Professional Documents
Culture Documents
Slide 1
Emphysema
Bronchitis
Slide 2
Asthma
Chapter 11
Chronic Bronchitis
Slide 3
Slide 4
Etiology
Slide 5
Cigarette smoking
Atmospheric pollutants
Infection
Slide 6
Slide 9
Slide 10
Pursed-lip breathing
Cyanosis
Digital clubbing
Figure 2-36. The way a patient may appear when using the
pectoralis major muscles for inspiration.
Slide 11
Slide 12
Digital
Clubbing
Slide 14
Pitting edema
Distended
Neck Veins
Figure 2-47. Pitting edema. From Bloom A, Ireland J: Color atlas of diabetes, ed 2,
London, 1992, Mosby-Wolfe.
Slide 16
Slide 17
Crackles/rhonchi/wheezing
Slide 19
Slide 20
Slide 21
FVC
FEVT
FEF25%-75%
FEF200-1200
PEFR
MVV
FEF50%
FEV1%
RV
FRC
N or
IC
ERV
VC
N or
N or
Slide 22
TLC
RV/TLC ratio
N or
Slide 23
pH
PaCO2
HCO3
(Slightly)
PaO2
Alveolar Hyperventilation
100
90
PaO2 or PaCO2
80
70
60
PaO2
50
40
30
20
PaC
O
10
0
Slide 24
Figure 4-2. PaO2 and PaCO2 trends during acute alveolar hyperventilation.
pH
Normal
Slide 25
PaCO2
HCO3 (Significantly)
PaO2
Alveolar Hyperventilation
100
90
Pa02 or PaC02
80
70
60
O2
C
a
50
40
30
Pa
O
20
10
0
Figure 4-7. PaO2 and PaCO2 trends during acute or chronic ventilatory failure.
Slide 26
Slide 27
Oxygenation Indices
QS/QTDO2
Slide 28
VO2
C(a-v)O2
Normal
O2ER
SvO2
Normal
Hemodynamic Indices
(Severe Chronic Bronchitis)
Slide 29
CVP
RAP
PA
PCWP
Normal
CO
SV
SVI
CI
Normal
Normal
Normal
Normal
RVSWI
LVSWI
PVR
SVR
Normal
Normal
Hematology
Increased hematocrit and hemoglobin
Electrolytes
Slide 30
Sputum examination
Streptococcus pneumoniae
Haemophilus influenzae
Moraxella catarrhalis
Copyright 2006 by Mosby, Inc.
Radiologic Findings
Chest radiograph
Slide 31
Enlarged heart
Figure 11-2. Chest X-ray film of a patient with chronic bronchitis. Note the translucent (dark)
lung fields, depressed diaphragms, and long and narrow heart.
Slide 32
Radiologic Findings
Bronchogram
Slide 33
Figure 11-3. Chronic bronchitis. Bronchogram with localized view of left hilum. Rounded
collections of contrast lie adjacent to bronchial walls and are particularly well seen below
the left main stem bronchus (arrow) in this film. They are caused by contrast in dilated
mucous gland ducts. (From Armstrong P, Wilson AG, Dee P: Imaging of diseases of the
chest, St. Louis, 1990, Mosby.)
Slide 34
General Management of
Chronic Bronchitis
Behavioral management
Slide 35
Avoidance of infections
GOLD Standards
Slide 36
Figure 11-4. Acute exacerbation of COPD (AECOPD): Guideline algorithm (ACCP/ACP-ASIM). CXR,
Chest X-ray; NPPV, noninvasive positive pressure ventilation; PEFR, peak expiratory flow rate; URI,
upper respiratory infection. (From GUIDELINES Pocketcard: Managing Chronic Obstructive
Pulmonary Disease. Baltimore, 2004, Version 4.0, International Guidelines Center.)
Slide 42
Classroom Discussion
Slide 43