This document provides an overview of Chronic Obstructive Pulmonary Disease (COPD). It defines COPD as a preventable and treatable lung disease characterized by limited airflow. The two main conditions that make up COPD are chronic bronchitis and emphysema. Chronic bronchitis involves long-term inflammation of the bronchial tubes, while emphysema involves breakdown of lung tissue. Cigarette smoking is the primary cause of COPD. Symptoms include shortness of breath, cough, and sputum production. Diagnosis involves patient history, exams, pulmonary function tests, chest x-rays, and blood tests. Management focuses on smoking cessation, medications like bronchodilators, oxygen therapy, pulmonary rehabilitation
Reading material on COPD (CHRONIC OBSTRUCTIVE PULMONARY DISEASE) for Nursing students and teachers. It tells pathophysiology, clinical manifestations, diagnostic evaluations, medical and nursing management of COPD.
Reading material on COPD (CHRONIC OBSTRUCTIVE PULMONARY DISEASE) for Nursing students and teachers. It tells pathophysiology, clinical manifestations, diagnostic evaluations, medical and nursing management of COPD.
Emphysema is a type of COPD involving damage to the air sacs (alveoli) in the lungs. As a result, your body does not get the oxygen it needs. Emphysema makes it hard to catch your breath. You may also have a chronic cough and have trouble breathing during exercise. The most common cause is cigarette smoking
chronic obstructive pulmonary disease and its management
chronic obstructive pulmonary disease is a chronic inflammatory lung disease that causes obstructed airflow from the lungs.
COPD typically has a clear cause and a clear path of prevention, and there are ways to slow the progression of the disease.
Acute bronchitis (brahn-KITE-uss), or chest cold, is a condition that occurs when the bronchial (BRAHN-kee-uhl) tubes in the lungs become inflamed. The bronchial tubes swell and produce mucus, which causes a person to cough. This often occurs after an upper respiratory infection like a cold. Most symptoms of acute bronchitis (chest pain, shortness of breath, etc.) last for up to 2 weeks, but the cough can last for up to 8 weeks in some people.
Lung abscess is a type of liquefactive necrosis of the lung tissue and formation of cavities (more than 2 cm) containing necrotic debris or fluid caused by microbial infection.
Both acute and chronic pharyngitis are common diseases and they are important for the students to understand, Moreover acute tonsillitis is also very common and it becomes one of the most important causes of throat pain and fever.
Emphysema is a type of COPD involving damage to the air sacs (alveoli) in the lungs. As a result, your body does not get the oxygen it needs. Emphysema makes it hard to catch your breath. You may also have a chronic cough and have trouble breathing during exercise. The most common cause is cigarette smoking
chronic obstructive pulmonary disease and its management
chronic obstructive pulmonary disease is a chronic inflammatory lung disease that causes obstructed airflow from the lungs.
COPD typically has a clear cause and a clear path of prevention, and there are ways to slow the progression of the disease.
Acute bronchitis (brahn-KITE-uss), or chest cold, is a condition that occurs when the bronchial (BRAHN-kee-uhl) tubes in the lungs become inflamed. The bronchial tubes swell and produce mucus, which causes a person to cough. This often occurs after an upper respiratory infection like a cold. Most symptoms of acute bronchitis (chest pain, shortness of breath, etc.) last for up to 2 weeks, but the cough can last for up to 8 weeks in some people.
Lung abscess is a type of liquefactive necrosis of the lung tissue and formation of cavities (more than 2 cm) containing necrotic debris or fluid caused by microbial infection.
Both acute and chronic pharyngitis are common diseases and they are important for the students to understand, Moreover acute tonsillitis is also very common and it becomes one of the most important causes of throat pain and fever.
These lecture notes were prepared by Dr. Hamdi Turkey- Pulmonologist- Department of internal medicine - Taiz university
It contains :
- The new GOLD classification of severity
- The new GOLD treatment guidelines for the treatment of
COPD
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COPD is a lung disease that makes it hard to breathe. It is caused by damage to the lungs over many years, usually from smoking.
