Bronchiectasis

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Bronchiectasis

Respiratory system

Upper respiratory tract disorders

Choanal atresia

Laryngomalacia

Allergic rhinitis

Nasal polyps

Upper respiratory tract infection

Sinusitis

Laryngitis

Retropharyngeal and peritonsillar abscesses

Bacterial epiglottitis

Nasopharyngeal carcinoma

Lower respiratory tract disorders

Tracheoesophageal fistula

Congenital pulmonary airway malformation

Pulmonary hypoplasia

Neonatal respiratory distress syndrome

Transient tachypnea of the newborn

Meconium aspiration syndrome

Apnea of prematurity

Sudden infant death syndrome

Acute respiratory distress syndrome

Pulmonary changes at high altitude and altitude sickness

Decompression sickness

Cyanide poisoning

Methemoglobinemia

Emphysema

Chronic bronchitis

Asthma

Cystic fibrosis

Bronchiectasis

Alpha 1-antitrypsin deficiency

Restrictive lung diseases

Sarcoidosis

Idiopathic pulmonary fibrosis

Hypersensitivity pneumonitis

Pneumonia

Croup

Bacterial tracheitis

Lung cancer

Pancoast tumor

Superior vena cava syndrome

Pleura and pleural space disorders

Pneumothorax

Pleural effusion

Mesothelioma

Pulmonary vascular disorders

Pulmonary embolism

Pulmonary edema

Pulmonary hypertension

Apnea and hypoventilation

Sleep apnea

Apnea of prematurity

Respiratory system pathology review

Respiratory distress syndrome: Pathology review

Cystic fibrosis: Pathology review

Pneumonia: Pathology review

Tuberculosis: Pathology review

Deep vein thrombosis and pulmonary embolism: Pathology review

Pleural effusion, pneumothorax, hemothorax and atelectasis: Pathology review

Obstructive lung diseases: Pathology review

Restrictive lung diseases: Pathology review

Apnea, hypoventilation and pulmonary hypertension: Pathology review

Lung cancer and mesothelioma: Pathology review

Assessments

Bronchiectasis

Flashcards

0 / 6 complete

USMLE® Step 1 questions

0 / 2 complete

High Yield Notes

13 pages

Flashcards

Bronchiectasis

of complete

Questions

USMLE® Step 1 style questions USMLE

of complete

A 17-year-old girl comes to the clinic for evaluation of a worsening productive cough. The symptoms have been worsening over the past week, and she has noticed increased production of foul-smelling, blood-tinged sputum. She has had multiple similar episodes in the past that mildly improved with antibiotics, but the cough has always persisted. The patient does not smoke cigarettes or use illicit substances. She takes pancreatic enzyme supplements for chronic diarrhea. Temperature is 39.0°C (102.2°F), pulse is 104/min, respirations are 22/min, and blood pressure is 124/75 mmHg. Physical examination reveals digital clubbing. Lung auscultation demonstrates diffuse wheezes and crackles. Which of the following findings will most likely be present in this patient?  

External References

First Aid

2022

2021

2020

2019

2018

2017

2016

Aspergillosis

bronchiectasis p. 700

Bronchiectasis

Aspergillus fumigatus p. , 150

cystic fibrosis p. 58

Kartagener syndrome p. 47, 714

Cystic fibrosis p. 58

bronchiectasis p. 700

Transcript

Content Reviewers

Rishi Desai, MD, MPH

Amanda J. Grieco, Ph.D.

Contributors

Feiyang Pan

Will Wei

Tanner Marshall, MS

Bronchiectasis can be broken down into “Bronchi” which refers to the bronchi and bronchiole airways of the lower lungs, and “-ectasis” means a dilation or expansion.

So in bronchiectasis chronic inflammation causes the bronchi and bronchioles to get damaged and dilated. Bronchiectasis is an obstructive lung disease, and that’s largely because the inflammation causes mucus plugs to form in the airways, and those mucus plugs obstruct airflow.

Normally, when taking a breath, the diaphragm muscle moves down and that creates negative pressure within the chest. This draws air in through the mouth or nose, and down the trachea.

Once there it goes into one of the primary bronchi or main bronchi, then secondary bronchi or lobar bronchus, then tertiary bronchi or segmental bronchus, and finally into the bronchioles which lead into the alveoli.

The alveoli is where the majority of gas exchange occurs in the lungs.

Taking a closer look at the airways, particularly the walls of the airways, they’ve got elastin fibers, which help give them their rubber-band like properties, and are lined with epithelial cells - some of which have brush-like projections, called cilia on their surface and others that secrete mucus.

The mucus traps foreign particles like bacteria and dust, and the mucus then gets swept upwards and out of the lungs by the cilia.

Together this whole system is called the mucociliary escalator.

Eventually that mucus and any stuck particles move into the esophagus and get swallowed and destroyed by the acid in the stomach! That’s right - you’re swallowing that mucus as you watch this.

Summary

Bronchiectasis is a chronic inflammation of the bronchi and the bronchioles, which damages the mucociliary escalator and the walls of the airways. This causes mucus to accumulate and get stuck in the airways, and form mucus plugs that can lead to serious infections, difficulty breathing, and a variety of other health problems. Common causes of bronchiectasis include long-term exposure to cigarette smoke, respiratory infections such as pneumonia, and cystic fibrosis.

Sources

  1. "Robbins Basic Pathology" Elsevier (2017)
  2. "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
  3. "Pathophysiology of Disease: An Introduction to Clinical Medicine 7/E (ENHANCED EBOOK)" McGraw Hill Professional (2014)
  4. "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
  5. "Non–Cystic Fibrosis Bronchiectasis" American Journal of Respiratory and Critical Care Medicine (2013)
  6. "Etiology of Non–Cystic Fibrosis Bronchiectasis in Adults and Its Correlation to Disease Severity" Annals of the American Thoracic Society (2015)
  7. "Bronchiectasis" Nature Reviews Disease Primers (2018)
Elsevier

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