EXAM3/CH19- COPD Flashcards
COPD
chronic obstructive pulmonary disease
how is COPD defined by the American Thoracic Society
a disease characterized by the presence of airflow obstruction that is attributable to either chronic bronchitis or emphysema
why do we combine emphysema + chronic bronchitis into 1 disease
because they are rarely pure expressions of either disease
-in general, they overlap a lot so we treat them the same
chronic bronchitis
the presence of a productive cough most days during 3 consecutive months in each of 2 successive years
ex: chronic cough January/February/March for 2 years straight
emphysema
a pathological or anatomical diagnosis marked by…
1) permanent enlargement of the respiratory bronchioles and alveoli
AND
2) destruction of the lung parenchyma without obvious fibrosis
can you see bronchioles + alveoli on x-ray
hard to see bronchioles + alveoli by x-ray or eye but we can see them via microscopic exam or more sophisticated imaging techniques
parenchyma
bronchioles + alveoli
fibrosis
deposition of collagen + elastin
diaphragm
acts as a piston to enlarge to draw air into the lungs
lung damage in COPD
-tissue has less elastic structures, causing constriction
-bronchioles lose their shape + become clogged with mucus
-walls of alveoli are destroyed, forming fewer, larger alveoli
what is COPD often associated with
cachexia
cachexia
a substantial loss of muscle mass + strength
physical characteristics of COPD patients
-pronounced neck muscles because they have stiff chest walls + strain neck muscles to try to bring air in
-bracing arms, typical postural behavior
-pursed lip breathing; attempt to facilitate gas flow from lungs to prevent lungs from collapsing prematurely
disease scope of COPD
-estimated that 24 million people in the United States have COPD
-a major cause of morbidity + disability + a major health care cost, estimated at $50 billion annually in the US
-4th leading cause of death in the US
-projected to be the third leading cause globally by 2020
causes of COPD
-smoking
-environment
-alpha-1antitrypsin deficiency
is there a cure to COPD
NO
-irreversible
causes of COPD- smoking
85-90% of all cases are caused by smoking cigarettes
causes of COPD- environment
long-term exposure to air pollution, second-hand smoke, dust, fumes, + chemicals
causes of COPD- alpha-1antitrypsin deficiency
a small number of people have this genetic disease
trypsin
enzyme that degrades proteins in lungs
what inhibits trypsin
antitrypsin
if you have a genetic deficiency where you don’t make antitrypsin, what would happen
the trypsin in your lungs will destroy lung tissue causing emphysema
-extremely rare
chronic bronchitis pathophysiology
-excessive cough + sputum production
-bronchial enlargement
-airflow obstructed by mucus plugging, inflammation, + increased smooth muscle
emphysema pathophysiology
-alveoli lose parenchymal tethering
-loss of lung elasticity and recoil
-reduced expiratory airflow
-increased work of breathing
-lung hyperinflation
-diaphragm flattening
-barrel chest
