Etiology: Predisposing factor: Precipitating factor:

Streptococcus pneumonia Hereditary Poor environmental

Age Smoking

Lung inflamation

Highly concentrated Chemo attractants up regulates

Free radical adhesion molecule

Eosinophils, neutrophil, alveolar

Highly actice oxidants macrophage activation

Alpha 1 antitrypsin inactivation Hydrogen peroxide

elastase

Elastin, collagen proteoglycan

destructrion

Cytokine
Respiratory epithelial ciliary movement Mucus secreting gland hypertrophy
impairment
Sustained inflamed process

Increase mucus production

Peribronchial Fibrosis

Bronchial wall thickening

Mucus plug proliferation at
bronchial lumen
Bronchial lumen narrowing
 Bacterial proliferation at bronchial lumen Alveolar wall injury
Crackles, wheezes
Increased WBC Increased macrophage and mast cells

Greenish yellowish sputum fibrinogenesis

Cough reflex stimulation Increased number/ size of alveolar fenestrae

cough Alveolar distention/destruction

Loss lung recoil Airflow limitation

Overdistended parenchyma Increased O2 reaching alveoli

Alveolar hyperinflation Increased Alveolar gas exchange

Increased anterioposterior diameter hypoxia

Barrel chest
Peripheral vasoconstriction Increased RR

pallor Cold and clammy skin