Week 5 Case Study Respiratory

Case Study

Emphysema is a form of lung disease characterized as a chronic obstructive pulmonary disease (COPD). It is a progressive condition associated with reduced airflow in the lungs and inflammation of the airways. The physical findings which can be indicative of a patient with emphysema include limited expiratory flow, pursed lips, and thin patient with a barrel chest. The patient takes longer to exhale than it does to inhale. Pulmonary function test is defined as a group of tests which measures how well a person’s lungs work including if the individual can breathe and how effective their lungs can bring oxygen to the rest of their body (Lam, 2018).

    The pathophysiology of emphysema can be described based on reduced pulmonary elastic recoil. The lung volume is higher than normal at any pleural pressure. Such compression limits airflow during forced expiration and in severe cases during tidal expiration. Patients with relatively pure emphysema maintain blood gases in or normal ranges until very late in their course (Lam, 2018).

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    The respiratory center is found in the pons and medulla oblongata in the brainstem. The respiratory center is composed of three main respiratory groups of neurons one in the pons and two in the medulla. The respiratory center performs three functions including adjusting homeostatic response to physiological changes, generate and maintains the rhythm of respiration as well as regulating the rate and depth of breathing.

    The oxygen-hemoglobin dissociation curve is a curve that plots the proportion of hemoglobin against prevailing oxygen. This curve results from allosteric interactions of globin monomers which form hemoglobin tetramer when each one binds oxygen. Different factors affect the affinity of hemoglobin for oxygen thus triggering the curve to shift to the right with decreased oxygen or to the left to indicate the increased oxygen affinity (Ellis & Pepple, 2015).

    The pathological findings specifying bronchitis involve the cells of the bronchial lining tissue being exasperated. The mucous membrane becomes edematous and hyperemic decreasing bronchial mucociliary function. As a result, irritation increases and air passages become blocked by debris. In response, full discharge of mucus leads to the characteristic cough of bronchitis (Lam, 2018).  

References

1. Ellis, S. S., and Pepple, D. J. (2015). Sildenafil Increases the p50 and Shifts the Oxygen–hemoglobin Dissociation Curve to the Right. The journal of sexual medicine, 12(12), 2229-2232.
2. Lam, K. (2018). " Casting" for a Diagnosis: A Case of Plastic Bronchitis in an Adult Patient Following Cardiopulmonary Bypass. In D39. DYSPNEA: CASE REPORTS II (pp. A6766-A6766). American Thoracic Society.