Respiratory Disorders: COPD Flashcards
What is COPD?
Persistent widespread inflm of the a/w, parenchyma, and vasculature
How does inflm lead to obstruction in the a/w?
inflm–> exudate produced in lumen of a/w–> obstruction in a/w–> increase prod. of mucus from cells lining the a/w
xs mucus and exudate cause more obstruction and serious consequences
T or F: COPD is recurrent throughout lifetime and persist through life
T
If recurs, a/w obstruction is ____ but not _____
acute, persistent
T or F: COPD is a combination of disease
T
COPD includes _____ _______ and/or _______ and may be accompanied by ______
chronic bronchitis
emphysema
asthma
Is asthma preventable?
almost completely preventable–> YES
What is the parenchyma?
parenchyma = epithelial cells involved in gaseous exchange @ alveolar level
What is the vasculature?
vessels involved in gaseous exchange eg. pulmonary capillaries
Etiology/Risks of COPD (4)
- smoking
- ageing
- recurring infections
- alpha-1 anti-trypsin deficiency (genetic)
Etiology: What % of COPD is linked to smoking? How does smoking cigs cause COPD (4)?
80-90% of COPD is linked to smoking
smoking cigs contain irritants which increase mucus secretion, destroy cilia, produce chronic coughing, and induce inflm
Explain the 4 effects of cigarette smokes in COPD in details.
- irritants in cig smokes increase mucus production –>overwhelms of the cilia –> unable to sweep up harmful debris–> impede GE
- irritants in cig smokes damage cilia
- irritants in cig smokes induce chronic coughing
- Irritants in cig smokes induce inflm in resp tissues —> damage a/w and walls between alveoli–> decrease fxn of alveoli
Is chronic coughs beneficial? why?
NOOOOOOO
constant repetitive coughing damage the lining of a/w
coughing shoots 100km/hr of air damaging tissues w/ this force
Etiology: How does ageing contribute to COPD? (3)
d/t
- degenerative change of tissues
- decrease elasticity
- decrease compliance
Compliance is ________ proportional to elasticity. What does this mean? What happens if elasticity decrease?
inversely
one variable increase and other decrease
compliance increases
What is the definition of compliance?
the ease in which we fill and empty the lungs during breathing
What happens if there is too much or too little elasticity? How does elasticity relate to recoil? What happens if there is too much compliance
- lungs cannot fill or empty completely
- little elasticity = less recoil
more elasticity = more recoil - more compliance = less elasticity (air remain in the lungs) = more work of breathing
Etiology: How does recurrent infections contribute to COPD?
there is chronic hypersecretion of mucus + coughing + inflm damage
infection–> inflm–> tissue damage
Etiology: What percentage of alpha-1 anti-trypsin deficiency applies to COPD?
1% of people with COPD –> not a great risk from genetic perspective
Fig 29-7: What % is a severe compromised lumen? How? How is it simulated?
70-90% lumen compromised
d/t damage of the a/w resulting in hypertrophy
Simulated as trying to breathe from a straw
Fig 29-7: What happens when 50% of lumen is compromised?
wall of lumen is normal and elasticity is normal BUT it is filled w/ mucus –> only 1/2 amount of air can be carried or lungs is inflated 50% d/t hypersec of mucus
Fig 29-7: What happens when there is a loss of elastic tissue?
A = there is some degree of ____________ a/w and _________ decrease
compromised
compliance
Diagnosis of COPD (4)
- hx and px
- labs: CBC, CRP, and ABGs
- Pulmonary function test (PFT)
- Chest X-Ray (CXR)
What is assessed in COPD? (5)
- breath sounds
- SOB
- accessory muscle use
- ventilation issues
- arms propped on table to help ease of breathing
What is used during PFT?
spirometry
What is identified during PFT?
cause of obstruction (CB, emphysema, and asthma)
What is FVC?
forced vital capacity = total volume maximally and forcefully exhaled
What is FEV1?
forced expiratory volume = volume of air forcefully exhaled in one second
In COPD, do FVC and FEV1 increase or decrease? In a normal person?
both decrease
Healthy person should exhale at least 80% total vital capacity in one second
What is the total volume and tidal volume?
normal volume of air when no extra effort is used
What is found on CXR (3)? It is taken on _____ and ______ and compared
- consolidation
- damaged in lungs
- decreased volume of lungs
taken on inhalation/exhalation and compared
Treatment of COPD (5)
- manage prognosis
- drugs
- vaccines
- cessation of smoking
- avoid a/w irritants
Drugs are _____ based
staged
Damage in lung tissue decrease in ____ min of quitting smoking
20 minutes
What are 3 examples of a/w irritants?
- cigarette smoke irritants
- smoke fires
- strong odours
Manage prognosis by ________ modifications
lifestyle
Drugs: begin with least _____ and least ____ ______.
expensive and SE
What drugs are given in early stage? “B-adrenergic agonists” are ________. What is given in early stage that is more advanced?
short acting beta agonists (SABA) and anticholinergics
bronchodilators
Inhaled steroids
What is the MOA of SABA?
stimulate beta-2 adrenergic receptors in lungs –> activating adenylate cyclase to produce cyclic adenosine monophosphate (cAMP)–> triggers relaxation of bronchial smooth muscles
What is the MOA of anticholinergics?
bronchodilators that act by blocking acetylcholine receptors on the bronchi tree so PNS is not activated to release ACh –> results in bronchodilation
Classification of inhaled steroids used in advanced early stage? How? Function (3)
inhaled steriods –> long acting beta agonists
directly in respiratory tract
- decrease inflm by decreasing mediators released
- limiting WBS activity
- increase responsiveness of bronchial smooth muscle to B-agonists
What drugs are given in the late stage? What is it prescribed with?
Long acting beta agonist (LABA) prescribed w/ glucocorticoids
Give an Example of LABA? Fxns (2)? Which function is it used for?
Xanthine Derivatives –> THEOPHYLLINE
Function:
1. cause bronchodilators by increasing levels of cAMP to trigger smooth muscle relaxation
- anti-inflm properties –> not solely for this fxn but is beneficial to COPD to tx inflamed a/w
What happens when adrenaline binds to beta receptors in a/w?
stimulates the beta-1 and beta-2 receptors and increase HR, CO, contractile force of heart, cause bronchodilation, and raise BG.
What vaccines are used prophylactically? (2)
pneumococcal vaccine and flu shots
to prevent complications and prevent pneumonia caused by this virus
