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Medicine Notes Respiratory Notes

Copd Notes

Updated Copd Notes

Respiratory Notes

Respiratory

Approximately 35 pages

Complete set of notes covering the respiratory system. Includes pathophysiology, aetiology, presenting symptoms, management and relevant pharmacology. Concise bullet points, colour coded by topic. Includes tables and summary charts. All you need to pass respiratory module at medical school....

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The following is a more accessible plain text extract of the PDF sample above, taken from our Respiratory Notes. Due to the challenges of extracting text from PDFs, it will have odd formatting:

COPD

Common progressive disorder of airway obstruction with little or no reversibility

  • FEV1 < 80% predicted

  • Fev1/FVC ratio <0.7

COPD vs Asthma

  • Patients usually have COPD OR Asthma (not both)

  • COPD favoured by

    • Age of onset > 35 yrs

    • Smoking

    • Chronic dyspnea

    • Sputum production

    • No marked diurnal/day to day variation in FEV1

Aetiology

  • Smoking

  • Long term exposure to toxic particles or gases

  • Alpha 1 anti-tripsin deficiency predisposes to early development

Pathophysiology

  • Chronic bronchitis

    • Defined clinically as a cough with sputum production daily for 3 months of 2 successive years

  • Emphysema

    • Defined histiologically as enlarged air spaces distal to the terminal bronchioles with destruction of alveolar walls

3 Mechanisms suggested for airflow limitation

  1. Mucus secretion blocks airways

    1. Hypertrophy in number of mucus secreting goblet cells of bronchial tree

  2. Inflammation + scarring causes narrowing of small airways

    1. Infiltration of acute and chronic inflammatory cells

    2. Ulcerated epithelium

    3. Ulcers heal with squamous epithelium replacing columnar

    4. Scarring + remodeling

  3. Emphysematous change

    1. Causes loss of elastic recoil of lungs with collapse of small airways during expiration + air trapping

    2. Classified according to site of damage

      1. Centri-acinar = damage around resp. bronchioles

      2. Pan-acinar = damage involves whole of acinus

      3. Irregula = damage affects lung parenchyma patchily

    3. Loss of elastic recoil = increased lung compliance

    4. Loss of alveoli = decreased gas exchange

Cigarette smoking

  • Irritation = hypertrophy of mucus glands

  • Increase in elastases + proteases, decrease in alpha 1 antitripsin (antiprotease)

= emphysema

Clinical features

Symptoms Signs

Cough

Sputum production

Wheeze

SOB

Frequent infections

Decreased exercise tolerance

Cold, fog + pollution exacerbate symptoms

Tachypnoea

Prolonged expiration

Wheeze

Use of accessory muscles

Barrel chest

Poor chest expansion

Loss of normal cardiac and liver dullness

Resonant/hyperresonant percussion

Peripheral/central cyanosis

Cor Pulmonale

...

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