Respiratory conditions Flashcards
Causes of COPD
Smoking
Dust inhalation
Outdoor air pollution
Childhood respiratory conditions
What is COPD
Disease characterized by persistent airflow limitation
Pathophysiology of COPD
Inhaling noxious particles
Causes mucus gland hypertrophy
Causing increased mucus production
Destruction of ciliated epithelial cells in airway walls
Chronic inflammatory changes, narrowing in small airways
Increase in bronchial smooth muscle, which induces airway narrowing and bronchial inflammation
Loss of alveolar walls
Results of destruction of cilia (COPD)
Increase sputum production
Reduced mucociliary clearance
Consequences of pathophysiology (COPD)
Airflow limitation and lung hyperinflation Gas exchange abnormalities Dyspnoea Reduced exercise tolerance Skeletal muscle dysfunction Reduced cardiac output
Airflow limitation and lung hyperinflation (COPD)
Airflow limitation causes gas trapping
Which causes lung hyperinflation
Which places diaphragm in shortened flat position
Therefore reduces its contribution to ventilation
Gas exchange abnormalities (COPD)
Due to capillary bed destruction
Causes increased physiological dead space and V/Q mismatch
V/Q mismatch causes oxygen desaturation and therefore increases ventilatory demand and dyspnoea
Dyspnoea (COPD)
Dyspnoea due to hyperinflation and gas exchange abnormalities
Cause of CF
Mutations in CFTR
Causing reduced secretion of chloride and water
Leading to dehydrated mucus
What treatment is integral in CF?
ACBTs
Benefits mucus transport
CF symptoms
Breathlessness
Reduced exercise capacity
Productive cough
Possible haemoptysis
Exercise and CF
Preserve lung function
Increase FEV and peak expiratory flow rate
Facilitate secretion clearance
Should exercise several times per week
Inhalation therapy in CF
Nebulised hypertonic saline
Draw fluid to airway surface
Improve mucociliary clearance
CF with haemoptysis
Avoid high pressure PEP and head down tilt
Modify or withhold ACT’s
Other training in CF
Weight bearing to maximise bone health
People with CF prone to osteoporosis/fractures
Reduced cardiac output consequence (COPD)
Reduced Q limits blood supply and oxygen to the working muscles
Which can cause early onset of lactic acidosis
COPD treatments
Bronchodilators Lung volume reduction surgery Long term continuous oxygen therapy to manage hypoxaemia NIV used to manage respiratory failure Breathing exercises, ACT's
What is an exacerbation of COPD
Characterized by a change in baseline dyspnoea, cough and/or sputum production that is beyond their normal and is acute.
Pathophysiology of Bronchiectasis
Damage to the cilia Bacteria remains in airway Stimulates host inflammatory response Which damages the bronchial walls And leads to dilation of bronchi Leads to cycle where clearance of secretions from dilated bronchi is impaired, secretions become infected, which produces an inflammatory response which results in a progressive destructive lung disease.
Bronchiectasis treatment
Hypertonic saline- reduced mucus viscosity, increased sputum clearance and improved lung function
Mannitol- enhance mucociliary clearance
ACBT, PEP and postural drainage to aid secretion clearance
Exercise to improve exercise capacity
What is asthma?
Widespread inflammation and airway narrowing
Pathophysiology of asthma
Antigen-antibody reaction degranulates mast cells which causes bronchoconstriction.
Symptoms of asthma
Wheezing Cough Breathlessness Chest tightness Hyperinflation Use of accessory muscles
Asthma treatment
Exercise training- increase aerobic capacity to reduce stimulus for exercised induced asthma
