Bronchiec

Predisposing Factors:  Recurrent Upper & Lower respiratory infections in early childhood  Measles  Influenza  Tuberculosis  Immunodeficiency disorders  Diffused airway injury  Airway obstruction  Immunodeficiency Precipitating Factors:  Congenital disease such as cystic fibrosis (Genetic Disorder)  Idiopathic causes

Productive cough (purulent sputum)

Pulmonary infections damaging the bronchial walls

Inflammation of the bronchial walls

Airway obstruction (dyspnea) Abnormal breath sounds (rales & crackles upon auscultation)

Loss of supporting structures of the bronchi Permanent distention and distortion of bronchial walls

Impaired mucociliary clearance

Dilated bronchial tubes amounts to lung abscess

Retention of secretions and subsequent obstruction affects peribronchial tissues

Hemoptysis

Excessive exudates drains freely through the bronchus

Inflammatory scarring / fibrosis of bronchus replace the functioning of lung tissue

A segment or lobe of lung collapse (bronchiectasis)

Respiratory insufficiency

Respiratory insufficiency

Reduced vital capacity

Decreased ventilation

Increased ratio of residual volume to total lung capacity

Ventilation – perfusion imbalance

Hypoxemia

Cyanosis (clubbing of fingers)

 Synthesis of the disease The inflammatory process associated with frequent pulmonary infections damages the bronchial wall, causing a loss of its supporting structure and resulting in thick sputum that ultimately obstructs the bronchi. The walls become permanently distended and distorted, impairing mucociliary clearance. The inflammation and infection extend to the peribronchial tissues; in the case of saccular bronchiectasis, each dilated tube virtually amounts to a lung abscess, the exudates of which drains freely through the bronchus. Bronchiectasis is usually localized, affecting a segment or lobe of a lung, most frequently the lower lobes. The retention of secretions and subsequent obstruction ultimately cause the alveoli distal to the obstruction to collapse (atelectasis). Inflammatory scarring or fibrosis replaces functioning lung tissue. In time, the patient develops respiratory insufficiency with reduced vital capacity, decreased ventilation, and an increased ratio of residual volume to total lung capacity. There is impairment in the matching of ventilation to perfusion (ventilation-perfusion imbalance) and hypoxemia.  Predisposing / Precipitating factors Bronchiectasis may be caused by a variety of conditions, including pulmonary infections and obstruction of the bronchus diffuse airway injury; genetic disorder (e.g, cystic fibrosis); and abnormal host defense (e.g, humoral immunodeficiency). A person may be predisposed to bronchiectasis (history of recurrent infections, measles influenza, tuberculosis, and immunodeficiency disorders).  Signs and symptoms Clinical manifestations includes chronic cough and production of copius purulent sputum, which has a quality of “layering out” into three layers on standing a frothy top layer, a middle clear layer, and a dense particulate bottom layer. Hemoptysis, clubbing of fingers, and repeated episodes of pulmonary infections are also manifested.

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