Obstructive lung diseases are respiratory disorders that affect the airways and make it difficult for a patient to breathe. There are several different types, which have a few key differences and similarities.

In this article, we will provide an overview of the different obstructive lung diseases, including their symptoms, causes, and treatment methods. We included helpful practice questions for your benefit as well.

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What is an Obstructive Lung Disease?

An obstructive lung disease occurs when there is some type of blockage or obstruction in the airways. Over time, this obstruction can damage the lungs and cause the airways to become narrow, which leads to shortness of breath and difficulty breathing.

If a patient has an obstructive lung disease, less air can flow in and out of the alveoli, which reduces the amount of gas exchange that can occur.

Types of Obstructive Lung Diseases

There are several types of obstructive lung diseases, including the following:

Each type is similar, but each has its own set of signs and symptoms, causes, and treatment methods.

COPD

COPD is a chronic respiratory disease that results in difficulty breathing due to narrowing of the airways within the lungs. It is a progressive disease, meaning it gets worse over time.

COPD is caused by exposure to irritants such as cigarette smoke, secondhand smoke, air pollution, and chemical fumes.

Asthma

Asthma is a chronic lung disease that inflames and narrows the airways. In people with asthma, the airways can become sensitive to allergens or other triggers, such as cold air, smoke, or exercise.

When exposed to one of these triggers, the muscles around the walls of the airways tighten, and there is an increase in inflammation. This narrowing of the airways and inflammation results in shortness of breath and difficulty breathing.

Cystic Fibrosis

Cystic fibrosis is a genetic disorder characterized by abnormally large amounts of thick secretions and pancreatic insufficiency. It causes frequent lung infections and difficulty breathing over time.

The average life expectancy for patients with cystic fibrosis is about 37 years, although this is slowly increasing as treatments improve.

Bronchiectasis

Bronchiectasis is an obstructive condition that causes irreversible destruction of the bronchial walls of the airways of the lungs. It results in an accumulation of copious amounts of bronchial secretions and a recurrent need for their removal.

The primary causes of bronchiectasis are infections, autoimmune diseases, and congenital abnormalities. However, the condition may also develop secondary to other lung diseases such as cystic fibrosis or COPD.

Chronic Bronchitis

Chronic bronchitis is a type of COPD that is characterized by increased mucus production in the trachea and bronchi. It results in a productive cough, which occurs for at least three months of the year for more than two consecutive years.

The cough is often accompanied by wheezing, shortness of breath, and chest tightness. Treatment for chronic bronchitis includes quitting smoking, avoiding exposure to irritants and pollutants, and taking medications to open the airways and relieve symptoms.

Emphysema

Emphysema is a type of COPD that results in increased lung expansion due to air trapping. It causes irreversible damage to the alveolar walls, which results in permanent enlargement of the air spaces distal to the terminal bronchioles.

This ultimately causes dyspnea and shortness of breath because the patient has difficulty exhaling air out of the lungs.

Signs and Symptoms

Each type of obstructive lung disease has its own unique signs and symptoms. However, there are some general symptoms that are seen in all types, including the following:

  • Dyspnea
  • Shortness of breath
  • Wheezing
  • Chest tightness
  • Coughing up mucus
  • Fatigue

These symptoms may occur intermittently or continuously, and they may vary in severity. Some patients may only experience symptoms during exertion, while others may have constant dyspnea and shortness of breath.

Causes

There are many different causes of obstructive lung diseases. However, the most common cause is exposure to irritants such as cigarette smoke, secondhand smoke, air pollution, and chemical fumes.

Other causes include genetic disorders, infections, autoimmune diseases, and congenital abnormalities.

Treatment

There are several treatment methods that can be used to manage the symptoms of obstructive lung diseases, including the following:

  • Inhaled medications
  • Smoking cessation
  • Oxygen therapy
  • Pulmonary rehabilitation
  • Lifestyle changes
  • Noninvasive ventilation
  • Mechanical ventilation (in severe cases)

The treatment methods will vary depending on the specific type of obstructive lung disease and the severity of the patient’s signs and symptoms.

