Respiratory System Pathologies 2 Flashcards
What is acute bronchitis?
An acute infection of the bronchial tree causing inflammation of medium and large-sized bronchi and trachea.
What are the key pathological effects of acute bronchitis?
• Bronchial mucosal irritation, hyperemia, and edema.
• Diminished bronchial mucociliary function.
• Airways blocked or clogged by debris.
• Increased mucus secretion leading to coughing.
What are common causes of acute bronchitis?
• Bacterial infection (most common).
• Viral infection.
• Allergic reactions.
• Exposure to toxins or pollutants.
• Smoking.
• Immunosuppression (young children, advanced age).
How long does acute bronchitis typically last?
Approximately 10 days; if bacterial, it can be effectively treated with antibiotics.
What can happen if inflammation extends into the bronchioles and alveoli?
Bronchopneumonia may result.
What are the long-term effects of recurrent acute bronchitis?
• Damage to mucosa and mucociliary elevator.
• Impairment of mucus and particle removal.
• Potential contribution to bronchial epithelial metaplasia (cancer).
What are the signs and symptoms of acute bronchitis?
• Productive intense cough with clear, yellow, green, or occasionally blood-tinged sputum.
• General malaise, extreme fatigue, muscle aches.
• Chest pain (severe cases, due to coughing).
• Dyspnea and cyanosis (if underlying COPD is present).
• Sore throat, stuffy nose, headache.
• Wheezing and use of accessory muscles (severe cases).
• Fever is rare; if present, flu or pneumonia is more likely.
What is COPD?
A term encompassing lung diseases associated with an abnormal reaction of the lungs to inhaled noxious particles/gases, leading to progressive, chronic, or recurrent airflow limitation.
What are the three main types of COPD?
• Emphysema
• Bronchiectasis
• Chronic Bronchitis
What are the key characteristics of COPD?
• Prolonged forced exhalations.
• Predominantly irreversible lung damage.
What are the primary causes of COPD?
• Cigarette smoking (most common; many patients are pack-a-day smokers for 20+ years).
• Secondhand smoke exposure.
• Potential relationship with air pollution and environmental factors.
Where do pathological changes in COPD primarily occur?
• Large airways.
• Small bronchioles.
• Lung parenchyma (in some cases).
What are the pathological features of COPD?
• Inflammation and edema of lung mucosa.
• Thickened basement membrane.
• Mucus gland hypertrophy.
• Goblet cell hyperplasia.
• Bronchial smooth muscle hypertrophy/constriction.
• Airway wall remodeling (chronic inflammation causes thickening of mucosa).
What is emphysema?
Emphysema is the destruction of alveolar walls and capillary beds supplying the alveoli, leading to abnormal, permanent enlargement of air spaces distal to the terminal bronchioles. This results in distention and expansion of alveoli into larger air sacs, making gas exchange inefficient.
What happens to lung elasticity in emphysema?
Damage to elastic fibers that hold airways open leads to loss of lung elastic recoil and impaired gas exchange.
Why do small airways collapse in emphysema?
Why do small airways collapse in emphysema?
How does emphysema affect lung compliance and recoil?
Lung compliance increases, meaning the lung becomes easier to distend, but recoil decreases, so airways empty slowly.
How does emphysema impact exhalation?
As the patient exhales, airways collapse before all the air is expelled, leading to chronic lung over-inflation.
How does emphysema affect the diaphragm?
Over-inflation of the lungs can impair diaphragm function, making it harder for the patient to expand an already over-expanded thorax.
What are bulla in emphysema?
Abnormal enlargements of air spaces distal to the terminal bronchioles.
What happens when bulla grow larger than 1 cm?
They can compress adjacent healthy lung tissue, further impairing ventilation and perfusion.
They can compress adjacent healthy lung tissue, further impairing ventilation and perfusion.
To reduce compression and prevent them from bursting, which could lead to pneumothorax.
What are the causes of emphysema?
• Smoking (primary and secondary)
• Genetic defects in the structure of the respiratory unit (small percentage)
• Repeated respiratory infections (especially chronic bronchitis)
• Atmospheric pollution
What are the two types of emphysema?
- Centriacinar (Centrilobular) and
- Panacinar (Panlobular)
Describe Centriacinar emphysema.
• Focal destruction of the respiratory bronchiole and central portions of the acinus.
• Associated with edema, inflammation, and thickening of the bronchiolar wall.
• Most common in upper lobes.
• Rare in non-smokers; almost exclusively seen in smokers.
• Begins at the alveolar duct.
Describe Panacinar emphysema.
• Destructive enlargement of the entire alveoli distal to the terminal bronchiole.
• Can occur throughout the entire lung, but more severe in the lower lung.
• Most commonly found in smokers, but also has a genetic correlation.
What are the key signs and symptoms of emphysema?
• Slow, insidious onset of dyspnea
• Tachypnea – rapid, shallow breathing
• Orthopnea – difficulty breathing except when upright
• Labored inhalation
• Forced exhalation due to loss of lung elastic recoil
• Hyperventilation in advanced stages to maintain normal blood oxygen levels
• Pursed-lip breathing with audible exhalation
• Prominent use of accessory respiratory muscles
• Pink Puffers – patients with advanced emphysema who hyperventilate to compensate for oxygen loss
How does emphysema affect musculoskeletal posture?
• Typical forward-seated posture (tripod position), hands on knees, shoulders elevated.
• Over-recruitment of accessory muscles of inspiration (linked to TOS, head-forward posture, headaches).
• Barrel chest due to lung hyper-inflation and flattened diaphragm.
• Thoracic hyperkyphosis and compression of abdominal contents (including liver in advanced stages).
• Compensatory lumbar and cervical hyperlordosis.
• Thoracic hypomobility, rib fixation, increased risk of osteoarthritis.
How does emphysema affect the cardiovascular system?
• Increased risk of hypertension and heart failure.
• Cor Pulmonale – right-side heart failure due to increased resistance in the lungs, forcing the right heart to work harder.
What emotional and psychological effects can emphysema have?
• Fear due to dyspnea and complications.
• Fatigue due to chronic hypoxia limiting activities of daily living (ADLs).
• Frustration, anger, and low self-esteem.
How does emphysema affect tissue health?
• Increased tissue fragility and poor healing.
• Nail bed changes.
• Severe emphysema may cause significant weight loss due to lack of energy to eat, leading to immune suppression and muscle atrophy.
What is pursed-lip breathing, and why is it beneficial?
A technique that prolongs exhalation, increasing back pressure in the airways to prevent airway collapse.
How do you perform pursed-lip breathing?
- Sit comfortably, relax shoulders and neck.
- Inhale through the nose for 1, 2.
- Pucker lips (as if blowing on a hot drink or about to whistle).
- Exhale and count 1, 2, 3, 4.
