WORKSHOP: RESPIRATORY DISORDERS WEEK: 3 1. Looking at the graph below, label whether each curve represents normal, restrictive or obstructive pulmonary ventilation. IF this spirometry test was performed on Mr Tien, which curve would best represent his result? What does the graph tell you? normal FVC - forced vital capacity, FEV,- forced expiratory volume (1st second) FEV. -obstructive Characteristic Restrictive Yes Obstructive Volume exhaled (L) - Inspiration impaired (Yes/NO) Expiration impaired ( Yes/ NO) Effect on FEV1 Effect on FVC Associated pathophysiology example with - no effect , but is reduced Yes, it is reduced Yes Yes , it is reduced normal no effect pneumonia , atelectasis , pulmonary fibrosis, neuromuscular disorder, penothank , can't expand OSHima, COPD - emphysema, chronic bronchitis -can expand, can't release an obstruction to air loving expire impact long ability to expand ( inspire ) -restrictive FVC 0 1 RIO, dostruck Time(s) out restrict in 2. Identify some pathophysiological changes that have occurred in Mr Tien's respiratory system that can result in chronic cough and wheezing which are typical signs of COPD airway obstruction - air can't get out - wheezing blockage , I coughing to remove blockage decreased space Conducting zone Respiratory zone . Nose · Pharynx · Larynx · Bronchi and divisions up to terminal bronchioles · Respiratory bronchioles ant related divisions · Alveoli coughing wheezing occurs in conducting zone Example : strow folded chronic coughing = trying to expel the moveus. Can't suck up as much. Cough comes from trying to blow out blockage reduction in airway diameter via constriction of smooth muscles in the branchides or mucus build up = wheezing over production of mucus = chronic cough 3. Compare and contrast the clinical manifestations of chronic bronchitis and emphysema Clinical feature/ Characteristic Chronic Bronchitis Emphysema Referred to as Blue bloaters Pink puffers Branchial Infection Common Not as common Appearance Obese, cyanosis Barrel chest, pursed lips, digital Clubbing, leaning forward Cor pulmonale Dysproca on exertion Sputum (Flegn) Age more common Mild Pululent (pus) sputum 50 less common Severe Not as prevalent ~ 60 mucoid ( muck ) sputum Cor pulmonale = right sided heart failure. Cor - heart pulmonale - heart disease from lung disease 4. Discuss some non-pharmacologic and pharmacologic management strategies For COPD What is the strategy / therapy How does it help What is the strategul therapy How does it help What is the strategy / therapy How does it help What is the strategy I therapy How does it help Non- Pharmacologic exercise increase respiratory capacity breathing retraining increase effeianan -inhalation smoking cessation limits noxious substances Prevent infections hygeine, mask Pharmacologic corticosteroids reduce immflammation Oxygen theraos increase oky sat. levels bronchodilator increase airway diameter Lairflow