COPD: Anatomy, Pathophysiology and Impact on the Body

Chronic obstructive pulmonary disorder is seen to be a lot more common in older adults and contribute to a lot of problems as people get older and enter into later life. Both Chronic bronchitis and emphysema are contributing factors which further develops into COPD. Working in an Older Adult ward there have been many individuals that suffer from this long term condition.

COPD, Chronic obstructive pulmonary disorder is an umbrella term and is used to describe a range of respiratory conditions such as emphysema and chronic bronchitis. This long term condition is most commonly diagnosed in both adult men and women older than 40 years of age. Those who suffer with COPD, prevalence increases with age and most people are not even diagnosed until they are in their 50’s. Where this diseases is more commonly diagnosed in men evidence shown by COPD Organisations have shown that more women die due to this condition. NHS UK states “COPD is most commonly associated with cigarette smoking and is responsible for around 9 in every 10 cases”. Chest & stroke Scotland 2010 “up to 1 out of every 4 people (25%) who are long term smokers will develop COPD. COPD is used to describe not only a worsening condition but also something that cannot be undone. However managed correctly people who suffer from this condition can live for many years and enjoy their lives. Department of Health England (2010) states that COPD affects over 3 million people in England. According to the British lung foundation, at the end of 2012 around 7,999 adults over the age of 81 were diagnosed with COPD.


Anatomy PATHOPHYSIOLOGY AND IMPACT ON BODY SYSTEMS

The respiratory system is made up of your lungs, trachea (windpipe) , bronchi (airways) bronchioles , alveoli and your capillaries which are also known as the tiny blood vessels within your lungs. In a normal healthy lung, air travels through the trachea into your lungs. For this air to get inside of your lungs, the trachea divides into branches which are split into the left and right bronchus. Divided further there are small passages called the bronchioles at the end of these bronchioles there are small air sacs which are called alveoli. Attached to the alveoli are the tiny blood vessels called the capillaries The oxygen in which we breathe in is passed through the trachea down into the bronchus and bronchioles until it passes through the wall of the alveoli to reach the capillaries in order for gas exchange to happen.

This process of gas exchange and breathing as a whole in a normal healthy lung is a lot simpler and smoother in comparison to an individual suffering with Chronic obstructive pulmonary disease.

In COPD lung, over a period of time inflammation to the lungs can cause permanent damage to not only your airways but to the air sacs. There is constriction in both the bronchi and the bronchioles in the lungs which contributes to them becoming inflamed and excessive mucous production clogging up the airways. The excess mucous production is used to trap and prevent any irritants from entering your lungs. Due to this excess mucous production the cilia have to work extra harder in order to move the mucous and over along period of time the cilia become damaged and therefore unable to discard any mucous. The air sacs, alveoli , become damaged and begin to loose their elasticity which is commonly due to the irritation caused in the lungs and airways . The combination of both the excess mucous production and smaller spaces and air entry makes the exchange of both gases CO2 and Oxygen a lot more harder for someone with this condition. Overtime the spaces between get larger casing trapped air and fewer air sacs to supply oxygen to the blood which also has an impact on the circulatory system. Poor gas exchange overtime can contribute to the damaging of pulmonary arteries in the lungs. This contributes to the damaging of the right ventricle in the heart. This is also known as pulmonary hypertension. In pulmonary hypertension the right side of your heart has to work a lot more harder in order to push blood into and through the lungs. Due to COPD and the obstruction in the pulmonary arteries overtime the heart becomes weaker and unable to pump effectively.


Social determinants WHO organisation

COPD is more commonly associated with socio economic deprivation. Smoking is one of the main causes contributing to an individual to have COPD. “Smoking contributes to 77% of all COPD deaths in England and is generally more common amongst the most deprived of communities”. (WHO 2017)

Poor housing and poverty can be linked to many respiratory conditions including COPD. Living in a house with mould spores and dust mites can lead to asthma and continue living can eventually contribute to COPD.


IMPACT OF COPD

COPD can have a severe effect on an individuals life, which can have an impact on many different aspects not only on a persons physical health but also on their emotional, mental and social wellbeing. Physically a person suffering from this long term condition will have a continuous productive cough, breathlessness and may even suffer from wheezing. Fatigue can also play a part in affecting the individuals physical wellbeing. Other contributing signs and symptoms of COPD

Managing COPD will not only have a physical impact on an individuals life but also their mental and emotional wellbeing could be at risk. Emotionally an individual suffering from a chronic disease or disorder may start to feel frustrated, and maybe even start to feel as if they are out of control. The symptoms of COPD may make it harder for individuals to take part in normal day to day activities. Loosing control of day to day living can eventually led into depression, sadness and even some forms of guilt e.g having to rely on their people for simple day to day tasks.

Below are some common signs and symptoms:

Physical Impact of COPD Psychological /Emotional impact of COPD
  • Persistent cough
  • Regular Sputum production
  • Frequent Bronchitis or Coughs
  • Wheeze when breathing
  • Weight loss
  • Ankle swelling
  • Fatigue
  • Anxiety
  • depression
  • feeling out of control
  • Guilt of relying on others
  • Isolated


Management

The management of COPD is person centred and looks at individuals current lifestyle and other co morbidities the individual has in order for the best treatment and prevention to be given. Smoking cessation reduces the decline in an individuals lung function while suffering from COPD. Many infections combined with the continuation of smoking can complicate COPD and can lead to the prevention of vaccinations. The symptoms of COPD can be alleviated through different types of medications one of which is a short acting bronchodilator. This form of inhaler is used when the obstruction in the airways are more severe. Other forms of therapies are can also be used depending on the individuals wishes and most importantly their needs. Pulmonary rehabilitation

Key documents

The Documents below relate to a patient’s health and wellbeing suffering with a COPD.

The nursing and midwifery council, NMC, (2018) set out four professional standards in which all health professionals must follow. PRIORITIES people, PRACTICE effectively

Public Health Englands – From Evidence into Action explains that Smoking is one of the highest risk factors for COPD. The orangisation sets out Englands 7 priorities which one being to reduce the amount of people smoking and to stop children starting.

PHE -From Evidence into action

NHS constitution

References


 

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