03.12.2014
Chronic obstructive pulmonary disease (COPD) is a global health problem that affects millions of people and is an important cause of morbidity, mortality, and extensive utilization of health care resources. In addition, the normal processes for breakdown and repair of cellular elements and immune defense are impaired. The graph below on the left from Fletcher and Peto shows the natural history of changes in FEV1 in non-smokers, smokers, and smokers who quit smoking.
This Concept Map, created with IHMC CmapTools, has information related to: COPD Cmap, Complications End-stage lung disease, Diagnostic Tests Alpha-1-Antitrypsin Levels, Air trapping during each expiration (cough effect) Development of hypoventilation and hypercapnea, Air trapping during each expiration (cough effect) Cough, Diagnostic Tests Oximetry, Signs and Symptoms Wheezing, 68 year-old male diagnosed with COPD exacerbation Treatments, Expiration becomes difficult because elastic recoil is lost thus less air can be expired. COPD is one of the top ten causes of death worldwide, and the direct costs of treating COPD in the United States alone are estimated to be around $30 billion per year.


These abnormalities produce a spectrum of largely irreversible changes ranging from mucous hypersecretion (chronic bronchitis), to chronic small airway inflammation and fibrosis (bronchiolitis), and outright tissue destruction and impaired airflow (emphysema). The graph on the right shows normal changes in lung volume over time during inspiration and expiration, both at rest and during forced inspiration and expiration.
The graph below on the right shows that the obstructive changes in COPD reduce the ability to expire air, and this results in an increased residual volume.
COPD actually represents a spectrum of disease ranging from destruction of the alveoli and thickening of the terminal airways on one extreme (emphysema) to thickening of the airways with chronic inflammation and repeated bouts of infection (chronic bronchitis) on the other extreme. All smokers have inflammation in their lungs and airways, and they all have thickening of the airways, damage to ciliated cells, and hypersecretion of mucus.


As a result, the ability to move air in and out of the lungs is progressively impaired, ultimately leading to diminished oxygenation of blood.



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