Chronic Obstructive Pulmonary Disease (COPD) Lecture Notes

Comprehensive vocabulary flashcards focused on the pathophysiology, diagnosis, and clinical presentation of COPD, including emphysema and chronic bronchitis.

Chronic Obstructive Pulmonary Disease (COPD)

A condition characterized by irreversible airway obstruction that prevents air from leaving the lungs, primarily due to collapse at the distal terminal bronchioles.

Air trapping

The phenomenon in COPD where irreversible airway obstruction prevents air from leaving the lungs.

Cigarette smoking

The most important risk factor for COPD, involving toxins that collect in the respiratory bronchioles and activate an inflammatory response.

Neutrophils

Inflammatory cells recruited to the distal airways in COPD that produce elastase.

Emphysema

A type of COPD affecting the distal airways, including the alveolar sac, alveolar ducts, and respiratory bronchioles, characterized by permanent airway dilation and decreased elasticity.

Chronic bronchitis

A type of COPD involving the proximal large airways, marked by mucus gland hypertrophy and hypersecretion in the trachea, bronchi, and bronchioles.

TLC and FRC

Pulmonary function test parameters that are increased in COPD due to air trapping and hyperinflation.

$FEV_1/FVC$ ratio

A pulmonary function test measurement that is typically < 0.7 in patients with COPD.

DLCO (Diffusing Capacity for Carbon Monoxide)

A measurement that is low in emphysema due to the destruction of the distal airways and alveolar units.

Centriacinar emphysema

A form of emphysema that predominantly affects the upper two-thirds of the lung.

Panacinar emphysema

A form of emphysema occurring throughout the respiratory unit, often associated with alpha-1 antitrypsin deficiency.

Elastase

An enzyme produced by neutrophils that, if uninhibited, results in increased compliance and damage to the distal airways.

Alpha-1 antitrypsin (AAT) deficiency

A genetic condition leading to widespread lung destruction (predominantly in the lower lobes) and liver damage or cirrhosis due to non-secreted AAT accumulation in hepatocytes.

Classic emphysema pose

A physical manifestation where patients use accessory muscles to help maintain pressure to inflate distal airways.

CXR findings for emphysema

Diagnostic imaging results including a flat diaphragm, more than $10$ posterior rib shadows, increased parenchymal radiolucency, and a lengthened cardiac silhouette.

Respiratory alkalosis

A condition occurring early in the course of emphysema due to hyperventilation maintaining normal arterial oxygen levels.

Respiratory acidosis

A condition occurring later in emphysema or during chronic bronchitis due to severe air trapping, mucus plugs, and increased $CO_2$ retention.

Goblet cell metaplasia

A change marked by the proliferation of goblet cells in the bronchioles as part of chronic bronchiolitis and chronic bronchitis.

Pulmonary arterial hypertension

A complication of chronic hypoxemia in COPD resulting from hypoxic vasoconstriction, eventually leading to right heart failure.

Peripheral chemoreceptors

Sensors in the aortic arch and carotid bodies that detect decreases in $PaO_2$; their inhibition by supplemental oxygen can potentially cause respiratory failure in COPD patients.