Bronchiolitis Bronchiolitis Inflammation of the bronchioles. Pediatric Chest Abnormalities obliterans is an obstructive lung disease triggered by a bronchiolar injury, which leads to inflammatory fibrosis and narrowing of the distal bronchioles Bronchioles The small airways branching off the tertiary bronchi. Terminal bronchioles lead into several orders of respiratory bronchioles which in turn lead into alveolar ducts and then into pulmonary alveoli. Bronchial Tree: Anatomy. The triggering bronchiolar injury is often due to inhalation of a noxious substance, infection, or drug toxicity Toxicity Dosage Calculation. Bronchiolitis Bronchiolitis Inflammation of the bronchioles. Pediatric Chest Abnormalities obliterans is also associated with rheumatic disease and is an important complication to recognize following a lung or hematopoietic stem-cell transplant. Following bronchiolar injury, there is an abnormal fibroproliferation within the bronchioles Bronchioles The small airways branching off the tertiary bronchi. Terminal bronchioles lead into several orders of respiratory bronchioles which in turn lead into alveolar ducts and then into pulmonary alveoli. Bronchial Tree: Anatomy, which results in small- airway Airway ABCDE Assessment obstruction. Patients Patients Individuals participating in the health care system for the purpose of receiving therapeutic, diagnostic, or preventive procedures. Clinician–Patient Relationship present with a persistent progressive cough and dyspnea Dyspnea Dyspnea is the subjective sensation of breathing discomfort. Dyspnea is a normal manifestation of heavy physical or psychological exertion, but also may be caused by underlying conditions (both pulmonary and extrapulmonary). Dyspnea. Diagnosis is usually made based on pulmonary function tests (showing a non-reversible obstructive pattern, air trapping, and decreased gas exchange Gas exchange Human cells are primarily reliant on aerobic metabolism. The respiratory system is involved in pulmonary ventilation and external respiration, while the circulatory system is responsible for transport and internal respiration. Pulmonary ventilation (breathing) represents movement of air into and out of the lungs. External respiration, or gas exchange, is represented by the O2 and CO2 exchange between the lungs and the blood. Gas Exchange) and high-resolution CT High-resolution CT Imaging of the Lungs and Pleura (showing air trapping and bronchial-wall thickening). Management involves supportive care, bronchodilators Bronchodilators Asthma Drugs, glucocorticoids Glucocorticoids Glucocorticoids are a class within the corticosteroid family. Glucocorticoids are chemically and functionally similar to endogenous cortisol. There are a wide array of indications, which primarily benefit from the antiinflammatory and immunosuppressive effects of this class of drugs. Glucocorticoids, and/or macrolide antibiotics. Immunosuppressive therapy is usually increased in patients Patients Individuals participating in the health care system for the purpose of receiving therapeutic, diagnostic, or preventive procedures. Clinician–Patient Relationship who have undergone transplantation, and retransplantation may be required if the condition worsens.
Last updated: 31 Mar, 2021
Small airway Airway ABCDE Assessment injuries that trigger Trigger The type of signal that initiates the inspiratory phase by the ventilator Invasive Mechanical Ventilation bronchiolitis Bronchiolitis Inflammation of the bronchioles. Pediatric Chest Abnormalities obliterans can result from inhalation, infections Infections Invasion of the host organism by microorganisms or their toxins or by parasites that can cause pathological conditions or diseases. Chronic Granulomatous Disease, drug exposure Exposure ABCDE Assessment, lung inflammation Inflammation Inflammation is a complex set of responses to infection and injury involving leukocytes as the principal cellular mediators in the body’s defense against pathogenic organisms. Inflammation is also seen as a response to tissue injury in the process of wound healing. The 5 cardinal signs of inflammation are pain, heat, redness, swelling, and loss of function. Inflammation due to a rheumatic process, or chronic transplant rejection.
