emphysema health

1. Clinical
medicine
Topic:
Emphysema
Presented by:
• HUMA NASIR
• WARDA SALEEM

2. Chronic obstructive pulmonary disease
(COPD)
 Definition: Group of diseases that causes airflow
blockage and breathing related problems .
 It includes :
 Emphysema
 Bronchitis

4. Emphysema
Definition
It is defined as abnormal and
permanent dilation of the air
spaces lying beyond the
terminal bronchioles
accompanies by destruction
of their walls known as
emphysema .

5. Risk Factors
 cigarette smoking: is the most important cause of
both chronic bronchitis and emphysema .
 Air pollution : recurrent lung infection ,familial
disorders and occupations like coal mining .
 Age.
 Exposure to secondhand smoke.
 Occupational exposure to fumes or dust.
 Exposure to indoor and outdoor pollution.

6. CLINICAL FEATURES
Symptoms
 Frequent coughing or wheezing.
 A cough that produces a lot mucus.
 Shortness of breath, especially with physical
activity.
 A whistling or squeaky sound when you breathe.
 Tightness in your chest.

7. On Examination
Inspection:
o Patient is dyspneic
o Central cyanosis
o Length of trachea is reduced above sternal notch
o Pursing of lips
o Jugular venous distension during expiration

8. Palpation
o Apex beat is not palpable
o Chest expansion becomes decreased
Auscultation
o Breath sounds are decreased
o Coarse crepitations at lung base heard during
inspiration and expiration
o Ronchi at expiration
Type 2 respiratory failure
o Central cyanosis
o flapping tremors
o Right heart failure
o Raised JVP
o Enlarged liver

9. BLUE BLOATERS AND PINK
PUFFERS

11. INVESTIGATIONS
Chest X-Ray
o Low flat diaphragm
o Narrow vetrical heart due to over
inflation of the lungs
o Hyper translucency of lung
field
Pulmonary function test
o TLC/residual volume ratio
increased

12. Contd…
ECG
o RV hypertrophy
o Tall P wave
Sputum Culture And Sensitivity
Echocardiography
Arterial Blood Gas Measurement

13. Management
o Stop smoking ( comp stop of smoking and change of occupation
related to dust)
o Bronchodilators
• Inhaled bronchodilators( salbutamol, terbutaline, salmetrol )
• Oral bronchodilators
• Bambuterol ( Tab.Bambec 10 mg )
• Theophyline (Theograde 350 mg )
o Corticosteriods
• Inhaled corticosteriods [Beclomethsone (clenil inhaler )]
• Oral corticosteriods ( prednisolone ( tab.Deltacortil 5mg)
o Oxygen Therapy
o Antibiotics

14. SURGICAL TREATMENT OF COPD
 Bullectomy : surgical removal of bullae that does not
take part in ventilation .
 Lung volume reduction surgery : experimental
surgical approach to relief dyspnea in patients with
advanced emphysema and lung hyperinflation.
 Lung transplantation : single or both lung
transplantation may be the choice in severe COPD not
responding to medical disease .