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Emphysema is one of the chronic obstructive pulmonary diseases. Smokers are more prone to emphysema. It destroys the air sacs resulting in difficulties in breathing hence shortness of breath. The disease is accompanied by chronic bronchitis with daily cough and phlegm. The major symptom is shortness of breath which begins gradually when one performs heavy tasks then it progresses to resting.

Pulmonary test functions are performed to test the functioning capacity of the lungs. The tests include spirometry which determines the amount of air one breathes in and out, pletismography test to measure the air volume in the lungs and diffusion capacity test to determine how well the alveoli function. Charlene’s PFT tests indicated an oxygen saturation level of 90% which is below the normal range, indicative of low rate of oxygen diffusion into the blood. The normal values of FEV1 and FVC range between 25-75% (Mahonka et al., 2012). Charlene’s are within the normal range. The ratio of the two parameters is below the normal range (75-80%) indicative of increased airway resistance due to obstructive disease (Mahonka et al., 2012).

Tobacco smoke and other irritants cause inflammation of the airway resulting in an imbalance between antiproteases and cytokines release. As a result elastin is trapped within the septa destroying alveoli which affect the gas exchange process. Inefficient air sacs also accumulate (Macklem, 2013).

The respiratory centres in the brain stem contain chemoreceptors that detect the pH of blood sending signals to the lungs to increase ventilation. The medulla oblongata sends signals to respiratory muscles to cause breathing to occur. Expiration is controlled by the ventral part while inspiration is controlled by the dorsal part of the medulla oblongata. It also controls other air movements that are non respiratory like coughing and sneezing.

The oxyhaemoglobin dissociation curve is the graph that shows the proportion of saturated haemoglobin on the Y axis and oxygen tension on the horizontal axis. It relates SO₂ (oxygen saturation) to PO₂ (partial pressure).

In conclusion, irritants cause airway inflammation resulting in accumulation of macrophages, lymphocytes and neutrophilli into the walls of the bronchi. Tobacco smoke also directly damage the bronchial wall cells hence oedema of the bronchi. Further bronchial damage results in increased mucous glands and goblets which release thick tenacious mucus that do not easily clear (Macklem, 2013). Bronchitis patients have long unproductive coughs lasting up to three months.


Macklem P.T. (2013) Pathophysiology of Chronic Bronchitis and Emphysema, Medical Clinics of North America, p 669-679, 57 (3).

Mahonka , M.R, McMcarthy, K., Xu, M., Stoller J.K, (2012) a survey of practices of pulmonary Function Interpretation in Laboratorie in North east Ohio.Chest.