COPD Risk Factors
Smoking 1st & 2nd hand
Environmental exposure to irritants/air pollution
Age
Gender
Unemployed, retired, unable to work
Less than high school ed
Native American/Alaskan native
Genetics
COPD Prevelance
14.2 M adults
6th lead cause of death
Women > Men
Higher in:
Native pops than others
Increased age
Decreased Ed
Decreased Urbanicity
Typical forms of COPD affecting alveoli
Emphysema: hyperinflation of alveoli, mucus filled, air cannot be expelled, alveolar walls break down, alveoli die
Typical forms of COPD affecting airways
Chronic Bronchitis: inflammed mucus membranes in the bronchial passages
How does Obstructive Lung Disease
Exhalation decr. > more air left in lungs >
Why does Obstructive Lung disease result in incr. RR?
Restrictive Lung Disease
Inability to fill lungs bc lungs cannot full expand
Causes of reduced expansion: Stiffness in lungs or chest wall, weak mm., damaged nerves
Primary pathologies causing Restrictive Lung Disease
Idiopathic Pulmonary fibrosis
Sarcoidosis - autoimmune
Obesity
Scoliosis
Muscular Distrophy
Amyotrophic Lateral Sclerosis
Clinical Presentation of COPD - Chronic Bronchitis Dominant
Persistent cough
Copious daily sputum
Intermittent dyspnea
Freq. Respiratory infections
Onset in adulthood
Barrel chest deformity
Clinical Presentation of COPD - Emphysema Dominant
Exertional dyspnea
Min. cough/sputum production
Accessory m. use for breathing
Wheezing
Cachexia
Tripod posture
Barrel chest deformity
Complications of COPD
Polycythemia
Arrhythmias
Pulmonary Arterial Hypertension
Cor Pulmonale
HF
Respiratory Infections
Respiratory Failure
Death
Dx tests for COPD
Chest x-ray
Lung volumes
Diffusion capacity
ABG
Echocardiograph
CT
CPET
Clinical Tests for COPd
Med Hx
Vitals
Pulse Ox
BMI
Spirometry
6MWT
TUG test
Goals for COPD PT
Incr. Oxygenation &Decr. CO2 retention
Facilitate elimination of bronch. secretions
Prevent/treat respiratory infections
Increase Ex tolerance
Control complications
Avoid airway irritants and allergens
Relieve anxiety, treat depression
Maintain/improve f(x) capacity
Hypoxemia
decreased O2 in blood
Hypercapnea
increase CO2 in blood
Restrictive - What does problem does fibrosing of lungs create?
Fibrosing of lungs leads to less gas exchange happening
Causes of fibrosing in lungs
Radiation from cancer treatment
Prolonged Obstructive Disease
Pulmonary f(x) tests
Chest expansion
Lung auscultation
Phonation and Cough
Evaluate Extremities
Trunk/thoracic obs.
Neck evaluation
Facial Characteristics
Characteristics of interest - Evaluation of extremities for PAD
-cyanosis
-clubbing of nails
-peripheral edema
-Distal limb temp
Characteristics of interest - Evaluation of sputum
Color
Consistency
Odor
Characteristics of interest - Lung auscultations
Crackles/rales
Wheezing
Ant./Post.
L/R
Upper, Middle, Lower
Describe the possibilities of phonation in lung auscultations.
