Emphysema is described as a pathological condition of irreversible enlargement of airspaces at the terminal bronchioles. Thus, enlargement causes a decrease in the alveolar surface area and limits gaseous exchange. The air sacs lose their original shape and become floppy and small in size. The primary etiology of emphysema is the progressive damage of pulmonary connective tissues due to smoking tobacco and marijuana and exposure to harmful fumes and dust (Amariei et al., 2019). On rare occasions, it can be caused by inherited genes. Smoke and fumes cause relatively impactful damage to the lungs’ air sacs, leading to the development of emphysema.
When conducting a comprehensive physical exam of an emphysema patient, inspection is the first technique used. On observation, the patient will look HG and will seem to be in distress and disturbed. The anterior-posterior diameter will be increased, making the chest barrel. From observation, he will also be using accessory muscles to aid himself in breathing in and out (Amariei et al., 2019). HG will have adapted to a tripod position with severe tachypnea and shortness of breath on exertion.
On palpation of Mr. HG’s chest, there will be a decrease in tactile fremitus and a reduced chest expansion. On percussion of the chest, a hyper resonance sound will be heard, which indicates lung hyperinflation with air. Upon auscultation of HG’s chest using the stethoscope, a wheezing sound will be heard (Amariei et al., 2019). The expiration rate of Mr. HG will be prolonged and the breath sounds also will be diffusely reduced.
Muffled heart sounds will also be heard due to the over-distention of the lungs. Following inspiration, additional sounds of coarse crackles will be heard too. Subjective finding refers to the information about the condition provided by HG himself during the presentation (Amariei et al., 2019). This includes his social history of smoking for 45 years. The objective findings are confirmed information, such as the positive PMH of frequently experienced episodes of pneumonia.
References
Amariei, D. E., Dodia, N., Deepak, J., Hines, S. E., Galvin, J. R., Atamas, S. P., & Todd, N. W. (2019). Combined pulmonary fibrosis and emphysema: pulmonary function testing and a pathophysiology perspective. Medicina, 55(9), 580.