Respiratory Disorders: Chronic Bronchitis

Question 1

What is Chronic Bronchitis (CB)?

Answer 1

inflm and obstruction of the a/w

Question 2

What is occurring in the lumen of the a/w in CB?

Answer 2

the wall of lumen is 50% compromised but lumen thickness and elasticity is normal

Question 3

What are 2 causes of CB?

Answer 3

1. smoking

2. recurrent infections

Question 4

What is the hx of productive coughs in CB?

Answer 4

persistent coughing for 3 months in a year and for 2 consecutive years

Question 5

What differentiates acute bronchitis from CB?

Answer 5

the duration of the coughs

Question 6

What the histological change in the a/w in resp tract?

Answer 6

look at the respiratory anatomy notes

Question 7

Occurs in the _______ a/w first and then the ______ a/w.

Answer 7

larger

smaller

Question 8

What are 3 histological changes in the a/w? In small or large a/w?

Answer 8

1. early hypersec of mucus in large a/w
2. enlargement of submucosal glands in trachea and bronchi
3. increase goblet cells–> increase mucus secr. (small a/w)–> a/w obstruction–> inflm and fibrosis

Question 9

What are the large a/w? Small a/w?

Answer 9

lrg a/w = trachea and bronchi

sm a/w = alveoli

Question 10

What changes occurs in hypersec of mucus? The changes are ____ and ______. Does it also occur in alveoli?

Answer 10

to increase mucus secretion, the number and size of submucosal gland increases

gradual and progressive

Yes but not yet impacted

Question 11

Why is there an enlargement of submucosal glands?

Answer 11

due to increase in demand of mucus secretion –> there is an increase in size and number of submucosal gland –> leading to submucosal gland hypertrophy

Question 12

Is submucosal gland hypertrophy protective or a consequence?

Answer 12

Submucosal gland hypertrophy is initially protective but is persists–> leads to a/w obstruction

Question 13

How does the increase in goblet cells compromise GE? Occur in small or large a/w?

Answer 13

Increase in goblet cells–> increase mucus secr. –> a/w obstruction–> not enough air in and out of alveoli–> compromised GE and breathing

small a/w

Question 14

How does a/w obstruction result in non-functional tissues?

Answer 14

obstructed a/w induces inflm –> prod of exudate–> person coughs to expectorate sputum –> if coughing is chronic the ability to repair tissue is lost –> functional tissue is replaced with non-functional tissue

Question 15

Pathophysiology of CB (7)

Answer 15

xs mucus production –> mucociliary blanket is impaired–> infection occurs –> inflm of a/w–> obstruction –> a/w collapse–> air trapped

Question 16

damages leads to more production of _____

Answer 16

mucus

Question 17

xs muxus—> _______ the a/w.

xs mucus —>_________ defenses are impaired.

xs mucus—>______ is overwhelmed.

Answer 17

compromise

mucociliary

cilia

Question 18

Cilia is unable to _______ mucus to the ______ and bacteria _____ and cause an _____ .

Answer 18

propel

mouth

settles

infection

Question 19

How does an infection happen? What environment bacteria need for survival (3)?

Answer 19

xs mucus traps debris and microbes in a/w that cannot be expectorated creating a warm, nutritive and moist environment for microbes to proliferate

Question 20

Infection—> inflm —> ______ damage in _____ and ______

Answer 20

inflammatory

a/w and alveoli

Question 21

Why does the a/w collapse?

Answer 21

When there is an obstruction, the alveoli is not receiving more air –> air is absorbed into circulation leaving alveoli empty –> alveoli collapse

Question 22

How does a/w collapse lead to no GE?

Answer 22

if a/w collapse–> less SA for GE –> decrease alveolar ventilation –>air remain trapped in alveoli –> no GE

Question 23

No GE = imbalance _______ and ______

Answer 23

ventilation and perfusion

Question 24

Imbalance of ventilation and perfusion leads to _____ b/c there is inadequate _____/____ supply

Answer 24

hypoxemia

blood/air

Question 25

For proper GE, the alveoli must be filled with ______ and _____ supply must be sufficient in pulmonary ________.

Answer 25

oxygen

blood

capillaries

Question 26

If the V:P ratio is off, ____ or ____ are not within normal limits

Answer 26

air

blood

Question 27

What leads to hypoxia?

Answer 27

decrease oxygen in arterial blood

Question 28

What is the volume of air breathing in/out per min?

Answer 28

~4.2L

Question 29

What is the volume of blood pumped into the circuit per min?

Answer 29

~5.5L

Question 30

What is the V:P ratio? What happens if the ratio is halved?

Answer 30

4.2/5.5 = ~0.8

If ratio is halved, there is deficient of oxygen in arterial blood = hypoxia

Question 31

T or F: ratio of ~0.8 means that the GE is normal?

Answer 31

FALSEEEEE: it could mean there is decrease air and blood supply leading to V:P imbalance