These abnormalities produce a spectrum of largely irreversible changes ranging from mucous hypersecretion chronic bronchitis , to chronic small airway inflammation and fibrosis bronchiolitis , and outright tissue destruction and impaired airflow emphysema. One of the hallmarks of COPD is reduced airflow, which occurs as the result of one or more of the following:.
These episodes can be treated, but the underlying pathology remains unchanged. The first image below on the left shows a subject breathing through a tube connected to a spirometer, which measures changes in air flow. The graph on the right shows normal changes in lung volume over time during inspiration and expiration, both at rest and during forced inspiration and expiration. Move your cursor over the lines of the graph to get a more detailed explanation.
Move your cursor over the different phases of the graph to see a description. This content requires JavaScript enabled. Spirometry is abnormal in people with COPD. The graph below on the right shows that the obstructive changes in COPD reduce the ability to expire air, and this results in an increased residual volume.
As a result, the ability to move air in and out of the lungs is progressively impaired, ultimately leading to diminished oxygenation of blood. Move your cursor over the phases of the line graph for a more complete explanation. The graph below on the left from Fletcher and Peto shows the natural history of changes in FEV1 in non-smokers, smokers, and smokers who quit smoking. These medications open the breathing tubes in your lungs to make it easier to get all the air out and thus easier to breathe.
There are 2 types of inhaled bronchodilators, and they work in different ways to open your breathing tubes. Your provider can measure the amount of oxygen in your blood by putting a clip called an oximeter on your finger. Starting a pulmonary rehabilitation program is the one of the best ways to improve shortness of breath, quality of life, and your ability to exercise. Depending on your situation, your provider may consider surgical treatments. For example, parts of your lung that are damaged or destroyed can interfere with more normal parts of your lung.
A surgical procedure can remove these damaged parts. Another surgical procedure used for people with advanced emphysema is to insert little one-way valves—called endobronchial valves —into the breathing tubes in your lungs. The lung specialist or surgeon uses a long, flexible tube, called a bronchoscope , with a camera and tools on the end to place the valves.
The valves allow air to exit the healthy parts of your lungs and collapse the areas of your lungs that are damaged. Your lungs deflate, which helps your diaphragm muscle work better so that you can breathe better.
Make sure that you know as much as possible about your condition so that you can function at the highest possible level. Also, create an action plan in case your breathing gets worse. You can expect your emphysema to get worse if you continue to smoke or inhale second-hand smoke and other irritants in the air. Many people with emphysema find that they reduce their activities to avoid breathing difficulty.
You can expect that using inhaled medications will open your airways and make it easier to breathe. You can also expect to be able to be more active if you exercise regularly, either on your own or by participating in a pulmonary rehabilitation program. If you follow recommended treatments, your breathing may remain stable for a long time.
Ideally, you should lead a healthy life style that includes not smoking, eating healthy foods, maintaining a normal body weight, exercising regularly, getting 7 to 8 hours of sleep each night, and avoiding too much stress. Get a yearly flu shot to reduce the chances of getting the flu. Also, you should get the two pneumonia shots to prevent the most common bacterial cause of pneumonia. Be sure to use your inhaled medications correctly and as prescribed by your health care provider.
Use your albuterol inhaler if you have difficulty breathing. This medicine opens the breathing tubes in your lungs quickly, but it lasts only 3 to 4 hours. Finally, make sure that you get a written action plan from your health care provider.
Keep it with you in case your breathing gets worse. Most action plans recommend using your rescue inhaler every 2 to 4 hours as needed and calling your health care provider if you have a chest cold or start to cough up yellow or green mucus.
Call your provider if you experience any major change in your breathing, Regular appointments with your health care provider are important for monitoring your emphysema and discussing treatments. Some local hospitals and clinics offer monthly support groups for COPD. For more information about COPD and emphysema, visit the following websites:. About Emphysema Key facts about Emphysema. Emphysema destroys the air sacs and narrows the breathing tubes in your lungs.
Cigarette smoking is the major cause of emphysema. Also, the bullae can become very large. Normal lung tissue next to the bullae cannot expand properly, reducing lung function.
Chronic bronchitis affects the oxygen and carbon dioxide exchange because the airway swelling and mucus production can also narrow the airways and reduce the flow of oxygen-rich air into the lung and carbon dioxide out of the lung. The damage to the alveoli and airways makes it harder to exchange carbon dioxide and oxygen during each breath.
Decreased levels of oxygen in the blood and increased levels of carbon dioxide cause the breathing muscles to contract harder and faster. The nerves in the muscles and lungs sense this increased activity and report it to the brain. As a result, you feel short of breath.
Yoneda MD - Pulmonology. Author: Healthwise Staff. Medical Review: E. This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information.
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