COPD/Emphysema/Bronchitis

[bri.mcelveen]

I understand that COPD is a combination of emphysema and bronchitis. However, I'm trying to piece together a couple things from my lecture. Bronchitis' main component is thick sputum with coughing (productive). Emphysema's main component is air trapped in alveoli resulting in hyperinflation of the lungs. One symptom noted is NON-productive cough. If one has COPD, it stands to reason that both of the aforementioned components would be visible/assessable on a patient.

Since a person can have either of these conditions as a stand alone diagnosis, I'm an looking now at emphysema by itself. My powerpoint from school states "inflammation of bronchioles and excessive mucus". Since it's Sunday, I wont get an answer from my instructor until tomorrow. So my question is, is it possible that an emphysema patient can have mucus accumulation with a NON-productive cough and will emphysema affect the bronchioles? So much focus was placed on "air trapped in alveoli" that I am wondering if this is a misprint in the notes.

Thanks!

[GrannyRRT]

You do not have to have both emphysema and bronchitis to be labeled COPD. For bronchitis to be COPD it has its own set of criteria which sets it apart from a once a year thing with a couple days of misery and a chronic condition.

You also have to include Alpha-1 Antitrypsin Deficency when addressing COPD and Emphysema.

For COPD, use the definitions provided GOLD.

GOLD - the Global initiative for chronic Obstructive Lung Disease

The ATS (American Thoracic Socety)

American Thoracic Society - We help the world breathe - PULMONARY :: CRITICAL CARE :: SLEEP

Has several good links for these diseases and also training modules.

[roser13, ASN, RN]

You may be overthinking the issue. The textbook definitions of COPD, emphysema, bronchitis & (don't forget) asthma are just that - basic textbook definitions. Of course an emphysema patient can have any & all mechanisms & symptoms going on. As can a bronchitis patient.

And no, it is not a mistake in your notes to talk about the alveolar air trapping of emphysema. In regular emphysema, the damaged tissue usually occurs around the base of the lungs. In A1At, the bullae can occur randomly on the lung surface.

[bri.mcelveen]

Ok. So I think it's all coming together, and yes, I do have a strong tendency to overthink things. ONe last clarification: I know that the medulla mediates breathing control. I understand that hypoxia is the drive for a COPD patient to breathe and they can't receive high amounts of O2 or that will decrease the drive. However, in my lecture my instructor stated that in a normal patient, with no issues, that the drive to breathe is high CO2 levels. She said "when we breathe in O2, it travels to the alveoli and is exchanged for the CO2, and then is exhaled and cycle of ventilation is repeated". So when she says "high CO2 level" she means that moment where the O2 and CO2 are exchanged? And at that point, the medulla senses that higher amount of CO2 which makes us exhale it and then breathe in more O2?

In a nutshell, I jut need to understand the need/drive for normal person to breathe.

Thanks guys!! O2 exam this Friday. Last one of the semester and I wanna rock it!

Bri