Bronchiectasis

Question 1

what is bronchiectasis?

Answer 1

irreversible dilation (widening) of bronchial airways, causing a risk of infection

Question 2

why does the dilation of the airways occur?

Answer 2

due to:
- infection
- airway obstruction
- fibrosis (thickening or scarring) of bronchial airway walls

Question 3

where does localised bronchiectasis affect?

Answer 3

it is localised (focal) and affects a specific lobe or segment of the lung

Question 4

what is the causes of localised bronchiectasis?

Answer 4

due to:
- tumours
- foregin bodies
- mucus plugs due to obstructed airways

Question 5

where does generalised bronchiectasis affect?

Answer 5

usually affects both lungs, most commonly lower lobes

Question 6

what is the causes of generalised bronchiectasis?

Answer 6

due to:
- inherited or acquired disorders that introduce infectious organisms into airways

Question 7

what are the causes of bronchiectasis?

Answer 7

• post-infection
• inhalation injury
• airway obstructive disease
• mucociliary clearance disorders
• bronchial obstruction
• immunodeficiency

Question 8

what are the different types of bronchiectasis?

Answer 8

• Cylindrical
• Varicose
• Cystic (saccular)

Question 9

What is cylindrical bronchiectasis?

Answer 9

bronchi are enlarged and are cylindrical in shape

Question 10

What is varicose bronchiectasis?

Answer 10

irregular bronchi with areas of dilation (varicosities) and constriction

Question 11

What is cystic (saccular) bronchiectasis?

Answer 11

clusters of cysts formed from dilated bronchi. Most severe from, often found in patients with Cystic Fibrosis.

Question 12

Describe the vicious cycle of bronchiectasis

Answer 12

• Initially, there is infection
• The infection then causes airway inflammation
• Consequences of this is impaired mucociliary clearance
• This leads to increased mucus secretion
• This then causes microbial colonisation and infection
• Finally airway obstruction and bronchial dilation occurs

Question 13

what are the symptoms of bronchiectasis?

Answer 13

• Chronic productive cough – copious amounts of purulent, foul-smelling sputum and blood-stained mucus (haemoptysis)
• History of repeated, severe lung infections
• Dyspnoea & wheeziness
• Fatigue and poor concentration

Question 14

can bronchiectasis be treated?

Answer 14

damage to the airways is permanent therefore treatment is aimed at the prevention of further damage and worsening of symptoms

Question 15

what is a physiotherapists role in bronchiectasis treatment?

Answer 15

• active cycle of breathing techniques (ACBT)
• Breathing control and deep breathing
• Huffing
• Positioning for gravity assistance of sputum drainage
• Chest percussion to loosen sputum