Wednesday, September 4, 2019
Emphysema :: essays research papers
     Emphysema is one of several diseases usually labeled collectively as chronic obstructive pulmonary disease (COPD). It’s the most common cause of death from respiratory disease in the United States; approximately 2 million Americans are afflicted with the disease. Emphysema(COPD) appears to be more prevalent in men than women. Postmortem findings reveal few adult lungs without some degree of emphysema. Causes      Emphysema(COPD) may be caused by a genetic deficiency of alpha 1 -antitrypsin (AAN) and by cigarette smoking. Genetically, one in 3,000 newborns are found with the disease, and 1% to 3% of all cases of emphysema are due to AAT deficiency. Cigarette smoking is thought to cause 20% of the cases. Other causative factors are unknown. Complications      In emphysema(COPD), complications may include recurrent respiratory tract infections, cor pulmonale, and respiratory failure. Peptic ulcer disease strikes 20% to 25% of patients with COPD. Additionally, alveolar blebs and bullae may rupture, leading to spontaneous pneumothorax or pneumomediastinum. Assessment findings      The patient history may reveal that the patient is a long-time smoker. The patient may report shortness of breath and a chronic cough. The history may also reveal anorexia with resultant weight loss and a general feeling of malaise.      Inspection may show a barrel-chested patient who breathes through pursed lips and also uses accessory muscles. You may notice peripheral cyanosis, clubbed fingers and toes, and tachypnea.      Palpation may reveal decreased tactile fremitus and decreased chest expansion. Percussion may detect hyper resonance. On auscultation, you may hear decreased breath sounds, crackles and wheezing during inspiration, a prolonged expiratory phase with grunting respirations, and distant heart sounds. Diagnostic tests      Chest X-rays in advanced disease may show a flattened diaphragm, reduced vascular markings at the lung periphery, over aeration of the lungs, a vertical heart, enlarged anteroposterior chest diameter, and large retrosternal air space.      Pulmonary function tests typically indicate increased residual volume and total lung capacity, reduced diffusing capacity, and increased inspiratory flow.      Electrocardiography may reveal tall, eymmetrical P waves in leads II, III and aVf; vertical QRS axis; and signs of right ventricular hypertrophy late in the disease. Red blood cell count usually demonstrates an increased hemoglobin level late in the disease when the patient has persistent severe hypoxia.
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