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COPD(Chronic Obstructive Pulmonary Disease)

COPD(Chronic Obstructive Pulmonary Disease)

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Published by Emily Anne

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Published by: Emily Anne on Jan 30, 2011
Copyright:Attribution Non-commercial

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03/07/2013

 
 
CASE STUDY:
COPD
(CHRONIC OBSTRUCTIVE PULMONARY DISEASE)
 
2 |Page 
INTRODUCTIONChronic obstructive pulmonary disease (COPD)
also
kn
ow
n
as
chr
o
nic
obstructivelung disease (COLD), chronic obstructive airway disease (COAD), chronic airflowlimitation (CAL)
 
a
nd
chronic obstructive respiratory disease (CORD
), refer
s
t
o
 
chronic bronchitis
 
a
nd
emphysema
,
a
p
a
ir
o
f c
ommo
n
ly
c
o-
exi
s
ting di
s
e
as
e
s
 
o
f the
lu
ng
s
in
w
hich the
a
ir
ways
bec
om
e n
a
rr
ow
ed. Thi
s
 
l
e
a
d
s
t
o
 
a
 
l
i
m
it
a
ti
o
n
o
f the f
low
 
o
f
a
ir t
o
 
a
nd fr
om
the
lu
ng
s
c
aus
ing
s
h
o
rtne
ss
 
o
f bre
a
th. In c
l
inic
al
pr
a
ctice, COPD i
s
 defined b
y
it
s
ch
a
r
a
cteri
s
tic
ally
 
low
 
a
irf
low
 
o
n
lu
ng f
u
ncti
o
n te
s
t
s
. In c
o
ntr
as
t t
o
 
as
th
ma
, thi
s
 
l
i
m
it
a
ti
o
n i
s
p
oo
r
ly
rever
s
ib
l
e
a
nd
usually
get
s
pr
o
gre
ss
ive
ly
 
wo
r
s
e
o
verti
m
e. In Eng
la
nd,
a
n e
s
ti
ma
ted 842,100
o
f 50
m
i
ll
i
o
n pe
o
p
l
e h
a
ve
a
di
a
gn
os
i
s
 
o
f COPD;tr
a
n
sla
ting int
o
 
a
ppr
o
xi
ma
te
ly
 
o
ne per
so
n in 59 receiving
a
di
a
gn
os
i
s
 
o
f COPD
a
t
som
ep
o
int in their
l
ive
s
.COPD i
s
c
aus
ed b
y
n
o
xi
ous
p
a
rtic
l
e
s
 
o
r g
as
,
mos
t c
ommo
n
ly
fr
om
t
o
b
a
cc
o
 
smo
king,
w
hich trigger
s
 
a
n
a
bn
o
r
mal
inf
lamma
t
o
r
y
re
s
p
o
n
s
e in the
lu
ng. The inf
lamma
t
o
r
y
 re
s
p
o
n
s
e in the
la
rger
a
ir
ways
i
s
kn
ow
n
as
chr
o
nic br
o
nchiti
s
,
w
hich i
s
di
a
gn
os
edc
l
inic
ally
 
w
hen pe
o
p
l
e reg
ula
r
ly
c
ou
gh
u
p
s
p
u
t
um
. In the
al
ve
ol
i, the inf
lamma
t
o
r
y
 re
s
p
o
n
s
e c
aus
e
s
de
s
tr
u
cti
o
n
o
f the ti
ssu
e
s
 
o
f the
lu
ng,
a
pr
o
ce
ss
kn
ow
n
as
e
m
ph
ys
e
ma
.The n
a
t
u
r
al
c
ou
r
s
e
o
f COPD i
s
ch
a
r
a
cterized b
y
 
o
cc
as
i
o
n
al
 
su
dden
wo
r
s
ening·
s
 
o
f
sym
pt
oms
c
all
ed
a
c
u
te ex
a
cerb
a
ti
o
n
s
,
mos
t
o
f
w
hich
a
re c
aus
ed b
y
infecti
o
n
s
 
o
r
a
irp
ollu
ti
o
n.The di
a
gn
os
i
s
 
o
f COPD req
u
ire
s
 
lu
ng f
u
ncti
o
n te
s
t
s
. I
m
p
o
rt
a
nt
ma
n
a
ge
m
ent
s
tr
a
tegie
s
 
a
re
smo
king ce
ssa
ti
o
n, v
a
ccin
a
ti
o
n
s
, reh
a
bi
l
it
a
ti
o
n,
a
nd dr
u
g ther
a
p
y
(
o
ften
us
inginh
al
er
s
). S
om
e p
a
tient
s
g
o
 
o
n t
o
req
u
ire
lo
ng
-
ter
m
 
o
x
y
gen ther
a
p
y
 
o
r
lu
ngtr
a
n
s
p
la
nt
a
ti
o
n.W
o
r
l
d
w
ide, COPD r
a
nked
as
the
s
ixth
l
e
a
ding c
aus
e
o
f de
a
th in 1990. It i
s
pr
oj
ected t
o
 be the f
ou
rth
l
e
a
ding c
aus
e
o
f de
a
th
wo
r
l
d
w
ide b
y
2030 d
u
e t
o
 
a
n incre
as
e in
smo
kingr
a
te
s
 
a
nd de
mo
gr
a
phic ch
a
nge
s
in
ma
n
y
c
ou
ntrie
s
. COPD i
s
the f
ou
rth
l
e
a
ding c
aus
e
o
f
 
