COPD or chronic obstructive pulmonary disease is progressive disease that affects the brain, thus causing difficulty in breathing. Cigarette smoking is the leading cause of COPD and the indications include:

• Barrel Chest-change in the shape of the thorax

• Wheezing

• Increased expiratory phase of breathing

• Decreased heart and lung sounds (lung hyperinflamation)

• Severe cough from respiratory infection

• Cyanosis –described as bluish discoloration of the skin due to poor supply of oxygen. Common places for cyanosis to appear are the lips, tongue, nail beds and earlobes.

• Clubbing of the fingers- is an indicator of long-term oxygen deprivation, causing the nail bed to curve downward.