COPD is defined as Chronic Obstructive Pulmonary Disease

COPD consists of:
Chronic Bronchitis and Emphysema, defined as

1.Irreversible airflow obstruction
2.Frequently occur together
3.Strongly correlated with air pollution and smoking

Understanding them clearly :

-Chronic Bronchitis :-

1.A persistent cough productive of sputum for at least 3 months, in at least 2 consecutive years.

2.Involves bronchi and/or bronchioles

It includes Large airway disease and Small airway disease

Large airway disease :-

1.Cough and sputum production
2.Histological changes
increased numbers of goblet cells in the epithelium
increased volume of the submucosal mucus glands
a component of chronic inflammation

Small airway disease:-

1.Decrease in maximum forced expiratory flow
2.Histological changes
presence of goblet cells in the lining epithelium
a component of chronic inflammation

Clinical findings:

1.insufficient oxygenation of blood (hypoxemia).
2.labored breathing (hypoventilation) .
3.right-sided heart failure (cor pulmonale.

Treament:

1.No cure
2.relieving symptoms
3.preventing complications

-Emphysema:-

1.Abnormal permanent enlargement of airspaces distal to the terminal bronchiole, and the destruction of their walls

2.Imbalance between proteases and anti-proteases (alpha-1 antitrypsin) in the lung

3.Cigarette smoking
a.Recruits neutrophils and macrophages
b.Oxidants and free radicals inhibit the alpha-1-antitrypsin circulating in the lung
c.Chronic bronchitis and repeated infections
d.Alpha-1 antitrypsin deficiency (1%)

Types of emphysema:-

1.Centriacinar (centrilobular) emphysema
2.Penacinar (panlobular) emphysema
3.Distal acinar (paraseptal) emphysema

clinical findings:
1.Short of breath, wheezling
2.Cough with or without mucous
3.Fatigue
4.Weight loss
5.Ankle feet leg swelling
6.lung infections

Complications:-

1.Respiratory infections
2. Respiratory failure
3. Corpulmanale

General:-

1.People with COPD may be classified as "pink puffers" or "blue bloaters".

2.Pink puffers characteristically suffer from emphysema.

3.They overbreathe because they feel that they are not getting enough air and are often thin and wasted, since a lot of energy is expended trying to breathe.

4.They are not cyanotic. Often, respiratory failure is the end-point for these patients; the damage is irreversible , and they cannot get better.

5.Blue bloaters are cyanotic.

6.They do not overbreathe - for some reason, the normal central nervous system response that would speed up respiration to compensate for the cyanosis is blunted.

7.They are bloated because they are edematous due to right heart failure (called cor pulmonale - right heart failure due to lung disease).

8.Blue bloaters characteristically suffer from chronic bronchitis

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