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Emphysema

Definition
 Emphysema is defined as the impaired gas exchange resulting from the
destruction of the wall of alveoli.
 Emphysema is abnormal permanent enlargement of the air space distal
to the terminal bronchioles.
 Emphysema is a chronic, progressive disease of the lungs and occurs
when the alveolar walls are destroyed.
 Emphysema is a type of COPD, including excessive air in the terminal
bronchioles.

Types of Emphysema
1. Centrilobular emphysema - Emphysema mainly in the centre of
secondary lobules.

2. Pan lobular emphysema - It is a permanent destruction of the

3. Distal acinar emphysema - distal part of acinus is involved.

4. Irregular emphysema - The acini irregular involved.

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Cause
 Cigarette smoking
 Air pollution
 Older age ( more than 45 years )
 Sex ( generally in females )
 X, antigen deficiency
 COPD
 Allergens.

Pathophysiology
Cause / Smoking
↓
Inflammation into alveoli
↓
Deficiency of x, antitrypsin enzyme
↓
Decrease antineoplastic activity of bronchioles or alveoli
↓
Dilation of distal and terminal bronchioles.

Clinical manifestation
 Cough
 Shortness of breath
 Wheezing
 Barrel chest
 Chronic bronchitis
 Tachycardia
 Tachypnea
 Pursed lips breathing
 Tripod position

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 Cyanosis
 Respiratory acidosis
 Right ventricular failure
 Puff vasodilation
 Stress anxiety depression
 Spontaneous pneumothorax.

Diagnostic examination
 History collection and physical examination.
 Chest x ray.
 Arterial blood gas analysis.
 Pulmonary function test.
 Blood test- Increase WBC, increase ESR.
 CT scan and MRI.
 Monitor total lungs capacity.

Medical management
Pharmacological -

 Bronchodilators - Reduce airway obstruction.

Complications
 Respiratory failure

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 Respiratory acidosis
 Atelectasis
 Pneumonia
 Pneumothorax.

Surgical management
 Segmental resection
 Lobectomy
 Pneumonectomy.

Nursing management
 Nurses monitor vital signs and respiratory problems.
 Provide appropriate position (high Fowler position).
 Administer oxygen ( 1-3 litre )
 Provide IV line medication and nebulization.
 Provide chest physiotherapy and postural drainage.
 Maintain patient NPO.
 Provide chest vibration therapy to loosen cough.
 Encourage deep breathing and coughing exercise.
 Pushliped breathing.
 Provide immunization.
 Maintain personal hygiene and provide proper nutrition.
 Administer all prescribed medication in Right manner.
 Nurse prepares the patient for surgical intervention.
 Nurses follow the barrier of nursing.

Key Points

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 Excessive air accumulates in the air sac - Emphysema.

 Emphysema is a disorder of - COPD.

 Common cause of emphysema - Cigarette Smoking.

 Common finding seen in emphysema patients - Barrel Chest.

 Most common type of emphysema - Centrilobular Emphysema.

 Which part of lungs affect centrilobular emphysema -

 Tiny air sacs in the lungs called - Alveoli

 Treatment of X1 - antigen - Prolastin.

 Which age group commonly affected by emphysema - Older

 Respiratory acidosis treated by - Sodium Bicarbonate.

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