Chronic Obstructive Pulmonary Disorder

In the given case study, it is informed that Alasdair is showing symptoms such as barrel chest, productive cough and progressive dyspnoea. The symptoms indicate that the person is suffering from chronic obstructive pulmonary disorder (COPD). This is because people with COPD develop dyspnea and moist productive cough as their bronchial tubes become inflamed as well as narrow as a result of damage to the alveoli leads the lungs to produce excess mucus and experience issues in maintaining proper flow of air (Kawayama et al. 2016). For students seeking psychology dissertation help, understanding the physiological aspects and symptoms of COPD can provide the most valuable insights into respiratory disorders and their management. The main cause of COPD is extensive tobacco smoking because the harmful elements present in the tobacco smoke damages the cells and tissues in the lungs making the airways to be narrowed and obstructed hindering proper airflow for breathing (Janciauskiene and Welte, 2016). The genetic disorder in which individuals express low level of alpha-1-antitrypsin protein also leads to the development of COPD. The alpha-1-antitrypsin primary role is to save the lungs from neutrophil elastase which is an enzyme that functions to digest the ageing or damaged cells in the lungs for promoting healing (Martinez-Delgado et al. 2016).

The case study informs that since Alasdair was a boy he extensively smoked tobacco which is one of the lifestyle issues that contributed to the development of COPD in the individuals. This is because the smoke from the tobacco damaged the alveoli in the lungs leads the bronchioles to be inflamed hindering air passage and secreting excess mucus making the individual cough and develop dyspnoea (Jiménez-Ruiz et al. 2015). The diagnosis of COPD is done through spirometry test in which the person estimated to the suffering from COPD is asked to breathe through a machine after inhaling bronchodilator. In the test, the volume of the air breathed in and out in a second is measured to take reading and compare it with normal readings (Lange et al. 2016). The chest X-ray in which the image of the lung is taken to determine its condition is used for the diagnosis of COPD (Lange et al. 2016). The treatment available for COPD includes use of medications which are bronchodilators, oxygen therapy in which supplementary oxygen is given and lung surgery in severe cases (NHS, 2018).

The case study informs that Fraser experiences issues with breathing properly when running and doing physical activity which indicates that he is suffering from exercise-induced bronchoconstriction (EIB). The exercise-induced bronchoconstriction is the condition faced by athletes in which the airways are narrowed creating difficulty in movement of air through the lungs while executing physical activity. The loss of water or heat or both from the airways during breathing while executing physical activity which results in drying the airways extensively compared to what is needed in the body is regarded as the cause of exercise-induced bronchoconstriction (EIB) (Boulet and O’Byrne, 2015).

The diagnosis of EIB is done through spirometry test in which at first the diagnosis is performed for ruling out underlying asthma (Weiler et al. 2016). The spirometry test in the case reveals abnormal results indicating an obstruction is present in the lungs leads health professionals to determine that the person is suffering from EIB and asthma. However, if the patients show normal results in the spirometry test and it an elite athlete then the individual is to perform bronchial provocation test for EIB diagnosis (Weiler et al. 2016). In the given case study, Fraser is seen to be an elite athlete who is into sports from his early 12 years of age and thus the bronchial provocation test is to be performed for identification of EIB. The treatment for EIB includes intake of medications such as short-acting bronchodilator, mast cell stabiliser, long-acting bronchodilator and anti-leukotriene. These medications are usually taken 15-30 minutes before exercise to help the airways avoid from getting constricted in turn ensuring proper flow of air is maintained for normal breathing. Moreover, the athletes can warm-up and cool down before and after executing exercise to ensure less signs and symptoms related to EIB are experienced (familydoctor, 2019).

