Obstructive Lung Disease Flashcards
What’s the difference between obstructive and restrictive lung diseases?
- Restrictive lung disease is a problem getting air in (“Tight” or small lungs).
- Obstructive lung disease is a problem getting air out (“Big” lungs).
What are the primary lung function test values for obstructive lung disease?
- FEV1/FVC < 70%, indicates obstructive lung disease.
What are the hallmark features of COPD?
broad
COPD involves
- chronic inflammation
- narrowing of airways
- air trapping
- lung hyperinflation
Common forms include emphysema and chronic bronchitis
What’s the difference between emphysema and chronic bronchitis?
- Emphysema is characterized by alveolar sac destruction and air trapping (pink puffers).
- Chronic bronchitis involves mucus production, chronic cough, and airway blockage (blue bloaters).
What are the signs of lung hyperinflation seen in COPD?
- increased AP diameter
- barrel chest
- horizontal ribs
- flattened diaphragm on a chest X-ray
- Larger than normal TLC and RV
What are common symptoms of COPD exacerbations?
COPD symptom exacerbations:
- increased cough
- dyspnea
- purulent sputum
- occasional wheezing
What is the role of pulmonary function tests (PFT) in diagnosing COPD?
- PFTs assess airflow limitations by measuring FEV1 and FVC.
- In obstructive diseases, FEV1 decreases and FEV1/FVC < 70%.
What is the main goal of medical management for COPD?
- to relieve symptoms
- prevent progression
- improve exercise tolerance
- prevent and treat complications
- reduce mortality
What are physical therapy interventions for COPD?
- secretion clearance
- controlled breathing techniques (pursed lips, paced breathing)
- endurance and strength training
- postural reeducation
How does asthma differ from COPD?
Asthma involves reversible airway obstruction with episodes of airflow limitation, wheezing, and dyspnea.
COPD is a progressive, non-reversible condition.
What are the common triggers for asthma?
Asthma can be triggered by environmental factors such as allergens, smoke, pets, exercise, and respiratory infections.
What is bronchiectasis and its common symptoms?
- Bronchiectasis involves chronic dilation of bronchi due to inflammation and infection.
- Symptoms include chronic cough with purulent sputum, hemoptysis, and fatigue.
What is…
- cystic fibrosis ?
- symptoms ?
- Cystic fibrosis is a multisystem disorder affecting the lungs with thick mucus, leading to chronic infections, as well as the pancreas and intestines, affecting nutrient absorption.
- Symptoms Persistent cough, recurrent lung infections, thick mucus, poor growth, and greasy stools.
What are key physical exam findings in a patient with emphysema?
- barrel chest
- hyperresonance with percussion
- prolonged expiratory phase
- diminished breath sounds
What are physical exam findings in chronic bronchitis?
- Rhonchi (low-pitched wheezing)
- increased use of accessory muscles
- productive cough lasting for at least 3 months over 2 consecutive years
What diagnostic tests confirm bronchiectasis?
CT scans showing the signet ring and tram-track signs, ABGs for VQ mismatch, and sputum testing for infection.
What is the significance of the FEV1/FVC ratio in obstructive lung diseases?
A ratio of <70% indicates airflow obstruction and suggests diseases like COPD or asthma.
What physical therapy interventions are used for asthma management?
- Airway clearance, breathing exercises, endurance training, and relaxation techniques.
- Monitor exercise-induced asthma with bronchodilators prior to activity.
What are the medical management goals for cystic fibrosis?
- control infections
- promote mucus clearance
- improve nutrition
- manage comorbidities like diabetes
Explain…
- Forced Vital Capacity = ?
- Forced Expiratory Volume 1 = ?
- FEV1/FVC ratio = ?
Forced Vital Capacity (FVC): Maximum amount of air exhaled after a maximal inhalation
- Low could suggest restrictive issues as elasticity is not normal
Forced Expiratory Volume 1 (FEV1): Amount of air exhaled in the first second as forcefully as possible from a full lung
- Liters/second
- Reduced speed could indication obstruction or narrowing in airways
FEV1/FVC ratio: Identification of airflow obstruction
- < 70% = obstruction
- > 70% = normal or restricted
- Minute Ventilation = Tidal Volume (VT) x Respiratory Rate (RR)
What are…
- Emphysema = ?
- Bronchitis / Chronic Bronchitis = ?
- Bronchiectasis = ?
- Asthma = ?
- Cystic Fibrosis = ?
Obstructive Lung Disease Conditions (CANNOT GET THE AIR OUT):
- Emphysema: Destruction of the alveolar walls and enlargement of air spaces distal to the terminal bronchioles
- Bronchitis / Chronic Bronchitis: Inflammation of bronchi with hypertrophy of mucus secreting glands
- Bronchiectasis: Progressive dilation of one or more bronchi with chronic inflammation and infection.
- Asthma: Episodic obstructive lung disease and periods of relatively normal lung function
- Cystic Fibrosis: Pulmonary system is affected by chronic airway obstruction and inflammation, thick tenacious mucus, and recurrent bacterial infections
- Emphysema and Chronic Bronchitis – most common forms of COPD
Classifying COPD
- Stage 1 = ?
- Stage 2 = ?
- Stage 3 = ?
- Stage 4 = ?
(Stage 1) Mild:
- FEV1 = > 80
- FEV1/FEV = < .07
- Symptoms = Chronic cough, +/- sputum
(Stage 2) Moderate:
- FEV1 = > 50-80
- FEV1/FEV = < .07
- Symptoms = Chronic cough, +/- sputum, and dyspenea
(Stage 3) Severe:
- FEV1 = > 30-50
- FEV1/FEV = < .07
- Symptoms = Chronic cough, +/- sputum, and dyspenea
(Stage 4) Very Severse:
- FEV1 = < 30
- FEV1/FEV = < .07
- Symptoms = Chronic cough, +/- sputum, and dyspenea, respiratory or R heart failure, weight loss
