{ COPD Emphysema Pathophysiology sary Abigail D, CarreonPathophysiology Mary Abiyail D. Carreon Alveoli with emphysema Microscopic view of normal alveoli -Pathophysiology Lary ABipail D. of In normal breathing, air is drawn in hough the bronchial passages and down into the increasingly fine network of tubing in the lungs called the alveoli, which are many millions of tiny sacs surrounded by capillaries. These absorb the oxygen and transfer it into the blood. When toxins such as smoke are breathed into the lungs, the particles are trapped and cause a localized inflammatory response. Chemicals released during the inflammatory response (¢.g., elastase) can break: down the walls of alveoli. This leads to. significant modifications of lung architecture, characterized mainly by intrapulmonary air collections and confining parenchyma collapse; as far as the process proceeds expitatory bronchial obstruction and thoracic cage expansion also occur, with the clinical picture of COPD. The enlarged air sacs (alveoli) of the hmgs reduces the surface area available for the movement of gases during respiration, This ultimately leads to dyspnea in severe cases. But mainly decreased is the ability to exude carbon dioxide due to ventilation deficit Emphysema is characterized by alveolar destruction. As the elastin and fiber network of the alveoli are broken down the alveoli enlarge and many of the alveoli walls are destroyed. This results in the formation of larger than normal air pools which greatly reduces surface area, thus decreasing the ~~ area_— available for gas exchange. 1. Inflammation of the bronchial mucosa 2. Excessive mucous production 3. Loss of elastic recoil of the airways 4. Collapse of bronchioles and redistribution of air to the functional alveoli After a prolonged period, hyperventilation becomes inadequate to maintain high enongh oxygen levels in the blood. The body compensates by vasocoustricting appropriate vessels. This leads to pulmonary hypertension, in our case, it had not yet developed such complication, which places increased strain on the right side of the heart, the one that pumps deoxygenated blood to the lungs, and it often fails, The failure causes the hear muscle to thicken to pump more blood, Eventually, as the heart continues to ful, becomes larger and blood backs up in the liver.