The main symptoms are:
• A long-lasting (chronic) cough.
• Mucus that comes up when you cough.
• Shortness of breath that gets worse when you exercise.
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This 𝐂𝐎𝐏𝐃 animated template is designed by RxSlides, a medical professional team covering the following topics about 𝐂𝐎𝐏𝐃
𝐓𝐡𝐞 𝐭𝐞𝐦𝐩𝐥𝐚𝐭𝐞 𝐜𝐨𝐯𝐞𝐫𝐬 𝐭𝐡𝐞 𝐟𝐨𝐥𝐥𝐨𝐰𝐢𝐧𝐠 𝐭𝐨𝐩𝐢𝐜𝐬
𝐃𝐞𝐟𝐢𝐧𝐢𝐭𝐢𝐨𝐧
Chronic obstructive pulmonary disease (𝐂𝐎𝐏𝐃) is a group of lung diseases that cause airflow blockage and breathing-related problems.
𝐩𝐫𝐞𝐯𝐚𝐥𝐞𝐧𝐜𝐞
COPD is more prevalent in developing countries, but it is also a growing problem in developed countries. In the United States, COPD is the third leading cause of death.
Forms of 𝐂𝐎𝐏𝐃
• Chronic bronchitis
• Emphysema
𝐏𝐚𝐭𝐡𝐨𝐩𝐡𝐲𝐬𝐢𝐨𝐥𝐨𝐠𝐲
In normal lungs, air flows freely in and out of the bronchi and alveoli. However, in people with COPD, the airflow is blocked. This can be caused by inflammation of the airways, mucus production, or damage to the air sacs.
𝐑𝐢𝐬𝐤 𝐅𝐚𝐜𝐭𝐨𝐫𝐬
There are several risk factors for COPD, including smoking, air pollution, and genetics. Smoking is the most common risk factor for COPD. Smoking is responsible for about 80% of COPD cases. Air pollution, particularly indoor air pollution from cooking and burning fuels, can also increase the risk of COPD. Genetics can also play a role in COPD. People with a family history of COPD are more likely to develop the disease.
𝐜𝐚𝐮𝐬𝐞𝐬
The main causes of COPD are smoking and air pollution. Smoking damages the lungs and makes it difficult to breathe
𝐒𝐭𝐚𝐠𝐞𝐬
• Stage 1
• Stage 2
• Stage 3
.
𝐒𝐲𝐦𝐩𝐭𝐨𝐦𝐬
The most common symptoms of COPD are:
• Shortness of breath
• Cough
• Wheezing
• Chest tightness
• Fatigue
𝐂𝐨𝐦𝐩𝐥𝐢𝐜𝐚𝐭𝐢𝐨𝐧𝐬
COPD can lead to several complications, including:
• Anemia
• Right-sided heart failure
• Muscle weakness
• Lung infections
• Bone thinning
• Collapsed lungs
𝐃𝐢𝐚𝐠𝐧𝐨𝐬𝐭𝐢𝐜 𝐦𝐞𝐭𝐡𝐨𝐝𝐬
COPD is diagnosed with a spirometry test, which measures how much air a person can exhale.
𝐓𝐫𝐞𝐚𝐭𝐦𝐞𝐧𝐭 𝐎𝐩𝐭𝐢𝐨𝐧𝐬
There is no cure for COPD, but there are treatments that can help manage the symptoms and slow the progression of the disease. Treatment options include:
• Bronchodilators
• Antibiotics
• Supplemental oxygen
• Vaccination
𝐏𝐫𝐞𝐯𝐞𝐧𝐭𝐢𝐯𝐞 𝐌𝐞𝐭𝐡𝐨𝐝𝐬
The best way to prevent COPD is to avoid smoking and air pollution. Several lifestyle changes can help reduce the risk of COPD, such as eating a healthy diet and exercising regularly.
