Obstructive Lung disorders - Sakit

Chronic Obstructive Pulmonary Disease

— Airflow LIMITATION that is not fully reversible

— Is a group of diseases that includes emphysema, chronic bronchitis and other combinations of lung disorders.

• Chronic Cough

• Sputum production

• Dyspnea on exertion

Emphysema

— Abnormal distention of the airspace beyond the terminal bronchioles which results to the destruction of the wall of the alveoli - making it hard to breath

— Lung air sacs damaged and cannot hold air

— Dead spaces due to destruction of alveoli and alveolar surfaces decreases, which leads to hypoxemia.

— Dead Space is a lung area where there is no gas exchange.

— Pink puffer happens because the person has to work hard to exhale due to decrease in recoil. To achieve breathing, they will use pursed lip breathing.

• Barrel chest

• Severe dyspnea

• Thin-framed body

— S/sx:

• Barrel chest

• Severe dyspnea

• Thin-Framed body

Chronic Bronchitis

— Daily PRODUCTIVE COUGH for 3 months or more, in at least 2 consecutive years

— Problem inside the airway, specifically the bronchioles, which is inflamed.

— Hypertrophy of a smooth muscle of the airway tract. There is an increase and growth of smooth muscles in the inner lining of the airway tract that can cause obstruction.

— Hypersecretions of mucus

— Also called as “Blue Bloater” due to cyanosis and patients with chronic bronchitis looks bloated due to increasing chest diameter.

— Air trapping due to air in the lungs cannot exhale. It may contribute in rising of blood pressure in the artery of the lungs that results into pulmonary hypertension.

— S/Sx:

• Overweight

• Elevated hemoglobin

• Peripheral edema — Wheezing

Dx:

• Spirometry

• ABG: mild-mod hypoxemia

Bronchiectasis

— Irreversible DILATION of the bronchial tree and bronchioles 

• Predisposing factors: 

  • Recurrent RTI 

  • Cystic fibrosis 

• Inflammation damage bronchial wall 

• Permanent distention and distortion of the bronchial walls 

• Impair mucociliary clearance 

• Affects most frequently the lower lobes of the lungs 

• Atelectasis 

S/Sx:

• Consistent productive cough

• Hemoptysis

• Rales/crackles

• Clubbing of fingers

Bronchial Asthma

— REVERSIBLE inflammatory lung condition d/t HYPERSENSITIVITY to allergens that results to narrowing of SMALLER airways  

— S/Sx:

— TRIAD:

• Cough

• Wheezing

• Dyspnea

— Occurs at night / early AM

• Circadian variations