Pathophysiology of Emphysema Paper Example

Emphysema is the loss of lung elasticity compounded with an inflammation of the air sacs close to the air sacs attached at the tips of the alveoli. Emphysema also leads to the obliteration of the alveolar walls. It can take three forms: panacinar, paraseptal, and centriacinar. The pathophysiology of the condition begins with the loss of elasticity of the organs responsible for ensuring the bronchioles remain open (Elicker & Webb, 2013). Emphysema causes the windpipes to break down, leading to the entrapment of gas within the organ distally. A wearing away of the alveolar septa occurs, leading to the widening of the air spaces within the alveoli. In some cases, bullae may also be deposited using the contracted lung tissue. Smoking is one of the most noteworthy causes of the condition. The chemicals contained in tobacco lead the alveolar macrophages and polymorphonuclear leukocytes to discharge inflamed cells (Elicker & Webb, 2013). Smoking also inhibits alpha1-antitrypsin, thus reducing the amount of antiprotease necessary to tackle the adverse impact of surplus protease. The elastic tissue and collagen diminish as a result.

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One of the most significant clinical manifestations of emphysema is dyspnea, which results from personal exertion and eventually damages the body. Dyspnea usually features when the affected person is at rest or has advanced levels of bronchitis. A rise in bronchitis is concomitant with an increase in dyspnea. Pulmonary emphysema may adversely affect the wellbeing of the lungs while maintaining blood gas levels (Ebert, 1965). Such inadequate ventilation, combined with insufficient perfusion of blood, causes dyspnea. Some patients experience hypoxia and hypercapnia (Ebert, 1965). Usually, such people have traces of emphysema and advanced bronchitis. Of polyeythemia exists and the physician faultily diagnoses the condition, then myocardial disease may be the natural diagnostic result. This circumstance may result if the clinical manifestation is right heart failure. Some patients may have hypoxia and edema, the result of which is symptoms of hypoventilation (Elicker & Webb, 2013). They may not be able to respond effectively to the balance between carbon dioxide and oxygen, which starves the arterial blood of the much-needed oxygenated.

One essential differential diagnosis is congestive heart failure. The nature of the symptoms of this condition can at times be confusing with emphysema. For instance, if orthopnea and paroxysmal nocturnal dyspnea exist in the patient's past, then their chances of being diagnosed with congestive heart failure (Animated Biomedical Productions & INTELECOM Intelligent Telecommunications (Firm), 2014). The same case applies to the existence of basal crackles and tests of chest radiographs. Asthma has characteristics that may blur the line between it and emphysema include the allergies, eczema, rhinitis, and a history of asthma may predispose one to either a second bout of asthma or emphysema. Bronchiectasis has various attributes with which one can confuse with emphysema. Prime examples include the secretion of excessive sputum, in addition to deflated bronchial tubes and infection of the lung with bacteria. Irregular growth of fingers is also a likely occurrence. Tuberculosis, a contagious condition resulting from a Mycobacterium tuberculosis infection, has the primary symptom of filling up the lungs with fluid, as can be confirmed from an X-ray, as well as high deposits of sputum (Animated Biomedical Productions & INTELECOM Intelligent Telecommunications (Firm), 2014). The final differential diagnosis is obliterative bronchiolitis, whose noteworthy symptoms are thinning of the lung tissue, restriction of the air passage, and an occurrence of rheumatoid arthritis in the patient's past.

Some of the lab tests that a physician may conduct to determine a diagnosis of emphysema include pulmonary function testing, imaging, blood tests, and oximetry (Animated Biomedical Productions & INTELECOM Intelligent Telecommunications (Firm), 2014). Pulmonary function testing takes various forms. For instance, peak flow, which is often referred to as expiratory flow rate, applies the use of devices that help the patient to breathe out. Spirometry, on the other hand, involves encouraging the patient to take in as much air into their lungs as practically admissible. A tube inserted through the mouth is then used, where the patient exhales as quickly and forcefully as possible. Oximetry involves the use of a pulse oximeter to determine whether or not the patient's blood is oxygenated. The ideal percentage of oxygen in blood should be 90 or above (Animated Biomedical Productions & INTELECOM Intelligent Telecommunications (Firm), 2014). Imaging tests can take the form of either x-rays or computed tomography scans. A history of emphysema may encourage the use of a chest x-ray, while a CT scan is more accurate, with the ability to identify the presence of a possible inflammation of the lungs. Like imaging tests, blood tests eliminates the possibility of the existence of other conditions. For instance, the physician may test the patient to determine the percentage of white blood cells, a higher proportion of which indicates an infection. One may also measure the amount of oxygen in the blood by drawing blood from an artery through a process known as arterial blood gas.

Conclusion

One of the most prevalent treatment mechanisms for emphysema is using medications. These may take the form of corticosteroids, which should decrease the level of inflammation in the lungs, antibiotics, to prevent the advancement of certain infections, expectorants to somewhat thaw the mucus and eliminate the incessant need to cough, and bronchodilators, whose purpose would be to open up the airways in the patient (Green, 2007). If the patient is a smoker, it may be necessary to put them into programs that can help them stop the habit. Through the use of vaccinations, one may avert the occurrence of flu or pneumonia, while surgery may be necessary to rid the lungs of aerated lesions and take out impaired lung tissue (Green, 2007). In some cases, it may require the physician to perform a lung transplant, especially when the emphysema is too advanced for other forms of treatment.

References

Animated Biomedical Productions, & INTELECOM Intelligent Telecommunications (Firm). (2014). Emphysema. Pasadena, CA: INTELECOM.

Ebert, R. V. (1965). Clinical and physiologic manifestations of emphysema. Bull. N. Y. Acad. Med, 41(9), 920-926. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1750774/pdf/bullnyacadmed00282-0016.pdf

Elicker, B. M., & Webb, W. R. (2013). Fundamentals of high-resolution lung CT: Common findings, common patterns, common diseases, and differential diagnosis. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams and Wilkins.

Green, R. J. (2007). Natural therapies for emphysema and COPD: Relief and healing for chronic pulmonary disorders. New York, NY: American Thoracic Society.