Professional Documents
Culture Documents
Pathologic Changes
Hypersensitivity response Bronchoconstriction May become chronic with irreversible changes
Presentation
Bronchospasm Increased mucus secretion Dyspnea Wheezing Cough
Asthma
Allergic asthma is triggered when an allergen cross-links IgE receptors on mast cells, which are then activated to release histamine and other inflammatory mediators (early-phase response). A late-phase response may occur due to further inflammation
. Lewis ed 8 Fig. 29-2
Asthma
Factors causing obstruction (especially expiratory obstruction) in asthma. A, Cross section of a bronchiole occluded by muscle spasm, swollen mucosa, and mucus in the lumen. B, Longitudinal section of a Bronchiole Lewis 8th ed Fig 29-3
Asthma
Lewis 8th ed, Fig. 29-4. Drug therapy: stepwise approach for managing asthma.
Chronic Obstructive Pulmonary Diseases (COPD) Chronic Airflow Limitation (CAL) Emphysema Chronic Bronchitis
Emphysema
Loss of lung elasticity Hyperinflation of the lung Formation of Bullae Small airway collapse and air trapping VQ mismatching
Hereditary Emphysema or Alpha 1-Antrypsin Deficiency (A1AD) is an inherited disorder that results in low or non-existent levels of AAT in the blood.
AAT Deficiency
Alpha-1 antitrypsin (AAT) deficiency Alpha1 is an inherited condition in which there are low levels or no levels of AAT in the blood. *Also known as AAT Deficiency, AATD, A1-PI deficiency, alpha-1 proteinase deficiency, A1AD, or hereditary or genetic emphysema. Alpha-1 antitrypsin (AAT), also known as alpha1-proteinase inhibitor (A1-PI), is an enzyme produced by the liver and released into the bloodstream. One of the primary roles of AAT is to protect the lungs from neutrophil elastase (NE), an enzyme released by white blood cells. Neutrophil elastase can attack healthy lung tissue if not controlled by AAT. http://www.alpha1health.com/paf/respiratory_system.html
Classifying Emphysema
Panlobular
Centrolobular
Clinical Manifestations
Progressive dyspnea on exertion Prolonged expiratory phase & tachypnea Increased work of breathing Anorexia, weight loss Barrel Chest Flattened diaphragm
Accessory Muscles
Clubbing of Fingers
Chest cavity/ autopsy: reveals numerous large bullae apparent on the surface of the lungs in a patient dying with emphysema
Surgical management
Bullectomy Lung volume reduction surgery
Video-Assisted Lung Volume Reduction Surgery (may also be called thorascopic or endoscopic LVRS)