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What is emphysema?
Emphysema is a condition that forms part of chronic obstructive pulmonary disease (COPD) and involves the enlargement of the air sacs in the lung.
The alveoli at the end of the bronchioles of the lung become enlarged because of the breakdown of their walls. The fewer and larger damaged sacs that result mean there is a reduced surface area for the exchange of oxygen into the blood and carbon dioxide out of it.
Definition
Emphysema is a condition in which the alveoli become stiff expands and continuously filled the air even after expiration. Emphysema is a chronic obstructive disease due to lack of elasticity in the lungs and alveoli surface area.
Classification
Panlobular (panacinar)
It is damage to the respiratory bronchi, alveolar ducts and alveoli. All air space in the little lobes much enlarged, with little inflammatory disease. The characteristics that have chest hyperinflation, and is characterized by dyspnea on exertion, and weight loss.
CENTRILOBULAR (CENTROACINAR)
The pathological changes mainly occur in the centre of the secondary lobes, and peripheral of acini remain good. Often there is chaos-ventilation perfusion ratio, which lead to hypoxia, hypercapnia (increased CO2 in the arterial blood), polycythaemia and heart failure episodes right. The condition leads to cyanosis, peripheral oedema, and respiratory failure.
CAUSES OF EMPHYSEMA
The biggest known cause or risk factor for emphysema - and for COPD - is smoking. Cigarette smoking is responsible for around 90% of cases of COPD. However, COPD will develop only in smokers who are genetically susceptible - smoking does not always lead to the disease.
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MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
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Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
2. DEFINITION OF COPD
Chronic obstructive pulmonary disease
(COPD) is a preventable and treatable
disease state characterized by air flow
limitation that is not fully reversible.
(ask.com)
Air flow limitation is usually progressive
and is associated with an abnormal
inflammatory response of lungs to
noxious particles or gases,primarily
caused by cigarette smoking.
3.
4. COPD is a lung disease defined poor
air flow as a result of break down of
lung tissue or dysfunction of small air
ways .primary symptom include
shortness of breath ,cough ,and
sputum production( medical
dictionary)
8. Chronic Bronchitis
Chronic
bronchitis is defined
clinically as the presence of a
cough productive of sputum not
attributable to other causes on
most days for at least 3 months
over 2 consecutive years.
Chronic inflammation of the
bronchii
9.
10. Chronic Bronchitis
Chronic
nonspecific inflammation
Symptoms of cough and sputum
production with or without gasping
Recurrent attacks
Chronic proceeding
11. Classification of Chronic Bronchitis
Simple type
of Chronic
Bronchitis
(without
gasping)
Cough
Sputum expectoration
Chronic
Bronchitis
with
gasping
Cough
Sputum expectoration
Gasping
12. Stages of Chronic Bronchitis
Stages
Time Courses
Exacerbation
In a week
Chronic lag
phase
One month or longer
stable
Lasts for two months
18. Diagnosis of chronic
bronchitis
History
Cough
& Sputum expectoration &
Gasping
Three months /per year or longer
Continuously longer than two years
Exclude other lung and heart disease
If shorter than three months /per year
then definite objective evidences are
demanded (such as X-Ray and lung
function et al.)to diagnose.
21. Definition of Emphysema
Pulmonary
emphysema
(a pathological term)
is characterized by abnormal,permanent
enlargement of air spaces distal to the
terminal bronchioles ,accompanied by
destruction of their walls and
hyperdistension leading to reduction in
lung elastics recoil and airway
obstruction.
22. Classification of Emphysema
Obstructive Emphysema
senile
Emphysema emphysema(Physiological)
without
Interstitial Emphysema
Obstruction
Compensating Emphysema
Scarred Emphysema
25. •Lung parenchyma (respiratory bronchioles and
alveoli)
Alveolar wall destruction, apoptosis of epithelial
and endothelial cells.
