St.

Norbert Senior Secondary School

Biology Assignment (2018-19)
Topic: Emphysema
Submitted to: Mrs. Anamika Kakirde
Submitted by:
Name: Vaishnavi Priya Jha
Class: 11 B
Roll No: 26
Scholar No: 107494
 Acknowledgement

I would like to express my special thanks of gratitude to

my teacher Mrs.Anamika Kakirde as well as our principal
Sr. Lilly Mary who gave me the golden opportunity to do
this wonderful project on the topic Emphysema, which
also helped me in doing a lot of Research and I came to
know about so many new things. I am really thankful to
them.
Secondly I would also like to thank my parents and
friends who helped me a lot in finalizing this project
within the limited time frame.
 Index
1) Emphysema: An Overview ……………..4
2) History of Emphysema ………………....5-7
3) Statistics related to emphysema………..8
4) Density of patients suffering from
Emphysema …………………………….9

5) Symptoms of Emphysema……………10-11
6) Stages of Emphysema………………...12-13
7) Medication for Emphysema…………..14-17
8) More to know about Emphysema….....18
9) Bibliography…………………………..19
 Emphysema: An Overview
The word ‘Emphysema’ means ‘full of air’ or ‘inflation’.
It is a chronic disorder. The major cause is excessive
cigarette smoking. Others may include inhalation of
smoke or toxic substances over a period of time.
The walls of alveoli are damaged due to excessive
smoking, loss of elasticity of walls of bronchioles and
alveoli. Due to this, the surface area for exchange of gases
is reduced. Alveolar sacs remain filled with air even after
expiration. The lungs remain inflated as exhalation
becomes difficult.
 History of Emphysema
Ballie, a British physician who inherited his father’s
anatomy school, documented emphysema in detail and
with pictures. He found that the “enlarged air spaces”
within the lungs that did not collapse properly. From 1793
to 1807, Ballie researched emphysema to the best of his
abilities and published his findings in his book, “The
Morbid Anatomy of Some of the Most Important Parts of
the Human Body.”
In 1814, British Physician Charles Badham became the
first to use the term “bronchitis” to denote “inflammatory
changes in the mucous membrane.” This changed the way
that doctors viewed a variety of medical conditions.
Moving ahead to 1821, Dr. Rene Laennec, known as the
father of chest medicine thanks in part to his invention of
the stethoscope, accurately discovered the relationship
between emphysema and chronic bronchitis. Laennec
became the first to connect emphysema to aging, and he
was the first to define emphysema as tissue damage in the
peripheral air passages. To him, emphysema was a
breakdown of tissue in the parenchyma of the lungs as
opposed to air trapped in the alveoli due to an obstruction
such as occurs in asthma and chronic bronchitis.
Enter John Hutchinson in 1846, the very man that
invented the spirometer. Despite believing that his device
was limited in its use, it became the prominent tool used
in diagnosing and treating many lung diseases. Many
more doctors went on to describe the effects of
emphysema leading us right back to the 20th century.
By 1898, the air sacs in the lungs were no longer called
“cells;” they were referred to as alveoli in books and
magazines. Emphysema was now clearly defined as
“dilation of the alveoli of the lungs and atrophy of the
alveolar walls.” During the 1930s and 40s, researchers
discovered even more information about the lungs and the
role of emphysema. In 1933, Ronald V. Christie, a
professor of medicine at the University of London who
specialized in emphysema, performed a study that showed
the relationship between loss of lung elasticity and airflow
limitations. Christie said that emphysema could possibly
be found from different symptoms, which included
shortness of breath and coughing.
By the 1950s, physicians had learned so much about the
lungs. True emphysema was now be considered air in the
interstitial spaces due to breakdown of parenchymal lung
tissue such as the walls of the alveoli. From the 1960s on,
pulmonary function testing was used with increased
frequency to study lung diseases, and it was during this
era that the term FEV1 was first used to measure
expiratory flow. This test made it possible to differentiate
asthma from chronic bronchitis, emphysema and other
lung diseases.
As you can probably tell, there is quite a bit of history
involved with emphysema. A number of doctors and
researchers have adapted over time to understand this
disease more clearly. Now there are treatments available
to help relieve the symptoms of emphysema. There is a
wealth of information available out there if you would
like to know more about emphysema.
 Statistics related to Emphysema
 As of 2015, emphysema affected about 174.5 million
(2.4%) of the global population.
 It typically occurs in people over the age of 40 Males
and females are affected equally commonly.
 In 2015, it resulted in 3.2 million deaths, up from 2.4
million deaths in 1990
 . More than 90% of these deaths occur in the
developing world.
 The number of deaths is projected to increase further
because of higher smoking rates in the developing
world, and an aging population in many countries.
 It resulted in an estimated economic cost of
$2.1 trillion in 2010.
Density of Emphysema Suffering patients
 Symptoms of Emphysema
Two of the key symptoms of emphysema are shortness of
breath and a chronic cough. These appear in the early
stages. A person with shortness of breath, or dyspnea,
feels being unable to catch a breath. This may start only
during physical exertion, but as the disease progresses, it
can start to happen during rest, too.

