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Obstructive Pulmonary Disease

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Submitted By illuminati36
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Obstructive Pulmunary Disease
A. Hallmarks
1.Airflow limitation
2.Irreversible type disease: (COPD) Emphysema, bronchitis, asthma, cystic fibrosis, bronchiectasis,bronchiolitis
3.Reversible Type:Hyper-reactive airway disease, Athma, chronic inflammatory disease

B.Airflow reduction
REduced bronchiole Tone elevated air trapping
FEV1 is reduced
Emphysema: low elastic recoil of bronchiles, low air flow, low airway tone, pressure drive of air is low

Asthma:Bronchoconstriction with higher resistance Residual volume and Residual Capacity along with Total lung capacity elevated

Emphysema: effects create greater work of breathing and dyspnea
Chest xray shows flattened diaphragm, lower intra-thoracic pressure and shortened muscle fibers also hyperlucency
Greater air trapping
Airway narrowing due to low elastic recoil
Decreased driving pressure for air flow reduced FEV1 reduced FEV1/FVC
RV, TLC and FRC elevated
Hyperinflation
reduced alveoli with loss of surface area
Ventilation to Perfusion mismatch creates hypoxemia
Low Diffusion capacity

Genetic link: Alpha 1 antitrypsin reduction
Alpha 1 is made in liver , then travels to lung helps reduce the degradation of Elastin which helps the elasticity recoil of bronchioles

Pathogenesis : Inflammatory( neutrophils, cytokines, macrophages Oxidant: lipid peroxidation with active proteases Neurogenic: Beta 2 adrenergic effects of dilation of bronchiles

Clinical presentation: respiratory distress, pursed lips, use of accessory muscles.
"The Pink Puffer"

BRONCHITIS:

Sputum productive cough for 3 months in 2 consecutive years
Etiology: tobacco, pollution
Pathogenesis: increased globlet cell hyperplacia creating mor mucus and musus plugs, fibrosis,
Creation of airway disease via increased airway resistance and

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