What is emphysema? Emphysema is a condition that forms part of chronic obstructive pulmonary disease (COPD) and involves the enlargement of the air sacs in the lung. The alveoli at the end of the bronchioles of the lung become enlarged because of the breakdown of their walls. The fewer and larger damaged sacs that result mean there is a reduced surface area for the exchange of oxygen into the blood and carbon dioxide out of it. Definition Emphysema is a condition in which the alveoli become stiff expands and continuously filled the air even after expiration. Emphysema is a chronic obstructive disease due to lack of elasticity in the lungs and alveoli surface area. Classification  Panlobular (panacinar) It is damage to the respiratory bronchi, alveolar ducts and alveoli. All air space in the little lobes much enlarged, with little inflammatory disease. The characteristics that have chest hyperinflation, and is characterized by dyspnea on exertion, and weight loss. CENTRILOBULAR (CENTROACINAR) The pathological changes mainly occur in the centre of the secondary lobes, and peripheral of acini remain good. Often there is chaos-ventilation perfusion ratio, which lead to hypoxia, hypercapnia (increased CO2 in the arterial blood), polycythaemia and heart failure episodes right. The condition leads to cyanosis, peripheral oedema, and respiratory failure. CAUSES OF EMPHYSEMA The biggest known cause or risk factor for emphysema - and for COPD - is smoking. Cigarette smoking is responsible for around 90% of cases of COPD. However, COPD will develop only in smokers who are genetically susceptible - smoking does not always lead to the disease.

1. EMPHYSEMA
Presented By :-
Rajkumar Shingnath
HOD &Assist prof. VION Parli V.

2. What is emphysema?
 Emphysema is a condition that forms part of chronic
obstructive pulmonary disease (COPD) and involves
the enlargement of the air sacs in the lung.
 The alveoli at the end of the bronchioles of the lung
become enlarged because of the breakdown of their
walls. The fewer and larger damaged sacs that result
mean there is a reduced surface area for the exchange
of oxygen into the blood and carbon dioxide out of it.

3. Emphysema is a condition in which the alveoli
become stiff expands and continuously filled the
air even after expiration.
Emphysema is a chronic obstructive disease due to
lack of elasticity in the lungs and alveoli surface
area.
Definition

4. Classification
Panlobular (panacinar)
It is damage to the respiratory bronchi, alveolar
ducts and alveoli. All air space in the little lobes
much enlarged, with little inflammatory disease. The
characteristics that have chest hyperinflation, and is
characterized by dyspnea on exertion, and weight
loss.

5. CENTRILOBULAR (CENTROACINAR)
The pathological changes mainly occur in the centre of the
secondary lobes, and peripheral of acini remain good. Often there is
chaos-ventilation perfusion ratio, which lead to hypoxia,
hypercapnia (increased CO2 in the arterial blood), polycythaemia
and heart failure episodes right. The condition leads to cyanosis,
peripheral oedema, and respiratory failure.

6. CAUSES OF EMPHYSEMA
 The biggest known cause or risk factor for emphysema - and
for COPD - is smoking. Cigarette smoking is responsible for
around 90% of cases of COPD. However, COPD will
develop only in smokers who are genetically susceptible -
smoking does not always lead to the disease.

7. While the following are not as important as primary
cigarette smoke exposure, they are minor contributory
risk factors:
 Low body weigh
 Childhood respiratory disorders
 Exposure to passive cigarette smoke
 Air pollution
 Occupational dust (mineral dust, cotton dust, for
example)
 Inhaled chemicals (coal, grains, isocyanates, cadmium,
for example).

8. SYMPTOMS OF EMPHYSEMA
 Two symptoms are the main markers of emphysema and present early on
 Shortness of breath
 Cough.
 Shortness of breath is also known as dyspnea and gives the feeling of being unable
to catch a breath. This symptom may be present only during physical exertion but
as the disease progresses may be present during rest.

9. CONT…..
Frequent lung infections
Producing a lot of mucus (phlegm or sputum)
Wheezing

10. CONTD……..
 Reduced appetite
 Weight loss
 Fatigue
 Blueness of the lips or fingernail beds (from cyanosis caused by
poor respiration)
 Anxiety, depression
 Sleep problems
 Morning headache signals nighttime breathing difficulty
(nocturnal hypercapnia or hypoxemia)

11. PATHOPHYSIOLOGY
Due to etiological factor
Charging excessive air with obstruction
Occurs as a result of partial obstruction of the bronchi or bronchioles
Output of the air in the alveoli become more difficult than the input.
In such a situation occurs that increases the accumulation of air in the distal alveoli.
Narrowing of the airways, it can lead to narrowing of the airway obstruction and tightness,
Constriction of the airways caused by reduced lung elasticity.
Alveoli collapse and formation of Emphysema

12. TESTS AND DIAGNOSIS OF EMPHYSEMA
 Specific tests are used to identify emphysema and COPD,
and doctors also perform physical examinations and "take
histories" (ask questions about the problem) to support a
diagnosis. This also helps to differentiate it from other
conditions such as asthma and heart failure.

