Obstructive Pulmonary Diseases

Nursing 205: Pathophysiology

(adapted)
Classification of Pulmonary
Diseases
• Vascular - mostly dead space disorders:
• Pulmonary embolus
• Pulmonary hypertension
• ARDS? – Acute respiratory distress syndrome
• Restrictive – mostly shunt disorders:
• Atelectasis
• Pneumonia
• Obstructive – also mostly shunt disorders:
• COPD – both emphysema & chronic bronchitis
• Asthma
• Cystic fibrosis
Obstructive Lung Disease: Asthma
• Chronic disease characterized by acute exacerbations

• Hyperresponsiveness of airways with episodes of

bronchospasms

• Triggers cause:
• Inflammation and Edema of airways – due to neutrophils
• Bronchoconstriction
• Mucus production
Asthma
• Types:
• Extrinsic (most common): atopic or allergic asthma
• IgE mediated
• Activation of eosinophils & mast cells
• See EAR & maybe LAR (Early and Late reactions)
• Intrinsic
• Neurologically mediated
• Familial component
• Maybe autoimmune
Asthma Treatment
• Control is key

• Control with reducing exposure to triggers

• Pharmacological control
• Control with inhaled corticosteroids
• Treat acute exacerbations with rescue inhaler (Albuterol)
• Education on proper administration is important
Chronic Obstructive Lung Disease
(COPD)
• Pathological lung changes:
• Loss of lung elasticity
• Lung hyperinflation
• Bullae formation
• Airway collapse
• U.S. Statistics:
• 27 million cases
• 3rd leading cause of death
• Morbidity & mortality rising
• Prevalence now higher among women
COPD Risks
• Exposure to tobacco smoke
• Increasing adult age
• Occupational exposure to toxins
• Alpha-1 protease inhibitor deficiency
 Classification of COPD
• Emphysema:
• Dilation & destruction of
alveolar ducts & alveoli
• Chronic Bronchitis:
• Inflammation &
thickening of bronchial
walls
• Increased mucus
secretion
• Decreased mucus
clearance
Normal Chest Wall vs. Chest Wall in
COPD