Question

1. Why did the nurse who listened to Mr. JD’s chest not hear breath sounds over the area of infection?
2. How did such a large area of Mr. JD’s lung become involved in the infection so quickly?   

The alveolar spaces of the lung are connected to one another through many small openings known as the Pores of Kohn. These openings allow equalization of air pressure during inspiration and expiration. Unfortunately in the case of pneumonia, the openings also allow the passage of bacteria, thus permitting an entire lobe of the lung to become rapidly involved with infection.

Mr. JD is a 32-year-old elementary school teacher who developed a cough and fever shortly after the school year started. He experienced right-sided chest pain when he coughed and his temperature increased to 103.2 degrees Farenheit. He developed chills and coughed up sputum that was yellow with traces of blood. In the middle of the night Mr. JD’s wife took him to a local hospital emergency room.


• The bacteria spread throughout the upper lobe of his right lung using the little alveolar pores that connect alveoli.

• These little openings are there for the purpose of equalizing air pressure within the lung, but the bacteria used them as a conduit to spread.

• This type of pneumonia is known as lobar pneumonia (because it involves an entire lobe) and it can be life-threatening.

• The fact that all the alveolar spaces in the affected lobe were filled with inflammatory material and bacteria meant that no gas exchange could take place in the affected region.

• The x-Ray findings indicated this as the area of increased density in the upper right lung field. The X-Ray density is more consistent with solid tissue rather than air filled spongy lung tissue.
  

Answer 1

1)The nurse did not hear any breath sounds near infection area because the alveoli present inthe lungs are filled inflammatory cells and bacteria so there is no gas exchange in this area so inturn there is no breath sounds.

2) Alveoli pores are used by the bacteria to spread rapidly throughout the lobe of lung because they are connected and spread throughout the lungs.So the infection spread rapidly.