The Pathophysiology of Chronic Obstructive Pulmonary Disease

Course overview

The pathophysiology of COPD impacts many body systems. The disease of COPD is classified in four stages using the GOLD (Global Initiative for Chronic Obstructive Lung Disease) Standards. While most people think of the direct pulmonary changes that are a result of the pathophysiology of COPD, the disease impacts multiple body systems. Changes in connective tissue quality lead to both increased compliance in the lung tissue as well as accelerated airway collapse on rapid exhalation, which both impact the propensity for CO2 retention and can alter pH. There is a direct impact on muscle physiology in COPD that is not related to impaired oxygenation but that does relate to both the morbidity and mortality of patients with COPD. Cor pulmonale is a term related to right heart failure that is a result of changes in pulmonary pressures and the heart's ability to flow blood forward into the pulmonary vasculature that is altered by the connective tissue environment of the lungs that surrounds it. Common medications required to manage the respiratory symptoms of COPD further impact tissue quality of the skin that reduce turgor and resilience. And, ongoing breathlessness impacts a patient's ability to manage their respiratory rate and volume. All of these sequelae will be explored to best understand the multisystem impairments of a patient with COPD as they progress through the continuum of the first through fourth stages.