Chronic Obstructive Pulmonary Disease



Chronic Obstructive Pulmonary Disease
Chronic Obstructive Pulmonary Disease 

Definition:

A group of respiratory disorders affecting the expiratory airflow, inspiratory airflow might be affected.

Example:

1. Chronic Bronchitis.

2. Pulmonary Emphysema.

Causes:

- Excessive accumulation of mucus and secretions block the airway as in bronchitis and bronchiolitis.

- Destruction of the walls of the alveoli leads to impaired CO2, O2 exchange as in emphysema.

Related factors :

- Genetic: lake of enzyme inhibitors that prevent the destruction of lung tissue by certain enzymes.

Environmental: as smoking, respiratory infection.

Air pollution, and allergy.

The process takes 20-30 years to develop, it progresses slowly, and the result is impaired ventilation.


Chronic Bronchitis:

Definition:

A serious disease that is characterized by hypersecretion of mucus by the bronchial glands as well as chronic or recurrent respiratory infection.

Aetiology:

Air pollution

Cigarette smoking

Chronic infection of the airway.

Signs and symptoms:

1. Chronic productive cough.

2. Thick white mucus that might change to purulent copious and blood-streaked mucus.

3. Recurrent acute respiratory infection.

Diagnosis:

1. Histor.

2. ABGs.

3. Chest X-ray.

4. Pulmonary function studies.

Treatment:

- Palliative treatment to relieve symptoms with an emphasis on avoidance of factors that trigger irritation of the bronchial mucosa.

- Stop smoking.

- Avoid chemical allergens.

- Antibiotics to treat recurrent bacterial infections.

- Bronchodilators to relieve spasm.

- Adequate oxygenation to promote alveolar ventilation .

Avoid respiratory irritant.

Pulmonary Emphysema:

A condition characterized by abnormal distention of air spaces with the destruction of the alveolar wall.

Smoking the major cause.

Several factors lead to airway obstruction:

- Inflammation and swelling of the bronchi.

- Increased mucus production.

- Loss of elastic recoil of the airway.

- A collapse of bronchioles.

- Redistribution of air to the functioning alveoli.

Signs and symptoms:

Dyspnea.

Patient has the barrel chest.

A chronic cough, wheezing, short of breathing and tachypnea.

Distended neck veins.

Decreased breath sounds with rhonchi, and prolonged expiration.

Diagnosis:

- History.

- CBC.

- ABGs.

- CXR.

Treatment:

1. Bronchodilators: as aminophylline, salbutamol.

2. Aerosol therapy: as saline and bronchodilator or my Celtics.

3. Treatment of infection: use antibiotics.

4. Corticosteroids: used as the bronchodilator and decrease oedema.

5. Oxygen therapy at the low rate.


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