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Chronic Obstructive Pulmonary Disease (COPD) (Diagnostics (Imaging tests (…
Chronic Obstructive Pulmonary Disease (COPD)
Etiology
Chronic Bronchitis
-Smoking
-Exposure to tobacco smoke (2nd hand)
-Environmental and occupational exposure to dust
-Pollution
Emphysema
-Smoking
-Inherited deficiency of alpha-1 antitrypsin protein
-Exposure to tobacco smoke (2nd hand)
-Air pollution
Pathophysiology
Inflammation
Sites of inflammation
-Airway epithelium
-Lung tissues
-Pulmonary blood vessels
Inflammatory cells
-Neutrophils
-CD8+
-T-lymphocytes
-B cells
-Macrophages
Inflammatory mediators
-Tumor necrosis factor alpha (TNF-α)
-Interferon gamma (IFN-γ)
-Matrix-metalloproteinases (MMP-6, MMP-9)
-C-reactive protein (CRP)
-Interleukins (IL-1, IL-6, IL-8)
-Fibrinogen
Pathologic & Structural changes
-Airway remodeling
-Narrowing of the airway
-Peribronchial fibrosis
-Goblet cell hypertrophy
-Build up of scar tissue
-Loss of lung tissue elasticity
-Small airways collapse during exhalation
-Impediment of airflow
-Air trapping
-Decreased lung capacity
Diagnostics
Imaging tests
-X-Rays
-Computed tomography scan (CT)
Laboratory test
-Arterial blood gas analysis (ABG)
Lung Function test
-Spirometry
Assessment
-Physical assessment
-Family history
-History of presenting symptoms
Epidemiology
-24 million people affected in the United States
-3rd leading cause of death
-Approximately 64 million cases world wide
-Women are twice as likely to be diagnosed
Treatment & Management
Lifestyle Modifications
-Smoking cessation
-Avoid respiratory irritants
-Avoid air polluted environment
-Avoid cold air
-Protect against respiratory infections
-Exercise regularly
Medications
-Bronchodilators
-Inhaled steroids
-Antibiotics
Therapy
-Pulmonary rehabilitation
-Nutrition therapy
-Supplemental oxygen
Surgery
-Lung transplantation
-Lung volume reduction
Clinical Manifestations
Persistent Cough
-With mucus production
-Without mucus production
-Increased mucus production
-Change in color and consistency of mucus
Activity intolerance
-Shortness of breath with activity
-Shortness of breath without activity
-Tachypnea
Physical appearance
-Cachectic thin frame
-Barrel chest
-Prolonged expiration
-Use of accessory muscles
-Leans forward when sitting
-Exhales through pursed lip breathing