Week Three - Case One Flashcards
what is COPD characterised by
airflow obstruction, most commonly a result of a combination of chronic bronchitis and emphysema
what is bronchitis
cough and sputum production on most days for at least 3 months during the last two years
what is emphysema
enlarged airspaces distal to the terminal bronchioles with destruction of the alveolar walls
what is different between asthma and COPD
there is little to no reversibility of the obstruction
the airflow limitation is usually progressive and is associated with an abnormal inflammatory response of lung tissues to certain particles
COPD is the ‘…..’ leading cause of death worldwide
COPD is the fourth leading cause of death worldwide
what is the FEV1;FVC ratio in COPD
<70%
how many people in the UK have COPD
1.5 million
when is COPD unlikely to develop
with a smoking history less than 10 pack years
what percentage of smokers will develop COPD
10-20%
up to 50% of those with a >20 pack year smoking history will get COPD
what are the other causes of COPD
Coal mining
Exposure to air pollution – particularly from indoor fires and cooking in the developing world
Genetic, i.e. α1 –antitrypsin deficiency causes emphysema
Low socioeconomic status and low birth weight are predisposing factors
Low birth weight is associated with reduce maximum lung capacity in adulthood
Asthma and COPD may also co-exist
what are the symptoms of COPD
Breathlessness (dyspnoea)
Cough – may or may not be productive (of sputum)
Regular exacerbations
what is the reduced cricosternal distance
<3cm
this is the distance between the cricoid cartilage and the sternal angle - this is reduced due to hyperinflation - thus the thorax is raised in relation to the cricoid cartilage
what are the signs of COPD
tachypnoea
use of accessory muscles in respiration
hyperinflation
reduced cricosternal distance
reduced chest expansion
resonant chest sounds
quiet breath sounds
wheeze
stridor
cyanosis
cor pulmonale
prolonged expiration
pursed lip breathing
where would there be quiet breath sounds
over areas of emphysematous bullae
what is wheeze
an abnormal high pitched or low pitched breath sound heard on expiration.
what does polyphonic wheeze mean
it is made up of many different notes, and thus this shows it is caused by many abnormal airways
what is wheeze normally caused by
abnormally narrowed airways
what is a monophonic wheeze indicative of
a single airway obstruction, and this is most likely to be a cancerh
what is stridor
the name for a sound heard on inspiration
what is stridor typically caused by
upper airway obstruction - such as croup
what is prolonged expiration due to
because their FEV1 is low, they have to have prolonged expiration to allow for adequate respiration
what is pursed lip breathing
it creates a smaller opening through which air can exit the respiratory system, keeps the pressure in the airways higher.
stops smaller airways from collapsing, and thus creates a larger surface area for gas transfer
what does pursed-lip breathing reduce
dyspnoea
what is the dynamic closure point in COPD
in COPD some of the airways will collapse at a point proximal to many of the alveoli
occurs due to the destruction of elastin tissue