Bronchitis Flashcards
What is Bronchitis?
Where smoke irritates the lining of the bronchi and they become inflamed
What does the body attempt to do during bronchitis?
Clear the chemical irritants, and then ling produces mucus from the goblet cells
What clogs the airways?
The production of mucus is excessive and therefore clogs the airways
What is the common cause of Bronchitis?
Viral and bacterial infections
What is Acute Bronchitis?
usually caused by a viral infection - it lasts for a short period (a few weeks)
What is Chronic Bronchitis?
More serious and lasts for more than three months and often recurs over several years
What is in the epithelial layer?
Inside the airways, the epithelial layer contains Goblet Cells
What are Goblet Cells
They produce mucus
What is the role of the mucus?
Mucus traps dust, microbes and other irritants preventing them entering the lungs
What do the lungs do in Bronchitis?
The lungs increase mucus production as a defence mechanism
What happens when there is excessive mucus?
Can caused clogged airways
Increase coughing
Potential for infection
What are the four symptoms of Bronchitis?
Coughing
Wheezing
SOB
Chest discomfort
Management and treatment of Bronchitis
- Rest and hydration
- Cough suppressants
- Bronchodilators
- Avoiding irritants
What causes the irritation in the airway?
Collection of chemicals, tar and other products of cigarette smoke
The ongoing mucus traps causes what?
Causes ongoing irritations
Inflammation to the bronchial tubes
How do we clear out the mucus and irritants?
Cough reflex
When coughing up mucus, what does this show?
Sputum may be discoloured from trapped irritants
What does chronic inflammation cause?
Hypertrophy and Hyperplasia of the Goblet Cells - more obstructive. This makes the goblet cells grow larger.
As the Goblet Cells become larger and more numerous, what does this cause?
Even more mucus which clogs the airway and therefore worsening the cycle of cough causing more difficulty in breathing.
What are the three treatment strategies to help with coughing and difficulty in breathing?
Bronchodilators - helps open the way
Corticosteroids - reduce inflammation
Expectorants - aids in mucus clearance
What does chronic inflammation and irritation cause?
Pulmonary fibrosis
What is Pulmonary Fibrosis
This causes the bronchi wall to thicken
What does this mean for the fibrosis tissues?
Do not contract and therefore lung function is impaired
What is Pulmonary Fibrosis?
When the lung tissue becomes scarred and thickened due to chronic inflammation
What can happen to the patient in severe cases?
Hypoxia
What do the exposure to higher levels of CO2 cause?
This means the peripheral chemoreceptors, that once signalled to the brain to drive breathing, are no longer sensitive to CO2
When the peripheral chemoreceptors are no longer sensitive to CO2 what does this cause?
Hypoventilation
What are the symptoms of hypoxia?
SOB
Fatigue
What are the two managements for hypoxia?
Oxygen therapy
Ventilatory support
What is hypoxic drive?
Instead of the drive to breath being the detection of high CO2 it now reverts to detecting low levels of O2 instead
What is the Assessment of Gas Exchange?
Regular monitoring of O2 and CO2 levels through arterial blood gas tests
What is inadequate ventilation?
If the body relies too much on low CO2 levels it may not respond adequately leading to further hypoxia
Hypoxia causes a reflex, which is what?
Vasoconstriction of pulmonary arteries in attempt to increase perfusion
What does the ECG have for pulmonary hypertension?
Tall pointy p-waves
When oxygen levels are low, the pulmonary arteries constrict. Why?
To improve blood flow to better oxygenate parts of the lungs
What can the constriction of pulmonary arteries lead to?
Pulmonary hypertension where the pressure in the pulmonary arteries become too high
What would the treatment and management be for pulmonary hypertension?
- Oxygen therapy
- Medications to reduce pulmonary artery pressure and improve blood flow
What is Pulmonary Hypertension when linked to Right Ventricular Hypertrophy?
Pulmonary Hypertension leads to an increase in pressure back down to the right side of the heart. Overtime this causes right ventricular hypertrophy and eventually right ventricular failure.
What is the term Cor Pulmonale?
Right ventricular hypertrophy or failure that occurs as a result of lung disease.
What are the symptoms of Pulmonary Hypertension and Right Ventricular Hypertrophy?
SOB
Fatigue
Swelling in legs and ankles
Distended neck veins - increased pressure in venous system
When giving O2 to those with pulmonary hypertension, what happens?
- It will relieve the reflex vasoconstriction, causing a reduction in pulmonary perfusion.
- It can relieve hypoxic pulmonary vasoconstriction.
When hypoxic pulmonary vasoconstriction is alleviated through O2 therapy, what does the body do?
Blood flow may be redistributed and in some cases this can result in reduced pulmonary perfusion to area that may not be effectively ventilated
Patients with bronchitis, what are they sometimes referred to?
Blue bloaters - due to cyanosis as they are hypoxic
What is polycythaemia?
The body attempts to increase its oxygen-carrying capacity by producing more RBC - this is a response to chronic hypoxia.
In relation to the kidney detecting low 02, what does the kidney do?
The kidney responds by increase production of erythropoietin, a hormone that stimulates the bone marrow to produce RBC
What does Polycythaemia do to the blood?
Increases RBC which can leads to thickened blood
What can the thickened blood cause?
- Elevated BP
- Increased risk of thrombosis
- Strain on heart as it works harder to pump thicker blood
When erythropoietin travels through the bloodstream to the bone marrow, what does it bind to?
They bind to specific receptors in the bone marrow called erythroid progenitor cells
Those with CKD, what does this do to the production of EPO?
They often experience anaemia therefore the production is reduced
How does polycythaemia link to circulation?
Causes sluggish circulation and the pt will appear bloated and plethoric with cyanosis - especially when coughing or on exertion
What does heightened RBC mass lead to?
Increased blood viscosity
What can sluggish circulation lead to?
Reduce overall blood flow making it more difficult for the heart to pump blood effectively and increases workloads on the heart and lungs
What can help reduce blood viscosity?
Hydration
What can be done to reduce mass and improve circulation?
Therapeutic phlebotomy which is the removal of blood
