Obstructive Pulmonary Disease Flashcards
what does air trapping result in?
hypoventilation and hypercapnia
what are present in all obstructive diseases?
dyspnea and wheezing
what is air trapping?
–person is not able to fully exhale
–CO2 is higher since air can’t escape
–air is trapped in alveoli –> person works harder to breathe and lungs are hyperinflated
–normal exhalation is obstructed
asthma
chronic inflammation of bronchial airways
risk factors for asthma
–usually starts in childhood
–familial link
–levels of allergen exposure
–urban residency
–exposure to indoor and outdoor air pollution
–tobacco exposure/smoke
–recurrent respiratory tract viral infections and GERD
early asthmatic response
cellular responses are activated immediately and cascade of release of inflammatory mediators occurs within minutes
late asthmatic response
4-8 hours after early response
two responses of asthma
- bronchoconstriction (#1 symptom)
- inflammation (biggest problem; causes seriousness)
status asthmaticus
–severe symptoms
–unrelenting asthma attack (silent chest, pCO2 > 70)
–life threatening
chronic bronchitis
hypersecretion of mucus and chronic productive cough for at least 3 months of the year for at least 2 consecutive years
simple bronchitis
inflammation of bronchi and bronchioles
etiology of simple bronchitis
bacterial or viral infection
NO AIRWAY OBSTRUCTION
etiology of chronic bronchitis
–cigarettes
–+ airflow obstruction = form of COPD
prognosis of chronic bronchitis
premature morbidity and mortality
patho of chronic bronchitis
–inhaled irritants result in airway inflammation
–continual bronchial inflammation
–thick, tenacious mucus produced and cannot be cleared
why can’t secretions be cleared in chronic bronchitis?
–damaged cilia bronchial walls become inflamed/thickened secondary to edema
–accumulation of inflammatory cells
–thickened smooth muscle secondary to chronic bronchospasm
late clinical manifestations of chronic bronchitis
pulmonary hypertension
patho of pulmonary HTN
increase in pulmonary artery pressure d/t elevated pulmonary venous pressure, increased pulmonary blood flow, pulmonary vascular obstruction, or hypoxia
s/s of pulmonary HTN
syncope, DOE, and fatigue
cor pulmonale
right sided heart failure
treatment of chronic bronchitis
–bronchodilators
–expectorants/prophylactic antibiotic therapy
–CPT
–steroids late in disease
–home O2
emphysema
abnormal, permanent enlargement of gas exchange airways, accompanied by destruction of alveolar walls
major effect of emphysema
major mechanism of airflow limitation is loss of elastic recoil with collapse of the airways during expiration
characteristics of emphysema
–loss of elastic recoil
–abnormal permanent enlargement of air spaces
–lung hyperinflation
–destruction = tissue changes
causes of loss of elastic recoil in emphysema
–smoking
–air pollution
–childhood respiratory infections
–genetic emphysema
symptoms of emphysema
–gradual increase in breathlessness
–eventually SOA at rest
–wheezing
–malnourished
–decreased muscle mass
–barrel chest
–pursed lip breathing
–decreased breath sounds
diagnosis of emphysema
–PFTs (FEV1 decreased)
–CXR (hyperinflation)
–ABGs
–decrease in alpha1-antitrypsin
treatment of emphysema
–smoking cessation
–bronchodilators and anti-inflammatory agents
–O2 supplementation
–breathing retraining
–relaxation techniques
–antibiotics for acute infections
chronic bronchitis vs. emphysema
CB: overweight, cyanotic, elevated Hgb, peripheral edema, rhonchi, wheezing
Emphysema: older and thin, severe dyspnea, quiet chest, hyperinflation with flattened diaphragms
