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PATH1000 > COPD > Flashcards

COPD Flashcards

(72 cards)

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1
Q

dyspnoea

A

shortness of breath

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2
Q

COPD incldues

A

includes chronic bronchitis and emphysema and sometimes asthma

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3
Q

what is COPD

A
  • chronic obstructive lung disease
  • is preventable and treatable
  • irreversible
  • lung condition characterised by chronic respiratory symptoms due to abnormalities of the airways and/or alveoli that cause persistent airflow obstruction
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4
Q

tidal volume

A

amount of air inspired or expired with each breath

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5
Q

inspiratory reserve volume

A

amount that can be forcefully inspired after inspiration of tidal volume

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6
Q

expiratory reserve volume

A

amount that can be forcefully expired after expiration of tidal volume

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7
Q

residual volume

A

volume still remaining in respiratory passages and lungs after more forceful expiration

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8
Q

inspiratory capacity

A

tidal volume plus inspiratory reserve volume

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9
Q

functional residual capacity

A

expiratory reserve volume plus residual volume

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10
Q

vital capacity

A

sum of inspiratory reserve volume, tidal volume and expiratory reserve volume

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11
Q

total lunch capacity

A

sum of inspiratory and expiratory reserve volumes, tidal volume and residual volume

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12
Q

spirometry

A

process of measuring volumes of air that move into and out of the lungs

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13
Q

FVC

A

forced vital capacity
- the volume of air forcefully expired after a maximum inspiration and maximum rapid exhalation

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14
Q

FEV1

A

forced expiratory volume in 1 second

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15
Q

carbon monoxide diffusion capacity

A

measures the ability of the lungs to transfer gas from inhaled air to the red blood cells in the pulmonary capillaries

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16
Q

divisions of the respiratory system

A

upper
- nose
- pharynx
lower
- larynx
- trachea
- lungs

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17
Q

conducting zone

A

zone exclusively for air movement
from the nose to the bronchioles

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18
Q

respiratory zone

A

within the lungs and is where gas exchange between air and blood takes place

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19
Q

right vs left lung

A

right has 3 lobes
left has 2 lobes

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20
Q

obstructive

A
  • air flow limitation because of partial / complete blockage
  • decreased expiratory air flow
  • emphysema, chronic bronchitis, asthma, bronchiectasis
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21
Q

restrictive

A

reduced expansion of lung parenchyma (tissue)
- decrease lung capacity
- pulmonary fibrosis, rheumatoid arthritis

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22
Q

obstructive vs restrictive graph

A

obstructive
- reduced FEV1
- longer to reach outcome
- decreased FEv1/FVC ratio
restrictive
- FEV1/FVC ratio increased/normal
- decreased FEV1
- decreased FVC

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23
Q

asthma

A

chronic airway inflammation
hyper responsiveness of tracheobronchial tree to various stimuli leading to bronchoconstriction

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24
Q

asthma symptoms

A

wheezing, breathlessness. chest tightness, coughing
- vary in intensity
- worse at night or early in the morning

