Emphysema

Discussion of etiology, classification, symptom, diagnosis and treatment for emphysema.

1. Emphysema Ramzee Small 1012412

2. OUTLINE What is emphysema Brief overview of the lungs Pathophysiology of emphysema Classification of emphysema Causes of emphysema Signs and symptoms M edical complication Diagnosis Treatment Overview References

3. WHAT IS EMPHYSEMA Emphysema is a type of chronic obstructive pulmonary disease. Chronic Obstructive Pulmonary Disease (COPD) is a preventable and treatable disease that makes it difficult to empty air out of the lungs. Emphysema is a condition that involves damage to the walls of the air sacs (alveoli) of the lung making it difficult to breath.

4. BRIEF OVERVIEW OF THE LUNGS The lungs are sponge-like structures that lies within the chest, protected by the ribcage. They are made up of progressively branching air passages, the smallest of which end in minute air sacs(alveoli) In these air sac inhaled oxygen is transferred to the blood stream and carbon dioxide is transferred from the blood into the exhaled breath. ( Respiration )

5. BRIEF OVERVIEW OF THE LUNGS

6. PATHPHYSIOLOGY OF EMPHYSEMA The airways of healthy lungs have elastic properties. When you breathe in each air sac fills up with air, and when you breathe out, the air sac deflate and air goes out. Continued exposure to noxious substances, causes destruction of the walls of the alveoli. The alveolar membrane surface area decreases, thus lessening the area available for gas exchange Destruction of pulmonary capillary occurs

7. PATHOPHYSIOLOGY OF EMPHYSEMA When the alveoli walls are destroyed, the lungs lose their capacity to recoil and air becomes trapped in the lungs ( hyperinflation ). The destroyed lung tissue (called blebs ) results in alveolar collapse The combination of constantly having extra air in the lungs and the extra effort needed to breathe results in a person feeling short of breath

8. PATHOPYSIOLOGY OF EMPHYSEMA Airway obstruction occurs in emphysema because the alveoli that normally support the airways cannot do so during inhalation or exhalation. Without their support, the breathing tubes collapse, causing obstruction to the flow of air.

9. PATHOPHYSIOLOGY OF EMPHYSEMA

10. CLASSIFICATION OF EMPHYSEMA Emphysema has four principal classification, classified according to the site of damage. These are ; Centriacinar emphysema Panacinar emphysema Paraseptal emphysema Irregular emphysema

11. CLASSIFICATION OF EMPHYSEMA Centriacinar emphysema Also called centrilobular emphysema Occurs with damage to lung tissue around respiratory bronchioles whilst sparing distal alveoli Associated with long-standing cigarette smoking

12. CLASSIFICATION OF EMPHYSEMA Panacinar emphysema Also called panlobular emphysema Involves all lung fields, particularly the bases Generally observed in patients with alpha1-antitrypsin (AAT) deficiency.

13. CLASSIFICATION OF EMPHYSEMA Paraseptal emphysema Also known as distal acinar emphysema Involves the dilation of distal airway structures, alveolar ducts, and alveolar sacs.

14. CLASSIFICATION OF EMPHYSEMA Irregular emphysema Commonly known as paraciatricial emphysema Emphysematous changes adjacent to areas of pulmonary scarring.

15. CAUSES OF EMPHYSEMA Emphysema can be cause by irritant you breathe in; Occupational exposure to chemical irritant Exposure to environmental pollutant (certain fume, coal or dust ) Inherited genetic defect – Alpha-1- antitrypsin deficiency (AAT deficiency). And the most likely cause is

16. CAUSES OF EMPHYSEMA

17. SIGNS AND SYMPTOMS Shortness of breath is the main symptom of emphysema Wheezing Cyanosis - characterize by blue or gray lips or fingernails Hyperinflation Barrel-shaped chest Constant coughing or need to clear the throat Difficulty concentrating

18. OTHER MEDICAL COMPLICATION Pneumonia Collapsed lung Heart problems Death

19. DIAGNOSIS OF EMPHYSEMA Diagnosis can be made by performing physical examination for symptom manifestation. These include ; Decreased breath sounds through the stethoscope Rounded fingertips ( clubbing) Pursed-lip breathing (to counteract alveolar collapse) Hypoxemia (hypoxia ) Hypercarbia : High levels of carbon dioxide in the blood .

20. DIAGNOSIS OF EMPHYSEMA Cyanosis Increased chest size or "barrel chest Malnutrition : Muscles slowly waste away in advanced emphysema

21. DIAGNOSIS OF EMPHYSEMA Doctors can use various medical imaging techniques ; Chest X-ray- A chest X-ray of someone with emphysema may show abnormally large lungs CT scan of chest - A CT scan in someone with emphysema may show small pockets of air throughout the lung

22. DIAGNOSIS OF EMPHYSEMA Other diagnosis of emphysema includes; Pulmonary function tests (PFTs ) – is a simple test that measures airway obstruction. Complete blood count

23. TREATMENT OF EMPHYSEMA Treating emphysema focuses on improving emphysema symptoms; Smoking cessation Medications are usually prescribed to widen the airways ( bronchodilators) And reduce swelling in the airways ( anti-inflammatory drugs, such as steroids) Antibiotics (to treat lung infection)

24. TREATMENT OF EMPHYSEMA Oxygen therapy Lung volume reduction surgery - Surgical removal of large areas of damaged lung Pulmonary rehabilitation Lung transplantation - This is the most drastic of emphysema treatments

25. OVERVIEW OF EMPHYSEMA Emphysema is a condition that involves damage to the walls of the air sacs (alveoli) of the lung consequently causing short of breath. The damage walls causes the alveoli to be continuously fill up with air which build up in these sacs, causing expansion. The alveoli walls may break or become damaged and form scar tissue. Diagnosing emphysema usually requires physical exams combined with medical imaging techniques. While damaged airways don’t regenerate and there is no cure, emphysema is preventable and the condition can be managed using medications and adjustments to lifestyle

26. REFERENCES American Thoracic Society web site: "Standards for the Diagnosis and Management of Patients with COPD." Albert R. Clinical Respiratory Medicine, Mosby Elsevier, 2008. American Lung Association web site: "Diseases A-Z: Emphysema." National Heart Lung and Blood Institute web site: "Diseases and Conditions Index: COPD." Traver G.A. American Review of Respiratory Disease, 1979; vol 119: pp 895-902. Celli B.R., New England Journal of Medicine, 2004; vol 350: pp 1005-1012. from http://emedicine.medscape.com/article/298283-overview

27. REFERENCES www.betterhealth.vic.gov.au ATS/ERS Standards for the Diagnosis and Management of Patients with COPD, http:// www.thoracic.org/copd/patients_general.asp http:// www.copdfoundation.org/What-is-COPD/Understanding-COPD/What-is-COPD.aspx http:// www.lung.org/lung-disease/copd/about-copd/understanding-copd.html http:// patients.thoracic.org/information-series/en/resources/ATS_Patient_Ed_Breathlessness.pdf

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