Pulmonary ConditionsDescription & DefinitionsDescriptions/DefinitionsEtiology, Pathophysiology & Clinical FeaturesSlide 5EmphysemaSlide 7Chronic BronchitisCategories of COPDFunctional DisabilitiesSlide 11Slide 12Treatment of COPDSlide 14Psychological ImplicationsVocational implicationsAsthmaSlide 18Slide 19Pathology of AsthmaAsthma Prevalence* by Age United States: 1980–1996Asthma Prevalence* by Sex United States: 1982–1996Asthma Prevalence* by Race United States: 1982–1996Asthma Prevalence* by Race Ages 5-34, United States: 1980–1996Age-Adjusted* Asthma Mortality Rates by Sex, United States: 1979–1998Slide 26Slide 27Costs of Asthma United States, 1980–1998 Projection for the Year 2000Risk Factors for Development of AsthmaRisk Factors for Development of Asthma: Genetic CharacteristicsClearing the Air Categories for Associations of Various ElementsClearing the Air Indoor Air Exposures and Asthma DevelopmentClearing the Air Indoor Air Exposures and Asthma ExacerbationMedications to Treat AsthmaMedications to Treat Asthma: Long-Term ControlMedications to Treat Asthma: Quick-ReliefMedications to Treat Asthma: How to Use a Spray InhalerMedications to Treat Asthma: Inhalers and SpacersMedications to Treat Asthma: NebulizersManaging Asthma: Asthma Management GoalsManaging Asthma: Asthma Management PlanManaging Asthma: Indications of a Severe AttackResourcesResourcesCystic FibrosisCystic FibrosisSlide 47Slide 48CF - SymptomsCF – Symptoms (cont)Slide 51Slide 52CF - ComplicationsCF – Complications (cont)CF - TreatmentCF – Voc & Psych ImplicationsSlide 57ReferencesPulmonary ConditionsPulmonary ConditionsMedical and Psychosocial Medical and Psychosocial Aspects of DisabilityAspects of DisabilityRCS 6080RCS 6080Description & DefinitionsDescription & DefinitionsChronic Obstructive Pulmonary Chronic Obstructive Pulmonary Disease (COPD) is characterized by Disease (COPD) is characterized by decreased expiratory airflowdecreased expiratory airflowReduction in expiratory airflow has 2 Reduction in expiratory airflow has 2 causes:causes:•Decreased expiratory air flow pressure Decreased expiratory air flow pressure (decrease in driving pressure)(decrease in driving pressure)•Increased resistance to expiratory air flow Increased resistance to expiratory air flow (resulting from narrowing of airways)(resulting from narrowing of airways)Descriptions/DefinitionsDescriptions/DefinitionsEmphysema & chronic bronchitis are Emphysema & chronic bronchitis are often considered together under the often considered together under the term COPD because most people with term COPD because most people with one of these conditions has the other. one of these conditions has the other. Thus most people with COPD with have Thus most people with COPD with have both airway & alveolar disease.both airway & alveolar disease.COPD affects as many as 30,000,000 COPD affects as many as 30,000,000 AmericansAmericansCOPD is the 5th leading cause of deathCOPD is the 5th leading cause of deathEtiology, Pathophysiology Etiology, Pathophysiology & Clinical Features& Clinical FeaturesSeveral factors are involved in the Several factors are involved in the pathogenesis of COPD, but smoking is pathogenesis of COPD, but smoking is the most importantthe most important•Other factors include occupational Other factors include occupational exposure to dust, fumes & air pollution.exposure to dust, fumes & air pollution.Aside from these factors, the Aside from these factors, the development and progression of COPD development and progression of COPD is largely related to genetic disposition.is largely related to genetic disposition.EmphysemaEmphysemaEmphysema is an Emphysema is an enlargement of air enlargement of air spaces caused by spaces caused by destruction of alveolar destruction of alveolar walls. Air spaces walls. Air spaces greater than one cm greater than one cm are bullae. This photo are bullae. This photo shows apical bullous shows apical bullous disease with relatively disease with relatively little involvement of little involvement of the rest of the lung. the rest of the lung.EmphysemaEmphysemaEmphysema can be a result Emphysema can be a result of obstruction caused by of obstruction caused by chronic bronchitis. It occurs chronic bronchitis. It occurs when there is back pressure when there is back pressure on the alveoli. This on the alveoli. This increased pressure tends increased pressure tends over time to make their over time to make their walls break down, and walls break down, and instead of having lots of tiny instead of having lots of tiny air sacs functioning well, you air sacs functioning well, you end up with large cavities end up with large cavities consisting of alveoli that consisting of alveoli that have coalesced, and which have coalesced, and which do not adequately perform do not adequately perform the task of gas transfer. the task of gas transfer.Chronic BronchitisChronic BronchitisThe lungs essentially comprise lots of The lungs essentially comprise lots of tubes and tubules (called bronchi and tubes and tubules (called bronchi and bronchioles) of gradually diminishing bronchioles) of gradually diminishing size, which end in little collections of size, which end in little collections of air sacs called alveoli. It is across the air sacs called alveoli. It is across the walls of the alveoli that the gases are walls of the alveoli that the gases are exchanged, oxygen being taken into exchanged, oxygen being taken into the bloodstream and carbon dioxide the bloodstream and carbon dioxide passing into the alveoli to be exhaled. passing into the alveoli to be exhaled. Chronic bronchitis is an inflammation Chronic bronchitis is an inflammation or irritation of the airways in the or irritation of the airways in the lungs which is associated with:lungs which is associated with:Scarring or fibrosis of the walls of the Scarring or fibrosis of the walls of the bronchioles making them less pliablebronchioles making them less pliableThickening of their lining causing Thickening of their lining causing narrowing of the airwaynarrowing of the airwayProduction of excessive quantities of Production of excessive quantities of thick mucus which further plugs the thick mucus which further plugs the tubules and compromises breathingtubules and compromises breathingCategories of COPDCategories of COPDType A - “Pink Puffer”Type A - “Pink