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40 Cards in this Set

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COPD
dz stated characterized by airflow limitation that is not fully reversible
airflow limitation
progressive
assoc with an abnormal inflammatory response of the luings to noxious particles or gases
2 major forms of COPD
chronic bronchitis
emphysema
ce
chronic bronchitis
excessive mucus productxnby the tracheobronchial tree w/c results in airway obtruction due to edema and bronchial inflammation
bronchitis
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
emphysema
permanent alveolar enlargement distal to the terminal bronchioles and destructive changes of the alveolar walls
lack of uniformity in airspace enlargement
loss of alveolar surface area
collapse of small airways
airflow limitation that is independent of exertion
4th leading cause of death
COPD
COPD etiology
cigarette smoking
exposure to irritants
resp infxn
bronchial hyperreactivity
social,economic and hereditary factors
primary etilogic factor for COPD
cigarette smoking
alpha 1 antitypsin deficiency
(AAT)
serine protease inhibitor

acute phase reactive protein

inc risk for COPD
inhibition of neutrophil elastase
major physiological fxn of AAT
Smoking
oxidizes methionine(Met) 358 and prevents AAT from binding with and inactivating elastase
exposure irritants
sulfur dioxide (polluted air)
noxious gases
organic/inorganic dusts
son
respiratory tissue inflammation
results in vasodilation
congestion
mucosal edmea
goblet cell hypertrophy

these events trigger goblet cells to produce excessive amts of mucus
airway degenerate for chronic bronchitis
causing exertional dyspnea
sustain hypercapnia
inc PACO2
hypercapnia
respiratpry rate or depth inc
hypoxemia
serves as the stimulus for breathing in chronic bronchitis
lossof tissue elasticity
anatomical chgs in emphysema
air trapping in the alveoli
inflammation
excessive mucus secretion
clusters of alveoli emerge
# of alveoli diminish -> inc space available for air trapping
destruction of alveolar walls
collapse of small airways on exhalation and disruption of the pulmonary capillary beds
specific lung regions in w/c anatomical chgs of emphysema occur
centrilobular
panlobular
paraseptal
cpp
centrilobular (centriacinar)emphysema
assoc cigarette smoking,
destruction is central, selectively involving resp bronchioles

bronchiles and alveolar ducts become dilated and merge
panlobular (panacinar) emphysema
all lung segments are involved
enlarge alveoli and atrophy
pulm vascular bed destroyed
assoc with AAT deficiency
paraseptal emphysema
lung periphery adjacent to fibrotic region is the site of alveolar distenetion and alveolar wall destruction
assoc with spontaneous pneumothorax
predominant chronic bronchitis
chronic productive cough
exertional dyspnea
obesity
rhonchi
wheezes on auscultation
prolong expiration
chronic productive cough
hallmlark of chronic bronchitis
blue bloater
develop cyanosis

chronic bronchitis
pink puffer
emphysema

good oxygenation due to tachypnea
COPD diagnostic test results for chronic bronchitis
bld analysis
sputum inspection
arterial bld gas studies
pulm fxn test
chest radiograph
ECG
diagnostic test results for emphysema
bld analysis
sputum inspection
arterila bld gas studies
pulm fxn test
chest radiograph
COPD list of trmt
anticholinergics
b agonist
theo
corticosteroids
abx
mucolytics
expectorants
antioxidants
vaccines
anticholinergics
ipratropium br
tiotropium br
atropine
glycopyrrolate
1st line bronchodilators
anticholinergics
b agonist
relieve dyspnea due to airway obstruction

inc mucociliary clearance by stimulating ciliary activity
order of resp sys
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
dz of resp sys
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)