EMPHYSEMA VS CHRONIC BRONCHITIS EMPHYSEMA PATHO Cigarette smoke
EMPHYSEMA VS. CHRONIC BRONCHITIS
EMPHYSEMA: PATHO *Cigarette smoke (10%), Inherited alpha-1 antitrypsin deficiency (10%) Activation of inflammatory response Neutrophils flood alveoli and release enzymes such as elastase Alpha-1 antitrypsin deactivated (protective protein) Elastic fibers of alveoli broken down Damage and eventual break down of alveolar wall Loss of elastic recoil of lungs/ loss of gas exchange
EMPHYSEMA INTIAL PRESENTING SYMPTOM: Progressive dyspnea! Unique manifestations: Barrel chest (AP: lateral diameter): Caused by alveolar hyperinflation due to loss of elasticity Anorexia: Eat or breathe? Accessary muscle use/ pursed lip breathing/ tripod position: Can’t get air OUT Breath sounds: Diminished “Pink puffer”- secondary polycythemia to compensate for hypoxemia
CHRONIC BRONCHITIS: PATHO Cigarette smoke: Chronic irritation and inflammation of bronchi Fibrosis and thickening of bronchial walls Increased number and size of goblet cells Increased mucus secretion/ Decreased ciliary function Obstruction to airflow and clearing of secretions Mucus plugs and further obstruction of airflow SEVERE hypoxemia
CHRONIC BRONCHITIS INITIAL PRESENTING SYMPTOM: Productive cough! Unique manifestations: Purulent, thick secretions Breath sounds: Rhonchi Cyanosis “Blue boater”- there is secondary polycythemia but not enough to overcome the cyanosis caused by severe hypoxemia
CHRONIC BRONCHITIS: CARDIAC COMPLICATIONS Pulmonary hypertension: Chronic SEVERE hypoxemia Pulmonary vessels are overworked Pulmonary vessels undergo remodeling which includes thickening inside vessel walls Elevated pulmonary artery pressure = Pulmonary hypertension Cor pulmonale (right ventricular enlargement): Increased pressure in pulmonary vessels Right ventricle enlarges to overcome increased pressure.
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