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Pathophysiology: COPD

Terms in this set (20)

Chronic Obstructive Pulmonary Disease

(a disease that results in a gradual loss of lung function)
What does COPD stand for?
chronic bronchitis and emphysema
What 2 conditions are associated with COPD?
Chronic bronchitis
Identify term:
a condition in which the bronchi in the lungs are constantly swollen and clogged with mucus
a) Excessive secretions
· Increase in # of goblet cells
· Hypertrophy (enlargement) of submucous glands
· Mucus hypersecretion --> greatly increase production in larger airways
· Caused by inhaled materials (toxins, irritants, noxious fumes, chemicals)
b) Chronic inflammation - constant recruitment & activity of WBCs to regions in the lungs (due to presence of foreign material)
· Leads to tissue damage
c) Damaged cilia - can't function normally to clear foreign material out of airways
d) Fibrosis - presence of fibrous connective tissue in locations of airways due to tissue injury (scar tissue)
· Build up leads to obstruction of airway
Chronic bronchitis involves what 4 factors?
· Increased secretions & pus in airways, swelling of mucus membrane
· Severe narrowing of airway
· Obstruction of air passage (not enough air into lungs)
What is the final result when someone has Chronic bronchitis? (3 things)
(b - c) / (a - d) = 0.4 is normal, 0.7 is severe bronchitis
What is the reid index formula?
Reid index
Identify term:
the ratio of the thickness of the mucous gland layer in the bronchial wall submucosa to the thickness of the bronchial wall BETWEEN THE RESPIRATORY EPITHELIUM AND BRONCHIAL CARTILAGE.

progressive mucous gland enlargement is the major contributor to this thickness increase in bronchitis
Emphysema
Identify term:
- A condition in which the air sacs of the lungs are damaged and enlarged, causing breathlessness

-Tissue destruction of alveoli that leads to irreversible enlargement
a. Activation of immune system that leads to recruitment of inflammatory cells to alveoli
· Release of elastase & oxidants that cause tissue damage --> disintegration of alveolar wall
b. Fusion of alveoli: loss of many small airspaces & creation of large air sacs
c. Loss of elasticity: loss of radial traction which leads to the narrowing of bronchioles
· Radial traction keeps bronchiole lumen open via tension from normal, elastic alveoli
In 3 steps, describe the progression of emphysema
· Reduced surface area of lung
· Bronchiole narrowing less efficient breathing can't exhale completely
· Lungs are unable to remove O2 poor air due to loss of elasticity & recoil so old air gets trapped within swollen inelastic lungs
Describe the 3 results of emphysema on the respiratory system
1. Persistent cough & sputum production (for at least 3 months)
2. Hypoxemia: cyanosis (blue tint) of skin/lips due to inability to oxygenate the blood (blue bloaters)
3. Peripheral edema: excess fluids in extremities
Describe the 3 Symptoms & Signs of Chronic Bronchitis
1. Symptoms not present until at least 1/3 of lungs is damaged
2. Dyspnea: difficult /labored breathing; shortness of breath
3. Weight loss due to high energy expenditure to breath
4. Breathing in hunched position thru pursed lips
5. Prolonged expiration
6. Impaired expiratory flow (can't exhale easily)
7. Digital clubbing
8. Overdistention: barrel chest (pink puffers)
· Due to loss of elasticity in alveoli
Describe the 8 Symptoms & Signs of Emphysema
1. X-ray (coupled with CT scan)
2. CT scan
3. Blood test to determine how well the body is removing CO2
4. Spirometer - instrument that measures lung volume
Name the 4 ways to test for COPD
1. Cigarette smoking: 80 - 90%
2. Marijuana smoking (long inhale means more tar exposure)
3. Environmental & occupational pollutants / irritants
4. Airway hyper-responsiveness due to asthma
5. Genetics
Name the 5 causes of COPD
Smog, coal mine dust, chemical fumes, cotton fibers, silica, grain
Name 6 examples of environmental & occupational pollutants that can contribute to COPD
· 1% of emphysema patients have a defect called alpha1-antitrypsin deficiency
o alpha1-antitrypsin - protease inhibitor that inhibits activity of elastase (& other proteins that are released by immune cells)
· Genetic variants of receptors thought to be involved in addiction to smoking
Give 2 examples of genetic factors that can contribute to COPD
alpha1-antitrypsin
Identify this enzyme:
protease inhibitor that inhibits activity of elastase (& other proteins that are released by immune cells)
1. Quit smoking / avoid environmental pollutants
2. O2 therapy
3. Long acting bronchodilators with inhaled corticosteroids (anti-inflammatory)
4. Physical therapy - teach different breathing techniques
5. Bullectomy - surgical removal of overinflated airspaces
6. Removal of non-functioning or damaged lung tissue
7. Lung transplant
8. alpha1-antitrypsin replacement therapy being investigated (in the process of being tested)
Name 8 possible treatments for COPD
Heart failure
COPD eventually leads to what?
Bullectomy
Identify term:
a procedure to remove an air pocket from the lung that has resulted from several years of COPD. Bullae are air pockets in the lung that form from tissue destruction as a result of cancer, COPD, emphysema, etc.
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