Cardio Pathologies (COPD)

Question 1

What is COPD

Answer 1

COPD is characterised by airflow obstruction which is: progressive in severity doesn’t change markedly over several months

Question 2

What conditions come under COPD

Answer 2

Chronic bronchitis, emphysema, chronic asthma

Question 3

What’s normal airway clearance

Answer 3

Airways are lined by cells which produce mucus, tiny hairs called cilia which beat mucus traps dust particles and bacteria, cilia move mucus until it reaches throat and we swallow or cough it

Question 4

What can go wrong with the normal airway

Answer 4

In COPD and bronchiectasis excess mucus is produced, mucus is thicker and stickier, cilia unable to beat, smoking paralyses cilia so dust gets trapped in airways, mucus build up provides warm environment for bacteria so infections develop

Question 5

What is chronic bronchitis

Answer 5

Bronchi become inflamed, inflammation causes mucus production, narrows airways, increased sputum and it’s difficult to clear, wheezing common after coughing, reduced air enters lungs

Question 6

What’s emphysema

Answer 6

Alveoli of lungs become inflamed and loose elasticity over expand and lose ability to fill up and contract
As air fills up sacs some rupture, sa reduced when you breathe out trapped air isn’t released so breathing is more difficult

Question 7

What’s chronic asmtha

Answer 7

Increase in airway obstruction caused by various stimuli = increased air way resistance
Can be reversible
Airways sensitive can become irritated, inflamed and narrow reduced air flow through air ways can become chronic due to fixed airway damage (therefore COPD)

Question 8

Causes of COPD

Answer 8

Smoking, occupational exposure, alpha 1 atrypsin deficiency, social delreigation

Question 9

What would you observe in someone recently diagnosed with COPD

Answer 9

Morning cough, winter chest infections, breathless when exercising, spirometry reduced

Question 10

What would you observe in someone with moderate COPD

Answer 10

Cough, wheeze, SOB, wheeze, barrel chest, flat diaphragm on CXR

Question 11

What would,you observe in someone with severe COPD

Answer 11

Cyanosis, weight loss, raised JVP, peripheral oedema

Question 12

What objective tools could you use for someone with COPD/ chronic bronchitis/ emphysema/ chronic asmtha

Answer 12

CXR 
Oxygen sats 
Ausculatation 
Borg breathlessness scale
Exercise testing 
Spirometry if diagnosed recently

Question 13

What treatments can physios use for COPD/ chronic bronchitis/ chronic asmtha/ emphysema

Answer 13

Smoking cessation

Pulmonary rehab: exercise, education, self management, diet and lifestyle modifications