Emphysema is a chronic lung disease characterized by destruction of the alveoli, or air sacs, in the lungs. It causes shortness of breath and occurs most often due to long-term smoking. The document discusses the definition, causes, risk factors, symptoms, diagnosis, and treatment of emphysema. Treatment options include quitting smoking, oxygen therapy, medications like bronchodilators and corticosteroids, and potentially lung surgery for severe cases.

1. Submitted to: Dr. Thangaraj
Submitted by: Inam ul Haq
BPT IV Year

2.  Emphysema is a greek word ,
em-physema
em - without
physema – blowing
 Or literally meaning excess air
in the lungs.
 It is the most 4th
common cause
of death in the world.
 It occurs in association with
bronchial asthma and chronic
bronchitis
 All these entities comes under
an umbrella term ‘COPD’
i.e. CHRONIC OBSTRUCTIVE
LUNG DISEASE

3.  Permanent
abnormal
enlargement of the
acini
 Destruction of
alveolar walls
without obvious
fibrosis
Specifically, two things combined:

4.  Emphysema is a chronic respiratory disease due to
over-inflation or abnormal increase in the size of the
air-sacs (alveoli) in the lungs, causing a decrease in
lung function, or breathlessness.
 Emphysema is a long-term, progressive disease of the
lungs that primarily causes shortness of breath.
 Emphysema is called an obstructive lung disease because
the destruction of lung tissue around smaller sacs,
called alveoli, makes these air sacs unable to hold their
functional shape upon exhalation. It is often caused by
smoking.

6.  Smoking- more common about in 80-90% of all
the cases.
 Occupational exposure to chemical fumes
 Hereditary-deficiency of AAT

7.  HIV infection
 Severe respiratory
efforts
 Use of intravenous
drugs -rare

8.  Occurs more in males than females due to more
percentage of male smokers
 As the number of female smokers increase,
emphysema also develops in them rapidly
 Death rate increases yearly

9. Primary emphysema
 1-2% of cases
 Inherited lack of alpha-1 antitrypsin, a
protective protein (inhibits neutrophil elastase)
Secondary emphysema
 Also caused by inability to inhibit proteolytic
enzymes in the lungs
 From inhaled toxins (e.g., cigarette smoke)
 20% of smokers at risk

10.  Toxins (smoke) cause inflammation
 Infiltration of neutrophils, macrophages
and lymphocytes
 Inflammatory cytokines increase
protease activity, inhibiting normal anti-
protease activity (antitrypsin)
 Alveoli are destroyed because elastin is
being broken down by proteases

11.  The entire respiratory acinus , from respiratory
bronchiole to alveoli, is expanded.
 Occurs more commonly in the lower lobes,
especially basal segments, and anterior
margins of the lungs.
 In age 30-40 years

12. -Respiratory bronchioles in proximal portion of
acinus are lost
-In above 50 years
-Alveoli distal to terminal bronchiole intact
-Occurs in smokers with chronic bronchitis
-Usually in upper lobes

13. Person inhales cigarette smoke or other irritants
Immune system of body respond
Substances release to defend lungs against smoke
Substances also attack the cells of the lungs
But normally body inhibit that action by releasing other
substances
If no prevention occurs

14. Lung tissue damage and loss their elasticity
Bronchioles leading to alveolar collapse
Air trapped within alveoli(difficulty in expiration)
Finally lungs cannot supply enough oxygen to
blood
EMPHYSEMA occurs

16.  Dyspnoea
 Shortness of breath/Breathlessness
 Wheezing is minimal
 Barrel chest, often thin
 Tachypnoea with prolonged expiration
 Pursed lip breathing
 Loss of appetite and weight loss
 Hypoxemia &/or hypercapnia
 Chronic hypoventilation (later stage)
 Not much coughing with little sputum
(Productive cough with infection)

18.  Chest X-Ray
- shows translucent lung.
- emphysematous bullae.
 ABG analysis
- measures how well your lungs transfer oxygen to your
bloodstream.
 PFT
- decreased CO diffusion factor.
 Sputum examination
 Spirometry

22. Normal Spirograph
Emphysema
Spirograph
FEV1/VC normally
greater than 75%
Decreased FEV1/VC
Total Lung Capacity normal
or increased
RV increased

24. Non Pharmacological Treatment
- General treatment
 By quit smoking
 By oxygen therapy
 By taking precautions
 Avoid dust
 Avoid extremes of temperature and humidity
 Avoid high altitude
 Improved nutrition, hygiene and exercise
 Special breathing patterns and positions

25. Pharmacological Treatment
- Medicinal Treatment
 Bronchodilators
 albuterol
 ipratropium bromide
 Methylxanthines
 Corticosteroids
 Antibiotics

26. - Surgical Treatment
 Lung volume reduction surgery(LVRS)
 Lung transplantation