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13 Cards in this Set
- Front
- Back
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Etiology - Exposures
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-Smoking/tobacco use
-Occupational dusts -Air pollution |
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Etiology - Host Factors
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-Hereditary a1-antitrypsin deficiency
-Airway hyperresponsiveness -Infancy or childhood lung impairments |
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Smoking
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-Promotes lung injury
-Stimulate inflammatory cells -Increase oxidative stress |
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Inherited a1-antitrypsin deficiency
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-Antiprotease enzyme that functions to protect the lung
-Deficiency leads to lung damage -Inhibits neutrophil elastase -1% of call COPD cases -More common in younger emphysema patients -Autosomal recessive disorder -Smoking further decreases the enzyme |
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Pathological changes
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-Inflammatory exudate
Increase goblet cells increase mucus decrease ciliary motility -thickening of smooth muscle and connective tissue -Scarring --> airway narrowing |
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Parenchymal changes
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-Affect gas-exchanging units
Alveoli & pulmonary capillaries -Smoking-related disease Centrolobular emphysema Affects the bonchioles Initial preservation of alveoli -AAT-related disease Panlobular emphysema Initial involvment of the peripheral alveoli Later expansion into bronchioles |
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Vascular changes
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-Thickening of pulmonary vessels
-Increase pulmonary pressure |
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Thoracic hyperinflation
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-Air trapping
-Leads to flattening of diaphram -Increases functional residual capacity Air left in lung after exhalation |
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Symptoms
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-Cough
-Sputum production -Dyspnea |
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Physical exam
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-Use of accessory muscles
-Increased resting respiratory rate -Barrel chest -Expiration through pursed lips -Shallow breathing |
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Arterial blood gas
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-Hypoxemia
-Hypercapnia -Cyanosis |
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Pulmonary function tests (PFT)
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-Airway obstruction --> Increase expiratory phase
-Forced Vital Capacity (FVC) Normal = 4-6 seconds Increased for COPD -Forced Expiratory Volume in 1 second Decreased in COPD -Increased total lung capacity |
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FEV1.0/FVC
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-<70% FEV1 - COPD
-Decreased in COPD -<70% with FEV1 of >80% Stage 1:mild FEV1 50-80% Stage 2: moderate FEV1 30-50% Stage 3: severe FEV1 <30% or 50% with respiratory failure or right heart failure = Stage 4: severe disease |
