Pulmonary Flashcards
(106 cards)
Define chronic bronchitis
Chronic cough and production sputum for a minimum of 3 months a year for at least two consecutive years
Microscopic features of chronic bronchitis
- Increase in glands
- Patches of inflammatory cells (WBCs)
- Damaged lining with increase goblet cells
What does increased mucus production lead to in chronic bronchitis?
- Prolonged coughing
- Expectoration of purulent sputum
- Dyspnea
Blue bloaters
Chronic bronchitis
Hypoxia during coughing
Chronic Cor Pulmonale
Right heart failure due to pulmonary hypertension
CXR findings in chronic bronchitis
- Increase in bronchovascular markings
2. Enlarged heart
Define emphysema
Enlargement of the airspaces distal to the terminal bronchioles with destruction of the alveolar walls
What is the genetic deficiency in non-smokers who get emphysema?
Alpha-1-Antitrypsin
Gross pathology of emphysema
- Enlarged lungs
- Lungs remain filled with air and do no collapse
- Lungs are whiter than normal, billowy and touch in teh chest midline
Define blebs
Subpleural air-filled spaces formed by ruptured alveoli which can rupture into the pleural cavity
What is the main complication we are worried about with blebs?
Pneumothorax
Define bullae
Parenchymal (interstitial of the lung) air-filled spaces >1 cm in diameter
Clinical features of emphysema
- Tacyhpnea
- Barrel-shaped chest
- Hyperventilate=”Pink puffers”
- NOT cyanotic
- No cough
CXR findings in emphysema
- Increased interstitial markings
- Flattened diaphragm
- Long AP diameter
- Over-inflation, a lot of space between ICS
Etiology of bronchial asthma
Hypersensitivity reaction (IgE)
Bronchial asthma attacks are marked by what?
- Wheezing during expiration
- Cough
- Dyspnea
What are the two major forms of asthma?
- Extrinsic asthma
2. Intrinsic asthma
What is extrinsic asthma mediated by?
- Exposure to exogenous allergens
- ->pollen, dander, feather, mold, dust
- Typically affects children
What is intrinsic asthma precipitated by?
Non-immune mechanism:
- Physical factors (heat or cold)
- Exercise
- Psychological stress
- Chemical irritants
- Air pollution
- Bronchial infection
Vasoactive substances
- Histamine
- Bradykinins
- PGs
What do the inflammatory mediators cause?
- Bronchoconstriction
- Edema
- Mucus hypersecretion
Histological findings in bronchial asthma
- Bronchial wall hyperplasia
- Overproduction of mucus in lumen
- Curschmann spirals
- Thickening of basement membrane
- Thick smooth muscle cells
Define bronchiectasis
Permanent dilation of the bronchi
What is the most common complication of chronic bronchitis?
Bronchiectasis