Week 5 Pulmonary Pathophysiology Part 1 Flashcards
chronic lower respiratory diseases are the ___ leading cause of death in the US
third
what are some forces that affect the work of breathing
airway compliance and elastic recoil of the lungs and chest wall, also airway resistance (mucus, bronchoconstriction and airway thickening)
what is compliance, and how does it affect work of breathing
compliance is the ability the lungs to change volume for a given pressure. the amount it can stretch. it is the change in volume over the change in pressure
what is the compliance like in a COPD patients vs a RLD patient
COPD: increased compliance, which can lead to air trapping. RLD: decreased compliance.
what are some ways we can asses lung function
lung volume/ capacity (PFT)
gas exchange (ABG and DLCO)
imaging (X-ray, ST scan, perfusion scan)
Function (6MWT, ETT)
what is the DLCO
it is the diffusion capacity of the carbon monoxide in the body. Give CO, then max inhale, hold for 10 seconds, then max exhale. look at the initial and final alveolar concentrations of CO.
what is the DLCO in normal or pathology conditions
normal: 80-100%
pulmonary pathology: less than 80%
DLCO is dependent on what 5 factors
- volume inspired
- pulmonary blood flow
- AC surface area
- hemoglobin
5 . thickness of AC membrane.
what are the common sequelae of chronic lung disease
right HF
pulmonary hypertension
a-fib
obstructive sleep apnea.
digital clubbing is most commonly caused by
lung cancer
TF: digital clubbing is always present
false
COPD is a problem with getting air ___
out
what is the FEV1/FVC ratio and the FEV1 values for COPD
FEV1/FVC: less than .7
FEV1: less than 80% predicted.
COPD is accompanied with increased or decreased compliance
increase
COPD is characterized by
persistence progressive airflow limitation with an enhanced chronic inflammatory response to noxious particles or gases.
most common risk factor for COPD is
tobacco smoking
what are the types of COPD
chronic bronchitis
emphysema
alpha 1 antitrypsin deficiency
asthma
what is chronic bronchitis
cough and sputum production in the winter, for most days of 3 months for 2 consecutive years.
what is emphysema
loss of alveolar walls, increased size of acinar airways in the upper lobe segments
what kind of pattern does emphysema create
centrilobular or centriacinar patters.
what is alpha 1 antitrypsin deficiency
genetic deficiency that gives you pacing emphysema and the lower regions of the lungs are affected first.
what is asthma
reversible bronchospasm with wheezing, short lived bouts. from plane or allergies.
what is some of the pathophysiology of emphysema
fibrotic and thin membranes
mucus hyper-secretion
alveolar walls destroyed
macrophages overtaxed and ruptured.
how is air trapped in COPD
there are collapse or narrowing in some of the airways, which makes it hard for air to leave, so you get trapped air.