If you are a smoker, past smoker, someone who worked around certain chemicals while breathing in the fumes for many years, worked in a dusty area over a period of time or worked where there is heavy exposure to air pollution, then you may illustrate the signs and symptoms of Chronic Obstructive Pulmonary Disease. COPD is a lung disease in which the lungs are damaged making it hard to breathe. Chronic Obstructive Pulmonary Disease patients have both chronic bronchitis and emphysema, but are classified as "blue bloaters" or "pink puffers." A "blue bloater" will suffer from chronic bronchitis and a "pink puffer" will suffer primarily from emphysema.
Patients suffering from chronic bronchitis are termed "blue bloaters". The term is traced from the bluish color of the lips and skin commonly seen in patients who have Type B Chronic Obstructive Pulmonary Disease (COPD). If a person has the chronic bronchitis COPD, the damaged airways will have become inflamed and thickened and there will also be an increase in the number and size of mucus producing cells. When the walls of the airways become thick or swollen, many of the air sacs are destroyed. The cells accumulate more mucus which tends to clog the airways and the person will develop a cough and difficulty inhaling and exhaling air through the lungs. A "blue bloater" will demonstrate the following signs and symptoms.
HISTORY OF COUGH WITH SPUTUM FOR 3 MONTHS TO A YEAR OR MORE
Coughing is one of the most common lung disease symptoms. When trying to clear the airways of toxins, mucus, or a foreign body, coughing is used as a defense mechanism. Coughing can be productive or unproductive depending on how its did and the result. Along with other mechanisms, coughing helps to protect the lungs from particles that have been inhaled and sometimes brings up sputum. Sputum is also known as phlegm which is a mixture of mucus, debris, and cells expelled by the lungs. Airway could easily be irritated by bacterial or viral respiratory infections, allergies, and smoke. Smoke damages the cells that line the airways, including the hairlike projections that normally cleanse the airways of debris. Coughing may result from gastroesophageal reflux, postnasal drip or drugs. When airways are narrowed below the windpipe, foreign bodies or tumors, it can cause coughing, wheezing or, both.
CYANOSIS DUE TO A DECREASE IN SUFFICIENT AMOUNTS OF OXYGEN IN THE BLOOD
Cyanosis is a condition in which the skin, lips and nails become bluish or purplish in color. When there is an insufficient amount of oxygen in the blood, Cyanosis occurs. It could result from blood vessel and heart malformations that allow blood to flow directly to the heart without ever flowing past air sacs of the lung where oxygen is taken from the air. Blood form oxygen-depleted veins may flow directly into the vessels returning blood form the lungs to the left side of the heart or directly into the left side which is called a shunt. As in acute lung disease, Cyanosis may appear suddenly or gradually over time as a lung disease progresses.
SWOLLEN ANKLES OR LEGS AND DISTENTION IN THE NECK VEINS
Pay attention to swelling of the face, legs, arms and ankles which may show lung disease. The swelling occurs because of an increase in pressure in the lungs blood vessels. Then, blood backs up in the body's vein which causes excess fluid to leak into surrounding tissues allowing gravity to take over. Normally accompanied by shortness of breath, swelling is associated with heart disease.
DEVELOP SIGNS OF RIGHT-SIDED HEART FAILURE
Right-sided heart failure is a condition in which the right side of the heart loses its ability to pump blood efficiently. The right ventricle loses it's pumping function and blood may back up into areas of the body, producing congestion. Congestion affects the liver, the gastrointestinal tract, and the limbs.
When "blue bloaters" are analyzed and tested, the Arterial Blood Gas results will show evidence of hypoxemia, carbon dioxide retention and compensated respiratory acidosis. The prognosis for blue bloaters is poor and most die within 2 to 4 years. Long-term oxygen therapy at home using concentrators is the only treatment shown to improve the prognosis of a "blue bloater."
Patients suffering from emphysema are called "pink puffer". The term is traced from the reddish complexion and the "puffing" or hyperventilation seen in patients who have Type A Chronic Obstructive Pulmonary Disease. Type A In a case of emphysema type COPD, the walls between most of the air sacs are destroyed which leads to a few number of large air sacs instead of the normal number of many tiny ones. These larger air sacs have less surface area for the exchange of oxygen and carbon dioxide and the lungs looks like a sponge with many large bubbles in it. The poor exchange of oxygen and carbon dioxide, result in shortness of breath. A "pink puffer" will demonstrate the following signs and symptoms.
TYPICALLY THIN
Weight loss is normally difficult to maintain on a healthy level. It is usually easier for a "pink puffer" to lose weigh and much harder for them to gain. Therefore, they remain typically thin in body size.
BREATHES WITH PURSED LIPS
Breathing for a "pink puffer" takes an extreme amount of effort. He or she will have rapid and very shallow breathing. Due to the high residual lung volume a "pink puffer" may have a barrel chest.
INCREASING RESPIRATORY RATE AND EXPERIENCES DIFFICULTY BREATHING
During exercise and high altitudes, an increase in the rate and depth of breathing occurs, but the increase should not cause discomfort. Dyspnea is a term used to describe difficulty in breathing and is a common symptom of many lung diseases. It is termed shortness of breath, or difficulty breathing. With Dyspnea the person feels a sensation of not being able to breathe fast or deep enough and the faster breathing is accompanied by the feeling of running out of air. Another sensation of Dyspnea is the increased muscle effort to expand the chest while breathing, which is described as tightness in the chest.
When "pink puffers" are analyzed and tested, the Arterial Blood Gas results show evidence of less hypoxemia than "blue bloaters" and no carbon dioxide retention. The prognosis for "pink puffers" is a lot better than for "blue bloaters."
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Chronic bronchitis
In this type, chronic bronchitis plays the major role. Chronic bronchitis is defined by excessive mucus production with airway obstruction and notable hyperplasia of mucus-producing glands.
Damage to the endothelium impairs the mucociliary response that clears bacteria and mucus. Inflammation and secretions provide the obstructive component of chronic bronchitis. In contrast to emphysema, chronic bronchitis is associated with a relatively undamaged pulmonary capillary bed. Emphysema is present to a variable degree but usually is centrilobular rather than panlobular. The body responds by decreasing ventilation and increasing cardiac output. This V/Q mismatch results in rapid circulation in a poorly ventilated lung, leading to hypoxemia and polycythemia.
Eventually, hypercapnia and respiratory acidosis develop, leading to pulmonary artery vasoconstriction and cor pulmonale. With the ensuing hypoxemia, polycythemia, and increased CO2 retention, these patients have signs of right heart failure and are known as "blue bloaters."
Emphysema
The second major type is that in which emphysema is the primary underlying process. Emphysema is defined by destruction of airways distal to the terminal bronchiole.
Physiology of emphysema involves gradual destruction of alveolar septae and of the pulmonary capillary bed, leading to decreased ability to oxygenate blood. The body compensates with lowered cardiac output and hyperventilation. This V/Q mismatch results in relatively limited blood flow through a fairly well oxygenated lung with normal blood gases and pressures in the lung, in contrast to the situation in blue bloaters. Because of low cardiac output, however, the rest of the body suffers from tissue hypoxia and pulmonary cachexia. Eventually, these patients develop muscle wasting and weight loss and are identified as "pink puffers."
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