Emphysema Flashcards
(23 cards)
ephysema
an obstructive disease disease characterize by destruction of lung tissue
panlobular
destruction of parenchyma distal to the terminal bronchioles
typically a lower lobe disease or pattern
alpha one antitrypsin defiency
centrilobular
usually an upper lobe disease
usually characterize by destruction of central respiratory bronchioles sparing the distal portion
smoke increase protease activity and it does what?
an enzyme which destroys the terminal bronchioles and alveolar walls
which decreases mucocillary transport
paralyzes cilia
thickens mucous increase mucous production from irruption
smokers are most likely to develop in?
centrilobular emphysema of upper lobes
alpha 1 protease inhibitor
responsible for the inactivation of elastase
breaks down elastin during an inflammatory response
if enzyme alpha 1PI is missing then
lung tissue is lost due to action of elastic
inhierated emphysma
approximately 1% of cases
most people with genetic problem of deficiency alpha 1PL due well if they don’t smoke
PFT lung volumes decrease in
FVC
FEV1
IC
ERV
pft lung volume increase in
`
tidal volume TLC FRC RV RV/TLC%
what is decrease in flow
FEF25-75%
decrease DLCO
lung pathology affects on oxygenation and ventilation
decrease surface area
v/q mismatch
affects hypoxemia and hypercapnea
symptoms of chronic emphysema
often symptoms occur with chronic bronchitis
dyspnea during exertion
typically worse following or during upper respiratory illness
chest expectation
tachypnea
use of accessory muscle
increase AP diameter
pursed lip breathing
in palpation you should feel
decrease tactile and vocal fremitous
percussion and auscultation
hyperresonance and flat lower diaphragm
diminished breath sounds
x-ray
flattend diaphragm
hyperinflation
compress heart
increased retrosternal airspace
ABG we expect
and ekg
compensated respiratory acidosis with hypoxemia
right shift of p and QRS in frontal plane
support oxygenation and ventilation
low flow oxygen
cpt breathing retraining
decrease work of breathing
symoathomimetics
methylxanthines
cortisteriod
respiratory rehab is very important
improvement in exercise tolerance knowledge of disease state
improvement in self-care
smoking cessation is important
supplemental oxygen
administer if resting pa02<55 mm Hg
usually low flow system are adequate
v/q mismatching is the pathology
prolastin replacement
must be done fairly early in life prior to lung loss
very expensive
