Predisposing Factors Precipitating Factors

Female Lifestyle:
76 years old husband is a chain smoker
Genetics workplace is near the loading
area and unloading area of jeepneys

Carcinogenic insult changes in the genome of normal cells

In the lining of major bronchi

DNA damage

Failure DNA repair

Mutilation in the genome somatic cells

Activation of growth promoting gene Inactivation of growth inhibiting gene Alteration in gene that regulate apoptosis
(oncogene) (cancer-suppressor gene)
Decrease apoptosis

Expression of altered gene products

Unregulated cell proliferation

Abnormal cell growth

Primary MALIGNANT TUMOR grows in the Lungs

(Lining of major bronchi)

Tumor cells shed and invade Tumorproduces enzymes,hormones

the basement membrane and and other toxic substances
highly vascular tumor bed

Dysphagia
hoarseness Recurrent involvement of Edema Tumor cells move and penetrate dull, intermittent Activation of pain receptors
of voice Laryngeal nerve the alveolar capillary membrane poorly localized in the peribronchial afferent vagal fibers
retrosternal pain
 Travel via lymph node
and blood circulation hemoptysis Erodes blood vessels chemicals interfere RBC
causing ulceration and with RBC production
Establish in new environment necrosis Tumors take up sodium
and proliferate to new site
Inflammatory response produces anorexigenic
STAGE IV is triggered anorexia substances that act in
BRONCHOGENIC the satiety center of the
CARCINOMA hypothalamus
METASTASIS Goblet cells crackles Emigration of WBCs fever
Secrete mucus
Tumor proliferation and wt loss Consumes glucose
angiogenesis in the Accumulation and deplete glycogen
pleural cavity of secretions stores

Blockage of the veins Airway obstruction wheezes cachexia body consumes weakness
of the lungs and irritation Chest pain and tightness protein for energy

Imbalances on the hydrostatic

and oncotic pressure Decrease lung difficulty of cilia along the
compliance of breathing the bronchial wall
Increases capillary permeability move debris up the airway
to the larynx
Fluid shift from ICF to ECF peripheral
edema
Impaired function and reabsorption
of pleural fluid

Accumulation in the pleural space Removal of secretions

Through cough hacking
PLEURAL EFFUSION cough