Emphysema (COPD)

Emphysema

1. Emphyse m a RELIANCE INSTITUTE OF NURSING TOPIC PRESENTED BY :- MR. ROMAN BAJRANG BASIC BS.C NURSING 2 ND YEAR RELIANCE INSTITUTE OF NURSING

2. 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.

3. Emphysema is a disease of the lungs that usually develops after many years of smoking. Both chronic bronchiti s and emphysema belong to a group of lung diseases known as chronic obstructive pulmonary disease (COPD) . Once it develops, emphysema can’t be reversed. This is why not smoking or stopping smoking is very important.

4. Emphysema is a condition that involves damage to the walls of the air sacs (alveoli) of the lung. Alveoli are small, thin-walled, very fragile air sacs located in clusters at the end of the bronchial tubes deep inside the lungs. There are about 300 million alveoli in normal lungs. As you breathe in air, the alveoli stretch, drawing oxygen in and transporting it to the blood. When you exhale, the alveoli shrink, forcing carbon dioxide out of the body.

5. WHO GETS EMPHYSEMA? OVER 3 MILLION PEOPLE IN THE UNITED STATES HAVE BEEN DIAGNOSED WITH EMPHYSEMA. OVER 11 MILLION AMERICANS HAVE COPD. EMPHYSEMA IS MOST COMMON IN MEN BETWEEN THE AGES OF 50 AND 70.

6. 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 )

7. BRIEF OVERVIEW OF THE LUNGS

8. 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

9. 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

10. 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.

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

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

13. 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

14. What causes emphysema ? Smoking is the number one factor. Because of this, emphysema is one of the most preventable types of respiratory diseases. Air pollutants in the home and workplace, genetic (inherited) factors (alpha-1 antitrypsin deficiency), and respiratory infections can also play a role in causing emphysema. Cigarette smoking not only destroys lung tissue, it also irritates the airways. This causes inflammation and damage to cilia that line the bronchial tubes. This results in swollen airways, mucus production, and difficulty clearing the airways. All of these changes can lead to shortness of breath.

15. CAUSES OF EMPHYSEMA

16. SYMPTOMS Shortness of breath, especially during light exercise or climbing steps Ongoing feeling of not being able to get enough air Long-term cough or “smoker’s cough” Wheezing Long-term mucus production Ongoing fatigue

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. PATHOPHYSIOLOGY 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

19. 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 PATHOPHYSIOLOGY OF EMPHYSEMA

20. 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.

21. PATHOPYSIOLOGY OF EMPHYSEMA

22. DIAGNOSIS X-RAY ABG ANALISIS PULSE OXIMETRY PULMONARY/LUNG FUNCTION TEST ECG

23. 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.

24. DIAGNOSIS OF EMPHYSEMA C y a n os i s Increased chest size or "barrel chest Malnutrition: Muscles slowly waste away in advanced emphysema

25. 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

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

27. MANAGEMENT

28. Quitting smoking : If you smoke, quit. This is the most important step you can take to protect your lungs. It is never too late to quit. Your doctor can help you find the best method for you. Bronchodilator medications : These medicines relax the muscles around the airways. They are often used to treat asthma . Bronchodilators , given through hand-held inhalants, immediate results and have fewer side effects than oral medications. Anti-inflammatory medication : These medications reduce inflammation in the airways. However, long-term side effects of these drugs include osteoporosis , hypertension , high redistribution. Oxygen therapy : Oxygen therapy is prescribed for patients whose lungs are not getting enough oxygen to the blood ( hypoxemia ). These patients can’t absorb enough oxygen and need to get more oxygen through a machine (a nasal catheter or a facemask). Lung volume reduction surgery : Lung volume reduction surgery involves removing a portion of diseased lung tissue, then joining together the remaining tissue. Doing this may on the breathing muscles and help improve lung elasticity (or stretch).

29. OTHER MEDICAL COMPLICATION P n eumon i a Collapsed lung Heart problems Death

30. 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)

31. 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

32. Classroom Discussion Begins Now !!!!