COPD Definition - -Life Threatening lung Total deaths are projected to increase by 30% in
disease that interferes with normal breathing - the next 10 years as a result of the baby boomer
not just a "smokers cough." It is a progressive generation.
disease state characterized by airflow limitation Affects men and women equally.
that is not fully reversible 50% of smokers are affected
Mixture of: 80% of diagnosed patients have significant
-Airway disease exposure to tobacco smoke.
-Parenchymal destruction
-Abnormal pulmonary inflammation response
Resulting in: COPD Causes and Risk Factors - -Host
-Chronic inflammation factors
-Lung elastic recoil decreases -Genetic predisposition - hereditary deficiency of
-Expiratory small airway collapse a-1-antitrypsin glycoprotein
-Airway hyper-responsiveness
-Retarded lung growth
COPD - -Combination of Chronic Exposures
Bronchitis and Emphysema -Tobacco somke
-Occupational dusts and chemicals
-Environmental exposures
Chronic Bronchitis - -Excessive bronchial
mucus.
Daily productive cough >3 months in 2 COPD Pathophysiology - -Can cause
consecutive years. fibrosis at the bronchial lining
Bronchiolar fibrosis Hypertrophy of smooth muscle cells
Hyper-responsiveness Breakdown of alveolar walls - Honeycomb to
Excessive mucus production balloon
- hypertrophy of mucosal glands Stimulation of goblet cells to produce more
- Increase in number of goblet cells mucus.
- Inflammatory infiltration
Emphysema Airway - -
Emphysema - -Abnormal permanent
enlargement of air space distal to terminal
bronchiole. Emphysema Clinical Presentation - -
Destruction of alveolar walls without obvious Hyperinflation of the lungs helps to prevent
fibrosis. respiratory bronchioles from collapsing
Loss of elastic recoil leads to increased lung
compliance.
Genetic risk factor *Alpha-1-antitrypsin Cor Pulmonale - -Enlargement of the right
deficiency*- may not ever smoke. side of the heart due to high blood pressure in
the pulmonary blood vessels, usually caused by
chronic lung disease.
COPD Epidemiology - -2004 - 64 million Associated with Chronic Bronchitis
cases worldwide, accounting for 6-10% of adult
population
2005 - 3 million related deaths (5% of all deaths)
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