Form of COPD that involves damage to the air sacs (alveoli) Air sacs are unable to completely deflate (hyperinflation) – unable to fill w/ fresh air to ensure adequate O 2 supply to body Characterized by normal or increased lung capacity Lack of elastic recoil in the lungs Generally bilateral 155
More common in males May lead to cardiac failure Is a significant public health problem Does NOT show hemoptysis A tissue change, rather than mucous production (seen in asthma & chronic bronchitis) Cigarette smoker with gradual onset of progressive, labored breathing, with prolonged expiratory effort Labored breathing Show Pursed Lips Dyspnea, decrease in breathing sounds, tachycardia and decreased I/E ration Increased susceptibility to infection May be fatal, results from degenerative atrophy; and may be secondary to bronchial inflammatory disease Two problems: 1) Lungs are fixed in inspiration 2) Respiratory surfaces of lungs have deteriorated so much that they no longer adequately exchange gases Complete blood count likely shows polycythemia Recurring attacks of bronchial asthma may predispose to emphysema Most commonly caused by cigarette smoking Tobacco smoke & other pollutants are thought to cause lungs to release chemicals that damage the walls of alveoli Damage worsens over time, affecting O 2 & CO 2 exchange in the lungs A naturally occurring substance in the lungs called alpha-1 antitrypsin may protect against this damage People w/ alpha-1 antitrypsin deficiency are at increased risk Alpha-1 antitrypsin deficiency affects both the Lung and Liver Two important types: Centrilobar – upper lobes of lungs most affected – cigarette smoking is major cause Panlobular – lower lobes of lungs most affected – familiar antiproteinase (caused by alpha-1 antitrypsin deficiency) Chronic bronchitis: (blue bloater) Common, debilitating respiratory disease, characterized by ↑ mucous production by the glands of trachea & bronchi Characterized by: Productive cough, often w/ wheezing (universal factor in all cases) Produces purulent sputum for 3+ months in at least 2 consecutive years w/o any other disease that could account for symptom Dyspnea on exertion Ventilation-perfusion imbalance NOT decreased airway resistance Strong association w/ smoking Common results of chronic bronchitis: 156
Cor pulmonale (enlargement of the right ventricle) – from working too hard to push blood through pulmonary system Airway narrowing Obstruction of the bronchial tree along w/ squamous metaplasia Squamous metaplasia is most commonly encountered in the bronchial mucosa ( NOT stomach, oral mucosa, etc.) Characteristic pathologic change: Hyperplasia of bronchial submucosal glands & bronchial smooth muscle hypertrophy
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- Winter '20