Chronic obstructive pulmonary disorder (COPD)

Question 1

What is COPD?

Answer 1

COPD is a progressive disease that makes it hard to breathe.It can cause coughing that produces large amounts of mucus, wheezing, shortness of breath, chest tightness, and other symptoms.

Question 2

Phase two of breathing

Answer 2

• diaphragm contracts
• thoracic volume increases and lungs EXPAND
• air pressure within lungs is less than atmospheric pressure

Question 3

Phase three of breathing

Answer 3

• diaphragm relaxes
• air flows out of the lungs
• thoracic volume decreases and lungs RECOIL
• air pressure within the lungs is larger than atmospheric pressure

Question 4

Inspiration

Answer 4

Active, volume increases and pressure decreases

Question 5

Expiration

Answer 5

Passive, uses intercostal and abdominal muscles

Question 6

How is breathing controlled?

Answer 6

By the medulla and pons in the respiratory centre. It is sensitive to positive and negative stimuli

Question 7

What % are the central chemoreceptors in the medulla responsible for?

Answer 7

70%

Question 8

What % in the peripheral chemoreceptors in the carotid and aortic bodies responsible for?

Answer 8

30%

Question 9

Obstructive respiratory disorders are defined by narrowing and obstruction of the airways. What are some examples?

Answer 9

Asthma, cystic fibrosis, COPD, and bronchitis

Question 10

Restrictive respiratory disorders are defined by less room for the lungs to expand in the thoracic cavity. What are some examples?

Answer 10

Pneumothorax, pulmonary fibrosis, scoliosis, respiratory muscle dysfunction

Question 11

Stridor

Answer 11

High pitched sound on inspiration, usually caused by obstruction to the larynx.

Question 12

Grunting

Answer 12

Associated with neonates. Usually indicates their respiratory function is decreasing

Question 13

Snoring

Answer 13

Usually normal. but in semi-conscious patient it may indicate the tongue is blocking the airway

Question 14

Wheezing

Answer 14

Commonly occurs on respiration, associated with asthma.

Question 15

Rattly chest

Answer 15

Build up of fluid in the lungs. Associated with pulmonary oedema.

Question 16

Risk factors for COPD

Answer 16

smoking, air pollution, second hand smoke, frequent chest infections, genetics

Question 17

COPD is exemplified clearly best by……

Answer 17

chronic bronchitis, and obstructive emphysema

Question 18

Chronic bronchitis

Answer 18

Associated with increased airway resistance from continual brochial irritation and inflammation.

• mucus secretion and narrowing of airways reduces airflow
• cannot properly expire from lungs, air becomes trapped

Question 19

Emphysema

Answer 19

Decrease lung elasticity and increased compliance.

• break down of elastin in connective tissue in lungs - airways are prone to collapse during respiration
• no elastic re-coil so harder to generate pressure to drive expiration
• expiration ends prematurely, and air becomes trapped

Question 20

What happens when air becomes trapped?

Answer 20

Trapped air increases residual volume and functional residual capacity. This decreases vital capacity.

Question 21

Routine lab tests for COPD admission

Answer 21

sputum sample, blood gases and pH, ECG, chest x-ray, pulmonary function testing.

Question 22

Other lab tests

Answer 22

Arterial blood gases, pulse oximetry, peak expiratory flow, blood plethysmography, forced expiratory volume, diffusing capacity, and sputum culture

Question 23

How does smoking cause COPD?

Answer 23

• stiffening of air sacs
• deterioration of the walls between the air sacs
• thickening and inflammation of the airway walls
  This lung damage restricts airflow into and out of the lungs.

Question 24

Why is nutrition important in regards to COPD?

Answer 24

weight loss can result in reduced muscle mass in the respiratory muscles. This can exacerbate breathlessness.

Fluid intake can help COPD patients cough up sputum.