Obstructive airway disease Flashcards
what are emphysema and chronic bronchitis grouped as
chronic obstructive pulmonary disease COPD
away obstruction diseases
asthma, emphysema and chronic bronchitis
how are obstructive airway diseases measured
spirometry. FEV1 and FVC
FVC is
final total amount of air expired
how are obstructive airway diseases measured
spirometry. FEV1 and FVC. or Peak expiratory Flow PEF
normal FVC is
about 5 litres
normal FEV1 is about
3.5-4litres
normal PEF is
400-600 litres/min. normal range is 80-100% of best value
chronic bronchitis is
cough productive of sputum most days in at least 3 consecutive months for 2 or more consecutive years. NOT bronchiectasis or chronic bronchial asthma
complicated chronic bronchitis is when
sputum turns mucopurulent or FEV1 falls
complicated chronic bronchitis is when
sputum turns mucopurulent (yellow or green) or FEV1 falls
morphological changes in chronic bronchitis in large airways
mucus glands hyperplasia, goblet cells hyperplasia, inflammation and fibrosis is a minor component
morphological changes in chronic bronchitis in small airways
goblet cells appear, inflammation and fibrosis in long standing disease
emphysema is
increase beyond the normal in the size of the airspace distal to the terminal bronchiole arising either from dilation or from destruction of their walls and without obvious fibrosis
forms of emphysema
centri-acinar- air concentrated in middle of acinus, found in apical sections of upper and lower lobe
panacinar- found in lower sections of lungs, huge areas of lung wiped out
periacinar- less clinically important, doesn’t have much affect unless bleb pops
bleb
spaces just underneath pleura
signs of emphysema on sight
hyper inflated lungs because only way of keeping small airways inflated
why do u get pulmonary hypertension in hypoxic cor pulmonale
pulmonary vasoconstriction, loss of capillary bed, muscle hypertrophy and intimal fibrosis in pulmonary arterioles, secondary polycythaemia (bone marrow produces more red blood cells so blood becomes more thick)
what causes pulmonary arteriolar vasoconstriction
alveolar oxygen tension falls, all vessels constrict if there is hypoxaemia, it is a protective mechanism that does not send blood to alveoli that are short of oxygen so if all alveoli are hypoxic this causes hypertension in pulmonary vascular system which leads to chronic hypoxic cor pulmonale
what is chronic hypoxic cor pulmonale
right ventricle of heart needs to work much harder and work against higher resistance which leads to hypertrophy of the right ventricle resulting from disease affecting the function and or the structure of the lung
why do u get pulmonary hypertension in hypoxic cor pulmonale
pulmonary vasoconstriction, loss of capillary bed, muscle hypertrophy and intimal fibrosis in pulmonary arterioles, secondary polycythaemia (bone marrow produces more red blood cells so blood becomes more thick)
what causes pulmonary arteriolar vasoconstriction
alveolar oxygen tension falls, all vessels constrict if there is hypoxaemia, it is a protective mechanism that does not send blood to alveoli that are short of oxygen so if all alveoli are hypoxic this causes hypertension in pulmonary vascular system which leads to chronic hypoxic cor pulmonale
what is chronic hypoxic cor pulmonale
right ventricle of heart needs to work much harder and work against higher resistance which leads to hypertrophy of the right ventricle resulting from disease affecting the function and or the structure of the lung
