Cardio
11/23/99
- Simple
Chronic—3 months of mucus production and coughing for 2 consecutive years
- Smoking
can lead to acute bronchitis and over time leads to simple chronic
- Leads
to changes in the bronchiole walls
- These
changes are believed to be reversible
- Chronic
obstructive (Respiratory Bronchiolitis)
- Occurs
in late 40's to 50's
- Early
emphysema
- Once
it has reached the respiratory zone it is classified as emphysema
- Findings
- Spirometry
findings
- Blood
gases may show some changes
Anatomy
- Bronchus
- Columnar
ciliated epithelial
- Mucus
glands
- Goblet
cells
- Serous
glands
- Bronchiole
- Cubiodal
epithelial cells ciliated
- No
mucus glands or goblet cells
- Alveolus
- Clara
cells—produces a watery lining of the alveolar wall for O2 diffusion
- Type
II cells produce surfactant
- Type
I cells are the squamous lining
- Mucus
- 2
layers
- Sol—thin
and watery, bottom layer, ¯viscous
- Gel—thick
and tenacious, ¯ viscous
- Goblet
and mucus produce the thick layer of mucus
- Mucus
is the thickest
- Goblet
is less thick than mucus
- Serous
glands produce the sol portion
- Do
not want the sol layer to become thick and tenacious
- Mucociliary
escalator
- Cilia
beat towards the mouth
- Rhythmic
beating—as long as the bottom layer is thin and watery
- About
200/cell
- Mucokinesis
(movement of the diminishes if the bottom layer becomes thick
- What
makes mucus thick and tenacious
- Increased
number and size of mucous glands
- Increase
the number of mucus glands from serous glands that grow up
- A
cause of this is chronic exposure to cigarette smoke
- A
nervous reflex can lead to the hypertrophy of mucus is sympatheticotonia
- Korr
says that NE will enhance the function of mucus glands
- Reid
Index in chronic bronchitis—no more than ½ the thickness of the wall
should be the mucous gland
- Normal
is .3-.5
- Abnormal
is >.5
- This
stage is reversible—may take up to 5 years after quitting smoking and
change of life style
- Chronic
inflammation of the wall can also create the same problem
- Cilia
will disappear
- Mucus
will become thick and tenacious
- Change
of mucous glands
- Nervous
reflexes play a roll
- Large
airways
- Thicker
mucus
- Cilia
diminishes
- Mucous
glands increase in size and number
- Serous
glands disappear
- Smaller
airways
- Alveoli
- Smokers
or constant irritation the Clara cells become goblet cells
- A
more viscous fluid will line the alveoli
- A
dry cough is not bronchitis
-