Module 8: Disorders of Ventilation and Gas Exchange Flashcards
Bronchiectasis
Abnormal permanent dilation of the large bronchi
An obstructive issue like COPD - hard to get the air out/CO2 out
Bronchiectasis is associated with…
infection and destruction of the bronchial walls
Why does infection occur in bronchiectasis?
Usually bronchi are straight, but this weakening can allow outpouching that fills with debris and can become a medium for bacterial growth and lead to lung and bronchial tube infections
Causes for Bronchiectasis
- local airway obstructions like tumors and foreign bodies
- congenital abnormalities
- lung infections (tb, fungal, lung abcess etc)
- cystic fibrosis
- immunodeficiency states
- exposure to toxic gases
Where can bronchiectasis occur?
It can be localized or generalized
Can be bilateral
Bronchiectasis impacts __ lobes more than __ lobes
lower ; upper
As bronchiectasis progresses what things can it develop and progress into?
Bronchial obstruction
atelectasis
smooth muscle relaxation
dilation of the airway walls
airway remains patent
infection
inflammation
impaired mucociliary function
pooling of secretions
chronic inflammation
development of new infections
Atelectasis
Alveolar collapse (no surfactant to prevent collapse)
“Empty Balloon syndrome”
can lead to complete or partial lung collapse and leads to less oxygenation in the body
Does atelectasis only occur with Bronchiectasis?
no it can happen with other things like post surgically
What happens if there is impaired mucociliary function
the secretions can pool and not push debris out and this allows a vicious cycle of infection to occur
chronic bronchitis can occur leading to more COPD
Is there a cure for Bronchiectasis?
No the only thing to do is detect it early to prevent permanent damage
Manifestations of Bronchiectasis
Fever
Recurrent Bronchopulmonary infection
Coughing
Production of copious amounts of foul smelling purulent sputum
Hemoptysis (from damage to the bronchial wall)
Weight Loss
Anemia
Marked Dyspnea and Cyanosis
Foul breath in bronchiectasis may lead to …
a bad taste in the mouth and not wanting to eat leading to subsequent weight loss
How does anemia relate to bronchiectasis
it could be an underlying factor leading to bronchiectasis or something that the bronchiectasis caused
Bronchiectasis is an ___ disorder by nature
obstructive
Why does cyanosis and dyspnea occur in bronchiectasis?
There is inability to exchange gasses from atelectasis or mucus
Cystic Fibrosis
An autosomal recessive genetic defect affecting the exocrine glands and cells leading to large amounts of thick mucous
These secretions collect and inspissate in ducts
How does Cystic Fibrosis work genetically?
Autosomal recessive
1 in 29 carry the gene on chromosome 7
there are 200 different types of defects
most fatal genetic disease in Caucasian newborn (1:2000)
Dx usually around 1 mo to 2 yrs
Not sex linked
Median survival age is 38
___ does not always go with cystic fibrosis but commonly does go with it?
Bronchiectasis
Inspissate
To thicken by evaporation or absorption of fluid
So this is the mucus in cystic fibrosis getting thick and acting like a sponge thus causing some atelectasis
There is ion channel dysfunction with CF, so what would this mean?
there are increased concentrations of sodium and chloride in the sweat of a patient with CF
Absorption Atelectasis
Thick secretions in CF causing fluids to be pulled into them - this also pulls fluids/surfactant in the alveoli causing decreased surface tension and collapse
What are the effects of CF on the pulmonary system?
Blocks alveolar ventilation
Absorption atelectasis
Chronic inflammation
Edema of capillary-alveolar interface
Bronchial scarring and fibrosis destroying the bronchial airways
Reduced lung compliance
Developing overinflated barrel chest
Increased risk of pneumonia and chronic bronchitis
Bronchiectasis
Increased incidence of nasal polyps and URIs
Digit Clubbing in severe cardiopulmonary disease
What does the edema of the capillary-alveolar interface impact the body in CF?
fluid/mucus fathers between cells of the alveoli and blood - building up in the interstitial space - and this leads to increased distance between O2 and CO2 to diffuse (increased diffusion capacity)
This leads to making it harder for CF to oxygenate tissues