Injury to the distal bronchioles Bronchioles The small airways branching off the tertiary bronchi. Terminal bronchioles lead into several orders of respiratory bronchioles which in turn lead into alveolar ducts and then into pulmonary alveoli. Bronchial Tree: Anatomy results in inflammation Inflammation Inflammation is a complex set of responses to infection and injury involving leukocytes as the principal cellular mediators in the body’s defense against pathogenic organisms. Inflammation is also seen as a response to tissue injury in the process of wound healing. The 5 cardinal signs of inflammation are pain, heat, redness, swelling, and loss of function. Inflammation. A dysregulated immune response then leads to fibroproliferation and narrowing of these small airways and decreases airflow.
Bronchiolitis
Bronchiolitis
Inflammation of the bronchioles.
Pediatric Chest Abnormalities pathophysiology:
The image on the left represents the structure of a normal bronchiole. The image on the right represents changes occurring in
bronchiolitis
Bronchiolitis
Inflammation of the bronchioles.
Pediatric Chest Abnormalities obliterans. Injury to the distal
bronchioles
Bronchioles
The small airways branching off the tertiary bronchi. Terminal bronchioles lead into several orders of respiratory bronchioles which in turn lead into alveolar ducts and then into pulmonary alveoli.
Bronchial Tree: Anatomy results in
inflammation
Inflammation
Inflammation is a complex set of responses to infection and injury involving leukocytes as the principal cellular mediators in the body’s defense against pathogenic organisms. Inflammation is also seen as a response to tissue injury in the process of wound healing. The 5 cardinal signs of inflammation are pain, heat, redness, swelling, and loss of function.
Inflammation of the
bronchioles
Bronchioles
The small airways branching off the tertiary bronchi. Terminal bronchioles lead into several orders of respiratory bronchioles which in turn lead into alveolar ducts and then into pulmonary alveoli.
Bronchial Tree: Anatomy and adjacent
alveoli
Alveoli
Small polyhedral outpouchings along the walls of the alveolar sacs, alveolar ducts and terminal bronchioles through the walls of which gas exchange between alveolar air and pulmonary capillary blood takes place.
Acute Respiratory Distress Syndrome (ARDS). Fibrosis occurs (which is abnormal) instead of normal repair. There is mucus buildup, tightening and
hypertrophy
Hypertrophy
General increase in bulk of a part or organ due to cell enlargement and accumulation of fluids and secretions, not due to tumor formation, nor to an increase in the number of cells (hyperplasia).
Cellular Adaptation of the bronchial
smooth muscles
Smooth muscles
Unstriated and unstriped muscle, one of the muscles of the internal organs, blood vessels, hair follicles, etc. Contractile elements are elongated, usually spindle-shaped cells with centrally located nuclei. Smooth muscle fibers are bound together into sheets or bundles by reticular fibers and frequently elastic nets are also abundant.
Muscle Tissue: Histology followed by narrowing of the small airways.
Bronchiolitis Bronchiolitis Inflammation of the bronchioles. Pediatric Chest Abnormalities obliterans should be suspected in patients Patients Individuals participating in the health care system for the purpose of receiving therapeutic, diagnostic, or preventive procedures. Clinician–Patient Relationship with slowly progressive dyspnea Dyspnea Dyspnea is the subjective sensation of breathing discomfort. Dyspnea is a normal manifestation of heavy physical or psychological exertion, but also may be caused by underlying conditions (both pulmonary and extrapulmonary). Dyspnea and cough, especially when the presentation Presentation The position or orientation of the fetus at near term or during obstetric labor, determined by its relation to the spine of the mother and the birth canal. The normal position is a vertical, cephalic presentation with the fetal vertex flexed on the neck. Normal and Abnormal Labor is otherwise atypical for asthma Asthma Asthma is a chronic inflammatory respiratory condition characterized by bronchial hyperresponsiveness and airflow obstruction. The disease is believed to result from the complex interaction of host and environmental factors that increase disease predisposition, with inflammation causing symptoms and structural changes. Patients typically present with wheezing, cough, and dyspnea. Asthma or chronic obstructive pulmonary disease Pulmonary disease Diseases involving the respiratory system. Blastomyces/Blastomycosis ( COPD COPD Chronic obstructive pulmonary disease (COPD) is a lung disease characterized by progressive, largely irreversible airflow obstruction. The condition usually presents in middle-aged or elderly persons with a history of cigarette smoking. Signs and symptoms include prolonged expiration, wheezing, diminished breath sounds, progressive dyspnea, and chronic cough. Chronic Obstructive Pulmonary Disease (COPD)).
