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PATHOPHYSIOLOGY

Predisposing Factors: Family history of Asthma Age: 61


Entry of noxious particles or gases to the lungs

Precipitating factors: ALCOHOL: consume 1 bottle/1 L DIET: increase salt, fat LIFESTYLE: sedentary , smokes 1 pack/day

Induced production of neutrophils, macrophages, lymphocytes

Loss of elastin

Abnormal inflammation of the lung

Blockage or narrowing of the airways

Scar tissue formation Chronic Bronchitis

Damage to the alveolar walls

Alveolar hypoxia

Thickened airways Constant Irritation Produced excess smooth muscles and connective tissues

Decrease exchange of air in the surface area

Hypoxic pulmonary vasoconstriction Pulmonary hypertension Increased pulmonary vascular resistance

Excess secretion of mucus

Increase right ventricular workload

Fibrosis Thickening of vessel wall Increase pressure in the chest Narrowing of airway lumen Right ventricular hypertophy

Right sided heart failure

Edema

Difficulty exhalation

Airflow limitation

Low oxygen supply

Inability to receive full pulmonary blood

Atrial dilation, remodelling, sympathetic activation

Increase cell death to the heart

Increase pulmonary pressure Fluid movement from interstitium to alveoli

Backward flow of blood from systemic circulation

LEFT Manifestations Shortness of breath Use of accessory muscles when breathing Productive cough Rales Pale extremities fatigue

Decrease ventricular contraction

Inability to receive full systemic blood Increase amount of blood in left ventricle Decrease capacity to receive blood from left atrium Blood goes back to left atrium Increase left atrial workload Atrial dilation, remodeling, sympathetic activation Increase right ventricular workload Increase preload Right ventricular dilation, remodeling, sympathetic activation

RIGHT Manifestations Bipedal edema Distended Jugular neck veins @ 45 degree position Headache

Decrease renal perfusion Systemic congestion Increase sodium retention

Decrease capacity to receive blood from right atrium Blood goes back to right atrium

Increased osmotic pressure

Increased water reabsorption

Increase right atrial workload Increase left atrial pressure

Fluid overload

Edema

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