- Collapse of lung with absorption of air from alveoli
- Produces dyspnea (shortness of breath)
- Due to imbalance of ventilation-perfusion
- Common 2 days Post-Operation
- Reversible
- Rule out severe anemia
- Mucus plug = obstruction = resorption type
Atelectasis
“Shock Lung”
Acute Respiratory Distress Sydrome (ARDS)
Inflammation and injury to septal capillaries (capillaritis) causes increased permeability (hyaline membranes)
Acute Respiratory Distress Sydrome (ARDS)
Microscopic Morphology of ARDS
Diffuse Alveolar Damage (DAD)
Increased capillary permeability results in
Hyaline membranes (fibrin exudates)
4 causes of ARDS?
1) Aspiration of Gastric Contents
2) Pulmonary infections (viral pneumonia)
3) Septic Shock
4) Shock associated with Head trauma
Measures how much and how quickly you can move air out of your lungs
Spirometry
This measures the amount of air you can exhale with force in one breath.
Forced expiratory volume (FEV)
This measures the amount of air you can exhale with force after you inhale as deeply as possible.
Forced vital capacity (FVC)
If your FEV1 is decreased = ______ disease
Obstructive = emphysema (COPD), bronchitis (COPD), asthma (REVERSIBLE if acute, irreversible =chronic)
If your FVC is decreased = _________ disease
Restrictive = Pregnancy, Obesity, Pulmonary Fibrosis, and Sarcoidosis
If FEV1/FVC ratio is below 0.7 =________?
Obstructive Pulmonary Disease (Bad)
80% of COPD (Emphysema or Bronchitis) is caused by?
Tobacco Smoke
Permanent enlargement (dilation) on bronchi due to infection in the walls (Obstructive)
-Associated with Cystic Fibrosis (mucus plug)
Bronchiectasis
Permanent increase in size of airways distal to terminal bronchiole, destruction of alveolar walls (due to smoking)
Alpha 1 antitrypsin deficiency
Emphysema (COPD)
Pathogenesis of emphysema
-Protease/Antiprotease imbalance
Smoking = increase protease (elastase) and decrease antiprotenase (deficiency)
-FEV1 reduced (no elastic walls)
Dyspnea, barrel chest, “pink puffer”, pursed lips, sits punched over, tripod position, open belt, for pulmonate (right heart failure)
Pulmonary Emphysema
How is pulmonary emphysema confirmed?
Spirometry (FEV1/FVC ratio below 0.7)
Subpleural balloon like spaces (blebs) that may rupture to produce spontaneous pneumothorax
Bullae
- Air within connective tissue of lung
- Crepitant
- Lady with swollen face
Interstitial emphysema
- Persistent cough with sputum production for atlas 3 months in 2 consecutive years
- Irreversible
- Almost always due to smoking
- Requires irritant + infection (H influenza)
- “Blue Bloater”
Chronic Bronchitis (COPD)
Clinical and microscopic features of chronic bronchitis?
- prolonged cough with sputum
- increased goblet cells by hyperplasia
- Reid index
