please explain more details Bernice Mottram is a 70 year old female. Bernice has
ID: 142878 • Letter: P
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please explain more details
Bernice Mottram is a 70 year old female. Bernice has smoked since she was 25 years old, smoking on average 10 cigarettes per day. Bernice has been finding that in the last 2 years, she fatigues easily, even with light exertion, experiencing significant shortness of breath. On consultation with her doctor for her increasing shortness of breath, Bernice was noted to have a prolonged expiratory phase in her breathing, increased anterior-posterior chest diameter and cyanosis of the nail beds. Bernice also describes a having a mucous producing cough that lasted for 3 months during winter, and this has happened every winter for the last years Bernice was referred to the respiratory investigations department, in which pulmonary function tests were performed. Her results were as follows TABLE1 Testing parameter Vital capacity Residual volume Functional residual capacity Increased Expiratory flow rate Arterial PO O, saturation Arterial PCO Test findings (in relation to normal values) Decreased Increased Decreased 48mmHg (normal> 100mmHg) 78% (normal >95%) 69mmHg (normalExplanation / Answer
The patient has an increased anteroposterior (AP) chest diameter because of the increase in functional residual capacity (FRC). FRC is the volume that remains in the lungs after a passive expiration. It is equal to the sum of residual volume and expiratory reserve volume. This patient has increased residual volume which has increased the FRC.
Due to the loss of lung elasticity in COPD patients, the walls of the chest recoils to a position of total lung capacity. That is why the AP chest diameter increases.
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