16. COPD Flashcards
Natural protection methods from COPD
Physical and physiological: Humidification, particle removal (cilia), particle expulsion, respiratory tract secretions
Humoral and cellular mechanisms: Non-specific soluble factors, lymphoid tissue, alveolar macrophages
Definition
Chronic, progressive condition that affects central airways, lung parenchyma and alveoli, causing narrowing and remodelling of airways. Irreversible destruction of tissues of lungs.
Complications
Emphysema: Destruction of alveoli. Gaseous exchange is impaired. Death of alveoli causes ‘holes’ in lungs because of absence of alveoli –> loss of exchange surface –> symptoms of COPD
Chronic bronchitis: Chronic inflammation of bronchi
Aetiology
Chronic asthma, emphysema, chronic bronchitis, influenced by genes. Smoking, vapours and fumes create more mucous and stops oxygen exchange in alveoli. All work together to reduce oxygen exchange.
Epidemiology
Over 40 years old, some children affected (1% genetics)
Pathophysiology
Chronic inflammatory response –> lung damage. Systemic inflammation associated with COPD>
Pathological changes in four lung components: Central airways, peripheral airways, lung parenchyma, pulmonary vasculature
Constant inflammatory process –> pathological lesions, causes oxidative stress, imbalance in proteins, ciliary dysfunction.
Diagnosis:
Physical examination (medical and family history), pulse oximetry, blood tests, spirometry, chest X-rays, stress and endurance test
Risk factors:
Exposure to air pollution, breathing second hand smoke, working with chemicals, form of emphysema, history of childhood respiratory infection
Signs and symptoms:
If bronchitis: Coughing, mucous production over 3 months, wheezing, chest tightness, throat clearing every morning, mucous production, frequent respiratory infections, decreased energy and endurance, weight loss or gain, morning headaches
Trajectory
1: Mild. Coughing, increased mucous production
2: Moderate: Cough, mucous, SOB
3: Severe: Declined lunch function, more pronounced symptoms, flare ups
4: Very severe: low lung function, high levels of fatigue during small activities, flare ups can be life threatening
Prognosis
BODE index: BMI, FEv1, dyspnoea scale, exercise tolerance.
Treatment
Not curable, reduce symptoms
Bronchodilators (inhalers, puffers), corticosteroids, pulmonary rehab, exercise, diet, quit smoking, oxygen therapy
Surgical intervention
Not often.
Bullectomy: Those with emphysema, removal of bullae
Lung volume reduction: COPD with emphysema, removal of all damaged lung tissue
Lung transplant: Only for very severe, average survival 5 years post op
Complication leading to co-occurring conditions:
Respiratory infections and pneumonia, CVD, lung cancer, pulmonary hypertension, depression
Co-morbidities:
High BP, arthritis, obesity, depression, psychological disorders, osteoporosis,