Other symptoms include:

 frequent lung infections

 a lot of mucus
 wheezing
 reduced appetite and weight loss
 fatigue
 blue-tinged lips or fingernail beds, or cyanosis, due to a
lack of oxygen
 anxiety and depression
 sleep problems
 morning headaches due to a lack of oxygen, when
breathing at night is difficult
 Stages of Emphysema

The GOLD Emphysema Staging System

This is a set of guidelines established by the Global Initiative
for Chronic Obstructive Lung Disease (GOLD).
It measures how much air you can blow out of your lungs in
1 second. Doctors call this the forced expiratory volume
(FEV1).
If you have emphysema, your doctor will look at your
FEV1. He’ll also look at your other symptoms, as well as how
many times you’ve been hospitalized in the past year
because of them. Doctors call this an “exacerbation.” It
means your symptoms flare up or suddenly get worse.
Your doctor may also do a CT scan of your lungs. He’ll then
use all of this information to place you into one of the
following four groups (they tell you how severe your
emphysema is):
Group A (GOLD 1 or 2): Your symptoms are very mild.
Your FEV1 is 80% or more. You might have had no flare-
ups over the past year, or perhaps just one. You weren’t
hospitalized for your symptoms.
Group B (GOLD 1 or 2): Your FEV1 is between 50% and
80%. You have more symptoms than people in Group A.
This is the stage where most people see their doctor
for coughing, wheezing, and shortness of breath.
You might have had one major flare-up, but you haven’t
been in the hospital for your symptoms within the past year.
Group C (GOLD 3 or 4): Air flow into and out of your
lungs is severely limited. Your FEV1 is between 30% and
50%.
You’ve had more than two flare-ups in the past year, or
you’ve been admitted to the hospital at least once.
Group D (GOLD 3 or 4): It’s extremely hard for you to
breathe in or out. You’ve had at least two flare-ups in the
past year, or you’ve been hospitalized at least once.
Doctors call this “end-stage” COPD. That means you have
very little lung function. Any new flare-ups could be life-
threatening.
 Medication for Emphysema
1) Medications as inhalants - Bronchodilators are
medications that relax the bronchiolar muscles and
improve airflow. Bronchodilators are available as
inhalers in both metered dose form and powder
inhalers, and through nebulizer machines (they
convert the powder to aerosol). Bronchodilators
may be used for short-term use for those needing
quick relief from symptoms, or for long-term daily
use. Steroids can also be used to treat emphysema.
Your doctor may prescribe corticosteroids in an
inhaler form. Corticosteroids relieve symptoms by
reducing inflammation. Some popular inhalers,
such as Advair — which brings salmeterol and
fluticasone together — combine a bronchodilator
with a corticosteroid.

2) Oral treatments for emphysema- People with

emphysema may be prescribed an oral steroid like
prednisone, in addition to using an inhaler.
Antibiotics are also popular treatments, preventing
infections that can lead to dangerous conditions
like pneumonia. Mucolytic agents are sometimes
 prescribed to help lessen mucous. These treatments
come in the form of expectorants; medications that
help bring mucus up from the lungs. Mucinex and
Robitussin are popular over-the-counter versions.

3) Oxygen supplementation- Many people who have

emphysema will eventually need to use an oxygen
treatment every day. As the disease progresses, the
need for oxygen often increases. Some will
eventually require oxygen all the time. Not
everyone with emphysema requires the large
mobile tank often associated with oxygen
supplementation. A much lighter and more portable
device called a concentrator can extract oxygen
from the air and convert it for use. Older versions
of these devices initially required a power outlet to
operate, but newer versions operate on battery
power, making them more viable for everyday use.
However, the battery-operated version isn’t
recommended for use during sleep, as the device
may have problems recognizing when a sleeping
user is inhaling.
 4) Surgery and Rehabilitation -Some people with
emphysema may qualify for surgery to reduce lung
volume, which helps to decrease symptoms. This
surgery is generally not performed on older adults
due to health risks. People who have lung damage
that’s centralized on the upper lobes of both lungs
are more likely to benefit from surgery. Your
doctor may recommend pulmonary rehabilitation.
Breathing exercises can also help you strengthen
your lungs. In addition to exercise, you may be
encouraged to interact with other people who have
emphysema during these sessions. This can help
build confidence and increase overall well-being. A
medical professional may also work with you to
help improve your understanding of medications
and available treatments.

There is no permanent cure for emphysema.

Treatments can only manage symptoms or slow the
prognosis of the disease. Quitting smoking is one of the
best things you can do to help manage your symptoms.
Talk to your doctor if you need help quitting smoking.
They can provide resources that will help you quit.
 More to know about Emphysema

November is COPD Awareness Month.

Advancements in COPD Research: Researchers

Create New Air Sacs in Mouse Model of Emphysema

Researchers at Johns Hopkins have identified a new

molecular pathway involved in the growth of tiny air

sacs called alveoli that are crucial for breathing. Find

out how this discovery may benefit those who suffer

from COPD, or premature infants born before their

lungs are fully developed.

 Bibliography
 NCERT Biology Textbook
 The Times Of India
 ‘Health and Nutrition’ magazine
 Whittaker’s Encyclopedia
 https://en.wikipedia.org/wiki/Chronic_obstr
uctive_pulmonary_disease
 https://www.healthline.com/health/copd/fact
s-statistics-infographic#5
 https://emedicine.medscape.com/article/298
283-clinical