COPD

Question 1

what is copd

Answer 1

lung disease that cases obstructed air flow from the lungs

• affects approx 5% of world pop
• chronic bronchitis and emphysema

Question 2

Chronic bronchitis

Answer 2

inflamation of the linning of the bronchial tubes which carry air to and from air sacs of lungs
-mucus blocks airway and inflammation further narrows it

Question 3

Emphysema

Answer 3

alveoli are destroyed as a result of damaging exposure to cig smoe and other particulate matter

Question 4

Flow of COPD

Answer 4

COPD–> expiratory flow limitation/air trapping–> dyspenea–> inactivity–> deconditioning–> reduced exercise tollerance (ultimatly exacerbates symptoms)

Question 5

exacerbation symptoms of copd

Answer 5

exacerbation–> worsoning expiratory flow/ dynamic hyperinflation( less room to inspire new air) –> increased ventilatory drive, tachypnoea, dyspnoea, decreased RV preload, increased LC afterload

Question 6

causes of systematic inflamation

Answer 6

Noxious gases partiicles
AATD deficiancy( cellular damage, oxidative stress)
Endothelial dysfunction, apoptosis

Question 7

Affects of systematic inflammation on brain, cardiac tissue, muscle tissue

Answer 7

Brain- cellular damage, neuroinflammation, hemodynamic impairment

Cardiac tissue- pre thrombotic status (before clotting), reduced fibrinolysis

Muscle tissue- muscle wasting, sarcopenia

Question 8

What is Alpha 1 anti trypsin deficiency (AATD)

Answer 8

genetic disorder that may result in lung disease

• 1/2500 ppl of european decent
• produced in liver, one of its functions is to protect lungs from neutrofil elasase ( enzyme that disrupts connective tissue) w/o leads to emphysema

Question 9

Cardiovascular dysfunction w/ copd

Answer 9

lung inflamation–> increase Tnfa–> increase c reactive pro.–> atherosclerosis

lung inflamation–> increase iL6–> coagulation

Question 10

Skeletal muscle dysfunction w COPD

Answer 10

circulating TNFa–> TnF-R binding–> increase ROS in mito–> pro loss

Question 11

etiology of muscle function in COPD (lower limb) and how exercise can help it

Answer 11

BAD

• oxidative stress (decreases pro synthesis)
• Apoptosis
• Decrease % of type 1 fibres
• Decrease mitochondrial density
• Atrophy

Exercise

• IL6 leads to decrease in pro breakdown becuase it decreases TNFa
• liver releases IGF1 which releases mTOR which increases synthesis

Question 12

Eitology of muscle function in COPD (repiratory muscles)

Answer 12

BAD’

• oxidative stress (decrease pro synthesis)
• Apoptosis

Good

• increase type 1
• increase mito density
• increase myoglobin

Question 13

How COPD affects VO2 max

Answer 13

decrease capillaeries and mitochondria
decrease muscle blood flow
increase afterload and decrease preload
decrease end expiratory lung volume

Question 14

exercise training recomendation for someone w copd

Answer 14

endurance- 20-30 min @60% 3-5xw
Resistance- 2-3 x week
Respiratory- resisted breathing 2x day 30 breathes