In general, the goal of treatment is to relieve symptoms and improve quality of life. In some cases, treatments may also be used to slow the progression of the disease or prevent complications.

What is CBABE?

CBABE is a mnemonic that can be used as a simple way to learn and memorize all of the types of obstructive lung diseases.

Each letter represents the first letter of the following diseases:

  • C – Cystic Fibrosis
  • B – Bronchiectasis
  • A – Asthma
  • B – Bronchitis (Chronic)
  • E – Emphysema

Again, you can easily memorize this acronym as a simple way to learn which disorders are classified as obstructive lung diseases.

Obstructive Lung Diseases Practice Questions:

1. Which of the following are obstructive lung diseases?
The types of obstructive lung diseases include COPD, asthma, cystic fibrosis, bronchiectasis, chronic bronchitis, and emphysema.

2. What are the late signs of COPD?
Barrel chest, flattened diaphragm, accessory muscle usage, edema from cor pulmonale, changes in mental status due to decreased oxygen.

3. COPD includes what two dysfunctions?
Emphysema and chronic bronchitis.

4. What is reduced or elevated in Obstruction Lung Diseases?
The FEV1 reduced, and the VC may be reduced, while the TLC is normal or high.

5. What are the causes of obstructive airway disease?
Emphysema, Chronic bronchitis, Asthma, Bronchiectasis, Bronchial neoplasms, Impacted foreign bodies, and Genetics.

6. What is Chronic Obstructive Pulmonary Disease and how may it occur?
It is a group of chronic respiratory disorders that causes irreversible and progressive damage to lungs. They are debilitating conditions that may affect the individual’s ability to work and may lead to the development of cor pulmonale. Respiratory failure also may occur.

7. What is the general issue with a obstructive disease?
Difficulty blowing air out.

8. Are Obstructive Diseases reversible?
They may be reversible, as with asthma, or fixed (nonreversible).

9. What do obstructive diseases result from?
Results from increased resistance to air flow due to a partial or complete obstruction.

10. Obstructive diseases occur at what level?
They may occur at any level, from the trachea to the respiratory bronchioles.

11. Obstructive diseases may result from what?
Anatomic airway narrowing (e.g. asthma); or the loss of elastic recoil of the lungs (e.g. emphysema).

12. Chronic Obstructive Pulmonary Disease leads to what?
It leads to large, permanently inflated alveolar air spaces.

13. What are the two major causes of COPD?
Cigarette smoking and alpha1-antitrypsin.

14. How can a COPD patient enhance survival?
Smoking cessation is first-line intervention; also annual influenza and pneumococcal vaccinations help enhance survival.

15. What is the emergency management of asthma?
Early and frequent use of aerosolized beta2 agonists; high dose corticosteroids; Oxygen therapy; and antibiotics.

16. What is the environmental control of asthma?
Remain inside with windows closed, no pets, air purifiers, dust, and avoid all known triggers.

17. What are two characteristics of Asthma?
Airway inflammation and increased mucus production.

18. What are two characteristics of Bronchiectasis?
Excessive purulent sputum, and irreversible dilatation of the bronchi.

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19. What are two characteristics of Chronic Bronchitis?
Bronchitis for 3 months out of the year, for 2 consecutive years; excessive secretions.

20. What are two characteristics of Cystic Fibrosis?
Genetic; high salt content in sweat.

21. What are two characteristics of Emphysema?
Less surface area in alveoli; little to no secretions; cor pulmonale.

22. How do you optimize lung function for COPD?
PRN bronchodilators for all COPD patients; Systemic corticosteroid trial; and Methylxanthines.

23. What is the primary goal of treating COPD?
To maximize ability to perform daily tasks.

24. What are the two types of atelectasis?
Resorption and passive.

25. What is an acute exacerbation of COPD?
A state of worsening of chronic obstructive pulmonary disease (COPD). Often defined by the need to increase medication and/or escalate care.

