英文ppt课件chronicobstructive pulmonary disease（32p）

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1、ChronicObstructivePulmonaryDiseaseHou-haifengLUNGSTRUCTURE2NORMALVENTILATORYFUNCTIONDiaphragmcontractsanddescends,ribcagemovesupwardsandoutward.Pressureinthethoraxislessthaninthemouthsoairflowintothelungsoccurs.Inexpirationdiaphragmrelaxesandmovesupwards,theribcagemo

2、vesinward.Expirationispassivesonomuscularcontractionisneeded.Lungtissueisintrinsicallyelasticandhasanaturalabilitytorecoil.Duringexerciseexpirationisaidedbythecontractionofabdominalandthoracicexpiratorymuscles.Contractionsgeneratepositivepressureinthethoraxpushingair

3、out.3COPDDISORDERSChronicBronchitisEmphysemaAsthma(?)AlthoughnotstrictlyaCOPDdisorderASTHMAisoftenlinkedwithbeingaCOPDdisorder.4DEFINITIONProgressive,non-reversible,obstructiveairwaydiseaseleadingtodamagedalveolarwallsandinflammationoftheconductingairwaysSomepartofth

4、eairwaybecomesobstructedornolongerfunctionsefficiently5CHRONICOBSTRUCTIVEPULMONARYDISEASE:67PathogenesisofCOPDNOXIOUSAGENT(tobaccosmoke,pollutants,occupationalagent)COPDGeneticfactorsRespiratoryinfectionOther89MECHANISMSBronchialglands/cellsinflameIncreasedsecretions

5、Inflammationspreadstosmoothmuscle(bronchiole)Airwayobstruction,decreasedciliaryactionAirtrapping/CollapseofsmallairwaysFurtherairtrappingHyperventilationIncreasedpressureinairwaysWeakenedairwaywalls/walldestructionAlveolardestructionOverstressedrightventricle10MECHAN

6、ISMSIIIncreasesinRBC,Bloodviscosity,BPVentilation/PerfusionimbalancesHypoxemiaCarbondioxideretentionBronchialhyperreactivityHyperinflation11CHRONICBRONCHITISChronicbronchitisisdefinedas"persistentcoughwithsputumproductionforatleast3monthsinatleasttwoconsecutiveyears"

7、.Themostimportantcauseofchronicbronchitisisrecurrentirritationofthebronchialmucosabyinhaledsubstances,asoccursincigarettesmokers.Thepathologicalhallmarksofchronicbronchitisarecongestionofthebronchialmucosaandaprominentincreaseinthenumberandsizeofthebronchialmucusglan

8、ds.Copiousmucusmaybeseenwithinairwaylumens.Theterminalairwaysaremostsusceptibletoobstructionbymucus.12CHRONICBRONCHITISAetiologyCha