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image (Clinical Manifestations image (Cough, Dyspnea, Expiratory…
Epidemiology
Fourth leading cause of death in the United States
More prevalent in women
More common in lower socioeconomic classes
3 million deaths in 2015
Clinical Manifestations
Cough
Dyspnea
Expiratory Wheezing
Chronic hypoventilation
Barrel chest
Prolonged expiration
Cynosis
Polycythemia
Cor pulmonale
Risk Factors
Smoking
A1-antirypsin gene
Inside and outside air pollutants
Second hand smoking
Diagnosis
Auscultation
Physical Assessment
ABGs
PFTs
H&P
Treatment
Antitussives
Bronchodilators
steroids
mucolytics
phosphodiesterase inhibitors
anticholinergics
supplemental oxygen
Severe cases may require lung resection (emphysema)
Severe cases may require mechanical ventilation (chronic bronchitis)
Pathophysiology
Chronic Bronchitis
Inspired irritants
Airway inflammation causing edema increased goblet cells and smooth muscle hypertrophy.
Impaired ciliary function
Thick mucus build up and narrowed airways
Emphysema
Breakdown of elastin
Destruction of lung structural cells
Increase in air spaces (bullae) and (blebs)
Insufficent gas exchange
Air trapping