• Centrilobular emphysema: dilatation and
destruction of respiratory bronchioles; most
commonly seen in smokers
• Panacinar emphysema: destruction of alveolar
sacs as well as respiratory bronchioles; most
commonly seen in alpha-1 antitrypsin deficiency
29. spirometric classification of COPD
FEV1/FVC
mild
<70%
moderate
<70%
severe disease <70%
Very severe
< 70%
FEV1%pred
≥80%
50~80%
30~50%
≤ 30%or<50%
following with respiratory failure
& right heart failure
32. Clinical Manifestations of copd
Symptoms:
Gradually
progressive
dyspnea is the most common
presenting character.
Dyspnea that is:
Progressive (worsens over time)
Usually worse with exercise
Persistent (present every day)
Described by the patient as an “increased
effort to breathe,”“heaviness,” “air hunger,”
or “gasping.”
33. •Chronic Cough
May be intermittent and may be unproductive.
•Chronic sputum production:
Recurrent
respiratory infection
Recurrent
attacks leading to cor pulmonal
heart disease
Unexpected
Decreased
weigh loss
food appetite
35. Clinical Manifestation
*Percussion :
Hyperresonant
depressed diaphragm,
dimination of the area of absolute cardiac dullness.
*Auscultation:
Prolonged expiration ;
reduced breath sounds;
The presence of wheezing during quiet breathing
Crackle can be heard if infection exist.
The heart sounds are best heard over the xiphoid area.
39. Chest X-Ray --emphysema
Chest
findings are also varible.
Marked over inflation is noted with
flattend and low diaphragm
Intercostal space becomes widen
A horizontal pattern of ribs
A long thin heart shadow
Decreased markings of lung peripheral
vessels
43. Labortory Examination
Blood examination
In excerbation or acute infection in airway,
leucocytosis may be detected.
Sputum examination
streptococcus pneumonia
Haemophilus influenzae
Moraxella catarrhalis
klebsiella pneumonia
44. Blood
gas analysis:
Arterial blood gas analysis may reveal
hypoxemia,particularly advanced
disease.
In patients with severe hypoxemia ,CO2
retention,it shows low arterial PO2 and
high arterial PCO2.
46. management
Aim
Based on the principles of
prevention of further progress of
disease
preservation and enhancement of
pulmonary functional capacity
avoidance of exacerbations in order
to improve the quality of life.
52. Drug Therapy
Bronchodilators
Three major classes of bronchodilators:
β2
- agonists:
Short acting: salbutamol & terbutaline
Long acting :Salmeterol & formoterol
Anticholinergic agents:
Ipratropium,tiotropium
Theophylline (a weak bronchodilator,
which may have some antiinflammatory properties)
53. Drug Therapy
2.Glucocorticoids
Regular treatment with inhaled
glucocorticoids is appropriate for
symptomatic patients with
anFEV1<50%pred and repeated
exacerbations.
Chronic treatment with systemic
glucocorticoids should be avoided
because of an unfavorable benefit-torisk ratio.
54. 3. COMBINATION THERAPY
Combination therapy of long acting
ß2-agonists and inhaled
corticosteroids show a significant
additional effect on pulmonary
function and a reduction in
symptoms.
Mainly in patients with an FEV1<50%pred
56. Oxygen Therapy
Oxygen
--
>15 h /d
Long-term oxygen therapy (LTOT)
improves survival,exercise,sleep and
cognitive performance in patients
with respiratory failure.
The therapeutic goal is to maintain
SaO2 ≥ 90% and PaO2 ≥ 60mmHg at
sea level and rest .
57. Long-term Oxygen therapy
LTOT
Indication:
For patients with a
PaO2 ≤ 55 mmHg or SaO2≤88% ,
with or without hypercapnia
For patients with a
PaO2 of 55~70 ( 60 ) mmHg or SaO2≤89%
as well as pulmonary hypertension / heart
failure / polycythemia (hematocrit >55%)