Question

In: Anatomy and Physiology

54-year-old man comes to him primary care physician because of gradually worsening shortness of breath. He...

54-year-old man comes to him primary care physician because of gradually
worsening shortness of breath. He also expresses concern that her lips turn blue when she
ascends stairs. On physical examination, the physician notes increased anteroposterior (AP)
diameter of her chest, hyperresonance on percussion of lung fields, and increased respiratory
effort. The patient’s blood pressure is 110/70 mm Hg and her pulse is 90/min. He has had well-
managed diabetes for 10 years and a 30-pack-year history of smoking. The patient is sent for
evaluation of him lung function.
Which is most likely during forced expiration?

Solutions

Expert Solution

The condition of the patient shows that he is suffering from emphysema.

Etiology

Book picture Patient picture
  • Cigarette smoking
  • Air pollution
  • Alpha 1 Antitrypsin deficiency
  • Inherited diseases like Marfan's syndrome, Menkes' syndrome
  • Cigarette smoking

Clinical Manifestation

Book picture Patient picture
  • Dyspnea
  • Cough with or without expectoration
  • wheezing
  • loss of weight
  • peptic ulceration
  • hypercapnia
  • barrel chest
  • Dyspnea
  • wheezing
  • barrel chest ( increase in anteroposterior diameter)

Diagnosis

Book picture Patient [picture
  • History
  • Physical examination
  1. Barrel chest
  2. Pursed lip breathing
  3. breath sounds quite diminished
  4. prolonged exhalation
  5. bluish discoloration of the lips and nail beds
  6. hyper resonance on chest percussion
  • Barrel chest
  • Bluish discoloration of the lips
  • hyper resonance on chest

During emphysema, the damage to the air sacs makes it harder for oxygen to pass in to the blood vessels of the lungs. As a result, the oxygen level in the body is frequently reduced. The body tries to compensate for the low oxygen by breathing more. This makes breathing difficult. As a result the forced vital capacity is reduced. The rate of expiratory flow is also reduced. Also it is very difficult for a person with an obstructive disease to exhale quickly due to the increase in airway resistance. As a result, the FEV/ FVC ratio will be much lower than normal.

Sydney Mullin answered 1 year ago
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