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Published by: Dr-Bahaa Mostafa Kamel on Oct 26, 2010
Copyright:Attribution Non-commercial


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Chronic Obstructive PulmonaryDisease------------------------------------------------------------
Chronic obstructive pulmonary disease (COPD), also known aschronic obstructive airway disease (COAD), is a group of diseases characterized by the pathological limitation of airflow inthe airway that is not fully reversible. COPD is the umbrella termfor chronic bronchitis, emphysema and a range of other lungdisorders. It is most often due to tobacco smoking, but can bedue to other airborne irritants such as coal dust, asbestos orsolvents, as well as congenital conditions such as alpha-1-antitrypsin deficiency.
Signs and symptoms
 The main symptoms of COPD include dyspnea (shortness of breath) lasting formonths or perhaps years, possibly accompanied by wheezing, and a persistentcough with sputum production.Itis possible the sputum maycontain blood and becomethicker (hemoptysis), usually dueto damage of the blood vessels of the airways. Severe COPD couldlead to cyanosis (bluishdecolorization usually in the lipsand fingers) caused by a lack of oxygen in the blood. In extremecases it could lead to corpulmonale due to the extra workrequired by the heart to get bloodto flow through the lungs.
COPD is particularly characterised by the spirometric measurement of a ratio of forced expiratory volume over 1 second (FEV1) to forced vital capacity (FVC)being < 0.7 and the FEV1 < 70% of the predicted value as measured by aplethysmograph. Other signs include a rapid breathing rate (tachypnea) and awheezing sound heard through a stethoscope. Pulmonary emphysema is NOT thesame as subcutaneous emphysema, which is a collection of air under the skin thatmay be detected by the crepitus sounds produced on palpation.
Cigarette smoking :
A primary risk factor of COPD is chronic tobaccosmoking. In the United States, around 90% of casesof COPD are due to smoking .Not all smokers willdevelop COPD, but continuous smokers have atleast a 25% risk.
Occupational pollutants :
Some occupational pollutants, such as cadmium and silica, have shown to bea contributing risk factor for COPD. The people at highest risk for thesepollutants include coal workers.
Air pollution :
Urban air pollution may be a contributing factor for COPD as it is thought toimpair the development of the lung function. In developing countries indoorair pollution, usually due to biomass fuel, has been linked to COPD, especiallyin women.
Genetics :
Very rarely, there may be a deficiency in an enzyme known as alpha 1-antitrypsin which causes a form of COPD.
Other risk factors :
Increasing age, male gender, allergy, repeated airway infection and generalimpaired lung function are also related to the development of COPD.

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