Emphysema: Difference between revisions

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== Definition/Description  ==
== Definition/Description  ==


Emphysema can be defined as having a loss of lung elasticity, permanent enlargement of the air spaces distal to the terminal bronchioles, and destruction to the alveolar walls. It can be classified under the umbrella term chronic obstructive pulmonary disorder (COPD) <ref>Voelkel NF, Gomez-Arroyo J, Mizuno S. COPD/emphysema: The vascular story. Pulmonary Circulation 2011; 1(3): 320–326.</ref>&nbsp;. <br>There are three types of emphysema; centriacinar, panacinar, paraseptal. Centriacinar emphysema affects the alveoli and airways in the central acinus, destroying the alveoli in the walls of the repiratory bronchioles and alveolar ducts <ref>Hochhegger B, Dixon S, Screaton N, Cardinal V, Marchiori S, Binukrishnan S, Holemans J, Gosney J, McCann C, Emphysema and smoking related lung diseases. The British Institute of Radiology 2014; 20 (4).</ref>&nbsp;. Panacinar emphysema affects the whole acinus <ref>Hochhegger B, Dixon S, Screaton N, Cardinal V, Marchiori S, Binukrishnan S, Holemans J, Gosney J, McCann C, Emphysema and smoking related lung diseases. The British Institute of Radiology 2014; 20 (4).</ref>&nbsp;. Paraseptal emphysema is believed to be the basic lesion of pulmonary bullous disease <ref>Hochhegger B, Dixon S, Screaton N, Cardinal V, Marchiori S, Binukrishnan S, Holemans J, Gosney J, McCann C, Emphysema and smoking related lung diseases. The British Institute of Radiology 2014; 20 (4).</ref>&nbsp;.<br>  
Emphysema can be defined as having a loss of lung elasticity, permanent enlargement of the air spaces distal to the terminal bronchioles, and destruction to the alveolar walls. It can be classified under the umbrella term chronic obstructive pulmonary disorder (COPD) <ref>Voelkel NF, Gomez-Arroyo J, Mizuno S. COPD/emphysema: The vascular story. Pulmonary Circulation 2011; 1(3): 320–326.</ref>&nbsp;. <br>There are three types of emphysema; centriacinar, panacinar, paraseptal. Centriacinar emphysema affects the alveoli and airways in the central acinus, destroying the alveoli in the walls of the repiratory bronchioles and alveolar ducts <ref name="2">Hochhegger B, Dixon S, Screaton N, Cardinal V, Marchiori S, Binukrishnan S, Holemans J, Gosney J, McCann C, Emphysema and smoking related lung diseases. The British Institute of Radiology 2014; 20 (4).</ref>&nbsp;. Panacinar emphysema affects the whole acinus <ref name="2" />&nbsp;. Paraseptal emphysema is believed to be the basic lesion of pulmonary bullous disease <ref>Hochhegger B, Dixon S, Screaton N, Cardinal V, Marchiori S, Binukrishnan S, Holemans J, Gosney J, McCann C, Emphysema and smoking related lung diseases. The British Institute of Radiology 2014; 20 (4).</ref>&nbsp;.<br>


== Epidemiology  ==
== Epidemiology  ==

Revision as of 21:52, 27 May 2015

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Definition/Description[edit | edit source]

Emphysema can be defined as having a loss of lung elasticity, permanent enlargement of the air spaces distal to the terminal bronchioles, and destruction to the alveolar walls. It can be classified under the umbrella term chronic obstructive pulmonary disorder (COPD) [1] .
There are three types of emphysema; centriacinar, panacinar, paraseptal. Centriacinar emphysema affects the alveoli and airways in the central acinus, destroying the alveoli in the walls of the repiratory bronchioles and alveolar ducts Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title . Panacinar emphysema affects the whole acinus Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title . Paraseptal emphysema is believed to be the basic lesion of pulmonary bullous disease [2] .

Epidemiology[edit | edit source]

Emphysema is generally found in those less than 40 years old, and more frequently found in those of Scandinavian decent, commonly developing in the 3rd to 5th decade of a life [3][4] . The disease tends to express no signs and symptoms until 50% of lung function is lost, as a result of the airway obstructions beginning in the smaller airways [5] . 1% of cases of emphysema are thought to be due to the deficiency of the alpha1-antitrypsin enzyme [6] .

The statistics relating to Emphysema are usually held within the wider spectrum of COPD, causing death to more than 14 million Americans, it is thought to be the fourth leading cause of deaths in America [7] . Within England and Wales, 1.5 million people are said to be affected by Emphysema being within the top 5 leading causes of death [8] .


