Chronic Obstructive Pulmonary Disease
(COPD; Emphysema) Pathophysiology
June 4, 2014
D.Z.is a 65-year-old man admitted to medical ward with an exacerbation of chronic obstructive pulmonary disease (COPD; emphysema). Past medical history (PMH) indicates hypertension (HTN), well managed with enalapril (Vasotec) past six years, diagnosis (Dx) of pneumonia yearly for the past three years. D.Z. appears cachectic with difficulty breathing at rest. Patient reports productive cough with thick yellow-green sputum. He seems anxious and irritable during subjective data collection. He states, he has been a 2-pack-a-day smoker for 38 years. He complains of (c/o) insomnia and…show more content… It includes emphysema, chronic bronchitis, and in some cases asthma (NIH.NHLBI, 2012). Emphysema as stated by American Association for Respiratory Care (AARC) is an abnormal enlargement of air spaces distal to the terminal bronchioles and does occur in the lung parenchyma in COPD patients (AARC, 2011; Rosdahl & Kowalski, 2003).
As a result of emphysema there is a significant loss of alveolar attachments, which contributes to peripheral airway collapse. There are two major types of emphysema according to the distribution within the acinus and they are; (i) centrolobular emphysema which involves dilatation and destruction of the respiratory bronchioles; and (ii) panlobular emphysema which involves destruction of the whole of the acinus. According to theory, centrolobular is the most common type of emphysema in COPD and is more prominent in the upper zones, while panlobular predominates in patients with alpha-1 antitrypsin deficiency and is more prominent in the lower zones. In relation to patients D.Z. with emphysema, the walls between the tiny air sacs in the lungs are damaged due to long-term cigarette smoking effect on his lungs as evidenced by patient c/o difficulty breathing at rest and productive cough with thick yellow-green sputum r/t a