Week 6: COPD Flashcards
In emphysema we are having issues at the a____ ____ junction, so we are going to have an issue with _____
Alveolar- capillary
Diffusion
_____ of the gas exchange airways and difficulty with ____ due to decreased airway patency. There can also be an ____ issue which is why it’s classified under c__ ___ ___ ____
Enlargement
Expiration
Obstruction
Chronic obstructive pulmonary disorders
The _____ have become ____ in emphysema and fibrotic so they don’t release ___
CAPILLARIES
Thickened
Co2
____ is the number one reason people get emphysema
Smoking
A genetic deficiency of a___ _ _______ can lead to an early form of emphysema that is not ___ related
Alpha 1 antitrypsin
Smoking
A__ ___ occurs with emphysema. We are getting ___ in but are having trouble getting ___ out
Air trapping
O2
Co2
The breakdown of the ___ ___ leads to a loss of surface area for ___ ___. This will lead to a loss of ____ capillaries and mess up the ____ _____ ratio
Alveolar wall
Gas exchange
Pulmonary
Ventilation: perfusion
The ____ of some capillaries can lead to ___ airways, weakened walls, and interfere with the p___ ___ airflow
Fibrosis
Narrowed
Passive expiratory
As condition progresses person will start to trap air in the ____ and eventually increase their t____ ___ ___, leading to inflation and altered chest anatomy
Alveoli
Total residual volume
Barrel chest ap:t ratio
Is 1:1
Normal chest ap: t ratio
1:2
Person with emphysema may have f___ of ___ in respiratory position, b___ ___, and f___ ____
Fixation of ribs
Barrel chest
Flattened diaphragm
_____ occurs when the damaged walls of the aveoli collapse and join together forming large air spaces and then rupture
Pneumothorax
In advanced emphysema there is h___ and there is an increase in that h___ drive. The chronic levels of __ are going to shut off those chemoreceptors looking at ___ as our respiratory drive and turn on our ___ ___ receptors
Hypercapnea Hypoxic drive Co2 Co2 Peripheral o2 receptors
Patients with advanced emphysema are more prone to i___ due to compromised immune function
Infection
emphysema: Issues with p___ and v___ and lack of ___ can result in ___ ____. Leading to ___ ___ ____ and eventually ___ ___ ___ ___
Perfusion Ventilation O2 Pulmonary HTN Right ventricular hypertrophy Right sided heart failure
Cor pulmonary
R ventricular hypertrophy due to work against pulmonary HTN
In emphysema ___will begin to occur on _____. Eventually this will occur __ ___
Dyspnea
Exertion
At rest
emphysema: have ______ with prolonged ____ phase because they are trying to ____ off that ____
Hyperventilation
Expiratory
Blow
Co2
emphysema: called ___ ____ because they are _____. It is not necessarily an ___ issue so they will be more _____
Pink puffers
Hyperventilating
O2
Pink
Patient with emphysema will have ____ _____, and possibly ____ in late stages
Anorexia
Fatigue
Cynosis
A ___ and _____ will help determine the cause of emphysema if they are a smoker
History
Physical
For a non smoker, test ____ _ ____ enzyme levels. If its ___ - ___% lower than the expected value, they likely have an a___ ____ disorder leading to the enzyme deficiency.
