A. Introduction
1.
Many pathophysiological ‘diseases’ are also possible in the lungs.
2.

With ‘normal’ physiology it is of course (always) interesting to know when something goes wrong! That’s what we’re going to find out here…

B. A number of diseases of the lungs
  1. Pneumonia

This occurs when there is an inflammation in one of the lobes of the lungs (virus, bacteria, etc.)

2. Pulmonary tuberculosis:

Inflammation of the lungs caused by the tubercle bacilli. Still occurs (but not as often as it used to …).

  1. Pulmonary embolism:

This is a (usually sudden) blockage of a pulmonary artery by a blood clot. These clots usually come from a vein somewhere else in the body, such as in the legs, where it has become detached from the blood wall.

 
4.
This embolism then flows, through the veins, back to the right heart where it is then pumped to the lungs. In the lungs, the blood clot then becomes stuck in one of the pulmonary artery branches. Very dangerous!

5. COPD (= Chronic Obstructive Pulmonary Disease) is a collective name for three conditions:

  1. Asthma
  2. Chronical bronchitis
  3. Emphysema

6. Asthma:

This is actually an excessive response of the respiratory tract to certain stimuli, such as dust, pollen, etc. The lungs respond with extra mucus production, which in turn can cause attacks of shortness of breath and wheezing, etc.

7. Chronical bronchitis:

Excessive mucous membrane production due to prolonged contact with irritating substances such as smoking, etc. So chronic coughing, phlegm and shortness of breath (especially during exertion).

8. Emphysema:

 Is a degeneration (= breakdown) of the lung tissue, loss of elasticity, stretching of the alveoli, less gas exchange. Unfortunately, this process is irreversible!

9. Lung carcinoma:

Lung cancer; a malignant tumor, often caused by chronic smoking. Nowadays all kinds of treatments are possible (surgery, radiation, etc.), but does that (always) help?

10. Lung metastases:

 Yes, that is of course also a complication for the lungs. If a tumor (cancer) is present elsewhere in the body, it can spread and, via the blood, the metastases can then end up in the (fine) lung tissue. Not fun either!

11. Pleurisy

That’s plain and simple: inflammation of either the visceral pleura and/or parietal pleura. Very painful when breathing!

C. Pneumothorax
1.
 We will take a special look at a typical pathophysiological disease of the lungs: pneumothorax.
2.

In pneumothorax there is (some) air in the pleural space, between the parietal and the visceral pleura. Of course, that should never happen!

3.

A hole in the visceral pleura is often caused by the bursting of one or more alveoli into the pleural space. Often due to wear and tear, coughing too much, smoking, etc.

4.
In most cases the pneumothorax is unilateral; either the left or the right lung collapses.
5.

If you accidentally collapse both lungs, meaning two holes appear at the same time (both pleural spaces are not connected, remember?), then you’re really out of luck. Both lungs will collapse and you will die instantly!

6.

However, if one lung is collapsed, you won’t die, because the other normal lung is enough to keep you alive! But a collapsed lung is painful and you need help.

(See also C.4.2. The Pleura)

D. Hyperventilation
1.
Hyperventilating means breathing too much and/or too fast.
2.

Sometimes this is as an expression of nervous tension; during stress or when you are in a dangerous situation.

3.

But some people also deliberately hyperventilate, because they believe that this works well for the body and/or the brain.

4.
You also often see it happen to people who dive underwater. They do this to be able to swim underwater for as long as possible without having to breathe.
5.
If you measure oxygen and carbon dioxide levels, you will see that hyperventilation has little influence on the oxygen level in the blood, because it is already very high during normal breathing.
6.

However, during hyperventilation the carbon dioxide content does indeed decrease sharply. As a result, when breathing stops, it takes longer for the respiratory center to be stimulated to start breathing again. So you can swim underwater (a little) longer!

7.

But! This is not without danger! Because oxygen is used during swimming, so the oxygen level in the blood drops, and you might faint! But underwater! Hyperventilating before diving is actually life-threatening.

Slides C.7.2. Pulmonary Pathophysiology