Module 4 - Chronic Respiratory Conditions Flashcards
What does it mean by the ‘asthma COPD overlap’
This refers to the fact that asthma and COPD are different conditions which involve a different approach to both diagnosis and subsequent management. However, it is noted that patients may exhibit both. Therefore when considering treatment and management it is important to ensure that both are taking into account
What are some presenting features of acute exacerbations of COPD
- Worsening of previous stable condition
- Increased wheeze
- Increased dyspnoea
- Increased sputum
- Chest tightness
- Fluid retention
What are the complications associated with a presentation of COPD
- Atelectasis / pneumothorax
- Diabetes (from steroid use)
- Anxiety / depression
- Heart disease - R) sided heart failure
- Muscle weakness
How does co2 make us breathe?
Carbon dioxide (CO2) is the waste product of metabolism and is expelled from the body during exhalation. CO2 is also one of the gasses that can cross the blood-brain barrier. In the cerebrospinal fluid, it combines with water to produce carbonic acid which in turn separates to form hydrogen ions. The concentration of hydrogen ions in a solution is known as the pH.
As the arterial level of carbon dioxide changes, this results in a change seen with the pH of the cerebrospinal fluid. This triggers a reaction in the central chemoreceptors located near the medulla. These sensory receptors are responsible for regulating respiratory function – breathing – and monitoring the levels of arterial carbon dioxide.
An increase in the arterial carbon dioxide level leads to an increase in the depth and rate of respiration, and the person breathes faster. A reduction in the arterial carbon dioxide level leads to reduced depth and rate of respiration, and the person breathes more slowly.
The link between Oxygen, CO2 and COPD patients leading to carbon dioxide retention
The disease process of COPD ultimately leads to chronically high arterial levels of carbon dioxide and low levels of oxygen. Over time, the central chemoreceptors become less sensitive to these changes. The stimulus for ventilation is then managed by the peripheral chemoreceptors located in the carotid bodies and the aortic arch. These receptors are stimulated by low arterial levels of oxygen, transmitting messages to the respiratory centre in the medulla. This leads to an increased respiratory rate and depth, with a low arterial oxygen level, and a reduced depth and rate with a high arterial oxygen level.
What happens when inappropriate levels of oxygen are given to a ‘CO2 retainer‘.
Arterial oxygen levels increase from what may be normal for that individual, leading to a reduction in the depth and rate of respirations, which will increase the arterial level of carbon dioxide. This is known as hypercapnia.
What is hypercapnia
is a condition of abnormally elevated carbon dioxide (CO2) levels in the blood.
What does FEV1 stand for
Forced expiratory volume in 1 second
What is cor pulmonale
abnormal enlargement of the right side of the heart as a result of disease of the lungs or the pulmonary blood vessels.
Is COPD directly related to Left sided heart failure?
No, but the two conditions can exacerbate each other
When blood is not properly oxygenated due to COPD, extra stress is placed on the heart, worsening the symptoms of left-sided heart failure. Conversely, excess fluid in the lungs from left-sided heart failure can make breathing more difficult for someone with COPD.
Is COPD directly related to Right sided heart failure?
Yes,
During right-sided heart failure, COPD can have a direct influence on the heart’s right ventricle. Pulmonary hypertension results when the blood pressure inside the arteries rises. This can be in response to abnormally low oxygen levels in the vessels inside the lungs as a result of COPD. The excess strain from pulmonary hypertension on the right ventricle can result in heart failure.
This is called Cor Pulmonale
