please explain more detail Bernice Mottram is a 70 year old female. Bernice has
ID: 3501349 • Letter: P
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please explain more detail
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 3 years. Bernice was referred to the respiratory investigations department, in which pulmonary function tests were performed. Her results were as follows TABLE Testing parameter Test findings (in relation to normal values) Decreased Increased Vital capacity Residual volume Functional residual capacity Increased Expiratory flow rate Arterial PO O, saturation Arterial PCO Decreased 48mmHg (normal > 100mmHg) 78% (normal >95%) 69mmHg (normalExplanation / Answer
Chronic Obstructive Pulmonary Disease is lung disease blocking airflow and making it difficult to breathe.
VITAL CAPACITY: After maximum inhalation the maximum amount of air that can be expelled is called VITAL CAPACITY.
RESIDUAL VOLUME: The amount of air remaning in the lungs after maximum forceful expiration is called RESIDUAL VOLUME.
THE RELATION BETWEEN VITAL CAPACITY AND RESIDUAL VOLUME:
Residual volume is nothing but the difference between Functional Residual Capacity and Expiratory Reserve Volume.
i.e. RV = FRC - ERV ... (1)
where, FRC is the amount of air remaining after normal exhalation.
ERV is the extra amount of air that can be exhaled with an extra effort after a normal exhalation.
Vital capacity is nothing but the sum of inspiratory reserve volume, tidal volume and expiratory reserve volume.
i.e. VC = IRV + TV + ERV ...(2)
where, IRV is the maximum amount of air that can be inhaled after the inhalation of normal Tidal Volume
TV is the general quantity of air inhaled in normal inhalaion and normal exhalation when extra effort is not applied.
Thus, ERV = VC - IRV - TV from (2)
Thus, RV = FRC - VC + IRV + TV from (1)
Thus, increase in FRC and decrease in VC consequently led to the increase RV.
THE EXPLAINATION FOR THESE RESULTS ON HER PULMONARY FUNCTION TESTS IN THE SETTING OF HER RESPIRATORY DISEASE:
Increase in RV:
1. Smoking decreases the efficiency of the lungs cleaning system. Cillia are reffered to as the hair like structures responsible for keeping the lungs clean. As a consequence of smoking not only are these slowed down but also reduced in number.
2. The mucus is not cleaned well too, making them stay in your lungs and clog your airway.
3. By this clogging, the lungs and airways get inflamed causing reduce in the airflow.
Increase in VC:
1. As a consequence of clogged airways the amount of air that can be inhaled largely goes down, making the IRV reach nil.
2. The tidal volume too becomes very less, on the whole making VC increase.
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