COPD Flashcards
What is COPD?
chronic obstructive airways made up of chronic bronchitis, emphysema and asthma
Chronic bronchitis pathology
hypertrophy of mucas glands
chronic inflammatory changes- secretions
initial pathology in small airways
small airways narrow due to increased wall odema
increased wall oedema
granulation and fibrosis making tissues less elastic
Emphysema pathology
affects parenchyma distal to temal bronchiole alpha antitrypisn deficiency excess lysosomal elects enlargement of air spaces loss of alveolar walls destruction of capillary bed small airways narrowed thin atrophied walls
Reasons for decreased work of breathing and decreased lung compliance
loss of alveolar speta
during expiration airways close sooner
air trapping (passive hyperinflation)
patient needs maintain hyperinflation to keep airways open (dynamic hyperinflation)
due to obstruct airways, air is further trapped
hinders cardiac output and lung perfusion
Hyperinflation in emphaysema
pursed lip breathing use of accessory muscles clavicle indrawing on inspiration tracheal tug flat diaphragm, short muscle fibres horizontal ribs
Symptoms of COPD
fatigue respiratory infections frequently use of accessory muscle to breath thin in appearance wheezing pursed lip when breathing chronic cough dyspnea bronchitis- increased sputum digital clubbing
Clinical features of COPD
insidious onset morning cough with sputum decreased exercise tolerance fatigue disturbances in sleep SOB in wheeze secretions on most days in winter months
What is central cyanosis?
blue lips
blue tongue
all of the time
low oxygen saturation
Chronic bronchitis symptoms
abandons blood gases less breathless oedematous higher mortality poor gas exchange lots of sputum wheezing easily fatigued
Emphysema
near normal blood gases intense breathlessness no oedema longivity scan secretions ive longer
Treatment goals
improve QOL symptom relief management of pulmonary rehab reduce airway obstruction drug therapy eduction breathing control prolong life prevent and treat complications
