysema

�� Permanent enlargement Permanent enlargement

of lower airways of lower airways

affecting elasticity in affecting elasticity in

alveolar wallsalveolar walls

�� Major cause is cigarette Major cause is cigarette

smokesmoke



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Emphysema Emphysema (cont(cont’’d.)d.)

�� Client might need Client might need

semirecliningsemireclining position if position if

breathing is difficult; in breathing is difficult; in

later stages, reduce later stages, reduce

treatment time and treatment time and

pressurepressure

From Salvo S: From Salvo S: Massage therapy: principles and practice,Massage therapy: principles and practice, eded 2, 2,

Philadelphia, 2003, WB Saunders.Philadelphia, 2003, WB Saunders.


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PneumoconiosisPneumoconiosis

�� Lung disease from longLung disease from long--

term dust inhalation, usually term dust inhalation, usually

occurring in the workplaceoccurring in the workplace

�� Reduce treatment time and Reduce treatment time and

pressure if client is overly pressure if client is overly

fatigued fatigued


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Pneumoconiosis, TypesPneumoconiosis, Types (cont(cont’’d.)d.)

�� Asbestosis Asbestosis –– From asbestos From asbestos

�� Allergic Allergic alveolitisalveolitis –– From fungal spores From fungal spores

�� ChalicosisChalicosis –– From stone dust From stone dust

�� AnthracosisAnthracosis –– From carbon particles From carbon particles

�� SiderosisSiderosis –– From iron oxide From iron oxide

�� Silicosis Silicosis –– From silica or quartzFrom silica or quartz


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BronchiectasisBronchiectasis

�� Irreversible dilation of Irreversible dilation of

bronchi caused by airway bronchi caused by airway

infection or inflammationinfection or inflammation


contraindicated if due to contraindicated if due to

infectious agentinfectious agent

From From DamjanovDamjanov I, Linder J, I, Linder J, edseds: : AndersonAnderson’’s pathology,s pathology, eded 10, St. Louis, 1996, Mosby.10, St. Louis, 1996, Mosby.


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Cystic FibrosisCystic Fibrosis

�� Genetic disorder causing Genetic disorder causing

hypersecretionhypersecretion of cells that of cells that

produce mucus, saliva, and produce mucus, saliva, and

digestive juice; poor nutrition digestive juice; poor nutrition

and small stature commonand small stature common

�� Obtain medical clearance Obtain medical clearance

From From ZitelliZitelli BJ, Davis HW: BJ, Davis HW: Atlas of pediatric physical Atlas of pediatric physical

diagnosis,diagnosis, eded 3, St. Louis, 1997, Mosby.3, St. Louis, 1997, Mosby.


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Obstructive Sleep ApneaObstructive Sleep Apnea�� Temporary cessation of Temporary cessation of breathing or absence of breathing or absence of spontaneous breathingspontaneous breathing

�� Favor clientFavor client’’s preferred s preferred position for majority of position for majority of massagemassage

Courtesy Robert Margulies, Miami, FL. In Smolley LA: How to help patients with obstructive sleep apnea, J Respir Dis 11:723-732, 1990.


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Vascular DisordersVascular Disorders

�� Pulmonary edemaPulmonary edema

�� Pulmonary embolismPulmonary embolism


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Pulmonary EdemaPulmonary Edema

�� Excessive amounts Excessive amounts

of fluid in lungs which of fluid in lungs which

interferes with its interferes with its

ability to expand; this ability to expand; this

limits gas exchangelimits gas exchange




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Pulmonary EmbolismPulmonary Embolism

�� Partial or complete Partial or complete

closure of pulmonary closure of pulmonary

artery or one of its artery or one of its

branches by an branches by an

embolusembolus

�� Massage isMassage is


From Gould BE: From Gould BE: PathophysiologyPathophysiology for the health professions,for the health professions, eded 3, Philadelphia, 2006, Saunders.3, Philadelphia, 2006, Saunders.


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Expansion DisordersExpansion Disorders

�� Acute respiratory distress syndromeAcute respiratory distress syndrome


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Acute Respiratory Distress Acute Respiratory Distress

SyndromeSyndrome

�� Severe condition Severe condition

causing fluid buildcausing fluid build--up up

in lungsin lungs

�� Massage isMassage is



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Immune DisordersImmune Disorders

�� Hay feverHay fever


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Hay FeverHay Fever

�� Hypersensitivity of nasal mucosa to allergensHypersensitivity of nasal mucosa to allergens

�� Also called allergic rhinitis Also called allergic rhinitis

�� Massage is contraindicated if acute allergic Massage is contraindicated if acute allergic

attack; otherwise, avoid allergens and scents attack; otherwise, avoid allergens and scents

that may be a trigger and have medications that may be a trigger and have medications

handy if they are needed handy if they are needed


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Common Cold vs. Hay FeverCommon Cold vs. Hay Fever


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Muscles of RespirationMuscles of Respiration

�� Muscles of inspiration: Muscles of inspiration:

�� Primary Primary –– diaphragm, external intercostals diaphragm, external intercostals

�� Secondary (Accessory) Secondary (Accessory) –– scalenesscalenes, ,

sternocleidomastoidsternocleidomastoid, , pectoralispectoralis minor, minor, serratusserratus

anterior, anterior, serratusserratus posterior superiorposterior superior


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Muscles of Respiration Muscles of Respiration (cont(cont’’d.)d.)

�� Muscles of expirationMuscles of expiration

�� Primary: none (passive process) Primary: none (passive process)

�� Secondary: internal intercostals, Secondary: internal intercostals, serratusserratus posterior posterior

inferior, abdominalsinferior, abdominals

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Mosby’s PATHOLOGY Lesson 10.1 Objective Massage · PDF fileDefine upper respiratory tract infections and Define upper respiratory tract ... Discuss the vascular disorders and include