Alpha 1 antitrypsin
10-15%
Autosomal recessive
Alpha 1 antitrypsin enzyme gets rid of the _____ enzymes that can be around the ______. If those enzymes remain they may degrade the _____ themselves
Proteolytic
Alveoli
Alveoli
emphysema: if FEV is less than ___% expected of their w___, h___, a___, and g___
30% Weight Height Age Gender
emphysema treatment: use the ______ to determine the ___ of the disease or ______
Spirometer
Progression
Exhasturbation
emphysema: in a _____ __-___ you can see h____
Chest x Ray
Hyperinflation
emphysema: An ABG will detect any h_____ or h_____
Hypercapnea
Hypoxemia
emphysema is ______, but we want to prevent further degreasing of the _____ and worsening of clinical manifestations
Irreversible
Alveoli
emphysema: avoid respiratory irritants such as ____
Smoking
Immunization against _____ and ____ is to prevent the patient with emphysema from getting an ____ and ___ respiratory tract infection, which will ___ their. emphysema
Flu Pneumonia Upper Lower Exhasturbate
Pulmonary rehab is structured ___ and ___ to optimize function. ____ ___ breathing and ____ position will help patient with emphysema expel ____
Diet Exercise Pursed lip Tripod Co2
Patient with emphysema may need b____ and s_____ just like a person with asthma. ______ will be given if infection is present. ____ therapy is provided as condition progresses
Bronchodilators
Steroids
Antibiotics
Oxygen
For emphysema patient with _____ of lung tissue some tissue might need to be removed to get rid of i___ and r____ v___
Hyperinflation
Inflation
Residual
Volume
Chronic bronchitis occurs with repeated ____ with ____ ____ that lasts for _ months or longer _ times in a _ year span
Infection
Chronic
Cough
3 months 2 times in a 2 year span
Chronic bronchitis is an _____ disorder that leads to ___ and difficulties getting __ our of the body and __ into the body
Inflammatory
Obstruction
Co2
O2
Primary etiology of Chronic bronchitis is ___
Smoking
___ areas where coming into contact with air pollutants may also lead to Chronic bronchitis
Urban
In Chronic bronchitis the ___ of the airways becomes ____ and the mucous glands are going to ______. there is going to _____ of them so there’s is going to be more ___ production
Mucosa Inflamed Hypertrophy Hyperplasia Mucous
Chronic inflammation can lead to f___ and thickening of the B__ wall so those large __ glands and large wall are going to start to close off the airway. This leads to low ___ levels, d___, and ____.
Fibrosis Bronchial Mucous O2 Dyspnea Fatigue
Chronic bronchitis:
As result of low oxygen levels, we are going to increase the amount of blood getting to the lungs to get more oxygen to. ___ ____ and eventually __ ____, and finally ___ ___ ___ ____
Pulmonary HTN
Cor pulmonale
Right sided heart failure
Emphysema is destruction to ____ ____ leading to reduced airway patency. Chronic bronchitis is no damage to ___ ___ but ___ of the ____ ____
Alveolar wall
Alveolar wall
Inflammation
Bronchial tree
The airway blockage in Chronic bronchitis is a result of ___ and ___ of the ___ membranes. Patient can have barrel chest due to ____ ____
Hypertrophy
Hyperplasia
Mucous
Air trapping
Patient with Chronic bronchitis will have a ___ ___ and ____ so they are constantly coughing up thick ____ sputum
Chronic cough
Infection
Purulent
On auscultation ___ and ____ might be heard in patient with Chronic bronchitis
Rhonci
Wheezing
Patient with Chronic bronchitis has __ ___ ___, t___, h___,h___ and ______
Shortness of breath Tachypnea Hypoxia/ Hypoxemia Hypercapnia Cyanosis
Chronic bronchitis patient is a “____ ____”
Blue bloated
Chronic bronchitis: due to poor oxygenation they are going to ___ the production of __ ____ ___ leading to p_____
Increase
Red blood cells
Polycythemia
Chronic bronchitis patient may have weight ___, c_____ ____, and c___ due to ___ and increase tissue in the fingers
Loss
Cor pulmonale
Clubbing
Chronic bronchitis:
____ and ____ needed for dx. ABG will test for ____ or ____ and changes in __ and ___ see how body is compensating.
History Physical Hypercapnea Hypoxia Co2 Bicarbonate
To diagnose Chronic bronchitis ___ and ___ pulmonary function tests can be done to determine progression. ____ ____ should also be tested
Fev1
Spirometery
Pulse oximetry
Treatment Chronic bronchitis:
Supplemental ____, ___ ___, chest _____, _____ rehab, ______ therapy can be used
O2 Smoking cessation Chest physiotherapy Pulmonary rehab Pharm therapy
If we give the patient with Chronic bronchitis too much oxygen to they body might think that they ___ have to ___. This might slow down their ___ and further exacerbate their symptoms. Prevent infections with ___ and ___ vaccines
Don't Breathe Respirations Influenza Pneumococcal
Emphysema is an abnormal ____ of the ___ ___ airways that is accompanied by the ___ of alveolar walls without any necessary ____
Enlargement
Gas exchange
Destruction
Fibrosis