13. CONT…
If the cause of the emphysema is thought to be a rare
case of α1-antitrypsin deficiency - there has been no
smoking or other typical risk factor, for example, or a
close relative has the deficiency - a laboratory test can
be ordered to diagnose this.

14. CONTD……
 Lung function tests
 Confirm airflow limitation
 Quantify the severity and reversibility (in response to drugs) of the
limitation
 Other tests
 X-ray
 CT scanning (computed tomography),
 arterial blood gas analysis to assess O2/CO2 exchange

15. TREATMENTS FOR EMPHYSEMA
 There are two main elements to the management of COPD and
emphysema: medication and supportive therapy, which includes
oxygen therapy and help with smoking cessation. The stable chronic
disease is continuously treated to relieve symptoms and prevent
exacerbations/complications, which are treated as they arise

16. CONTD……
 Prevention: smoking cessation
Because cigarette smoking is an established cause of COPD and
emphysema, not taking it up or stopping it is preventive.
 Vaccination
Vaccination is preventive of exacerbations in people with COPD
and emphysema - an annual flu immunization is required and a 5-
yearly one against pneumonia may be recommended
 Nutrition
Reduced lung capacity places higher energy demand on daily
activities so people with emphysema can be at risk of weight loss
and nutritional deficiency

17. DRUG THERAPIES
 The mainstay of medications used in people with COPD and
emphysema are inhaled bronchodilators to relieve symptoms.
 They help by relaxing and opening the air passages in the
lungs, and include these classes of drug:

18. CONT…
 Beta-agonists, which relax bronchial smooth muscle and increase
mucociliary clearance
 Anticholinergic (antimuscarinics), which relax bronchial smooth muscle.
 Corticosteroid drugs may also be prescribed for people with COPD and
emphysema, including fluticasone at between 500 and 1,000 micrograms a
day and beclomethasone at 400 to 2,000 micrograms a day.

19. OTHER TREATMENT ASPECTS
 Oxygen therapy
As emphysema progresses and respiratory function declines, this
makes independent breathing increasingly difficult. Oxygen therapy
improves oxygen delivery to the lungs by supplementing it via a number
of device options, including those used in the home.

20. CONT…..
 Pulmonary rehabilitation
Pulmonary rehabilitation is a program of care for people with emphysema that
includes the below supportive measures of help with smoking cessation and
nutrition, but also includes help with physical activities - exercise, education and
behavioral interventions.

21.  Surgery
 Surgical options may be considered for people with severe emphysema -
either lung volume reduction surgery or, in the last-case scenario, lung
transplantation.
 Lung transplantation improves quality of life, though not life-expectancy,
for people with severe cases of emphysema, and requires lifelong drug
therapy to suppress the immune system against tissue rejection. One or both
lungs may be transplanted.

22. TREATMENT OF EXACERBATIONS
 The drug and oxygen therapies above may be used when
complications develop, as may antibiotics when the acute
exacerbation is caused by a bacterial infection indicated by pussy
(purulent) sputum.
 Most exacerbations of COPD are treated with corticosteroid drugs
such as prednisone. Some cases require mechanical ventilation
for oxygen therapy, and some cases receiving

23. COMPLICATION
 Frequent infections of the respiratory tract.
 The immune system is less than perfect.
 The level of lung damage more severe.
 Chronic inflammatory process in the airways.
 Pneumonia.
 Atelaktasis.
 Pneumothorax.
 Increase the risk of respiratory failure in patients.

24. NURSING MANAGEMENT
1. Activity / Rest
Symptoms: Exhaustion, fatigue, malaise, inability to perform daily activities
because of difficulty breathing, inability to sleep, need to sleep sitting up high,
dyspnea at rest or in response to activity or exercise.
Symptoms: Fatigue, anxiety, insomnia, general weakness / loss of muscle mass.
2. Circulation
Symptoms: Swelling of the lower extremities.
Signs: Increased blood pressure, increased heart rate / severe tachycardia,
dysrhythmias, distended neck veins, edema dependent, not associated with heart
disease, heart sounds dim (which is associated with increased AP diameter of the
chest), color of skin / mucous membranes: normal or gray / cyanosis, pallor may
indicate anemia.

25. Thank you