Pulm 1 Shea Flashcards
What are the 4 diseases which compromise COPD?
- Chronic Bronchitis
- Emphysema
- Bronchial Asthma
- Bronchiectasis
(may coexist w/ one another)
A clinical term used for lung diseases characterized by chronic airway obstruction w/ increased resistance to air flow.
COPD
(chronic obstructive pulmonary disease)
What is the #1 bronchogenic carcinoma?
Squamous Cell Carcinoma
A chronic cough and production of sputum for a set time. What are the time parameters and which disease is this?
- Chronic Bronchitis
- Minimum of 3 months/year for at least 2 consecutive years
What causes 90% of cases of chronic bronchitis?
- Smoking, it correlates w/ # of cigarettes (pack year)
- Clinical sxs improve w/ cessation
What other 4 things play a role in the development or not of Chronic Bronchitis?
- Good genetics may prevent people of smoke from getting COPD
- Air polution
- Exposure to toxic fumes
- Pneumonias
Pathology of which disease?
- Fibrous thickening of the walls of the bronchi and bronchiole
- Their lumens are completely filled w/ thickened mucous
- Hypertrophy of bronchial mucous glands
- Increased # of goblet cells
- Mucosa is infiltrated w/ which 3 things??
- Chronic Bronchitis
- Mucosa contains:
- lymphocytes
- macrophages
- plamsa cells
Pathology of which disease?
- Surface epithelium w/ time may show focal ulcerations or metaplasia of columnar epithelium into –> stratified squamous epithelium
Chronic Bronchitis
Which disease?
- Increased mucous production causing prolonged coughing, expectoration of thick tenacious or purulent sputum and dyspnea
- Hypoxia may be so pronounced during coughing that it causes cyanosis.
Chronic Bronchitis
(Blue Bloaters)
- What is Cor Pulmonale?
- Which disease predisposes a patient to developing this?
- Right heart failure
- Chronic Bronchitis can lead to CHF/right heart failure/Cor Pulmonale
Which disease can lead to pulmonary hypertension?
Chronic Bronchitis
Is the pulmonary vasculature involved in chronic bronchitis?
Yes, the pulm vasculature is affected by the peribronchial fibrosis which results in pulm HTN and Cor Pulmonale.
Enlargement of airspaces distal to the _____ bronchioles w/ destruction of alveolar walls.
- Emphysema
- Terminal bronchioles
Which disease is rare in “non-smokers” except in patients w/ a ____ deficiency of _____?
- Emphysema
- Genetic deficiency
- Alpha 1 Antitrypsin
Pathology of which disease?
- Irritants in smoke provoke an influx of inflammatory cells into alveoli
Emphysema
W/ Emphysema, what causes the alveolar walls to be destroyed, leading to enlargement of the alveolar spaces?
- Leukocytes release proteolytic enzymes which causes destruction of the alveolar walls
W/ Emphysema, what accounts for the loss of elastin fibers in the alveolar walls?
Increased activity of leukocyte-derived elastases in the lungs
Pathology of which disease?
- Grossly, lungs are enlarged and remain filled w/ air and DO NOT collapse
- Lungs are whiter than normal, billowy, and touch in the chest midline
Emphysema
Subpleural air-filled spaces formed by rupture alveoli which can rupture into the pleural cavity causing a _____.
( a small collection of air between the lung and the outer surface of the lung (visceral pleura) usually found in the upper lobe of the lung. )
- Bleb
- causing a pneumothorax
Parenchymal air filled spaces greater than 1 cm in diameter
(Lung parenchyma is the portion of the lung involved in gas transfer - the alveoli, alveolar ducts and respiratory bronchioles. )
Bullae
Which disease?
- No bronchial obstruction
- Compensatory tachypnea, why?
- Over-expanded chest
- “Barrel-Shaped” chest
- What position are they in and why?
Emphysema
- Tachypneic bc/ of reduced respiratory surface
- Hunched forward to engage auxiliary respiratory muscles
Are emphysema patients hyperventilating or hypoventilating?
Hyperventilating, they oxygenate the blood adequately, so they are not blue and have no brain anoxia.
“Pink Puffers”
What are the 6 chest x-ray findings of a pt w/ emphysema?
- Clear lung fields
- Over inflated lungs
- Barrel Shaped chest
- Increased interstitial markings
- Flattened diaphragm
- Long AP diameter
- Some dyspnea
- Terrible cough
- Mucopurulent sputum
- Cyanosis
- Pulm HTN
- Peripheral edema
- Densities on radiograph
Bronchitis
