Obstructive Lung Disease Flashcards
what is the most common worldwide risk factor for COPD?
smoking
what % of FEV1 is lost within each year of smoking?
25%
how do cigarattes lead to COPD?
cigs destroy cilia in lungs –> difficulty moving secretions –> mucus plugs up –> obstructive
what are the two types of OLD?
non-septic and septic
what is non-septic OLD?
no sputum production
emphysema
asthma
what is septic OLD?
large volume purulent sputum production
chronic bronchitis
CF
what are the pathologic changes in OLD?
- hyperplasia of mucus-secreting cells (excess mucus production)
- reactive airways w/ terminal airway destruction
- alveolar sac destruction
— all lead to reduction of airflow, lung hyperinflatation, and impaired gas exchange
what is emphysema triggered by?
body’s inflammatory response
what is chronic bronchitis
presence of chronic productive cough for 3 months in 2 successive years in absence of other pathologies
in chronic bronchitis, what is the airway obstruction from?
- loss of elastic recoil
- inflammation of respiratory bronchioles
- hypertrophy of smooth muscle
- mucus plugging
what changes in lung function do we see in OLD?
- lung hyperinflatation
- impaired gas exchange (hypoxemia or hypercapnia/excessive CO2 in blood)
- impaired mucociliary function
what signs of hyperinflation are present on xray?
- elevation of shoulder girdle
- horizontal ribs
- barrel shaped thorax
- flattened diaphragm
- increased subcostal angle
clinical presentations of chronic bronchitis?
- cough
- minimal production
- sputum is thin unless infected
- dyspnea (persistent/progressive esp. w/ BUE movement)
- acute exacerbations
what is the V/Q ratio?
relationship between alveolar ventilation and pulmonary perfusion
V = alveolar ventilation (Va)
Q = pulmonary perfusion
what is the optimum V/Q ratio?
0.8 (4/5)
what is shunt perfusion?
perfusion without ventilation
what is dead space ventilation?
alveolar gas without perfusion
how much oxygen binds to hemoglobin in RBCs?
98%, 2% dissolves in plasma
how much oxygen can a hemoglobin hold?
four O2 molecules
characteristics of asthma?
- widespread and variable airway obstruction
- reversible spontaneously or w/ meds
- episodic - periods of obstruction w/ otherwise normal lung function
what is cystic fibrosis
multisystem disorder affecting children and young adults - affects epithelial cells
what does cystic fibrosis manifest as?
- recurrent and chronic cough
- recurrent infections
- salty skin
- wheezing / SOB
- poor growth + slow weight gain
- frequent greasy, bulky stools or difficult BMs
training pulmonary patients at what intensity results in substantial increases max. exercise capacity
60-85%
what exercise routine might be better tolerated in pulmonary patients?
HIIT - 3-4x/week, intervals, 80% of max work rate for 15-20min progress to 100%, 5-6 RPE / 3-4 DOE
