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WEEK 2, The disease in the lungs that cause low oxygen level leading to…

- - - - Feeling better
      - Getting healthier
      - Sparing your loved ones from secondhand smoke
      - Saving money
  - - - such as
        
        bupropion (Zyban)
        
        varenicline (Chantix)
- - - - pink puffers
  - - - using oxygen due to the association of COPD with smoking
- - - - Causes
        
        Unknown
        
        affects the distal part of acinus, mainly seen in the periphery of the lungs
    - - Caused by
        
        A1AP deficiency
        
        It affects the lower lobe of the lungs
    - - Caused by
        
        Smoking
        
        It affects the upper lobe of the lungs
  - - - It is
        
        Cor -->🫀
        
        Pulmonale --> 🫁
      - Causes
        
        COPD
        
        Massive PE
        
        CF
        
        Severe Bronchiectasis
        
        obstructive sleep apnea
        
        Idiopathic
      - Pathophysiology
        
        1- Low O2 level in the alveoli ( due to lung disease) --> Ventilation / perfusion mismatch --> Vasoconstriction of PA --> ⬆️ P -- ⬆️ R -- ⬇️blood flow
        
        2-Hypoxia / smoking --> endothelial dysfunction
        
        Vascular mediators
        
        ⬆️ ET -1
        
        ⬆️ PDGF A - B
        
        ⬇️ NO
        
        ⬆️ Pulmonary vascular resistence - ⬆️ Pulmonary arterial pressure - ⬆️ RV work --> right ventricular enlargement ( Dilation - thickening )
      - Clinical presentation
      - Management
        
        O2 therapy
        
        Diuretic
        
        Change life Style
- - - - due to
        
        increase the pressure in the polmunary artery
    - - caused by
        
        Cor pulmonale
        
        water retention
    - - due to
        
        increase of pressure in the right side of the heart
  - - - measures the (pH) and the levels of oxygen and carbon dioxide in the blood from an artery.
        
        pH - < 7.40
- - - - can be caused by
        
        Anaphylaxis
        
        Cardiac tamponade
        
        Heart attack
        
        Pneumothorax
        
        Pulmonary embolism
        
        Upper airway obstruction
        
        COVID-19
    - - can be caused by
        
        Asthma
        
        COPD
        
        Heart dysfunction
        
        Interstitial lung disease
        
        Obesity
        
        Pleural effusion
- - - - Trachea
      - Bronchi
        
        has three levels:
        
        R/L secondary bronchi
        
        R/L tertiary bronchi
        
        R/L primary bronchi
        
        Bronchioles
        
        types
        
        Conducting bronchioles
        
        Respiratory bronchioles
      - Alveoli
        
        cells present on alveoli:
        
        Macrophages
        
        Pneumocyte
        
        type 1
        
        Thin lining
        
        type 2
        
        secret surfactant
        
        basic structural unit facilitating gas exchange
      - lungs
        
        left lung
        
        2 lobes:
        
        superior lobe
        
        inferior lobe
        
        has only 1 fissure:
        
        oblique fissure
        
        cardiac notch
        
        right lung
        
        consist of 3 lobes:
        
        middle lobe
        
        inferior lobe
        
        superior lobe
        
        has 2 fissure:
        
        horizontal fissure
        
        oblique fissure
  - - - Ribs
        
        types:
        
        true ribs
        
        false ribs
        
        floating ribs
        
        protect the vital organs found in the thorax and provides attachment to some muscles that helps you to breath
      - Sternum
        
        manubrium
        
        Sternal body
        
        xiphoid process
    - - Includes :
        
        Serratus posterior muscles
        
        attached to the bony framework of the thoracic cage.
        
        They maintain
        
        the stability of the thoracic wall, and play a role in respiration.
        
        Levatores costarum muscles
        
        Intercostal muscles
        
        Subcostal muscles
        
        Transversus thoracis muscles
- - - - Moderate
        
        Add one or more long-term bronchodilators
        
        Add pulmonary rehabilitation
        
        which
        
        improve knowledge of lung condition
        
        reduce exacerbations
        
        increase the exercise tolerance
      - Severe
        
        Add inhaled steroids in case of repeated exacerbations
      - Mild
        
        Vaccinations
        
        Pneumococcal
        
        Influenza
        
        Pertussis
        
        Short-term bronchodilators when needed
        
        Stop smoking
      - Very severe
        
        Add long-term oxygen therapy
        
        May consider surgical treatment
- - - - due to
        
        increased tobacco use among women in high-income countries
        
        the higher risk of exposure to indoor air pollution
- - - - Caused by
        
        Chronic inflammation leading to hyperproliferation and malignant mutations
    - - Could be
        
        Left-sided
        
        Hypoxia caused by COPD makes the heart work harder
        
        Right-sided
        
        Cor pulmonale
    - - Due to
        
        Rupture of alveolar walls and leakage of air into the pleural space
    - - Such as
        
        URTI (Cold, Flu)
        
        LRTI (Pneumonia)
        
        Caused by
        
        A number of viruses, bacteria, and fungi. Most commonly: Streptococcus pneumoniae
        
        Which is
        
        Gram positive, alpha hemolytic bacteria
      - Due to
        
        Chronic inflammation and impaired immune responses
    - - Due to impairment of daily activities and SOB
    - - Which is
        
        Hypoxia (PaO2 less than 60 mmHg) or hypercarpnia (PaCO2 more than 50 mmHg).
      - Has 2 types
        
        Type 1
        
        Due to impaired gas exchange between the alveloar spaces and capillaries
        
        Type 2
        
        Due to decreased amount of air entering the lungs