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40 Cards in this Set
- Front
- Back
- 3rd side (hint)
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COPD
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dz stated characterized by airflow limitation that is not fully reversible
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airflow limitation
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progressive
assoc with an abnormal inflammatory response of the luings to noxious particles or gases |
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2 major forms of COPD
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chronic bronchitis
emphysema |
ce
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chronic bronchitis
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excessive mucus productxnby the tracheobronchial tree w/c results in airway obtruction due to edema and bronchial inflammation
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bronchitis
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chronic when pt has a cough producing more than 30ml of sputum in 24 hrs for at least 3 mos of the yr for 2 consecutive yrs
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emphysema
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permanent alveolar enlargement distal to the terminal bronchioles and destructive changes of the alveolar walls
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lack of uniformity in airspace enlargement
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loss of alveolar surface area
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collapse of small airways
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airflow limitation that is independent of exertion
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4th leading cause of death
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COPD
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COPD etiology
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cigarette smoking
exposure to irritants resp infxn bronchial hyperreactivity social,economic and hereditary factors |
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primary etilogic factor for COPD
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cigarette smoking
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alpha 1 antitypsin deficiency
(AAT) |
serine protease inhibitor
acute phase reactive protein inc risk for COPD |
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inhibition of neutrophil elastase
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major physiological fxn of AAT
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Smoking
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oxidizes methionine(Met) 358 and prevents AAT from binding with and inactivating elastase
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exposure irritants
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sulfur dioxide (polluted air)
noxious gases organic/inorganic dusts |
son
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respiratory tissue inflammation
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results in vasodilation
congestion mucosal edmea goblet cell hypertrophy these events trigger goblet cells to produce excessive amts of mucus |
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airway degenerate for chronic bronchitis
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causing exertional dyspnea
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sustain hypercapnia
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inc PACO2
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hypercapnia
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respiratpry rate or depth inc
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hypoxemia
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serves as the stimulus for breathing in chronic bronchitis
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lossof tissue elasticity
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anatomical chgs in emphysema
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air trapping in the alveoli
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inflammation
excessive mucus secretion |
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clusters of alveoli emerge
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# of alveoli diminish -> inc space available for air trapping
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destruction of alveolar walls
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collapse of small airways on exhalation and disruption of the pulmonary capillary beds
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specific lung regions in w/c anatomical chgs of emphysema occur
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centrilobular
panlobular paraseptal |
cpp
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centrilobular (centriacinar)emphysema
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assoc cigarette smoking,
destruction is central, selectively involving resp bronchioles bronchiles and alveolar ducts become dilated and merge |
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panlobular (panacinar) emphysema
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all lung segments are involved
enlarge alveoli and atrophy pulm vascular bed destroyed assoc with AAT deficiency |
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paraseptal emphysema
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lung periphery adjacent to fibrotic region is the site of alveolar distenetion and alveolar wall destruction
assoc with spontaneous pneumothorax |
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predominant chronic bronchitis
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chronic productive cough
exertional dyspnea obesity rhonchi wheezes on auscultation prolong expiration |
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chronic productive cough
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hallmlark of chronic bronchitis
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blue bloater
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develop cyanosis
chronic bronchitis |
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pink puffer
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emphysema
good oxygenation due to tachypnea |
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COPD diagnostic test results for chronic bronchitis
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bld analysis
sputum inspection arterial bld gas studies pulm fxn test chest radiograph ECG |
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diagnostic test results for emphysema
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bld analysis
sputum inspection arterila bld gas studies pulm fxn test chest radiograph |
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COPD list of trmt
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anticholinergics
b agonist theo corticosteroids abx mucolytics expectorants antioxidants vaccines |
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anticholinergics
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ipratropium br
tiotropium br atropine glycopyrrolate |
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1st line bronchodilators
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anticholinergics
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b agonist
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relieve dyspnea due to airway obstruction
inc mucociliary clearance by stimulating ciliary activity |
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order of resp sys
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Nostrils
Nasal cavity Pharynx (naso-, oro-, laryngo-) Larynx (voice box) Trachea (wind pipe) Thoracic cavity (chest) Bronchi (right and left) Alveoli (site of gas exchange |
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dz of resp sys
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Obstructive Diseases (e.g., Emphysema, Bronchitis, Asthma)
Restrictive Diseases (e.g., Fibrosis, Sarcoidosis, Alveolar Damage, Pleural Effusion) Vascular Diseases (e.g., Pulmonary Edema, Pulmonary Embolism, Pulmonary Hypertension) Infectious, Environmental and Other Diseases (e.g., Pneumonia, Tuberculosis, Asbestosis, Particulate Pollutants) |
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