32.6c Obstructive Lung Disease

widespread

Obstructive lung disease is {{?}} in our society.

asthma, emphysema, and chronic bronchitis

The most common obstructive lung diseases encountered in prehospital care are {{?}}.

asthma, COPD

{{?}} afflicts 7 to 8 percent of the U.S. population, and {{?}} is found in 5 to 6 percent of all adults.

50 percent

Patients with COPD have a {{?}} mortality within 10 years of the diagnosis.

chronic bronchitis

{{?}} is more common than emphysema.

cigarette smoking and environmental toxins

Although asthma can have a genetic predisposition, COPD is known to be directly caused by {{?}}.

already have

Other factors have been shown to precipitate symptoms in patients who {{?}} obstructive airway disease.

stress, upper respiratory infections, exercise

Intrinsic factors include {{?}}.

tobacco smoke, drugs, occupational hazards, allergens

Extrinsic factors include {{?}}.

abnormal ventilation

All obstructive lung diseases have {{?}} as a common feature.

bronchioles

This abnormal ventilation is a result of obstruction that occurs primarily in the {{?}.

beta-adrenergic receptor stimulations

Bronchospasm (sustained smooth muscle contraction) occurs, which can be reversed by {{?}}.

albuterol, levalbuterol and epinephrine

Agents such as {{?}} are used to accomplish this stimulation.

increased mucus production

{{?}} by goblet cells that line the respiratory tree also contributes to obstruction.

cilia are destroyed

This effect can be worsened by the fact that in many patients, the {{?}}, resulting in poor clearance of excess mucus.

fluid and inflammatory cells

Finally, inflammation of the bronchial passages results in the accumulation of {{?}}.

reversible

Depending on the underlying cause, some elements of bronchial obstruction are {{?}}, whereas others are not.

ipratropium

{{?}}, a parasympathetic blocker, can aid in drying bronchial secretions and in reversing bronchospasm.

dilate

During inspiration, the bronchioles will naturally {{?}}, allowing air to be drawn into the alveoli.

constrict

As the patient begins to exhale, the bronchioles {{?}}.

distal to the obstruction

When this natural constriction occurs—in addition to the underlying bronchospasm, increased production of mucus, and inflammation that exist in patients with obstructive airway disease—the result is significant air trapping {{?}}.

air trapping

{{?}} distal to the obstruction is one of the hallmarks of obstructive lung disease.