Ch. 16 Flashcards
What are the anatomic alteration of the lungs for broncheactasis?
chronic dilation and dis- tortion of one or more bronchi—usually as a result of exten- sive inflammation and destruction of the bronchial wall cartilage, blood vessels, elastic tissue, and smooth muscle components.
Frequently found in lower lobes; smaller bronchi are predominantly affected
What are the three patterns at bronchiectasis is divided into?
• Varicose (fusiform)
• Cylindrical (tubular)
• Cystic (saccular)
What is varicose (fusiform) bronchiectisis?
• Bronchi are dilated and constricted in an irregular fashion similar to varicose veins
• distorted bulbous shape
What is cylindrical (tubular) bronchiectasis?
• bronchi are dilated and rigid
• regular outlines similar to a tube
• x-ray shows dilated bronchi fail to taper for 6 to 10 generations
• appear to end abruptly because of mucous obstruction
What is cystic saccular broncheactasis?
• Bronchi progressively increase in diameter until the end in large cystlike sacs lung parenchyma
• greatest damage to TB tree
• composed of fibrous tissue
What are the pathologic and structural changes associated with bronchiectisis?
• Chronic dilation and distortion of bronchial airways
• Excessive production of often foul-smelling sputum
• Bronchospasm
• Hyperinflation of alveoli (air trapping)
• Atelectasis
• Consolidation and parenchymal fibrosis
• Hemoptysis secondary to bronchial arterial erosion
What is the etiology and epidemiology of bronchiectisis?
cystic fibrosis is the most common cause of bronchiectasis in children
The prevalence of noncystic fibrosis bronchiectasis (NCFB) in developed nations is relatively low.
What are the causes of broncheactasis?
What is the diagnosis for bronchiectasis?
overinflated lungs or marked volume loss, increased opacities, dilated fluid-filled airways, crowding of the bronchi, and atelectasis.
crowding of the bronchi, loss of bronchovascular markings and, in more severe cases, honey- combing, air-fluid levels, and fluid-filled nodules.
What are the clinical manifestations for bronchiectasis?
• excessive bronchial secretions
• bronchospasm
• atelectasis
• consolidation
• increased alveolar- capillary membrane thickness
What is the clinical data obtained at the patient’s bedside for broncheactasis?
the disease may create an obstructive or a restrictive lung disorder or a combination of both.
What are the vital signs for broncheactasis?
• increased respiratory rate (tachypnea)
• increased RR
• increased heart rate
What are the pathophysiologic mechanisms for bronchiectisis?
• Use of accessory muscles during inspiration and expiration
• pursed lip breathing (obstructive)
• barrel chest (obstructive)
• peripheral edema and venous distention
• cyanosis
• Digital clubbing
What will happen for a patient with broncheactasis?
Cough, sputum production, and hemoptysis
What are the pathologic factors in obstructive bronchiectasis?
• Decreased tactile and vocal fremitus
• Hyperresonant percussion note
• Diminished breath sounds
• Wheezing
• Crackles
What are the PFTs for moderate to severe bronchiectasis in obstructive lung pathophysiology?
Everything is decreased
What are the lung volume at capacity findings for moderate to severe obstructive bronchiectasis?
What are the PFTs for moderate to severe restrictive bronchiectasis?
FEV/FVC ratio is the only thing increased; because they can’t take in enough air because lung is smaller
What are the lung capacities and volumes for moderate to severe restrictive bronchiectasis?
Everything is decreased
What will the ABG look like for mild to moderate bronchiectasis?
pH is the only thing increased
What will the ABG look like for a severe stage of bronchiectasis?
What are the oxygen indices for mild to severe bronchiectasis?
The only things inc are the pulmonary shunt fraction and O2 extraction ratio.
What are the hemodynamic indices for moderate to severe bronchiectasis?
Everything thing is increased and normal