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25
long term changes in asthma
- increase in bronchial blood vessels - increased smooth muscle - thickening of collagen layers - loss of normal distensibility of the airway
26
atopic vs non atopic asthma
atopic - most common, specific allergens eg pollen dust - family history non-atopic - intermittent - persistant
27
3 main changes in asthma
- smooth muscles constrict - inflammation redness and swelling - increased mucous production
28
emphysema
enlargement and destruction of alveolar walls - loss of elasticity - trapping of air
29
chronic bronchitis
inflammation and thickening of mucous membranes - accumulation of musus and pus leading to obstruction - bronchial oedema (swelling of bronchioles) - increase in size and number of mucous glands and goblet cells - narrowing of airways - smooth muscle hypertrophy with fibrosis - thick mucus which can't be clearer because of impairs ciliary function = lead to pulmonary infection and ineffective repair
30
asthma
- reversible airflow obstruction - thick mucus, smooth muscle spasm causing obstruction of small airways
31
hemoptysis
coughing up blood
32
hypoventilation
CO2 removal doesn't match CO2 production, increase in CO2 - respiratory acidosis hypercapnia = high CO2 in blood
33
hyperventilation
lungs remove CO2 faster then it is produced hypocapnia = decreased CO2 in blood - repsiratory alkalosis
34
cyanosis
bluish discolouration of skin and mucous membranes eg lips
35
clubbing
enlargement of end of the fingers or toes = chronic hypoxemia (trapped air)
36
hypoxaemia
reduced oxygenation of arterial blood lead to tissue hypoxia
37
hypoxia
reduced oxygenation of cells in tissues
38
atelectasis
collapse of lung tissue
39
chronic bronchitis criteria
hyper secretion of mucus and cough for at least 3 months of the year for at least 2 years
40
smoking and chronic bronchitis
- interferes with ciliary action - causes direct damage to airway epithelium and inhibits the ability of bronchial and alveolar leukocytes - triggers inflammation - bronchial oedema, hypertrophy and hyperplasia of goblet cells - impaired mucus clearance - metaplasia of epithelial - smooth muscle constriction - floppy airways = increase risk of infection
41
primary and secondary emphysema
primary - inherited disorder secondary - smoking
42
emphysema mechanism
smokers have increase in antiproteinases and anti oxidants
43
what does destruction of alveoli produce
bullae - large air spaces within lung parenchyma blebs - air spaces adjacent to pleurae - results in ventilation perfusion
44
air trapping
causes hyper expansion of the chest - increases the workload of breathing = hypoventilation and hypercapnia
45
what does destruction of alveolar wall and pulmonary capillaries cause
- pulmonary artery hypertension - cor pulmonale
46
cor pulmonale
- right sided heart failure - enlargement of right ventricle due to high blood pressure in the lungs
47
pathophysiology of emphysema
- smoking = loss of elasticity by protease - destruction of alveoli - elimination of portion of the capillaries and increase are in acinus = decrease surface for gas exchange - cause blebs and bullae - air trapping = barrel chest - increase work for breathing - floppy airways = hypercapnia and hypoventilation = weight loss, muscle weakness, respiratory acidosis = increase risk of infection = pneumothorax
48
when is asthma considered reversible
- FEV1 increases by more then 200ml post bronchodilator
49
asthma vs COPD symptoms
asthma - vary over time often triggered by exposure COPD - continuous especially during exercise
50
asthma vs COPD lung function between symptoms
asthma - normal between symptoms COPD - persistent airflow limitation
51
asthma vs COPD onset
asthma - usually childhood COPD - usually 40+
52
asthma vs COPD response to brochodilator and steroids
asthma = good COPD = bad
53
type 1 respiration failure
low oxygen
54
type 2 respiratory failure
low oxygen and high carbon dioxide
55
bronchiectasis
permanent dilation of bronchi and bronchioles caused by destruction of the muscles and elastic tissue resulting from chronic necrotising infections
56
bronchiectasis pathophysiology
- airways are scarred and inflamed with thick mucous - airways become widened and cannot clear themselves properly = infected by bacteria - pockets in airways = trapped mucus = infection
57
pneumonitis
inflammation of lung parenchyma due to chemical or physical agents - secondary infection may result in pneumonia
58
pneumonia
infection of lower respiratory tract - result when pulmonary defence mechanisms are impaired
59
tuberculosis
- transmitted from person to person - highly contagious
60
latent vs active TB
latent - lives but doesn't grow in the body - doesn't make person feel sick - can't spread active - grows in the body - makes a person feel sick - can spread from person to person
61
pleural effusion
presence of fluid in pleural spaces - due to abscess draining into pleural space comes from blood or lymphatic vessels lying beneath pleural space
62
empyema
- pus in pleural space and develops when the pulmonary lymphatics become blocked - contaminated lymphatic fluid into pleural space
63
pneumothorax
gas or air in pleural space - caused by rupture of visceral pleura which surrounds the lungs - causes lung to collapse
64
thrombosis
- blood clot if blood vessel - caused by many things eg injury, alterations in blood flow, changes in blood composition - life threatening
65
haematoma
- life saving - extravascular clot eg when injury
66
embolism
- thrombus that travels - carried in the blood stream from its origin - why people use compression stockings to stock the pooling of blood
67
pulmonary oedema
- excess water in the lungs - caused by left sided heart disease - left ventricle fails - increase in pulmonary hydrostatic pressure - fluid moves from capillary into the interstitial space
68
right sided heart failure
- chronic hyperaemia due to lung disease = pulmonary vasoconstriction - narrowed pulmonary capillaries = pulmonary hypertension - right side of heart has to work harder = enlargement of heart muscles = reduced BV in right ventricle
69
determining if obstructive or restrictive with data
1. FEV1 = if low it can be obstructive or restrictive 2. Ratio (FEV1%): low = obstructive, high/normal = restrictive Confirmation 3. TLC/RV: reduced = restrictive, increased = emphysema (build up of air in alveoli) 4. Asthma = FEV1 improved by more then 200ml (0.2L), reversibility
70
3. Explain the pathophysiology behind the scarring and thickening of the airways noted in people with smoking associated chronic bronchitis.
Thickening – caused by swelling of epithelial cells as well as hypertrophy and hyperplasia of goblet cells, smooth muscles thicken all contributed to the thickening of the airways Scarring – metaplasia and lose of cilia as well as scarring of the smooth muscles o Healing by scarring – replacement of healthy tissue with non functioning tissue
71
4. Explain to your patient the pathophysiology behind ‘floppy airways’, early airway closure and why they ‘pursed lips breathe’.
o after smoking we lose elasticity the walls of the alveoli and this reduces the surface area for gas exchange and lose in capillaries as well as thickened and inflamed bronchioles o cant rely on elastic recoil as much and we have to force the air out, there is a chance that the airway may close early = floppy airways trapping more air in the alveoli. Leading to hyperinflated lungs = barrelled chest o Pursed lip breathing increases the pressure in the airways and allows them to get more air out o Eg paper straw becomes floppy and cant get anything through the straw
72

PATH1000 (8 decks)

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