COPD Flashcards
primary function of resp system:
gas exchange
structures involved in the generation of rhythmic resp mvmts and reflexes
medulla, pons (resp centre)
electrical impulses generated by resp centre carried by ___ nerves to _____
phrenic; diaphragm
contraction of diaphragm and other muscles increase _____ pressure and allow air to be sucked in, reaching ___
intrathoracic; alveoli
large pulmonary BV and conducting airways located in _____
pleural cavity
what are cilia?
hair like structures that move superficial liquid lining layer from deep within lungs toward the pharynx to enter GI tract (lung defense mechanism)
alveolar cells secrete _____ that maintain stability of pulmonary tissue by reducing surface tension
surfactant
fx of lungs?
regulate pH, make arachidonic acid–>prostaglandins and leukotrienes, convert angiotensin 1–>2,
how does malnutrition affect pulmonary system?
adverse affect on lung structure, elasticity, function, muscle mass/strength/endurance, lung immunity, control of breathing
pulmonary system disorders categorized as primary:
TB, bronchial asthma, cancer of lung
pulmonary system disorders categorized as secondary:
associated with cardiovascular disease, obesity, HIV, sickle cell disease, scoliosis
chronic conditions of pulm system?
cystic fibrosis and COPD
symptoms and signs of pulmonary disease:
cough, dyspnea, fatigue, early satiety, anorexia, wt loss
____ tests used to diagnose/monitor status of lung disease by measuring ability of resp system to exchange O2 and CO2
pulmonary function
this device uses light waves to measure oxygen saturation of arterial blood, placed on end of finger
pulse oximeter
third most common cause of death in the world
COPD
risk factors for COPD?
smoke from cigarettes, biomass fuel for cooking and heating in developing countries, air pollution, occupational smoke/dust, genetic factors
COPD encompasses :
chronic bronchitis, emphysema
pt with primary emphysema suffer from greater ____
dyspnea and cachexia
pt with bronchitis have ____
hypoxia, hypercapnia, pulmonary hypertension, right heart failure
condition characterized by destruction of lung parenchyma with lack of elastic recoil
emphysema
_____deficiency present in 1-2% of COPD pt
alpha 1 antitrypsin
allergies, smoking, congestive heart failure, pulmonary embolism, pneumonia, systemic infections are reason for _____% of COPD exacerbation
20-40
how does osteoporosis make COPD worse?
altering configuration of chest wall
mainstay of treatment for COPD pt
inhaled bronchodilators given by metered dose inhalers (in severe dyspnea, administered in nebulized form)
if resp failure, need ___
mechanical ventilation
breathing with normal lungs expends 36 to 72 kcals/day, but increases ____ x in COPD
10
two main goals in managing hypermetabolism seen in stable COPD:
prevention of wt loss and prevention of loss of LBM
inverse relationship between dietary ______ and COPD risk
iron and calcium
increased BP which leads to enlargement and failure of right ventricle of heart, can mask wasting cuz fluid retention
cor pulmonale
these have opposite effect, important indicators
leptin (satiety) vs. adiponectin (enhance appetite)
promotes inflammation and insulin resistance by production of IL6 and TNF-alpha
resistin
diet supplementation of _____ shown delay and reduce risk of upper resp infections and asthma, lowering incidence of bronchiolitis during first year of life
DHA, Arachidonic Acid
___ and ___ help with inflammation
PUFAs, aspirin
protein requirements:
1.2-1.7g/kg
fluid requirements:
35ml/kg up to 60 years, then 30ml/kg
ppl in advanced COPD are in state of ____
pulmonary cachexia (myostatin influence)
energy requirements during healing;
30kcal/kg
risk increases over age of ____
40
inflammatory cells and mediators involved in asthma vs COPD:
eosinophilic vs. neutrophilic
pathophysiological changes in COPD lead to
airflow limitation, gas trapping, gas exchange abnormalities, mucus hypersecretion, pulmonary hypertension, exacerbations, systemic features
max volume of air exhaled in first second of forced expiration
FEV1 (forced expiratory volume in first second)
what is max amount of air which can be exhaled from lungs on rapid complete exhalation?
FVC (forced vital capacity)
consequence of air trapping during expiration:
hyperinflation
signs of hypoxemia:
cyanosis, clubbing, polycythemia
if not treat hypoxemia what happens?
pulmonary artery hypertension, right sided heart failure
treatments for COPD:
pulmonary rehab programs, oxygen therapy, meds (bronchodilators, glucocorticosteroids, mucolytic agents, antibiotics), surgery
protein ____% energy, fat ___%, and CHO ___%
15-20; 30-45; 40-55
smokers need ___ supplement
Vit C (16-32 mg/day)
why early satiety?
hyperinflation of lungs cause flattening of diaphragm and pressure on abdominal cavity while eating; drinking too much fluids before meals
malnutrition classified as:
<20 BMI or <90% IBW
chronic bronchitis more common in ____ pt, emphysema more common in ____ pt
overweight; malnourished
