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33 Cards in this Set
- Front
- Back
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What is the clinical definition of Chronic Bronchitis?
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-Persistent cough w/ sputum production
-For at least 3 mo in any 2 consecutive years -No other identifiable cause |
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When are patients classified as showing Obstructive Chronic Bronchitis?
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When spirometry shows chronic airflow OBSTRUCTION
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What is spirometry going to show in obstructive chronic bronchitis?
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-Decreased FEV1:FVC ratio
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What do patients with chronic obstructive bronchitis often have?
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Associated emphesyma
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And what is it called when patients have both Emphesyma and chronic obstructive Bronchitis?
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COPD
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What is 90% of chronic bronchitis caused by?
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Inhalation of irritating substances - SMOKING
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What does the chronic irritaiton cause? What is it stimulated by?
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Hypersecretion of mucus
Stimulated by proteases |
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What does the hypersecretion of mucus get produced by? (2 things)
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-Hypertrophic submucosal glands
-Increased numbers of goblet cells |
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What 2 pathologic changes are important contributors to early bronchitis?
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-Bronchiolitis
-Small ariway disease |
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What are patients with chronic bronchitis prone to? How does it affect the course of the disease?
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Infections - they maintain the disease and cause acute exacerbations of the disease too.
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So what is the predominant issue that causes restricted air flow in chronic bronchitis?
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Hypersecretion of mucus
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How exactly does cigarette smoke predispose a person to infection? (2 ways)
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1. By paralyzing the cilia in the respiratory epithelium
2. By directly damaging the epithelium |
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What is the result of damaged epithelium and cilia?
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The ability of bronchial and alveolar WBCs to clear bacteria is inhibited.
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What are the predominant gross findings in chronic bronchitis?
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-Hyperemia
-Swelling/edema of mucus membranes -Mucinous secretions -Mucopurulent secretions |
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What are the Microscopic findings in chronic bronchitis?
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CHINS
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What does CHINS stand for?
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-Chronicly inflamed airways
-Hypertrophic mucus-secreting glands -Increased Reid index -Narrow bronchiolar lumens -Squamous metaplasia of bronchial epithelium |
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What is the Reid Index?
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The ratio of the thickness of the mucous gland layer to the thickness of the wall between the epithelium and cartilage
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What change is seen in the reid index in chronic bronchitis?
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Increased
Say normal is 5:10 = .5 Chronic br is 10:10 = 1 |
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What is the typical clinical course presentation of Chronic Bronchitis?
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1. Persistent productive cough
2. Dyspnea on exertion 3. Advanced COPD 4. Complications later |
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What does more advanced COPD include?
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-Hypercapnia
-Hypoxemia -Mild cyanosis |
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What are the main complications seen in chronic bronchitis?
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-Cor pulmonale
-Cardiac failure -Acute bacterial infections |
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What is the typical age of onset in patients with Chronic bronchitis? Emphesyma?
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CB: 40-45
Emph: 50-75 |
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When is dyspnea initially seen and how severe in Chronic bronchitis? Emphesyma?
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CB: mild, late
Emph: severe, early |
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When and what type of cough is seen in Chronic bronchitis? Emphesyma?
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CB: Early; copious sputum
Emph: late; scanty sputum |
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In which disease are infections more typically seen?
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Chronic bronchitis
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How does the presentation of respiratory insufficiency differ in CB vs emphesyma?
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CB: repeated
Emph: terminal |
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In which disease is cor pulmonale more frequent?
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CB
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What is the airway resistance in Chronic bronchitis? Emphesyma?
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CB: increased
Emph: normal or sl increased |
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What is the elastic recoil like in Chronic bronchitis? Emphesyma?
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CB: normal
Emph: low recoil |
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What will be seen on chest radiograph in chronic bronchitis?
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-Prominent vessels
-Large heart |
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What will be seen on the chest radiograph of a patient with emphesyma?
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-Hyperinflation
-Small heart |
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What do we call the clinical appearance of a patient with CB?
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Blue bloater
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What do we call the clinical appearance of a patient with emphesyma?
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Pink puffer
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