A 65 year old smoker presents for eval of dyspnea. He has a 100 pack year history of tobacco use. The dyspnea is exacerbated by exertion. He denies fever or chills, he has not had recent contact with anyone who is sick. You diagnose chronic COPD. On exam of the thorax you would expect to find:

a) increased AP diameter
b) decreased AP diameter
c) No change in AP diameter
d) Pectus excavatum
a) increased AP diameter

explanation:

two years ago, when picking flowers in the mountains back of yosemite valley, i found a book. it was blotted and storm-beaten; all of its outer pages were mealy and crumbly. the paper seemed to dissolve like the snow beneath which it had been buried, however; many of the inner pages were well preserved. and although all were more or less stained and torn, whole chapters were easily readable. this is the condition of the great open book of yosemite glaciers today; its granite pages have been torn and blurred by the same storms that wasted the castaway book.two years ago, when picking flowers in the mountains back of yosemite valley; i found a book. it was blotted and storm-beaten, all of its outer pages were mealy and crumbly. the paper seemed to dissolve like the snow beneath which it had been buried, however, many of the inner pages were well preserved. and although all were more or less stained and torn; whole chapters were easily readable. this is the condition of the great open book of yosemite glaciers today, its granite pages have been torn and blurred by the same storms that wasted the castaway book.

Dbecause it isn't always an athlete, breathing techniques don't have to be advanced, and consistent intensity won't make it go down or stay the same