Emphysema CAT Flashcards

1
Q

What is emphysema?

A

Pathologic accumulation of air in the lungs found w/ COPD

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2
Q

Classifications of emphysema

A
  • Centrilobular
  • Panlobular
  • Paraseptal
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3
Q

What causes emphysema?

A
  • Long history of chronic bronchitis
  • Non-reversible injury
  • Destruction of elastin protein in alveolar walls
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4
Q

Anatomical changes associated w/ emphysema

A
  • Loss of elastic recoil
  • Excessive airway collapse during exhalation
  • Chronic obstruction of airflow
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5
Q

Progression of emphysema

A
  • Further destruction of alveolar walls
  • Collapse of peripheral bronchioles
  • Impaired gas exchange
  • Pockets of air form b/t alveolar spaces –> increase in dead space –> diminished gas exchange
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6
Q

Risk factors for developing emphysema

A
  • Chronic bronchitis
  • Lower respiratory infection
  • Cigarette smoking
  • Genetic predisposition
  • Air pollution
  • Risk increases w/ age
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7
Q

How long can emphysema be asymptomatic?

A
  • Until middle age
  • Most often diagnosed b/t 55-60 y/o
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8
Q

Centrilobular emphysema

A
  • Usually destroys bronchioles in upper lungs
  • Alveolar sacs remain intact
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9
Q

Panlobular emphysema

A
  • Destroys air spaces of the acinus
  • Found in the lower lungs
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10
Q

Paraseptal emphysema

A

Destroys alveoli in lower lobes resulting in blebs along lung periphery

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11
Q

blebs

A

Pockets of air b/t alveolar space

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12
Q

Bullae

A

Pockets of air w/in lung parenchyma

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13
Q

Advanced disease symptoms

A
  • Increased use of accessory muscles
  • Severe dyspnea
  • Cor pulmonae
  • Cyanosis
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14
Q

Role of imaging w/ emphysema

A
  • X-ray to evaluate shape and spacing of lungs
  • Planogram to detect bullae
  • Bronchogram to evaluate mucus ducts
  • Arterial blood gas shoes decreased PaO2
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15
Q

Pulmonary function testing w/ emphysema

A
  • Impaired force expiratory volume, vital capacity, forced vital capacity
  • Total lung capacity, residual volume, functional residual capacity increased
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16
Q

Anatomical clinical presentation for emphysema

A
  • Barrel chest appearance
  • Increased subcostal angle
  • Rounded shoulder due to tight pecs
  • Rosy skin
17
Q

Complications that can arise w/ emphysema

A
  • Rupture of bullae and blebs –> pneumothorax
  • Cor pulmonae
18
Q

Medical management of emphysema

A
  • Pharm –> bronchodilators, improved oxygenation, ventilation expectorants, antihistamines
19
Q

PT management of emphysema

A
  • General exercise
  • Endurance training
  • Breathing exercise (pursed-lip breathing)
  • Ventilatory muscle strengthening
  • Airway secretion clearance
  • Energy conservation techniques
20
Q

Long-term outcomes for emphysema

A
  • Chronic progressive disease process
  • Life expectancy decreases to <5 years w/ expiratory slowing to <1L of air during forced expiratory volume