EMPHYSEMA

DEFINITION OF THE DISEASE

Emphysema is a condition of the lung

characterized by abnormal enlargement of
the airspaces distal to the terminal
bronchiole, accompanied by destruction of
their walls and without obvious fibrosis
Pulmonary emphysema literally means
excess air in the lungs
Chronic Pulmonary emphysema - complex
obstructive and destructive process of the
lungs generally is meant
Mechanism of Cough in Emphysema

Chronic infection
caused by inhaling
smoke/other subs. w/c
irritates bronchi and
bronchioles

Deranges the normal Mucus cant be moved

protective mechanism easily out of the
of the airways-partial passageway-
paralysis of the cilia stimulation of excess
caused by nicotine mucus secretion occur
 Clinical Term Anatomic site Major Pathologic Etiology Signs
Changes & Symptoms

Chronic Bronchus Mucous gland Tobacco Cough,

Bronchitis hyperplasia, smoke, air sputum
hypersecretion pollutants production

Emphysema Acinus Airspace Tobacco Dyspnea

enlargement; smoke
Wall destruction
A. History
3 most common symptoms in COPD:
Cough, Sputum production, & Exertional dyspnea
Many patients seeking medical attention after
months or years
It is best to elicit a history on how the patient
perform their physical activities has changed
Arm work particularly at or above shoulder level- difficult for COPD
patient
As the COPD advances excertional dyspnea worsen
In the most advanced stages, patients are breathless
doing simple activities of daily living.
B. Physical Examination
In the early stages of COPD, patients usually have an
entirely normal physical examination
In patients with more severe disease, the physical
examination is notable for a prolonged expiratory phase
and expiratory wheezing
In addition, signs of hyperinflation include a barrel chest
(hyperresonance) and enlarged lung volumes with poor
diaphragmatic excursion as assessed by percussion.
Patient may develop cyanosis, visible in the lips and
nail beds
Laboratory Findings

Arterial Blood Gases

Change in pH with PCO2 is 0.08 units/10 mmHg acutely
0.03 units/10 mmHg in the chronic state
An elevated hematocrit suggests the presence of
chronic hypoxemia
Radiographic studies may assist in the
classification of the type of COPD. Obvious
bullae, paucity of parenchymal markings, or
hyperlucency suggest the presence of
emphysema