NURS 6501 Pathophysiology COPD Exam Walden University

What is Chronic Obstructive Pulmonary Disease (COPD)? A grouping of lung diseases that damage the small or large airways permanently increasing lung compliance (Varying degrees of symptoms and exacerbations between patients. Main forms are chronic bronchitis and emphysema) Does smoking cause COPD? No, but because of the way it interacts with the lungs it significantly increases the chances that it will be developed. What are 6 diseases that are frequently associated with a COPD diagnosis? Osteoporosis, cardiovascular disease, skeletal muscle dystrophy, lung cancer, depression, and anxiety What are the 3 ways that emphysema changes the lungs? (Airways and lung parenchyma) Oxidative stress, airway remodeling, and enzyme-enzyme inhibitor imbalance What are the 2 ways that chronic bronchitis changes the lungs? (Airway and lung parenchyma) Airway remodeling and hypersecretion of mucous How does emphysema cause oxidative stress? Cigarette smoke and particulates destroy the cells of the lungs. This signals an inflammatory response where white blood cells release enzymes to break the particles down causing further cell damage in the process. All of this cell damage releases free radicals (highly reactive oxygen compounds that indiscriminately destroy cells) further enhancing the cell damage. How does emphysema cause airway remodeling? Constant damage to the tissues causes smooth muscle generation (tougher cells to protect against further damage) where it doesn't belong. This leads to fibrotic changes to the airways, decreasing the airway lumen. (Increasing resistance) How does emphysema cause enzyme-enzyme inhibitor imbalance? Methionine sulfate is produced in response to cigarette smoke which reduces the activity of alpha 1 antitrypsin (enzyme for enzymes) allowing for increasing number of proteases (enzymes for proteins) that damage cells How does chronic bronchitis cause airway remodeling? Constant inflammation causes enlargement of mucous glands and a thickening of the airway walls. How does chronic bronchitis cause hypersecretion of mucous? Constant inflammation and damage leads to an increase in secretion and viscosity of mucus. The products of inflammation and smoke particles impair ciliary function, resulting in decreased mucous clearance What are 4 common symptoms of COPD? Persistent productive cough, increased production of mucous, PROGRESSIVE dyspnea, and muscle fatigue Are the lung changes caused by COPD permanent? Yes What is a basic way to describe emphysema? The destruction of alveolar surface area leading to floppy (low elasticity) alveoli. (Increased compliance and poor diffusion in late stages = air trapping) What is panlobular emphysema? Destruction of the distal (end/tip) of alveoli caused by alpha 1 antitrypsin deficiency. (Aka lack of enzymes that stop inflammation from damaging healthy cells) What is centrilobular emphysema? Destruction of the proximal alveoli (close to the bronchi) caused by smoking or inhaling large particles. What is a basic way to describe chronic bronchitis? The presence of cough and sputum production for at least 3 months in each of two consecutive years