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Risk Factors:

Irritants (cement dust, gases and fumes from factory), cigarette


smoking, secondhand smoking from co-workers, inappropriate use

Entry of irritants through


inhalation

Increased
respiratory effort
a.m.b tachypnea,
increased RR,
S.O.B.

Prolonged exposure to particles

Chronic irritation

Decreased Lung
Compliance and
increased airway

Inflammation of bronchial walls


Hypertrophy of submucosal glands in larger
airways and increase in goblet cells in smaller
airways

If prolonged,
fibrosis of
bronchial walls
and scar

Increase in mucus secretion


Accumulation of mucus in airways

Obstruction
with
parenchymal
damage

Narrowing of lumen and plugging

Decrease
in
circulatin
g oxygen

Impaired
ciliary function

Increased
susceptibility to
infection

Chronic
Bronchitis

Obstruction of
airflow which
leads to V/Q
mismatch

Progressive coughing
a.m.b. chronic cough that
produces sputum that
may be clear, white,
yellow or greenish.

COPD
Exacerbatio
n
period

Dyspnea

Alveolar tissue
destruction
If cannot
compensate,
Hypoxemia,
hypercapnia,

COPD
Decrease in
surface area
for gas
exchange

Increase in RBC
production

Polycythemia a.m.b.
plethora, cyanosis,
warm moist skin
Higher blood
viscocity

Increased heart
workload

Manifestations:
Progressive decrease in
exercise tolerance,
prolonged expiration,
expiratory wheezes and
crackles, chest tightness

Hypoxic
pulmonary
vasoconstriction

Increased pulmonary
vascular resistance

Pulmonary
hypertension

Ventilation
-Perfusion
coupling
Manifestations:
S.O.B, venous
congestion,
peripheral
edema, chest
pain, fatigue,
excessive
coughing, and
abnormal heart

Cor
pulmonale
Increased right
ventricular
afterload

Right
ventricular
hypertophy

Right
ventricular
failure

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