26. What is Airway Hyperresponsiveness?
State of airways that causes them to constrict abnormally in response in response to stress or insults (e.g., exercise, inhaled materials such as dust or allergens).

27. What is Airway Inflammation?
Localized protective response to pathogens occurring within the routes for passage of air into and out of the lungs and invoking the release of mediators including mast cells, eosinophils, macrophage, epithelial cells, and T lymphocytes.

28. What is Airway Obstruction?
A state of abnormally slowed expiration, characterized most commonly by a decrease in FEV1.

29. What is Asthma?
It is a clinical syndrome characterized by airway obstruction, which is partially or completely reversible either spontaneously or with treatment.

30. What is a Bronchodilator?
A drug that relaxes contractions of the smooth muscle walls of the bronchioles to improve ventilation to the lungs. Pharmacologic bronchodilators are prescribed to improve aeration in asthma, bronchiectasis, bronchitis, and emphysema.

31. What is Bronchospasm?
Abnormal contraction of the smooth muscle of the bronchi, which results into acute narrowing and obstruction.

32. What is Chronic Bronchitis?
A condition in which chronic productive cough is present for at least 3 months per years for at least 2 consecutive years.

33. What is Chronic Obstructive Pulmonary Disease?
Refers to a disease state of the respiratory system characterized by the presence of the presence of incompletely reversible airflow obstruction.

34. What is Emphysema?
A condition characterized by abnormal, permanent enlargement of the airspaces beyond the terminal bronchiole, accompanied by destruction of the walls of airspace without fibrosis.

35. What is Supplemental Oxygen?
Oxygen delivered at concentrations exceeding 21% to increase the amount circulating within the blood.

36. Why do patients with Emphysema have a progressive difficulty with expiration?
Air trapping and increased residual volume.

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37. Air trapping and increased residual volume can be caused by what?
Overinflation of the lungs, Fixation of ribs in an respiratory position, increased anterior-posterior diameter of thorax (barrel chest), and a Flattened diaphragm (on radiographs).

38. How can a flattened diaphragm be discovered?
Radiographs, for example, as in Emphysema.

39. What is barrel chest?
Fixation of ribs in an respiratory position, increased anterior-posterior diameter of thorax; commonly seen in patients with Emphysema.

40. What are the signs and symptoms of Emphysema?
Dyspnea, Hyperventilation with prolonged expiratory phase, Development of barrel chest, Anorexia, Fatigue, Weight loss, and clubbed of the fingers.

41. What are the Emphysema diagnostic tests?
Chest radiography and pulmonary function tests.

42. What is the treatment for Emphysema?
Avoidance of respiratory irritants, Immunization against influenza and pneumonia, Pulmonary rehabilitation, Appropriate breathing techniques, and Adequate nutrition and hydration.

43. What are the warning signs of Chronic Bronchitis?
Inflammation, obstruction, repeated infection, chronic coughing for 3 months or longer in 2 years.

44. What is typically the patient history with Chronic Bronchitis?
History of cigarette smoking or living in urban or industrial areas.

45. What is the process of Chronic Bronchitis?
Mucosa inflamed and swollen, Hypertrophy and hyperplasia of mucous glands, Fibrosis and thickening of bronchial wall, Low oxygen levels, Severe dyspnea and fatigue, and then Pulmonary hypertension and cor pulmonale.

46. What are the signs and symptoms of Chronic Bronchitis?
Constant productive cough, Tachypnea, Shortness of breath, Frequent thick and purulent secretions, Cough and rhonchi more severe in the morning, Hypoxia, Cyanosis, Hypercapnia, Polycythemia, Weight loss, and Signs of cor pulmonale. 

47. What is Asthma?
Bronchial obstruction that occurs in persons with hypersensitive or hyperresponsive airways.

48. Asthma often occurs in what ages?
It may occur in childhood or have an adult onset. There is often family history of allergic conditions.