The case study informs that Morgan is suffering from respiratory issues after falling from the bike and soft bulges in the ribs and her skin. This indicates that she is suffering from pneumothorax which is termed as collapsed lung. In this condition, the air is seen to leak into the spaces present between the lungs and the chest wall as a result of blunt wound or server chest injury in the accident (Roberts et al. 2015). The symptoms related to pneumothorax include shortness of breath, chest pain, uneven chest movement, rapid heartbeat and coughing to gasp air (Van Schil et al. 2016). The case study informs that all the symptoms experienced in pneumothorax are faced by Morgan indicating she is suffering from the condition. The key cause of pneumothorax is chest injury experienced in car crash or any assaults. The other cause of pneumothorax includes the presence of underlying damage in the lung tissues or development of small air blisters known as blebs on the top side of the lungs making the air to get leaked within the spaces (Van Schil et al. 2016).

The diagnosis of pneumothorax is done by executing an X-ray of the chest along with computerised tomography (CT) scan of the chest to develop detailed images regarding the condition of the lungs. In CT scan, computers along with rotating x-ray machines are implemented to develop cross-sectional images of the chest region for diagnosis of pneumothorax (Chen and Zhang, 2015). The treatment for pneumothorax includes relieving the lungs from the pressure created by allowing it to become re-expanded. The needle aspiration is used for the treatment of pneumothorax in which insertion of the flexible catheter is done between the ribs into the filled space with air which is leads the lungs to be collapsed. The inserted needle is removed and in the place, a syringe is placed on the catheter to pull out the excess air (Thelle et al. 2017). The chest tube insertion is another treatment for pneumothorax in which insertion of flexible chest tube is done in the space filled and it is attached with the one-way valve device for removing the excess air (Ghazali et al. 2016).

The individual mentioned in the case study is informed to be suffering from pulmonary hypertension. The pulmonary hypertension is a nature of increased blood pressure which mainly affects the arteries present in the lungs on the right side of the heart. The condition results the tiny pulmonary arteries present in the lungs to be blocked, narrowed or destroyed. This leads to increase pressure of blood flow into the lungs from the heart making the individual suffering from the illness (Kolte et al. 2018). The symptoms of pulmonary hypertension involve fatigue, shortness of breath, chest pressure and pain, increased heart rate and others (Simonneau et al. 2019). The mentioned symptoms are similar to the symptoms expressed by Archie indicating that the person is suffering from the same disease. The miners while working in deep pit for years develop pulmonary hypertension because the airborne dust and harmful gases in the pit affect the pulmonary arteries to be stiffened and become thick leading to inflame the blood vessels creating pressure in the pulmonary arteries (Kolte et al. 2018).

The diagnosis of pulmonary hypertension is done through a routine physical examination, The health practitioners by considering the signs as well as symptoms expressed by the patients relate them with the disease sign and symptoms to ensure the person is suffering from the illness (Herve et al. 2015). The echocardiogram is performed in the diagnosis of pulmonary hypertension where through sound waves heartbeat ranges are recorded. The recorded readings are analysed by the doctor to determine the functional efficiency of the right ventricle and the thickness of the wall (Maron and Galiè, 2016). The treatment for pulmonary hypertension includes administration of medications such as endothelin receptor antagonists, blood vessel dilators, high-dose calcium channel blockers, sildenafil and others (Maron and Galiè, 2016). In addition, surgeries such as atrial septostomy is done to open the right and left chambers of the heart in a surgical manner to ensure smooth respiration (Maron and Galiè, 2016).

References

Boulet, L.P. and O’Byrne, P.M., 2015. Asthma and exercise-induced bronchoconstriction in athletes. New England Journal of Medicine, 372(7), pp.641-648.

Chen, L. and Zhang, Z., 2015. Bedside ultrasonography for diagnosis of pneumothorax. Quantitative imaging in medicine and surgery, 5(4), p.618.

Ghazali, A., Léger, A., Petitpas, F., Guéchi, Y., Boureau-Voultoury, A. and Oriot, D., 2016. Development and validation of a performance assessment scale for chest tube insertion in traumatic pneumothorax. J Pulm Respir Med, 6(346), p.2.

Herve, P., Lau, E.M., Sitbon, O., Savale, L., Montani, D., Godinas, L., Lador, F., Jaïs, X., Parent, F., Günther, S. and Humbert, M., 2015. Criteria for diagnosis of exercise pulmonary hypertension. European Respiratory Journal, 46(3), pp.728-737.

