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10 Cards in this Set
- Front
- Back
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Define what is meant by the term COPD |
-ill defined term for patients with chronic obstructive disease that may emcompass emphysema, chronic bronchitis, or a mixture of the two |
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Define emphysema and chronic bronchitis |
-emphysema- destruction of the lung tissue, enlargement of the air spaces distal to the terminal bronchiole with destruction of their walls -Chronic bronchitis- hypersecretion of mucus in the airways |
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Describe and explain the typical patterns of FEV1, FVC, FEV1/FVC, expiratory time, the flow volume curve, and lung volumes in COPD |
-reduced FEV1, FVC and FEV1/FVC values, increased expiratory time, a scooped out volume flow curve, and higher than normal lung volumes -TLC, RV, FRC -FVC is reduced because the airway closes prematurely during expiration at an abnormally high lung volume, leaving an increased residual volume (this also explains the shape of the scooped out graph) |
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Explain the mechanism of increased airway resistance in emphysema based on the relationship between airway conductance and elastic recoil pressure |
-The relationship between conductance and transpulmonary pressure for patients with emphysema is almost normal -this means that almost their entire ventilatory capacity almost entirely on the of the smaller elastic recoil -this reduces the effective driving pressure during an expiration and also allows the airway to collapse more easily because of the loss of radial traction |
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WHat is the typical clinical presentation on Type A COPD, blood gas values, and the mechanism of hypoxia associated with it? |
-Pink puffers -increasing dyspnea over years - little or no cough -marked chest overexpansion -no cyanosis -quiet breath sounds -normal jugular venous pressure - no peripheral edema -Arterial PO2 only moderately depressed -Arterial Pco2 Normal |
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What is the typical clinical presentation onType B COPD, blood gas values, and the mechanism of hypoxia asociated with it. |
Blue bloaters -increasing dyspnea over the years -frequent cough with sputum -moderate or no increase in chest volume -cyanosis -rales and rhonchi - raised jugular venous pressure -peripheral edema -PO2 often very low -PCO2 often raised
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What are the two mechanisms that may reduce the amount of ventilation perfusion inequality in COPD
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-hypoxic vasoconstriction and collateral ventilation reduce the amount of ventilation-perfusion inequality in COPD |
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Explain why the arterial PCO2 is often normal in patients with mild to moderate COPD but patients with sever COPD have CO2 retention |
-vastly increased work of breathing |
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Describe the likely findings regarding measurement of diffusion capacity in emphysema and chronic bronchitis |
-diffusion capacity is reduced in emphysema but may be normal in chronic bronchitits |
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Explain why pulmonary arterial pressure can be incrreased in COPD |
- Pulmonary arterial pressure can be elevated in COPD due to the destruction of the vascular beds and because of hypoxic vasoconstriction |
