Epidemic Respiratory Disease: The pneumonias and other infections of the repiratory tract accompanying influenza and measlesOpie, Eugene L. (Eugene Lindsay)
History
Epidemic Respiratory Disease: The pneumonias and other infections of the repiratory tract accompanying influenza and measles
A study of the progress of the changes which result in the formation of
bronchiectatic cavities has shown how the inflammatory irritant within
the bronchus destroys the epithelium of the bronchus, penetrates into
the deeper tissues and produces fissures which extend through the entire
thickness of the bronchial wall at one or usually several places. These
longitudinal fissures, which at first often give a stellate outline in
cross section to the cavity of the affected bronchus, permit the
separation of the edges of the fissure, so that an increase in the
circumference occurs. The base of the fissure is formed by surrounding
alveolar tissue and its edges are the site of necrosis. Tears may extend
into the surrounding alveolar tissue, thus permitting further stretching
of the bronchial wall. The consequences of rupture of the small bronchi
into the adjacent alveoli are to some extent overcome by the
inflammatory reaction which plugs the adjacent alveoli with fibrin.
Compression of the lungs by forced expiration, even though the glottis
were closed as in coughing, would not dilate the bronchi, because
pressure outside and within the bronchi would be equally elevated
(Thornton and Pratt[89]). The pressure within the bronchi does not
differ greatly from atmospheric pressure, whereas the negative pressure
within the pleural cavity may vary from approximately 6 mm. of mercury
during quiet inspiration to 30 mm. with forced inspiration. Excess of
pressure upon the inner surface of the bronchial walls will vary with
coughing and other respiratory efforts, between these limits depending
upon the readiness with which pressure is equalized within and without
the bronchi by penetration of air into the alveoli. The presence of
viscid mucopurulent fluid within bronchioles will obstruct these tubules
and retard the entrance of air into alveoli.
Public-domain text, read in full here on John Shaqi.
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