Janciauskiene, S. and Welte, T., 2016. Well-known and less well-known functions of alpha-1 antitrypsin. Its role in chronic obstructive pulmonary disease and other disease developments. Annals of the American Thoracic Society, 13(Supplement 4), pp.S280-S288.

Jiménez-Ruiz, C.A., Andreas, S., Lewis, K.E., Tonnesen, P., Van Schayck, C.P., Hajek, P., Tonstad, S., Dautzenberg, B., Fletcher, M., Masefield, S. and Powell, P., 2015. Statement on smoking cessation in COPD and other pulmonary diseases and in smokers with comorbidities who find it difficult to quit. European respiratory journal, 46(1), pp.61-79.

Kawayama, T., Kinoshita, T., Matsunaga, K., Kobayashi, A., Hayamizu, T., Johnson, M. and Hoshino, T., 2016. Responsiveness of blood and sputum inflammatory cells in Japanese COPD patients, non-COPD smoking controls, and non-COPD nonsmoking controls. International journal of chronic obstructive pulmonary disease, 11, p.295.

Kolte, D., Lakshmanan, S., Jankowich, M.D., Brittain, E.L., Maron, B.A. and Choudhary, G., 2018. Mild Pulmonary Hypertension Is Associated With Increased Mortality: A Systematic Review and Meta‐Analysis. Journal of the American Heart Association, 7(18), p.e009729.

Lange, P., Halpin, D.M., O’Donnell, D.E. and MacNee, W., 2016. Diagnosis, assessment, and phenotyping of COPD: beyond FEV1. International journal of chronic obstructive pulmonary disease, 11(Spec Iss), p.3.

Maron, B.A. and Galiè, N., 2016. Diagnosis, treatment, and clinical management of pulmonary arterial hypertension in the contemporary era: a review. JAMA cardiology, 1(9), pp.1056-1065.

Martinez-Delgado, B., Matamala, N., Lara, B., Saez, R., Castillo, S., Molina, M., Texido, A., Retana, D., Fernandez, T., Otero, A. and Lopez, L., 2016. B59 NOVEL GENES AND GENE EFFECTS IN COPD: Molecular Characterization Of Novel Rare Variants Of Serpina1 Gene In Alpha-1 Antitrypsin Deficiency Patients From Spain. American Journal of Respiratory and Critical Care Medicine, 193, p.1.

Roberts, D.J., Leigh-Smith, S., Faris, P.D., Blackmore, C., Ball, C.G., Robertson, H.L., Dixon, E., James, M.T., Kirkpatrick, A.W., Kortbeek, J.B. and Stelfox, H.T., 2015. Clinical presentation of patients with tension pneumothorax: a systematic review. Annals of surgery, 261(6), pp.1068-1078.

Simonneau, G., Montani, D., Celermajer, D.S., Denton, C.P., Gatzoulis, M.A., Krowka, M., Williams, P.G. and Souza, R., 2019. Haemodynamic definitions and updated clinical classification of pulmonary hypertension. European Respiratory Journal, 53(1), p.1801913.

Thelle, A., Gjerdevik, M., SueChu, M., Hagen, O.M. and Bakke, P., 2017. Randomised comparison of needle aspiration and chest tube drainage in spontaneous pneumothorax. European Respiratory Journal, 49(4), p.1601296.

Van Schil, P.E., Subotic, D., Vandenbroeck, C., Hendriks, J.M., Hertoghs, M. and Lauwers, P., 2016. Spontaneous pneumothorax. In Textbook of Pleural Diseases (pp. 508-522). CRC Press.

Weiler, J.M., Brannan, J.D., Randolph, C.C., Hallstrand, T.S., Parsons, J., Silvers, W., Storms, W., Zeiger, J., Bernstein, D.I., Blessing-Moore, J. and Greenhawt, M., 2016. Exercise-induced bronchoconstriction update—2016. Journal of Allergy and Clinical Immunology, 138(5), pp.1292-1295.

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