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What is COPD?
Chronic Obstructive pumonary Disease
Diffculty with expiration due to anatomic narrowing airways that reduced elastic recoil
What is a Restrictive Disease?
Difficulity with inspiration
due to reduced total lung capacity
can be caused by Fibrosis
What is Vital Capcity?
The most iar that can be inhaled or exhaled in a single breath
it is decreased in retrictive lung disease
What is the significance of Forced expiratory Volume (FEV1)?
it the air that you expelled in one sec
decreased in COPD
What is the Clinical significance of FEV1/VC?
Tell you what type of disorder you have>
low ratio you probally have COPD, same ratio you have a restrictive Pumonary disease
What is a terminal Repiratory unit or acinus?
it is the distal part of the lung to the terminal bronchile and contains respiratory bronchiole, alveolar duct and alveolar sacs.
How many lobule clustor at the end of a terminal unit?
3-5 terminal repiratory units
this is used to define emphysema
What cell type makes surfactant
What are two example of COPD?
Emphysema and Chronic bronchitis
If i were to use the typanic technique with some who has COPD what would I hear?
Dull sound--> indication of fluid in the lung. should should hollow
Fluind in the lung---> edema
What is panacinar?
Type of Emphysema that has uniform enlargment of acinus (terminal respiratory unit)
What is Emphysema?
Irreversible overinflation of air spaces distal to the terminal bronchiloes with destruction of their wall
can lead to formation of bullus
What is Centriacinar?
Enlargment of central parts of the acinus Respiratory bronchi or aveloar duct, sparing the peripheral alveoli
not very clinically significant
What are some of the causes of emphysema?
Enzymatic distrution of alveolar wall, due to definincy and alpha anti trypsin def.
What is the protease-antiproteae hypothesis?
Pathogenic cause of emphysema. destruction of alveolar walls due to an imbalance between protease and protease inhibitors
pt with herditory alpha 1 antitrypsin deficicy develop emphysema--panacinar at young age
What does smoking do?
recruits PNLs and macrophages--release protease like elastase and at the same time. smoke and macrophages inactivate alpha 1 anti trypsin
what are the incidence of emphysema?
releated to smoking
what is the clincial presntation of emphysema?
Dyspnea with prolonged expiration, cough, expectoration associated iwth bronchitis
Barrel shaped chest with slowing of forced espiration.
death in severve cases due to respiratory failure and CHF (cor pulmonale)
rupture of bullae
What is pink puffer a sign of?
what is chronic broncitis?
cough with sputum for at least 3 months to 2 years
chronicifrritation and inflammation of the bronchial mucosa
hypertrophy of mucus glands
bronchi and bronchioles are obstruced by mucs pugs and show hypermina and edema and cellular infilration
epithelium may sow squamus metaplasia and dysplasia
what is a blue botter a sign of?
What is a restrictive lung disease?
chronic inflamation of alveolar wall progressing to interstitial pumonary fibrosis and ending in a honeycob lungs
What are the three pathogensis step of restrictive lung disease?
Initial event- injyr to alveolar epith/endotheilum (ARDs)
Eary acute event- aleolitis, with inflammatory changes
Late even- diffuse interstial fibrosis--> honey comb lungs
Begins with alveolar wall and gets thicker with fibrosisi
What is Pneumoconioses?
Occupational and enviorment cause--coal workers pneumoconisis
What are the three type of Carbon dust coal workers pneumoconisis?
- Simple CWP-- aggregates of coal dust with macrophage--no significat dysfunciton
Progressive massive fibrosis- or compliacted disbling respiratory insufficncy
Upper zones more effected the lower zones
What is Silicosis?
inhalation of sillica particles causes dense nodular fibrosis
silica lead to macrophages activation and release fobrogenc fcators
What is Asbestosis?
heavey exposure to to asbestos particles---> lead to fibrous silicates
asbestos induces pleural effusion and adhesion. fibrocalcific plaques and is associated with increase risk of bronchogenic carcinoma na d pleural mesothelioma
What is geometric forms of asbetosis
Asbestos ferruginous body
can also see huge plurea or can attach to iron coataintin