The diagnosis of bronchiolitis Bronchiolitis Inflammation of the bronchioles. Pediatric Chest Abnormalities obliterans is usually made based on history, pulmonary function test Pulmonary function test Pulmonary function tests are a group of diagnostic procedures yielding useful, quantifiable information about the rate of the flow of air through the individual’s airways, lung capacity, and the efficiency of gas exchange in relation to time. The most commonly utilized tests include spirometry (before and after bronchodilator use), lung volumes, and quantitation of diffusing capacity for carbon monoxide (CO). The tests can be influenced by the individual’s effort/fatigue, disease state, or anatomical malformation. Pulmonary Function Tests, imaging, and biopsy Biopsy Removal and pathologic examination of specimens from the living body. Ewing Sarcoma findings.
Algorithm for interpretation of pulmonary function tests:
FEV1: forced expiratory volume in the 1st second
FVC: forced
vital capacity
Vital capacity
The volume of air that is exhaled by a maximal expiration following a maximal inspiration.
Ventilation: Mechanics of Breathing (total forced exhaled volume)
DLCO
DLCO
Pulmonary Function Tests: diffusing capacity of the
lungs
Lungs
Lungs are the main organs of the respiratory system. Lungs are paired viscera located in the thoracic cavity and are composed of spongy tissue. The primary function of the lungs is to oxygenate blood and eliminate CO2.
Lungs: Anatomy for
carbon monoxide
Carbon monoxide
Carbon monoxide (CO). A poisonous colorless, odorless, tasteless gas. It combines with hemoglobin to form carboxyhemoglobin, which has no oxygen carrying capacity. The resultant oxygen deprivation causes headache, dizziness, decreased pulse and respiratory rates, unconsciousness, and death.
Carbon Monoxide Poisoning (reflects the lung’s ability to transfer inhaled gas across the alveolar-capillary membrane)
COPD
COPD
Chronic obstructive pulmonary disease (COPD) is a lung disease characterized by progressive, largely irreversible airflow obstruction. The condition usually presents in middle-aged or elderly persons with a history of cigarette smoking. Signs and symptoms include prolonged expiration, wheezing, diminished breath sounds, progressive dyspnea, and chronic cough.
Chronic Obstructive Pulmonary Disease (COPD): chronic obstructive
pulmonary disease
Pulmonary disease
Diseases involving the respiratory system.
Blastomyces/Blastomycosis
ILD
ILD
Interstitial lung diseases are a heterogeneous group of disorders characterized by the inflammation and fibrosis of lung parenchyma, especially the pulmonary connective tissue in the alveolar walls. It may be idiopathic (e.g., idiopathic pulmonary fibrosis) or secondary to connective tissue diseases, medications, malignancies, occupational exposure, or allergens.
Interstitial Lung Diseases: interstitial lung disease
High-resolution CT
High-resolution CT
Imaging of the Lungs and Pleura (
HRCT
HRCT
Pulmonary Function Tests) in
bronchiolitis
Bronchiolitis
Inflammation of the bronchioles.
Pediatric Chest Abnormalities obliterans:
The
HRCT
HRCT
Pulmonary Function Tests at
expiration
Expiration
Ventilation: Mechanics of Breathing demonstrates a mosaic-attenuation pattern that results from air trapping.
Bronchiolitis Bronchiolitis Inflammation of the bronchioles. Pediatric Chest Abnormalities obliterans is often progressive and refractory to therapy; thus, management is often supportive, symptom driven, and based on the etiology.