Respiratory Disorders: Chronic Bronchitis Flashcards
What is Chronic Bronchitis (CB)?
inflm and obstruction of the a/w
What is occurring in the lumen of the a/w in CB?
the wall of lumen is 50% compromised but lumen thickness and elasticity is normal
What are 2 causes of CB?
- smoking
2. recurrent infections
What is the hx of productive coughs in CB?
persistent coughing for 3 months in a year and for 2 consecutive years
What differentiates acute bronchitis from CB?
the duration of the coughs
What the histological change in the a/w in resp tract?
look at the respiratory anatomy notes
Occurs in the _______ a/w first and then the ______ a/w.
larger
smaller
What are 3 histological changes in the a/w? In small or large a/w?
- early hypersec of mucus in large a/w
- enlargement of submucosal glands in trachea and bronchi
- increase goblet cells–> increase mucus secr. (small a/w)–> a/w obstruction–> inflm and fibrosis
What are the large a/w? Small a/w?
lrg a/w = trachea and bronchi
sm a/w = alveoli
What changes occurs in hypersec of mucus? The changes are ____ and ______. Does it also occur in alveoli?
to increase mucus secretion, the number and size of submucosal gland increases
gradual and progressive
Yes but not yet impacted
Why is there an enlargement of submucosal glands?
due to increase in demand of mucus secretion –> there is an increase in size and number of submucosal gland –> leading to submucosal gland hypertrophy
Is submucosal gland hypertrophy protective or a consequence?
Submucosal gland hypertrophy is initially protective but is persists–> leads to a/w obstruction
How does the increase in goblet cells compromise GE? Occur in small or large a/w?
Increase in goblet cells–> increase mucus secr. –> a/w obstruction–> not enough air in and out of alveoli–> compromised GE and breathing
small a/w
How does a/w obstruction result in non-functional tissues?
obstructed a/w induces inflm –> prod of exudate–> person coughs to expectorate sputum –> if coughing is chronic the ability to repair tissue is lost –> functional tissue is replaced with non-functional tissue
Pathophysiology of CB (7)
xs mucus production –> mucociliary blanket is impaired–> infection occurs –> inflm of a/w–> obstruction –> a/w collapse–> air trapped
damages leads to more production of _____
mucus
xs muxus—> _______ the a/w.
xs mucus —>_________ defenses are impaired.
xs mucus—>______ is overwhelmed.
compromise
mucociliary
cilia
Cilia is unable to _______ mucus to the ______ and bacteria _____ and cause an _____ .
propel
mouth
settles
infection
How does an infection happen? What environment bacteria need for survival (3)?
xs mucus traps debris and microbes in a/w that cannot be expectorated creating a warm, nutritive and moist environment for microbes to proliferate
Infection—> inflm —> ______ damage in _____ and ______
inflammatory
a/w and alveoli
Why does the a/w collapse?
When there is an obstruction, the alveoli is not receiving more air –> air is absorbed into circulation leaving alveoli empty –> alveoli collapse
How does a/w collapse lead to no GE?
if a/w collapse–> less SA for GE –> decrease alveolar ventilation –>air remain trapped in alveoli –> no GE
No GE = imbalance _______ and ______
ventilation and perfusion
Imbalance of ventilation and perfusion leads to _____ b/c there is inadequate _____/____ supply
hypoxemia
blood/air
For proper GE, the alveoli must be filled with ______ and _____ supply must be sufficient in pulmonary ________.
oxygen
blood
capillaries
If the V:P ratio is off, ____ or ____ are not within normal limits
air
blood
What leads to hypoxia?
decrease oxygen in arterial blood
What is the volume of air breathing in/out per min?
~4.2L
What is the volume of blood pumped into the circuit per min?
~5.5L
What is the V:P ratio? What happens if the ratio is halved?
4.2/5.5 = ~0.8
If ratio is halved, there is deficient of oxygen in arterial blood = hypoxia
T or F: ratio of ~0.8 means that the GE is normal?
FALSEEEEE: it could mean there is decrease air and blood supply leading to V:P imbalance
