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Lower airway bronchoscopic interpretation
Published in Don Hayes, Kara D. Meister, Pediatric Bronchoscopy for Clinicians, 2023
Kimberley R. Kaspy, Sara M. Zak
Bronchomalacia, like tracheomalacia, is the dynamic collapse of the bronchi during exhalation.19–21As the bronchi have cartilage rings just as the trachea does, abnormalities in the bronchial cartilage can lead to collapse of the posterior bronchial wall into the lumen and can be seen on bronchoscopy, as shown in Video 5.4. As with tracheomalacia, this can depend on the level of anesthesia, the use of positive pressure during the procedure, and how heavily the patient is breathing.Bronchomalacia can be localized to one part of the bronchial tree or present diffusely throughout the bronchi. The mainstem bronchi are the most likely to be affected by malacia, though any bronchus can be involved.
Tracheal and Bronchial Developmental Abnormalities, and Inflammatory Diseases including Bronchiectasis, Cystic Fibrosis and Bronchiolitis.
Published in Fred W Wright, Radiology of the Chest and Related Conditions, 2022
Bronchiolitis is not uncommon in children with viral infections. In the acute stage in adults (particularly with mycoplasma) bronchiolitis may produce a miliary type of pattern on plain chest radiographs (Illus. MY COPLASMA PN, Pt. 7). Clinically there is often an unexplained irreversible air flow limitation leading to air trapping. Non-specific symptoms (dyspnoea and cough) and signs (mid inspiratory squeaks) may be present. The severity of symptoms and rate of progression of the condition is highly variable. The bronchiolar walls may exude mucus or become thickened by inflammation (with some spread into the peri-bronchiolar tissues) and causing dilatation of the terminal bronchioles. In severe or chronic cases small cystic air-filled spaces may occur, especially at the lung bases. Ground glass shadowing and small granular nodules may be seen acutely on HRCT.
The patient with acute respiratory problems
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
The respiratory tract is described as a tree with different generations of branches (see Figure 5.3). The trachea is the trunk, referred to as generation zero. At the carina, the trachea divides into the right and left major bronchi, referred to as first generation branches. These, in turn, branch again, with each successive branch becoming smaller. The walls of the respiratory tree are made of cartilage to prevent collapse, smooth involuntary muscle and an inner lining of mucous membrane. At generation 16, the bronchi become terminal bronchioles and the cartilage disappears. From generation 16 onwards, the diameter of airways is approximately 1 millimetre. The walls of these bronchioles are made of simple ciliated epithelial cells, secretory Clara cells and smooth muscle. Because there are many of these bronchioles, the total resistance to flow is low, but because they are so small in diameter, the lumen can become further narrowed and obstructed by secretions and inflammation. Generations 20 and onwards of the respiratory tree are the even smaller respiratory bronchioles, which finally merge with the alveolar ducts and alveolar sacs. The respiratory bronchioles, together with the alveolar ducts and sacs, are the site for gaseous exchange.
Adverse pulmonary effects after oral exposure to copper, manganese and mercury, alone and in mixtures, in a Spraque-Dawley rat model
Published in Ultrastructural Pathology, 2023
M Draper, Mj Bester, M Van Rooy, Hm Oberholzer
The general histology of pulmonary tissue was evaluated with H&E and representative images, at X40 magnification, are shown in Figure 1 and Figure 2. In Figure 1A, the alveolar tissue of the control (saline) group has a well-defined alveolar space (A), thin epithelial walls, fine interstitium, type I (P1) and II (P2) pneumocytes and capillaries (c) containing erythrocytes (Er). The alveolar tissues of the experimental groups are presented in Figure 1(B–H). The histological architecture of the pulmonary tissue shows thickened inter-alveolar septa (red arrows) and altered intra-alveolar (green arrows) spaces in all the experimental groups (B to H). In Figure 2A, the bronchiole structure of the control (saline) group is depicted and has an intact epithelial lining (E) and smooth muscle (SM) surrounding the bronchiole. The bronchiole tissue of the experimental groups are presented in Figure 2(B–H). Histological architecture of the bronchioles shows stratification of epithelium (SE), disrupted smooth muscle (black ring) and desquamation of the epithelia (asterisk) to varying degrees in all the experimental groups (B to H). Stratification of epithelia occurs due to the metaplasia of normal pseudostratified pulmonary epithelia to an abnormal stratified form.34,35 The desquamation is evident by the presence of cellular debris within the bronchioles.
Nanocrystals based pulmonary inhalation delivery system: advance and challenge
Published in Drug Delivery, 2022
Pengfei Yue, Weicheng Zhou, Guiting Huang, Fangfang Lei, Yingchong Chen, Zhilin Ma, Liru Chen, Ming Yang
The lungs are the organs that contact with the exchange of air between the organism and the outside world. They are divided into two main regions: the conducting airway region and the respiratory region. The airway is a continuous branch from the bronchi to the lungs and consists mainly of bronchi, bronchioles, and terminal bronchioles. As the bronchi continue to branch, the diameter of the tubes becomes smaller, the tube wall becomes thinner, and the structure of the tube wall changes gradually. The annular smooth muscles of the bronchi contract or relax under splanchnic nerves innervation and it is responsible for the regulation of airflow passage into the alveoli. This is the site where the lung tissue completes gas exchange consisting of respiratory bronchioles, alveolar ducts, lung sacs, and alveoli. The respiratory bronchiole is the transitional pipes between the pulmonary airway and the respiratory site. Each respiratory bronchiole branch is divided into 2–3 alveolar ducts. The alveolar sacs are the common opening of several alveoli and are connected to the alveolar ducts. The gut is the main site for the digestion and absorption of nutrients.
Dysfunction of epithelial permeability barrier induced by HMGB1 in 2.5D cultures of human epithelial cells
Published in Tissue Barriers, 2022
Takashi Kojima, Yuma Shindo, Takumi Konno, Yuki Kodera, Wataru Arai, Maki Miyakawa, Kizuku Ohwada, Hiroki Tanaka, Mitsuhiro Tsujiwaki, Yuji Sakuma, Shin Kikuchi, Tsuyoshi Ohkuni, Kenichi Takano, Atsushi Watanabe, Takayuki Kohno
The airways are broadly classified into conducting and respiratory regions. The conducting airways consist of the trachea, bronchi, and bronchioles, while respiratory regions consist of respiratory bronchioles and alveoli. The conducting airways are lined by a continuous layer of bronchiolar epithelial cells, which act as a first barrier for inhaled materials and play an important role in protection from external pathogens such as bacteria, viruses, chemical substances and allergic components.23,24 On the other hand, alveolar epithelial cells, which are vital for gas exchanges, form a barrier for an air-liquid interface.25 To maintain the air-liquid interface and control gas exchanges, alveolar epithelial cells provide a proper permeability barrier.26 The main characteristic of epithelial tissues is that epithelial cells are arranged in monolayers or stratified layers and tightly adhere to each other. This sheet-like structure provides a barrier function that separates the apical and basolateral compartments of various tissues, and maintains homeostasis.