EMPHYSEMA
- Emphysema is a type of COPD (chronic obstructive pulmonary disease).
- Emphysema is defined as enlargement of the air spaces distal to the terminal bronchioles, with destruction of their walls of the alveoli.
- Blebs in respiratory airways
- Type 1 respiratory failure
- respiratory alkalosis
Air trapping on exhalation and amount of air going out is lesser
↓
So FEV1 less than normal
↓
On giving Salbutamol, no change in FEV1
So it is a Non Reversible Air flow obstruction
On examination :
- Breathlessness
- Exercise intolerance
- Tachypnoea
- Accessory muscle working excessively
- Barrel shaped chest ( anterioposterior diameter > Transverse diameter)
- Liver palpable (due to hyperinflation of lungs)
work up :
- Spirometry
- HRCT (investigation of choice) - Blebs
- ABG - Type 1 Respiratory failure (Respiratory Alkalosis)
- DLco - Diffusion capacity of lung for carbon monoxide - decreased
- chest x-ray
- Tubular heart
- Lungs appear more black than normal
- Vascular markings present
Treatment :
QUIT SMOKING - Nicotine buccal spray/varenicline (α2β2 partial agonist of nicotine receptor)
- Video assisted thoracoscopic surgery - Bullectomy
TOC (Treatment of choice) - Lung Transplantation
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