Emphysema CAT Flashcards
1
Q
What is emphysema?
A
Pathologic accumulation of air in the lungs found w/ COPD
2
Q
Classifications of emphysema
A
- Centrilobular
- Panlobular
- Paraseptal
3
Q
What causes emphysema?
A
- Long history of chronic bronchitis
- Non-reversible injury
- Destruction of elastin protein in alveolar walls
4
Q
Anatomical changes associated w/ emphysema
A
- Loss of elastic recoil
- Excessive airway collapse during exhalation
- Chronic obstruction of airflow
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
6
Q
Risk factors for developing emphysema
A
- Chronic bronchitis
- Lower respiratory infection
- Cigarette smoking
- Genetic predisposition
- Air pollution
- Risk increases w/ age
7
Q
How long can emphysema be asymptomatic?
A
- Until middle age
- Most often diagnosed b/t 55-60 y/o
8
Q
Centrilobular emphysema
A
- Usually destroys bronchioles in upper lungs
- Alveolar sacs remain intact
9
Q
Panlobular emphysema
A
- Destroys air spaces of the acinus
- Found in the lower lungs
10
Q
Paraseptal emphysema
A
Destroys alveoli in lower lobes resulting in blebs along lung periphery
11
Q
blebs
A
Pockets of air b/t alveolar space
12
Q
Bullae
A
Pockets of air w/in lung parenchyma
13
Q
Advanced disease symptoms
A
- Increased use of accessory muscles
- Severe dyspnea
- Cor pulmonae
- Cyanosis
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
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
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