49. What is extrinsic asthma?
Acute episodes triggered by type I hypersensitivity reactions.

50. What is intrinsic asthma?
The onset occurs during adulthood. Hyperresponsive tissue in airway initiates an attack.

51. What are the stimuli for intrinsic asthma?
Respiratory infections, Stress, Exposure to cold, Inhalation of irritants, Exercise, and Drugs.

52. What are the pathophysiological changes of Asthma?
In the bronchi and bronchioles there is inflammation of the mucosa with edema, bronchoconstriction caused by contraction of smooth muscle, there is increased secretions of thick mucus in the airways; and these changes create obstructed airways.

53. What are the symptoms of Asthma?
Cough, marked dyspnea, tight feeling in chest, wheezing, rapid and labored breathing, and expulsion of thick or sticky mucus.

54. What are the signs of Asthma?
Tachycardia, pulsus paradoxus, hypoxia, respiratory alkalosis, respiratory acidosis, severe respiratory distress, and respiratory failure.

55. What is pulsus paradoxus?
When the pulse differs on inspiration and expiration, as seen in patients with asthma.

56. Hypoventilation can lead to what?
Hypoxemia and respiratory acidosis.

57. What is status asthmaticus?
A persistent severe attack of asthma that does not respond to usual therapy. It is a medical emergency and may be fatal because of severe hypoxia and acidosis.

58. Cystic Fibrosis is caused from what?
Mucus obstructs airflow in bronchioles and small bronchi. Tenacious mucus from exocrine glands. It tends to increase over time.

59. Cystic Fibrosis is seen in what main organs?
The lungs and pancreas.

60. A patient with Cystic Fibrosis shows what in the lungs?
Mucus obstructs airflow in the bronchioles and small bronchi. It causes permanent damage to the bronchial walls, and infections are commonly caused by Pseudomonas aeruginosa and Staphylococcus aureus.

61. What does CBABE stand for?
Cystic fibrosis, bronchiectasis, asthma, bronchitis (chronic) and emphysema

62. Obstructive lung diseases, such as copd, involve breathing difficulty during what?
Exhalation

63. How do obstructive lung diseases such as asthma affect forced expiratory volume?
Obstructive lung diseases cause a decrease in the FEV1/FVC ratio.

64. What are some pulmonary characteristics of the obstructive lung diseases asthma and emphysema?
Dyspnea, shortness of breath, wheezing, chest tightness, and coughing.

65. Which spirometry volumes change in obstructive lung diseases?
Obstructive lung diseases cause an increase in residual volume and functional residual capacity (FRC).

66. What is the effect of residual volume in obstructive lung diseases?
It increases

Final Thoughts

Obstructive lung diseases have impacted millions of people around the world and will continue to do so for years to come. This why it’s important for respiratory therapists to be well-informed about these disorders, including their symptoms, causes, and treatment methods.

If you enjoyed this article, we have a similar guide on restrictive lung diseases that I think you’ll find helpful. Thank you so much for reading and, as always, breathe easy, my friend.

Medical Disclaimer: This content is for educational and informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Please consult with a physician with any questions that you may have regarding a medical condition. Never disregard professional medical advice or delay seeking it because of something you read in this article. We strive for 100% accuracy, but errors may occur, and medications, protocols, and treatment methods may change over time.

References

The following are the sources that were used while doing research for this article:

  • Rrt, Des Terry Jardins MEd, and Burton George Md Facp Fccp Faarc. Clinical Manifestations and Assessment of Respiratory Disease. 8th ed., Mosby, 2019. [Link]
  • “Chronic Obstructive Pulmonary Disease: An Overview.” PubMed Central (PMC), 1 Sept. 2008, www.ncbi.nlm.nih.gov/pmc/articles/PMC4106574.
  • Ryu, J. “Obstructive Lung Diseases: COPD, Asthma, and Many Imitators.” PubMed, Nov. 2001, pubmed.ncbi.nlm.nih.gov/11702903.

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