EMPHYSEMA a disorder in which the alveolar walls are destroyed leading to permanent overdistention of the air spaces distinguishing

characteristic is airflow limitation caused by lack of elastic recoil in the lungs also called as “pink puffer”

CAUSES
1. Smoking

- blocks the action of alpha1 -antitrypsin, causing damage that draws more elastase releasing phagocytes to the lungs, promoting excessive elastase release by phagocytes 2. Inherited deficiency in alpha1 –antitrypsin - an anti-protease enzyme that protects the lung from injury and determined by a pair of co-dominant genes referred to as PI (protein inhibitor) gene. THREE TYPES
1. Centrilobar

- most common type - produces destruction Iin the bronchioles, usually in the upper lung regions -alveolar sac reamin contact 2. Panlobar - affects both the bronchioles and the alveoli - most commonly involves the lower lung 3. Paraseptal - destroys the alveoli in lower lobes of the lungs resulting in isolated blebs along the periphery

MANIFESTATIONS progressive dyspnea on excertion that eventually becomes dypnea at rest hyperresonant sound of the chest upon percussion

AP diameter is enlarged (Barrel-shaped chest) cyanosis around the lips clubbing of fingers pitting peripheral edema

PATHOPHYSIOLOGY MANAGEMENT 1. Bronchodilators 2. Oxygen 3. Postural drainage

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