COPD Flashcards
what does COPD stand for?
chronic obstructive airway disease
what is the cardiopulmonary system?
Need abundant O2 and glucose – cellular respiration
•Need to ‘clear’ waste products of ATP metabolism – CO
- relies on diffusion of the skin
what is a limitation of the cardiopulmonary system and how is it overcome?
To overcome these limitations
•Respiratory system
•Cardiovascular system
–Provides a large surface area for gas exchange
–Allows gases to be dissolved in the blood and transported
•O2 (from atmospheric air) to respiring cells
•CO2 to the lungs (into atmospheric air) from respiring cells
is pulmonary circulation oxygenated or deoxygenated?
deoxygenated
what is tidal movement?
total movemet of air in and out of lungs
- generated by strexhing lung tissue - impression in airways as expand and allowing to collapse back
as pressure rises/ falls it equalises
is ventilation a voluntary or involuntary control?
autonomic pressure/ voluntary control
what happens in inhilation when PH falls?
h ion increases- drive to increase respiratory rate- accumulation by co2
- Alveoli are separated by alveoli septum
- Air moves predom by diffusion
- High co2- low o2
- O2 is bound by deoxygenated haemoglobin
- The blood vessels and resp epithelial surfaces shares
- Combined wall thickness being less than 2 microns
what are the respiratory function tests for COPD?
Blood gas analysis, spirometry(ESSENTIAL IN DIAGNOSIS AND MANAGMENT) and imaging help to assess lung function
What are ABG andhow do we measure?
ABG= arterial blood gases
- differ between similar conditions
assess lung function
how does spirometery work?
using volume/ time graphs
it can either be obstrictive or restrictive
how do obstuctive and restrictive present on a chart?
Obstructive–Loss of flow greater than proportional loss of volume
•Restrictive–Loss of volume greater than proportional loss of flow
what are the related conditions to COPD that may be confused for/ overlap?
Chronic bronchitis
•Emphysema–These may (often) co-exist – both diseases at same time
•May exist with other respiratory conditions e.g. asthma
what condition would obstructive spirometery show?
Asthma–COPD–Cystic fibrosis–Bronchiectasis
what conditions would restrictive spirometry show?
Fibrosis–Sarcoidosis–Neuromuscular (ALS)–Scoliosis / kyphosis
how would you differenciate COPD from similar diseases?
Obstructive
•Progressive (worsen over time)
•Irreversible (unlike asthma)
•Similar risk factors (smoking)•Overlap between the conditions
•Treatment is ostensibly the same
PEFR is reduced and FEV1 is lower than expected
what would and fev1 <0.7 indicate?
COPD
can something be done about the airflow limitation in COPD?
Preventable
•Inflammatory: secondary to an avoidable environmental ‘pollutant’ (extrinsic risk factors)•Host factors (intrinsic) may be important in some–Progressive
•Punctuated with exacerbations
what kind of preventable risk factors are there?
pollutanat- environmental
Demographic risk factors–Low socio-economic status»Housing (indoor pollution and outdoor pollution) and overcrowding»Poverty (co
ntrinsic risk factors–Low birth weight and poor early nutrition–Respiratory disease in development–Gestational problems inhibiting lung development
what effect does inflamation of the airways have?
causes increase mucous production by: Enlargement of mucus secreting glands –Increased goblet cell number –Inflammatory cell proliferation –Poor correlation to severity
what are the things that happen once airways are inflamed?
mucous secretion Inflammatory mediators •Complex (both innate and adaptive changes) local effects systemic consequences Loss of airway patency
how do the lungs longs lose airway patency?
–Reduced lumen diameter
–Loss of ciliated epithelial function
–Loss of airway elastic fibres
»Collapse during expiration
what is Emphysema?
Loss of elasticity
Reduced ᵳ1-anti-trypsin [anti protease] resulting in destruction of elastic fibres–Acquired – tobacco smoking–Intrinsic – ᵳ1-anti-trypsin deficiency (associated with liver dysfunction)
collapse of alveoli
loss of reticular structure
•Loss of associated vasculature