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Pulmonary Pathophysiology

Pulmonary Pathophysiology. Dr. Tarek Atia. Respiratory System Purpose. Takes in oxygen Disposes of wastes Carbon dioxide Excess water. O 2 + Glucose. The Cell. CO 2 + H 2 O. Histology of the lung. Respiratory epithelium

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Pulmonary Pathophysiology

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  1. Pulmonary Pathophysiology Dr. TarekAtia

  2. Respiratory System Purpose • Takes in oxygen • Disposes of wastes • Carbon dioxide • Excess water O2 + Glucose The Cell CO2 + H2O

  3. Histology of the lung • Respiratory epithelium • Connective tissue fibers, and cartilage: support and maintain open air way • Alveolar cells (type I and type II)

  4. Respiratory System Anatomy Nasopharynx Oropharynx Larynx Trachea Bronchi Bronchioles • Lung • Right lung 3 lobes • Left lung 2 lobes

  5. Bronchioles • Smallest airways • Walls consist entirely of smooth muscle (no cartilage present) • Constriction increases resistance to airflow • Dilation reduces resistance to airflow Alveoli • Air sacs • Site of oxygen and carbon dioxide exchange with blood

  6. Expiration • Passive process • Chest cavity size • Intra-thoracic pressure • Air flows out until pressure equalizes Inspiration • Active process • Chest cavity expands • Intra-thoracic pressure • Air flows in until pressure equalizes

  7. Function of the lung • Gas exchange • Protection against infection by alveolar macrophages (dust cells). • Surfactant secretion: allow expansion of alveoli with air

  8. Lung function tests • Tidal volume (TV): it is the amount of gas inhaled or exhaled with each resting breath. • Residual volume (RV): it is the amount of gas remaining in the lungs at the end of maximum exhalation.

  9. Vital capacity (VC): it is the total amount of gas that can exhaled following maximum inhalation. • Total lung capacity (TLC): it is the amount of gas in the lung at the end of maximum inhalation. TLC = RV+ VC

  10. Reduction of Pulmonary Function Inadequate blood flow to the lungs: Hypo-perfusion Inadequate air flow to the alveoli: Hypo-ventilation Both conditions cause hypoxia

  11. 1- Dyspnea: uncomfortable breathing, feeling “short of breath” Causes of Dyspnea: Airway obstruction: Greater force needed to provide adequate ventilation Wheezing: is a sound due to air being forced through airways narrowed due to constriction or fluid accumulation Common Signs and Symptoms of Pulmonary Disease

  12. 2- Cough: Attempt to clear the lower respiratory passages by forceful expulsion of air Most common when fluid accumulates in lower airways Causes of Cough: Inflammation of lung tissue (Pneumonia) Increased secretion in response to mucosal irritation Inhalation of irritants Tumor invasion of bronchial wall Increased blood pressure in pulmonary capillaries Pulmonary edema (left side heart failure)

  13. When cough can raise fluid into pharynx, the cough is described as a productive cough, and the fluid issputum. Production of bloody sputumis called hemoptysis, as in:- Tuberculosis, Lung abscess, Cancer, Pulmonary infarction.

  14. Cough that does not produce sputum is called a dry, or non-productive cough. Acute cough: resolves in 2-3 weeks from onset of illness or treatment of underlying condition. A chronic cough: persists for more than 3 weeks. In non-smokers: is due to postnasal discharge, asthma, or gastro-esophageal reflux disease In smokers: is due to chronic bronchitis and lung cancer.

  15. 3- Cyanosis: dark red-blue or bluish color of the skin and mucus membranes, because of blood contains a large amount of unoxygenated hemoglobin. 4- Chest pain: Originates in pleurae, airways or chest wall Inflammation of the pleura (Pleurisy) causes sharp or stabbing pain when pleura stretches during inspiration Usually localized to an area of the chest wall Laughing or coughing makes pain worse Common with pulmonary infarction

  16. 5- Clubbing Enlargement of the end of a digit (finger or toe). Usually painless Commonly associated with diseases that cause decreased oxygenation Lung abscess Congenital heart disease Lung cancer Cystic fibrosis

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