Chronic Bronchitis vs Emphysema Flashcards
How is Chronic Bronchitis and Emphysema similar ?
Both terms are categorized under the term COPD
Both limit airflow - in blood gases you will see a low oxygen level but a high carbon dioxide level. Not enough oxygen is getting in and CO2 is not being expelled enough … respiratory acidosis
Inability to fully exhale- there is a lot of residual left over. More volume will be added to lungs with each successive inspiration and over time it will lead to lung hyperinflation
there is no cure
Cases vary from mild to severe and some patients can develop both chronic bronchitis and emphysema
Both experience respiratory acidosis
Main cause is due to inhalation of some type of irritant: main cause SMOKING
Medications Treatment: bronchodilators, corticosteroids, theophylline, Pphosphodiestrace-4 inhibitors: “Roflumilast”
Spirometry is ordered to diagnose
Chronic Bronchitis Patho
The inflamed and deformed bronchioles produce EXCESSIVE MUCOUS due to hyperplasia of the goblet cells. The cilia are damaged so they can’t move mucus out of the airway and this limits the patient’s ability to have proper gas exchange and breathe with ease.
In chronic bronchitis there will be a ________ mismatch.
V/Q
ventilation - amount of air reaching the alveoli
Perfusion - blood reaching the alveoli through the capillary bed
What is the main issue in emphysema ?
Main issue is with damage to the alveolar sac (loses elasticity…becomes floppy and doesn’t inflate and deflate properly) leading to “air-trapping”.
This condition also leads to hyperventilation (puffing to breathe…compensatory mechanism) and pink complexion (they maintain a relatively normal oxygen level due to rapid breathing) rather than cyanosis as in chronic bronchitis. Patients with emphysema are sometimes called “pink puffers”.
CHRONIC BRONCHITIS PATHO
Main issue is with _____________due to the damage from inhalation of some type of irritant.
This leads to cyanosis “blue” color and increased lung volume “bloating” and edema (late effects on the heart for the development of cor pulmonale). Patients with chronic bronchitis are also known as “___________”.
The capillary bed (where gas exchange takes place) is NOT _____________ so this affects how the body will compensate. The bronchioles are surrounded by alveolar tissue which start to degenerate (lose form and disappear). When this happens the bronchiole lose support and don’t open properly to allow air to flow into the sacs for gas exchange.
Mainly, the problem is with ____________…because during inspiration the airways expand due to negative pressure. HOWEVER, on exhalation (because the lungs are full of air) the positive pressure prevents the airways from staying open. So, exhaled air does not all the way leave the lungs….hence the patient doesn’t have the ability to fully exhale. They experience hyperinflation of the lungs overtime.
There is also decreased oxygen and high carbon dioxide in the blood (respiratory acidosis). Remember the capillary bed works (so perfusion is good) BUT ventilation is very poor. So, there is a _______ MISMATCH. Hence, ventilation (V) doesn’t match perfusion (Q).
So, the body tries to compensate by increasing ____________ production and shifting blood which puts a lot of pressure on the pulmonary artery. This causes complications and leads to ____________hypertension and eventually right-sided heart failure “cor pulmonale”.
INFLAMMATION OF BRONCHIOLES; blue bloaters; damaged; exhalation; V/Q; red blood cell; pulmonary
In emphysema, the __________ lose their ability to inflate and deflate due to an inflammatory response in the body. Due to the damage to the __________, there is damage to the capillary bed so there will a __________V/Q defect (ventilation and perfusion both poor…hence they match). So, areas of low ventilation (V) have poor perfusion (Q).
Because the sac cannot deflate or inflate, inhaled air starts to get trapped in the sacs and this causes major ____________ of the lungs because the patient is retaining so much volume.
Hyperinflation causes the diaphragm to ______. The diaphragm plays a huge role in helping the patient breathe effortlessly in and out. Therefore, in order to fully exhale, the patient starts to hyperventilate and use accessory muscles to get the air out now. This leads to the barrel chest look and during inspection it may be noted there is an _________________
The damage in the sacs cause the body to keep high _____________ levels and low blood oxygen levels (respiratory acidosis). Inhaled oxygen will not be able to enter into the sacs for gas exchange and carbon dioxide won’t leave the cells to be exhaled.
The body tries to compensate by causing ____________ (increasing the respiratory rate…hence puffing) and the patient will have less hypoxemia “pink complexion” than chronic bronchitis (who have the cyanosis) because pink puffers keep their oxygen level just where it needs to be from hyperventilation.
alveoli sacs; alveoli sac; matched; hyperinflation; flatten ; INCREASED ANTEROPOSTERIOR DIAMETER; carbon dioxide; hyperventilation
