COPD Flashcards
What is COPD
chronic disease that cause obstruction of the airways
How prevalent if COPD
4th cause of death in US, 6th in the world
What is Emphysema
permenant damage to alveolar walls
enlargement of the air spaces distal to the terminal bronchioles
loss of lung elasticity
What are the two major causes
smoking
inherited deficiency of alpha1-antitrypsin
What is the pathology of emphysema
because leukocytes in the lung produce elastase (which breaks down the alveolar cell wall) and because smoking causes excessive amounts of leukocytes to come to the lung, an excess amount of elastase is produced that cant be neutralized anymore by antiproteases like alpha1-antitrypsin so destruction of the alveolar cell walls occur
What are the two types of emphysema and explain
Centriacinar- affects the terminal bronchioles first then later effects the alveoli
Panacinar- affects the alveoli fist then affects the terminal bronchioles
What happens to your air volume in emphysema
your total lung capacity increasing the amount of air trapped in the lungs (causing barrel chest)
What happens to the amount of surface area for gas exchange in emphysema
it decreases
Because of your loss of elasticity and gas exchange in emphysema, what happens to your CO2 levels
you retain a larger amount of CO2
What causes Chronic Bronchitis
obstruction of major and small airways from smoking or recurrent infection
What is the pathophysiology of Bronchitis
Infiltration of neutrophils, macrophages and lymphocytes in bronchial wall that leads to edema and increases size of mucous glands and goblet cells
Thick mucous impairs ciliary function
Has
What are Chronic B’s manifestations
Productive cough secondary to increased mucus production Prolonged expiration Dyspnea on exertion due to air trapping “Blue bloater”, cyanosis Chronic hypoventilation Cor pulmonale (R sided heart failure)
What is required to diagnose someone with Chronic B
Hypersecretion of mucus, chronic productive cough for more than 3 months for at least 2 years consecutively
What type of VQ mismatch is Bronchitis
V/Q mismatches- poor vent good perf
What type of VQ mismatch is Emphysema
Good vent poor perf
Why are people with emphysema called pink puffers
They have too much CO2 in they bodies
Why are people with Bronchitis called blue bloaters
they don’t have enough oxygen in there bodies
What is a risk the people with COPD have when given oxygen
If you give to much oxygen to someone with COPD it can cause them to lose their ventilation drive
What causes pulmonary edema
left sided heart failure
inflammation
pneumonia infection
what are the manifestations of pulmonary edema
pink frothy secretions Dyspnea, hypoxemia, increased work of breathing, crackles
How is pulmonary edema treated
supplemental O2
positive press mechanical ventilation
What is aspirations
Passage of fluid or solid particles into the lung.
What are the big risk factors for aspirations
periods of altered LOC like substance abuse, sedation, seizure disorders, stroke, elderly
What is the pathology of aspirations
Particles obstructing bronchi cause inflammation and airway collapse
What are the manifestations of aspirations
sudden choking, dyspnea, and wheezing
What happens to the lungs after aspirations
they become noncompliant
What are people with aspirations at a higher risk of
pneumonia
What is respiratory distress syndrome
hyaline membrane disease of premature infants that causes decreased surfactant production
Why is the lack of surfactant in premature infants problematic
its causes the alveolar to collapse, and a V/Q inbalance
What is the pathogenesis of RDS
the premature infant has a lack of surfactant and immature lung structures causing decreased compliance leading to atelectasis and hypoxia
What are the manifestations of RDS
increased WOB, tachypnea, retractions of the chest wall, diminished breath sounds, nasal flaring, cyanosis
What is RDS characterized by
hemorrhagic pulmonary edema, patchy atelectasis, increased work of breathing
How is RDS treated
supp O2
positive pressure ventilation
What are pulmonary emboli’s
a thrombus, air, fat, tumor that lodges in a pulmonary vessel
What is the patho of a pulmonary emboli
the obstruction causes perfusion to decrease (high V/Q) causing hypoxemia
What are the manifestations of pulmonary emboli
Unexplained anxiety Restlessness Dyspnea Tachycardia Tachypnea Pleuretic chest pain Pulmonary artery is most common place
Where are pulmonary emboli’s usually found
Pulmonary artery
What is cor pulmonale
peripheral edema from right sided heart failure or pulmonary hypertension
What are the manifestations of cor pulm
decreased vent decreased O2 Pulmonary vasoconstriction increased WOB productive cough altered LOC
How is cor pulm treated
treating lung disease or heart failure
What are the manifestations of emphysema
Dyspnea Prolonged expiration Barrel chest Wheezing Tachypnea Use of accessory muscles Decreased breath sounds Pink puffer-because lose of elasticity- causes shorteness of breath- lack cyanosis
