Bernie Sullivan is a 73-year old retired seamstress who has never married. She w

Question

Bernie Sullivan is a 73-year old retired seamstress who has never married. She worked in the alterations department of a men's clothier for 48 years. Bernie is a chain smoker. On the job, she was never found without a cigarette hanging from her lips. When her employer announced that smoking was no longer allowed in the store, Bernie retired. Since her retirement three years ago, Bernie has not been feeling well. She fatigues easily, even with light exertion. She has shortness of breath and recently has begun to sleep on two pillows. However, despite these problems, she has refused to stop smoking. Ms. Sullivan made an appointment with her physician, who noted a prolonged expiratory phase in her breathing, expiratory wheezes, and increased anteroposterior (AP) chest diameter. Her nail beds were cyanotic, and she had moderate pitting edema at her ankles. Based on these observations and results of laboratory and pulmonary tests, the physician concluded that Ms. Sullivan has a combination of emphysema and bronchitis, called COPD, which resulted from her long history of smoking. The results of pulmonary function and laboratory tests are given below. Vital Capacit Residual Volume Functional Residual Capacit FEVi; Expiratory Flow RateDe Decreased Increased Increased Decreased 14.5 g/dL (normal is 12-15 85% 45 mm H 70 mm H 34 mEq/L (normal is 24 mEa/L g/dL Hemoglobin O2 saturation Arterial Po2 Arterial Pco bicarbonate

Explanation / Answer

2} COPD-chronic obstructive pulmonary disease is a chronic disease of lung airways a group of disease such as emphysema and chronic bronchitis that makes airway to constrict and makes the lund harder thus makes the lungs to work hard to breath.

Vital capacity is the maxium air that a person can exhale after a full inspiration so its equal to sum of inspiratory reserved volume, tidal volume and expiratory reserved volume. Since the lungs lost its elasticity it fails to expands fully thus results in reduced vital capacity.

Resudial volume- is the space which is present in the lungs after the maximum expiration as Copd causes expiration to make difficult the person exales very shallow when compared to normal person thus making more space or volume in the lungs after the maximum inspiration.

Forced residual capacity is the volume of the air present in the lungs after passive expiration. In copd passive recoling of lung is reduced during expiration thus making less volume of air to exhale and more air remains in the lung after passive expiration

FEV1 The amount of air which is exhaled forcely. In copd it is very much decreased because of reudced lung volumes and capacities.

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