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
 Medical 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

28. Classroom Discussion
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