Emphysema

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Is defined as progressive destruction and permanent enlargement of the alveoli and results in the loss of the gas exchange surface leading to hypoxaemia. There is loss of elastic recoil in the small airways that are needed for expiration, so that they collapse on expiration which leads to hyperinflation of the lungs, trapping air inside. Hyperinflation results in breathlessness and reduces the person’s exercise capacity. The overall appearance presents like a classic COPD exacerbation.

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Characteristics:

• Little or no productive cough

• Breathing using accessory muscles

• Pursed lips

• Wheezing

• Heart sounds are very distant

• The person may be very thin but have a barrel chest

 

Inflammation in the alveoli is characterised by increased

macrophages, neutrophils and T-cells. Neutrophils can be

found at all sites and neutrophil elastase degrades elastin,

destroying the alveolar attachments and resulting in a loss

of elastic recoil.