Emphysema
Emphysema is abnormal permanent
enlargement of the airspaces distal to the
terminal bronchioles, accompanied by
destruction of their walls.
The presence of airfow limitation combined with
premature airway closure leads to gas trapping and
hyperinfation, adversely affecting pulmonary and chest
wall compliance.
Pulmonary hyperinflation also results, which flattens the
diaphragmatic muscles and leads to an increasingly
horizontal alignment of the intercostal muscles, placing
the respiratory muscles
at a mechanical disadvantage. The work of breathing is
therefore markedly increased – first on exercise, when
the time for expiration is further shortened, but then, as
the disease advances, at rest.
Emphysema may be classified by the
pattern of the enlarged airspaces:
centriacinar, panacinar and paraseptal.
Some individuals develop bullae;
permanent air-filled spaces within the lung
that are more than 1 cm in diameter. This
results in impaired gas exchange and
respiratory failure