Pathophysiologic Process of Bronchiolitis and Bronchiectasis
1. Both bronchiolitis and bronchiectasis present with a cough and dyspnea.
2. Describe the pathophysiologic process of both bronchiolitis and bronchiectasis.
3. Compare and contrast the two processes.
4. Provides a clinical example of bronchiolitis and bronchiectasis.
Sample Paper
Advanced Pathophysiology
Pathophysiologic Process of Bronchiolitis and Bronchiectasis
Bronchiolitis occurs when there is an inflammation in epithelial cells lining small airways and mainly affects children. This leads to mucus and cellular necrosis for the cells (Florin et al., 2017). Inflammation of these cells is responsible for the obstruction of the airways, which causes wheezing. Respiratory syncytial virus (RSV) spreads along the intracytoplasmic bridges through different mechanisms such as cell-to-cell transfer along the intracytoplasmic bridges and nasopharyngeal secretion (Florin et al., 2017). RSV may adversely affect the structural airway impairing the immune system of the cells in the lungs.
Bronchiectasis pathophysiological process follows distinct phases. It starts with an initial infective insult to the airways interfering with the mucociliary response (Bush & Floto, 2019). Toxins are released, and microorganisms trigger inflammatory responses within the airways, leading to the release of lymphocytes, macrophages, and neutrophils within the bronchial lumen. The functioning of the cilial epithelium is altered by neutrophils which changes the mucous gland hypersecretion. The airways become susceptible to microbial colonization due to the loss of mucociliary transport. Neutrophils releases mediators such as matrix metalloproteinase and inflammatory cytokines, destroying the bronchial elastin and other lung supporting structures (Keir & Chalmers, 2021). The bronchi are permanently dilated, and the airway becomes thickened while the structural cartilage may be diminished. Changes in the airway structure significantly contribute to mucus pooling and repetitive inflammation and infection, promoting progressive damage of the airways.
Compare and Contrast the Two Processes
Bronchiolitis is an inflammation of the bronchioles which results from viral infections, mainly the RSV, while bronchiectasis is a permanent health condition resulting from the damage of airway walls (Keir & Chalmers, 2021). Bronchiolitis is more prevalent among children than bronchiectasis, in which the risk of developing increases with age. In bronchiolitis and bronchiectasis, the patient produces a large amount of mucus with daily cough and wheezing (Florin et al., 2017). In both processes, there is the alteration of epithelial lining cells affecting the airway to the lung.
Clinical Example
An example of bronchiolitis is a child who admitted in the healthcare setting with a runny nose, cough, slight fever, and cough. The child was trying so hard to breathe, appeared sluggish with the fingertips and toes appearing blue. An adult man was diagnosed with bronchiectasis. Prevalent symptoms included shortness of breath which worsened during flare-ups, fever, wheezing, coughing up yellow and green mucus and daily production of mucus sputum.
References
Bush, A., & Floto, R. A. (2019). Pathophysiology, causes and genetics of paediatric and adult bronchiectasis. Respirology, 24(11), 1053-1062. https://doi.org/10.1111/resp.13509
Florin, T. A., Plint, A. C., & Zorc, J. J. (2017). Viral bronchiolitis. The Lancet, 389(10065), 211-224. https://doi.org/10.1016/S0140-6736(16)30951-5
Keir, H. R., & Chalmers, J. D. (2021, August). Pathophysiology of bronchiectasis. In Seminars in respiratory and critical care medicine (Vol. 42, No. 04, pp. 499-512). Thieme Medical Publishers, Inc.. https://doi.org/10.1055/s-0041-1730891
