COPD Flashcards
pulmonary disease that causes chronic obstruction of airflow from the lungs
COPD
Key points for COPD
Limited Airflow (due to thick and swollen bronchioles that have become deformed with excessive sputum production and this narrows the airways)
Inability to fully exhale (due to loss of elasticity of the alveoli sacs from damage and the sacs start to develop air pockets)
Irreversible once developed…cases vary among people from mild to severe…managed with lifestyle changes and medications.
Happens gradually….most people start to notice signs and symptoms middle-aged and will present with dyspnea with activity they could normally tolerate, recurrent lung infections, chronic cough etc.
COPD is a term used as a “______” for diseases that limit airflow and cause dyspnea.
catch all
What is the most common cause of COPD?
Tends to be environmental from harmful irritants that have been breathed into lungs
signs & symptoms tend to happen gradually and most people start to notice them at middle age
dyspnea with activity, chronic cough, recurrent lung infections
Emphysema “_________ puffers”
Chronic bronchitis “________bloaters”
pink (due to cyanosis & edema); blue
Why does Chronic bronchitis cause the diaphragm, which is normally dome shaped to flatten?
Over time, more and more air volume added to the lungs leads to hyperinflation of the lungs. This pushes down on the diaphragm and leads to flattening.
not enough oxygen getting in and retaining that carbon dioxide - this describes _______________
COPD
Normal breathing:
Inhaled oxygen travels down through the trachea which splits at the _________ into bronchial tubes starting with the primary bronchus then into smaller airways called secondary and tertiary bronchi which divide into bronchioles and the oxygen goes into the __________ sacs where gas exchange happens. As the alveoli inflate and deflate with ease, inhaled oxygen attaches to the __________ cells and carbon dioxide enters the respiratory system to be _____________.
carina; alveolar; red blood cells; exhaled
Those with chronic bronchitis are referred to as _________________. Why is this ?
blue bloaters
The name “blue bloaters” is due to cyanosis from “hypoxia” and bloating from edema AND increase in lung volume. The bloating is from the effects of the lung disease on the heart which causes right-sided heart failure.
What happens in chronic bronchitis?
Why does hyperinflation occur? How does the body attempt to compensate ?
Why does heart failure happen?
In chronic bronchitis, the bronchioles become damaged that leads them to be thick and swollen and deformed. This is accompanied by more sputum production. This limits the ability of the person being able to completely exhale the air taken in. So, when they take another breath in, it will increase the air volume even more (because they have retained air from the previous breath), and this leads to hyperinflation.
Also, less oxygen is getting into the blood and more carbon dioxide is staying in the blood. This leads to low blood levels and high carbon dioxide levels. Patients will have cyanosis due to a decreased oxygen level. To compensate, the body increases RBC production and cause blood to shift elsewhere which increases pressure in the pulmonary artery leading to pulmonary hypertension. Pulmonary hypertension leads to right-sided heart failure (which is why you will start to see bloating..edema in the abdomen and legs)
Those with emphysema are referred to as ______________. Why is this ?
pink puffers
The name comes from hyperventilation (puffing to breathe) and pink complexion (they maintain a relatively normal oxygen level due to rapid breathing) rather than cyanosis as in chronic bronchitis.
In emphysema, the alveoli sacs lose their ability to inflate and deflate due to an inflammatory response in the body. So, the sac is unable to properly deflate and inflate. Inhaled air starts to get trapped in the sacs and this causes major hyperinflation of the lungs because the patient is retaining so much volume.
Hyperinflation causes the diaphragm to flatten. The diaphragm plays a huge role in helping the patient breathe effortlessly in and out. Therefore, in order to fully exhale, the patient starts to hyperventilate and use accessory muscles to get the air out now. This leads to the barrel chest look and during inspect it may be noted there is an INCREASED ANTEROPOSTERIOR DIAMETER.
The damage in the sacs cause the body to keep high carbon dioxide levels and low blood oxygen levels. Inhaled oxygen will not be able to enter into the sacs for gas exchange and carbon dioxide won’t leave the cells to be exhaled.
The body tries to compensate by causing hyperventilation (increasing the respiratory rate…hence puffer) and the patient will have less hypoxemia “pink complexion” than chronic bronchitis who have the cyanosis because pink puffers keep their oxygen level just where it needs to be from hyperventilation.
S/S of COPD
LUNG DAMAGE Mnemonic
Remember: Lung Damage
Lack of energy
Unable to tolerate activity (shortness of breath)
Nutrition poor (weight loss) due to energy used breathing especially with emphysema
Gases abnormal (high PCO2 >45 and low PO2 <90)..respiratory acidosis
Dry or productive cough constant (productive with chronic bronchitis)
Accessory muscle usage during breathing, Abnormal lung sounds: diminished, coarse crackles (chronic bronchitis) or wheezing
Modification of skin color from pink to cyanosis in lips, mucous membranes, nail beds (“blue bloaters”)
Anteroposterior diameter increased (barrel chest)….emphysema “pink puffers”
Gets in the Tripod Position during dyspnea (stands leaning forward while supporting body with hands on knees or an object)
Extreme dyspnea
In turn over time, people with COPD will be stimulated to breathe due to low __________ levels RATHER than high _____________levels.
oxygen; carbon dioxide
Complications of COPD
Heart Disease (remember heart and lungs work together in replenishing the body with oxygen)…heart failure
Pneumothorax (spontaneous due to forming of air sacs)
Risk for Pneumonia
Cancer (especially lung)
How is COPD diagnosed ?
Spirometry: A test where a patient breathes into a tube that measure how much volume the lungs can hold during inhalation and how much and fast air volume is exhaled.
Measuring the FVC (Forced Vital Capacity): a low reading shows restrictive breathing….it measures the largest amount of air a person exhales after breathing in deeply in one second.
Forced Expiratory Volume: measures how much air a person can exhale within one second. A low reading shows the severity of the disease.
