Exam 3 - COPD Flashcards
Describe the difference between Type I and Type II cells of alveolar wall
Type 1 - give structure to alveolar wall
Type 2 - where surfactant (lipoprotein) is produced; fluid that reduces surface tension and contributes to elasticity of pulmonary tissue
**Both types make up alveolar epithelium
Describe the Bicarb/Carbonic acid buffering system
CO2 is produced by aerobic respiration. If you can’t breath it all out your body retains CO2, increasing your acidity level. Body compensates by producing more bicarbonate
Name two examples of nutritional status and pulmonary function being interdependent
- Macronutritents are fueled using oxygen and CO2
* Malnutrition can evolve from pulmonary disorders and contribute to declining pulmonary status
What are ABGs and what do they look at?
Arterial blood gasses
• pCO2
• PO2
What is pulmonary consolidation?
When lung parenchyma becomes engorged wiht fluid
Describe pulmonary effusion
When fluid exists between lung and chest wall, displacing lung upwards
What is the goal %O2 in the Hgb?
> 95% (approx pO2 saturation)
Give three factors that influence the pulmonary function test parameters
- Malnutrition
- Obesity - displacement of lungs by fat mas
- Development/progression of obstructive respiratory disease
What three things does pulmonary function measure?
- Oxygen saturation (want >95%)
- pH
- Minute ventilation
What does it mean when bicarbonate (HCO3) is high?
Compensatory response for acidic CO2 retention
Define COPD
Chronic Obstructive Pulmonary Disease - Progressive disease which limits airflow through INFLAMMATION OF BRONCHIAL TUBES (bronchitis) or DESTRUCTION OF ALVEOLI (emphysema)
• These usually occur together
Give the risk factors for COPD
- **SMOKING
- air pollution
- second-hand smoke
- history of childhood infections
- occupational exposure to certain industrial pollutants
Describe CHRONIC BRONCHITIS
- Productive cough and shortness of breath
- 3 months each year for 2+ years
- Decreased cilia function, increased phagocytosis, suppressed amounts of IgA
- Chronic inflammation leads to hyperplasia of mucus secreting cells; excess mucus sets up for infections
Describe EMPHYSEMA
- Develops gradually due to smoking; 95% occurs in people >45years
- Inflammation of airways causing oxidative stress/destruction of lung tx
- Loss of lung surface area and decreased amounts of surfactant
- Bronchioles lose their elasticity; collapse during exhalation
List the clinical manifestations of CHRONIC BRONCHITIS
• Decreased air flow rates • Dyspnea • Hypoxemia (low O2 due to inflammation) •Hypercapnia (high Co2) - cyanosis, clubbing, secondary polycythemia (making more red blood cells - sets up for stroke) • QOL diminishes • Require substantial oxygen • Cor pulmonale - increased size of rt ventricle due to increased resistance of passage of blood through lungs (leads to heart failure)
