AIR TRAPPING IN CHRONIC BRONCHITIS + EMPHYSEMA - MEASUREMENTS OF BRONCHIAL CARTILAGE

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Abstract
Selected bronchi from 15 patients with bronchitis and 8 controls were examined by a method for measuring the area of cartilage in histologic sections. Ten of the bronchitic patients had severe emphysema. A statistical comparison of the 2 groups showed no significant difference between them. No histologic differences were seen in the cartilages. Measurements of the area of tissue in the bronchial wall, other than glands are cartilage, showed a linear relationship between it and the areas of the glands, i.e., tissue and glands increased together. In chronic bronchitis the most peripheral bronchi are often moderately dilated at necropsy and can be traced almost to the pleura. Perhaps dilatation results from raised air pressure in this bronchus required during inspiration to force air past the narrowed bronchioles it supplies. It is concluded that the bronchial collapse observed roentgenologically by others, and thought by some to be responsible for the increased expiratory pulmonary flow resistance in emphysema, is not due to degenerative changes in the bronchial wall but to raised pressures in the peribronchial lung, perhaps from narrowing of bronchioles or reduction in their numbers.