COPD Flashcards

1
Q

Pathophysiology

A

combination of chronic bronchitis, emphysema and potentially asthma

CB

  • chronic irritation and inflammation of the epithelium
  • results in mucus gland hypertrophy and hypersecretion
  • results in destruction of ciliated epithelium which is replaced with non-ciliated cells
  • results in overall impairment to MCC
  • bronchial wall hypertrophy - thickening of the airways and increased propensity for bronchospasm

Emphysema

  • exposure to toxins = destruction of elastin = lost elastic recoil
  • reduced area for gas exchange
  • small airway walls become floppy and collapse
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2
Q

Clinical Implications

A
airflow limitation 
impaired airway clearance 
impaired gas exchange 
dyspnoea 
reduced exericise tolerance 
musculoskeletal dysfunction 
respiratory muscle dysfunction 
abnormal breathing pattern
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3
Q

Clinical Features

A
Hyperinflation - barrel chest, CXR changes 
Reduced BS throughout the lungs with ausc
Abnormal breathing pattern 
- accessory muscle use 
- upper chest breathing 
- pursed lip breathing 
- prolonged expiration 
chronic cough 
oxygen desaturation on pulse oximetry 
reduced functional exercise capacity 
reduced general muscle strength 
adopt positions for breathlessness for extended periods of time 
issues with incontinence
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4
Q

Medical Management

A
aimed at slowing deterioration and optimising QOL 
smoking cessation 
pharmacology - vaccinations, puffers 
surgical interventions 
oxygen therapy 
ventilatory support
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5
Q

COPD-X Plan

A

C - confirm diagnosis and assess severity
O - optimise function
P - prevent deterioration
D - develop support network and self-management
X - manage exacerbations

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6
Q

Physio Management

A
spirometry assessment 
time treatment to be post inhaled therapies 
exacerbation management - sputum, breathlessness etc. 
pulmonary rehab 
dyspnoea management 
airway clearance 
continence screening 
education
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