Chronic Obstructive Pulmonary Disease

also known as chronic obstructive lung disease (COLD)

chronic obstructive airway disease (COAD)chronic airflow limitation (CAL)

chronic obstructive respiratory disease (CORD)

Chronic Obstructive Pulmonary Disease

• Chronic obstructive pulmonary disease (COPD) is a general term which includes the conditions chronic bronchitis and emphysema.

• a chronic diseases of the lungs in which the airways become narrowed (obstruction). This leads to a limitation of the flow of air to and from the lungs, causing shortness of breath.

• Chronic bronchitis and emphysema commonly occur together.

EmphysemaA chronic , irreversible disease of the lungs characterized by abnormal enlargement of air sac (alveoli) in the lungs and destruction of the tissue lining the walls of the air spaces.

•alveoli are breaking down decreasing the overall surface area of the lungs, reducing the efficiency of gas exchange)

Most common cause of emphysema is Cigarette smoking

CAUSE:

Emphysema The image above shows extensive damage to the air sacs .You can also see a large amount of black pigment, which is carbon derived from cigarette smoke.

Gross specimen of a lung with emphysema.

Gross pathology of lung showing emphysema characteristic of smoking. cut surface shows multiple cavities lined by heavy black carbon deposits

Emphysema

Chronic bronchitis

• Lung damage and inflammation in the large airways results in chronic bronchitis.

• Chronic bronchitis is defined in clinical terms as a cough with sputum production on most days for 3 months of a year, for 2 consecutive years.

Chronic bronchitis• chronic bronchitis is an increased number

(hyperplasia) and increased size (hypertrophy) of the goblet cells and mucous glands of the airway. Increase the mucus narrowing of the airways and causing cough with sputum.

• Inflammation scarring and thickens of the walls narrowing of the airways.

• As chronic bronchitis progresses, squamous metaplasia and fibrosis thickening and scarring of the airway wall limitation of airflow.

Chronic bronchitis

• Cigarette smoke• Air pollution• Viral and bacterial infection

CAUSE:

Chronic bronchitisBronchial mucous plug

A large mucous plug is completely occluding the distal trachea and both main bronchi seen in patient with chronic

bronchitis

Bronchial mucous plugThis small bronchus is completely occluded by a

mucous plug.

Condition Main site Major changes Causes Symptoms

Emphysema AlveoliAirspace

enlargement and wall destruction

smoking Shortness of breath

Chronic bronchitis BronchusHyperplasia and

hypersecretion of mucus glands

Smoking and air pollutants

Productive cough

Chronic Obstructive Pulmonary Disease

Healthy Lung

Gross specimen of lungs from a smoker (right) and non-smoker. The smoker's lung is darker, rougher and misshapen. Smoking damages the lungs in several ways.1) chronic bronchitis, where the lung's airways are repeatedly inflamed.2) Emphysema , where the lung's air sacs (alveoli) lose their walls.

Case study • A 69 years old man smoker suffaring of

shortness of breath ,wheezing ,and history of cough productive of mucoid sputum in every winter for last 3 years.

Questions

1-which of his symptom suggest COPD?• shortness of breath (dyspnea) • wheezing • cough productive of mucoid sputum2-What is his risk factor for COPD? Cigarette smoking

Questions

3 .How is COPD diagnosed?• medical history which discloses many of the

symptoms of COPD diagnose COPD • chest x-ray• computerized tomography • (CAT or CT scan) of the chest• tests of lung function (pulmonary function tests) • measurement of carbon dioxide and O2 and CO2

levels in the blood.

question

4.COPD may be presented as all of the followings except a) increase in the amount sputum productionb) increase in the chest tightness c) wheezing d) fever

questions

5. Which of the following diseases is included in the umbrella term chronic obstructive pulmonary disease (COPD)?

• a. Emphysema • b. Chronic bronchitis • c. Lung cancer• d . A and B

questions

6.Long-term exposure to which of the following can increase the risk for COPD?

• The correct answer is • A. Airborne chemicals• B. Pollutants• C. Lung irritants• D. All of the above

Questions

• 7. How is COPD treated?• A. Bronchodilators • B. Inhaled corticosteroids• C. Supplemental oxygen• D. All of the above

Bronchial asthma

• A 40-year-old previously healthy woman, a non-smoker, has had episodes of fever, non-productive cough, and dyspnea over the past 3 months. Her symptoms disappeared after a month's vacation, but reappeared when she returned home to take care of her canaries. On physical examination there are no abnormal findings

question

1. What is most likely diagnosis?a) Emphazymab) Bronchial asthma c) Lung cancerd) Lung abscess

Questions

2.What is the bronchial asthma?• Is a condition characterized by reversible

bronchospasm and chronic inflammation of respiratory passages.

Questions

• Factors causing bronchial hyperresponsiveness in bronchial asthma are:

• A. Allergens, e.g. pollen, house-dust, mite• B. Drugs : NSAIDs, aspirin• C. Viral infections of the respiratory tract• D. All of the above