Chronic Obstructive Pulmonary Diseases Flashcards
Respiratory failure causes
-Ventilators defects(cns,neuromuscular defects,drugs)
-perfusion defects(cardiac failure,pulmonary emboli)
-gas exchange defects (fibrosis,consolidation,emphysema)
Main COPDs
Chronic bronchitis
Emphysema
Asthma
Risk factors for COPDs
Nutrition
Infection
Socio economic status
Aging population
Genes for alpha1 -anti trypsin decrease
Cigarette smoke
Occupational dust and chemical
Environmental tobacco smoke
Indoor and outdoor air pollution
Types of chronic bronchitis
And describe the features of each
Simple chronic bronchitis-productive cough raises mucoid sputum.airflow not obstructed
Chronic asthmatic bronchitis- hyper responsive airways with intermittent bronchospasm and wheezing
Chronic obstructive bronchitis -develop chronic outflow obstruction
Associated with emphysema
What occurs on a cellular level in chronic bronchitis
1.mucus gland hypertrophy
2.smooth muscle hypertrophy
3.goblet cell hyperplasia
4.inflammatory infiltrate
5.excessive mucus
6.squamous metaplasia
Complications of chronic bronchitis
-Pulmonary hypertension and cardiac failure
-recurrent infections
-respiratory failure
Signs and symptoms
Cough,sputum,frequent infections,intermittent dyspnea,wheeze
Outflows obstructing resulting in -hyoercapnia, hypoxemia,cyanosis
How is chronic bronchitis defined
Persistent productve cough for at least 3 consecutive months in at least 2 consecutive years
What is emphysema?
Permanent enlargement of airspaces distal to terminal bronchioles,accompanied by destruction of its walls
Causes of emphysema
Smoking
Deficiency of a1 anti trypsin
Function of anti 1 antitrypsin
Coat lung protecting it from neutrophil elastase
.neutroplil elastase produced by white blood cells to break down harmful bacteria
Potentially damaging to lungs if exposed
Explain the pathophysiology of tobacco smoke in emphysema?
-Tobacco produces nicotine and reactive oxygen species
-nicotine stimulate migration of neutrophils from capillaries into alveolar
-free radicals stimulate production of cytokines such as(IL-8,LTB4 ,TNF(tunor necrosis factor)
- neutrophils produce free radicals
-free radicals inactivate anti protease(alpha anti trypsin 1)
-increase in neutrophil elastase-tissue damage
-macrophage elastase-tissue damage
-congenital deficiency of alpha anti trypsin 1
Pathogenesis of emphysema
-Destructive effect of protease in the absence of anti protease
-Free radicals deplete the lungs antioxidant mechanisms(tissue damage)
Types of emphysema
Centriacinar-due to cigarette smoking
Panacinar-alpha 1 anti trypsin
Irregular (scarring
Paraseptal emphysema (distal acinar)(scarring
Complications of emphysema
Pulmonary hypertension
-hypoxia induced vascular spasm
-loss of capillary surface due to alveolar wall destruction
Right side heart failure
Respiratory failure