Aetiology[edit | edit source]

The exact cause of Emphysema is still yet to be distinguished, however research is suggesting the prevalence is strongly related to smoking, air pollutions and in some cases, occupation [9]. Another common association is the deficiency of the enzyme alpha₁-antitrypsin, which is the protein protecting the alveoli (Hough, 2014).
The prevalence of Emphysema within the smoking population is believed to increase as smoking is a major risk factor associated. It is thought to have a higher incidence in those with a lower socio-economic background, therefore affecting lifestyle and environment, resulting in the likelihood of respiratory infection [10].


Pathophysiology[edit | edit source]

The alveoli and the small distal airways are primarily affected by the disease, followed by effects in the larger airways Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title . Elastic recoil is usually responsible for splinting the bronchioles open. However, with emphysema, the bronchioles lose their stabilizing function and therefore causing a collapse in the airways resulting in gas to be trapped distally Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title .

There is an erosion in the alveolar septa causing there to be an enlargement of the available air space in the alveoli [11] . There is sometimes a formation of bullae with their thin walls of diminished lung tissue. 

Investigations[edit | edit source]

CT scan is a common method used to diagnosis emphysema. The observations mainly seen to identify emphysema are a decrease in lung attenuation and a decrease in the number and diameter of pulmonary vessels in the affected area [12] .

Clinical Manifestations[edit | edit source]

Patients diagnosed with emphysema may complain of difficult/laboured breathing and reduced exercise capacity as their predominating symptoms [13]. The loss of the elastic recoil in the lungs leads to irreversible bronchial obstruction and lung hyperinflation, which increases the volume over normal tidal breathing and functional residual capacity [14].

Physiotherapy and Other Management[edit | edit source]

Physiotherapy and other management. Other health professionals will be treating your patient. What is their input?

Prevention[edit | edit source]

Brief consideration of how this pathology could be prevented and the physiotherapy role in health promotion in relation to prevention of disease or disease progression.

Resources
[edit | edit source]

add appropriate resources here

Recent Related Research (from Pubmed)[edit | edit source]

see tutorial on Adding PubMed Feed

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References[edit | edit source]

  1. ↑ Voelkel NF, Gomez-Arroyo J, Mizuno S. COPD/emphysema: The vascular story. Pulmonary Circulation 2011; 1(3): 320–326.
  2. ↑ Hochhegger B, Dixon S, Screaton N, Cardinal V, Marchiori S, Binukrishnan S, Holemans J, Gosney J, McCann C, Emphysema and smoking related lung diseases. The British Institute of Radiology 2014; 20 (4).
  3. ↑ Banasik 2001
  4. ↑ Hough 2014
  5. ↑ Hough 2014
  6. ↑ Haas &amp;amp;amp;amp;amp;amp; Haas 2000
  7. ↑ Mattison S, Christensen M. The pathophysiology of emphysema: Considerations for critical care nursing practice. Intensive and Critical Care Nursing 2006; 22: 329-337.
  8. ↑ Health and Safety Executive. Occupational Respiratory Diseases: Work-Related Chronic Obstructive Respiratory disease — Intervention and Evaluation Plans Draft Document. London: Health and Safety executive; 2005.
  9. ↑ Mattison S, Christensen M. The pathophysiology of emphysema: Considerations for critical care nursing practice. Intensive and Critical Care Nursing 2006; 22: 329-337.
  10. ↑ Haas F, Haas SS. The Chronic Bronchitis &amp;amp;amp;amp;amp; Emphysema Handbook. Chichester: John Wiley &amp;amp;amp;amp;amp; Sons, Inc; 2000.
  11. ↑ Hough A. Physiotherapy in respiratory and cardiac care. Hampshire: Cengage Learning EMEA, 2014
  12. ↑ Newell, J. CT of Emphysema. Radiologic Clinics of North America 2002; 40 (1): 31-42. http://www.sciencedirect.com.gcu.idm.oclc.org/science/article/pii/S0033838903001076 (accessed 21 May 2015)
  13. ↑ Visca D, Aiello M, Chetta A. Cardiovascular function in pulmonary emphysema. BioMed Research International 2013. http://search.proquest.com.gcu.idm.oclc.org/docview/1471216436?pq-origsite=summon (accessed on 21 May 2015)
  14. ↑ Visca D, Aiello M, Chetta A. Cardiovascular function in pulmonary emphysema. BioMed Research International 2013. http://search.proquest.com.gcu.idm.oclc.org/docview/1471216436?pq-origsite=summon (accessed on 21 May 2015)
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