COPD

Question 1

Define COPD

Answer 1

Chornic, progressive, respiratory condition characterised by inflammation of the airway and airflow limitation

Question 2

2 types of COPD

Answer 2

Empheysmea- Damage to alveoli- Pink puffers
Chronic Bronchitits- Damage to bronchi- blue bloaters

Question 3

Descirbe the pathophysiology of Emphysema

Answer 3

Emphysema , is the irreversible destruction of the alveoli leading to a reduced surface area for gaseous exchange and airflow limitation.

1. Destruction of the alveolor walls
   - Chronic exposure to irritants activate immune cells e.g. macrophages
   - They release proteases that degrade elastin ( the protein for alveolar structure and elasticity)
   - The loss of alveolar walls decrease SA for gaseous exchange
2. Loss of elastic recoil
   - Damage to the elastin impaires the lungs ability to recoil during exhalation
   - Air becomes trapped in the alveoli, leading to hyperinflamation and difficulty to exhale.
3. Airway collapses
   - Small airways lose structural support from damaged alveolar walls
   - Leads to airway narrowing or collapse during exhalation causing more obstruction
4. Impaired gas exchange
   - Reduction in SA, limits 02 uptake and Co2 removal causing high CO2 retention and low 02

Question 4

Symptoms of Emphysema

Answer 4

• increased energy/fatigue- pt looks pink
• Pursed lip breathing- puffers, prevent airway collapse
• SOB
  -Weight loss
• Cough
• Use of accessory muscles

Question 5

Pathophysiology of Chronic Bronchitis

Answer 5

• Chronic inflammation of the airways, excessive mucus production and a persistent cough. Bronchi damage

1. Chronic inflammation
   - Long-term exposure to irritants leads to inflammation of the bronchial lining
   - Inflammatory cells e.g. lymphocytes, release mediators that cause tissue damage
2. Mucus hypersecretion
   - Goblet cells hyperplasia and hypertrophy of submucosal glands that increase mucus production.
   - Excess blocks alveoli and airways
   - 02 that enters the alveoli has a thicker membrane to pass through to get into the blood stream
3. Low 02 in the blood
   - The alveoli now have low 02 as they are filled with mucus
   - The low 02 is detected quickly and pulmonary arteries constrict causing a back flow to right side of heart causing pulmonary hypertension
4. Hypetension
   - Right side of heart tries to overcome by hypertropy (muscle bigger and thicker) leading to right sided HF and oedema
5. Cillia
   - Cillia become paralysed
   - Beta 2 receptors are the site of cilia restoration thats why we give salbutamol
   - Cillia move the fluid parts of mucus

Question 6

Symptoms of chronic bronchitis

Answer 6

Cyanosis- blue
Hypertension
oedema- bloaters
Cough
wheeze
fatigue
fever
chills