Restrictive and Obstructive Lung Disease Flashcards
what are the four main obstructive pulmonary diseases discusssed?
emphysema
chronic bronchitis
asthma
bronchiectasis
what is emphysema?
The permanent enlargement of the air spaces distal to the terminal bronchiole as a result of destruction of the alveolar walls without significant fibrosis.
what are the three types of emphysema?
Centriacinar
Panacinar
Distal acinar
what is Centriacinar?
a type of emphysema found Predominantly in upper lung zones.
Associated with smoking & “coal miner’s” pneumoconiosis.
what type of emphysema is associated with smoking & “coal miner’s” pneumoconiosis?
Centriacinar
what is Panacinar?
type of emphysema. More progressive, and with more severe symptoms because it involves the lower lung zones (areas of greater gas exchange).
Associated with alpha-1-antitrypsin deficiency.
what type of emphysema is associated with alpha-1-antitrypsin deficiency.
Panacinar
what is alpha-1-antitrypsin deficiency, this enzyme is associated with this Emphysema Type Panacinar?
Cigarette smoke inhibits AAT and causes release of digestive enzymes which digest lung tissue in absence of AAT
what is distal acinar?
Focal or multifocal disease.
Involves distal alveolar sacs and ducts, resulting in subpleural blebs and bullae (large ballooning type areas).
this type of emphysema causes spontaneous pneumothorax?
distal acinar
what are the clinical manifestations of emphysema?
“Pink Puffer,” increased AP diameter, insidious onset
what x-ray markers indicate emphysema?
Hyperinflation
Vascular deficiency
Irregular, asymmetric areas of decreased lung density
what is chronic bronchitis?
Hypertrophy of the submucosal glands in the trachea and bronchi, and an increase in goblet cells in the small bronchi and bronchioles, leads to excessive mucus production and obstruction.
what are indicators of chronic bronchitis?
Presence of a chronic, productive cough for 3 or more months, in at least 2 consecutive years, when all other causes of cough have been excluded
what causes chronic bronchitis?
tobacco smoke and other inhaled pollutants, not infection
how does infection relate to chronic bronchitis?
Infection appears to be significant in maintaining the disease.
what are the clinical manifestations of chronic bronchitis?
“Blue Bloater,” usually obese, copious sputum
what are the x-ray markers for chronic bronchitis?
Bronchial wall thickening
Overinflation
Oligema
what is asthma?
A chronic, relapsing inflammatory disorder characterized by hyperactive airways, leading to episodic, reversible bronchoconstriction.
what are the two types of asthma?
extrinsic and intrinsic
what is intrinsic asthma?
initiated by diverse, non-immune mechanisms (stress, pulmonary infection, exercise, cold, etc.)
what is extrinsic asthma?
initiated by a type I hypersensitivity reaction, induced by exposure to an extrinsic antigen.
what are the clinical manifestations off asthma?
Bronchial wall thickening
Air-trapping
Atelectasis
what is bronchiectasis?
A chronic, necrotizing infection of the bronchi & bronchioles, leading to abnormal, permanent dilatation of the involved airways.
what can bronchiectasis develop in association with?
Bronchial obstruction: localized (tumor, foreign body) or diffuse (asthma, chronic bronchitis)
Congenital/Hereditary: Cystic fibrosis, Kartagener’s syndrome
Necrotizing pneumonia
how is the incidence of bronchiectasis decreased?
due to the advent of antibiotics and immunizations
what are the major influences associated with bronchiectasis?
obstruction and infection
what are the clinical manifestations of bronchiectasis?
Chronic cough and expectoration of copious, purulent sputum
what are the x-ray markers for bronchiectasis?
“Tram lines” and “ring shadows”
what is COPD a general term for?
emphysema, asthma, and chronic bronchitis
what are the three lung diseases discussed?
Idiopathic Pulmonary Fibrosis
Pneumoconiosis
Sarcoidosis
what is Idiopathic Pulmonary Fibrosis?
Characterized by alveolar wall inflammation resulting in fibrosis
Chest X-ray shows “honeycombing pattern” when advanced
what is Pneumoconiosis?
Lung impairment caused by inhalation of dusts
Includes silicosis, asbestosis (mesothelioma), etc.
what is Sarcoidosis?
Granulomatous disease that affects multiple organ systems
Granuloma found are composed of macrophages, epithoidal cells, etc