3
|Page 
de
a
th in the U.S.
a
nd the ec
o
n
om
ic b
u
rden
o
f COPD in the U.S. in 2007
was
$42.6 bi
ll
i
o
nin he
al
th c
a
re c
os
t
s
 
a
nd
los
t pr
o
d
u
ctivit
y
.
ANATOMY AND PHYSIOLOGY
In h
uma
n
s
, the tr
a
che
a
divide
s
int
o
the t
wo
 
ma
in br
o
nchi th
a
t enter the r
oo
t
s
 
o
f the
lu
ng
s
. The br
o
nchi c
o
ntin
u
e t
o
divide
w
ithin the
lu
ng,
a
nd
a
fter
mul
tip
l
e divi
s
i
o
n
s
, giveri
s
e t
o
br
o
nchi
ol
e
s
. The br
o
nchi
al
tree c
o
ntin
u
e
s
br
a
nching
u
nti
l
it re
a
che
s
the
l
eve
l
 
o
fter
m
in
al
br
o
nchi
ol
e
s
,
w
hich
l
e
a
d t
o
 
al
ve
ola
r
sa
c
s
. A
l
ve
ola
r
sa
c
s
 
a
re
ma
de
u
p
o
f c
lus
ter
s
 
o
f
al
ve
ol
i,
l
ike individ
ual
gr
a
pe
s
 
w
ithin
a
b
u
nch. The individ
ual
 
al
ve
ol
i
a
re tight
ly
 
w
r
a
pped in b
loo
d ve
ss
e
ls
 
a
nd it i
s
here th
a
t g
as
exch
a
nge
a
ct
ually
 
o
cc
u
r
s
.De
o
x
y
gen
a
ted b
loo
d fr
om
the he
a
rt i
s
p
um
ped thr
ou
gh the p
ulmo
n
a
r
y
 
a
rter
y
t
o
the
lu
ng
s
,
w
here
o
x
y
gen diff
us
e
s
int
o
b
loo
d
a
nd i
s
exch
a
nged f
o
r c
a
rb
o
n di
o
xide in thehe
mo
g
lo
bin
o
f the er
y
thr
o
c
y
te
s
. The
o
x
y
gen
-
rich b
loo
d ret
u
rn
s
t
o
the he
a
rt vi
a
thep
ulmo
n
a
r
y
vein
s
t
o
be p
um
ped b
a
ck int
o
 
sys
te
m
ic circ
ula
ti
o
n.H
uma
n
lu
ng
s
 
a
re
lo
c
a
ted in t
wo
c
a
vitie
s
 
o
n either
s
ide
o
f the he
a
rt. Th
ou
gh
s
i
m
i
la
r in
a
ppe
a
r
a
nce, the t
wo
 
a
re n
o
t identic
al
. B
o
th
a
re
s
ep
a
r
a
ted int
o
 
lo
be
s
b
y
fi
ssu
re
s
,
w
iththree
lo
be
s
 
o
n the right
a
nd t
wo
 
o
n the
l
eft. The
lo
be
s
 
a
re f
u
rther divided int
o
 
s
eg
m
ent
s
 
a
nd then int
o
 
lo
b
ul
e
s
, hex
a
g
o
n
al
divi
s
i
o
n
s
 
o
f the
lu
ng
s
th
a
t
a
re the
small
e
s
t
su
bdivi
s
i
o
nvi
s
ib
l
e t
o
the n
a
ked e
y
e. The c
o
nnective ti
ssu
e th
a
t divide
s
 
lo
b
ul
e
s
i
s
 
o
ften b
la
ckened in
smo
ker
s
. The
m
edi
al
b
o
rder
o
f the right
lu
ng i
s
ne
a
r
ly
vertic
al
,
w
hi
l
e the
l
eft
lu
ngc
o
nt
a
in
s
 
a
c
a
rdi
a
c n
o
tch. The c
a
rdi
a
c n
o
tch i
s
 
a
c
o
nc
a
ve i
m
pre
ss
i
o
n
mol
ded t
o
 
a
cc
ommo
d
a
te the
s
h
a
pe
o
f the he
a
rt. L
u
ng
s
 
a
re t
o
 
a
cert
a
in extent '
o
verb
u
i
l
t'
a
nd h
a
ve
a
 tre
m
end
ous
re
s
erve v
olum
e
as
c
om
p
a
red t
o
the
o
x
y
gen exch
a
nge req
u
ire
m
ent
s
 
w
hen
a
tre
s
t. S
u
ch exce
ss
c
a
p
a
cit
y
i
s
 
o
ne
o
f the re
aso
n
s
th
a
t individ
uals
c
a
n
smo
ke f
o
r
y
e
a
r
s
 
w
ith
ou
t h
a
ving
a
n
o
tice
a
b
l
e decre
as
e in
lu
ng f
u
ncti
o
n
w
hi
l
e
s
ti
ll
 
o
r
mo
ving
slowly
; in
s
it
ua
ti
o
n
s
 
l
ike the
s
e
o
n
ly
 
a
 
small
p
o
rti
o
n
o
f the
lu
ng
s
 
a
re
a
ct
ually
perf
us
ed
w
ith b
loo
df
o
r g
as
exch
a
nge. A
s
 
o
x
y
gen req
u
ire
m
ent
s
incre
as
e d
u
e t
o
exerci
s
e,
a
gre
a
ter v
olum
e
o
fthe
lu
ng
s
i
s
perf
us
ed,
allow
ing the b
o
d
y
t
o
 
ma
tch it
s
CO2/O2 exch
a
nge req
u
ire
m
ent
s
.

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