pulm dzs pt 1 Flashcards
chronic obstructive pulmonary disease
chronic airflow limitation that is not fully reversible
what can COPD manifest as
chronic bronchitis
emphysema
asthma can also progress to COPD
COPD
second only to heart disease as a cause for disability in adults under 65
4th leading cause of death in US
deficiency of alpha1-antitrypsin (anti-inflammatory protein) develop COPD earlier and disease is accelerated
common presenting signs of COPD
dyspnea
sputum production
chronic cough
diagnosis COPD
spirometry
to measure how much air the lungs can hold and how well the respiratory system is able to move air into and out of the lungs
blood gas measurement
blood pH
treatment COPD
goals are to improve oxygenation and decrease CO2 retention
long term O2 treatment
prognosis COPD
poor b/c these are chronic, progressive, debilitating diseases
COPD is largely preventable
death rate has increased 22% in last decade
COPD risk factors (chronic bronchitis)
irritants (smoking)
long-term dust inhalation
air pollution
COPD pathogenesis (chronic bronchitis)
inflammation and scarring of the bronchial lining caused by mucus hypersecretion and hypertrophy of mucus producing glands
COPD clinical manifestations (chronic bronchitis)
persistent cough and sputum production result in shortness of breath, prolonged expiration and recurrent infection
COPD medical management (Chronic bronchitis)
reducing irritants and using combination of bronchodilators
2 types of COPD
chronic bronchitis
emphysema
COPD –> chronic bronchitis
productive cough lasting for at least 3 months per year for 2 years
COPD –> emphysema
pathologic accumulation of air in tissues
occurs as a results of prolonged respiratory difficulties
3 types of emphysema
centrilobular
panlobular
paraseptal
centrilobular emphysema
destruction in the bronchioles, usually in the upper lung
panlobular emphysema
destroys the air spaces of the entire acinus (lower lung)
paraseptal (paracinar) emphysema
destroys the alveoli in the lower lobes of the lungs
resulting in isolated blebs along the lung periphery
COPD emphysema pathogenesis
destruction of elastin in the lung that normally maintains the strength of the alveolar walls leads to permanent enlargement
COPD emphysema clinical manifestations
exertional dyspnea progresses to dyspnea at rest
cough is uncommon with little sputum production
pt is often thin, has tachypnea w/ prolonged expiration
must use accessory muscles for ventilation
COPD emphysema treatment
most important is cessation of smoking, pursed lip breathing, diaphragmatic breathing, pulmonary rehab and supplemental oxygen
lung transplantation
LVRS
AATD replacement
asthma
reversible obstructive lung disease characterized by inflammation and increased smooth muscle reaction of the airways to various stimuli
irreversible = COPD
asthma is an…
inflammatory response
produces bronchial smooth muscle spasm, vascular congestion, increases vascular permeability, edema formation, production of thick tenacious mucus and impaired mucocilary function