A Physio-Pathological Study of the Bronchial Movement by Motion Pictures

Abstract

1. A bronchographic study was carried out with an object of clarifying the physiopathological significance of bronchial movement and an analysis by motion pictures made on the state of movement of the bronchi in various diseases from the fluoroscopic plates.2. Bronchial movements may be divided into following fundamental movement: movement of tracheal carina and bronchial spurs; expansion and contraction of the lumen of the bronchus; elongation and shortening of the bronchus; torsion of the bronchus and pulsatory movement of the heart and great vessels.The displacement of the bronchus may be divided into the deviation of the stem bronchus and that of the peripheral bronchi.The movement of the peripheral bronchi was studied according to the displacement by pendulum and chordal movements.3. The movement of the bronchus is most marked at the time of coughing. All the bronchi do not uniformy contract during the expulsive movement, but show rapid successive contraction beginning at periphery and moving toward the trachea.4. The peristaltic movement of bronchus was not recognized.5. There was noted a increasing bronchial movement with gravity of the pulmonary tuberculosis. In mild case of pulmonary tuberculosis a pendulum movement and torsion of bronchi were recognized. In serious cases, howerver, chordal movement was noted and torsion of the bronchi was found to have disappeared. The emptying of a contrast media is rather rapid in mild cases and is prolonged in far advanced cases.6. In tuberculous stenosis of the main bronchus the lumen of the stenosed area shows a widening in deep inspiration, however, the expulsion of a contrast media on coughing is obstructed. This indicates an interference of the pulmonary ventillation due to stenosis. The bronchial lumen created by anastomosis shows normal patency and movement. No stagnation of the contrast media is reconized on coughing. This indicates that the ventillation of residual lung is improved by surgery of the bronchus.7. In bronchial asthma the filling of a contrast media into bronchi is rather poor. The bronchi generally show narrowing and sometimes spasmodic contractions are recognized. This indicates an increased resistance of the air passage and a disturbance of ventillation.8, As to the relationspip between bronchial movement and pleural adhesion it was found that the displacement of peripheral bronchi and torsion of bronchi are closely related with pleural adhesion.9. When there is present a ventillation disturbance the bronchial movements are generally restricted. In obstructive ventillation disturbance the filling and emptying of a contrast media is poor and in mixed ventillation distrubance, conditions differ according to the factors which are responsible for the disturbance.