COPD (& Emphysema) Explained Clearly – Pathophysiology & Treatment

By Adem Lewis / in , , , , , , , , , , , , , , , , , , , , , , , , , , , /

Welcome to another MedCram lecture. We’re going to talk about emphysema today,
otherwise known as C.O.P.D. It seems as all these diseases have abbreviations
in medicine. This one is “chronic obstructive pulmonary
disease.” What is C.O.P.D.? It’s a common preventable and treatable lung
disease and the typical symptoms that you’ll see in patients with emphysema C.O.P.D. is
shortness of breath, and you’ll also see cough, and if it’s wet you’ll have sputum as well. These are very nonspecific symptoms, but they’re
very typical of what you see in C.O.P.D. How important of a disease is this? Couple of statistics that you should know
is it’s the third most common cause of death in the US; pretty significant. There’s a number 2 and there’s a number 1
above it and that’s heart disease and cancer and sometimes these, depending on how you
survey, will flip spots. There’s also number 4 and number 5. The key here is that this is the only cause
of death in the United States out of these 5 that have actually gone up from about 2007
to 2010 all the others have gone down in frequency except for this one. This is a pretty significant disease that
we’ve got to be concerned about. In addition to all of this, it’s also the
second leading cause of disability. Okay, so the bottom line here is that this
is a very important disease to know about. In case of course, you’re wondering how much
of this costs the US healthcare system in the United States every year, the answer is
about 50 B with a billion; 50 billion with a B. That’s quite a lot of money
As I mentioned, C.O.P.D or emphysema is a disease that affects the lungs. Specifically, if you were to take a look your
lungs, you of course know that your lungs have 2 sides and that there’s a major airway
call the trachea and it branches off into the right and left main-stem bronchus. From there it just goes down to smaller and
smaller branches, without getting into too much anatomy. If we were to take these very small bronchioles
or respiratory bronchioles they would eventually end in a grape like cluster called a alveolus. This essentially increases the surface area. This is what a normal respiratory bronchioles
would look like. If you were to take all these alveoli in the
entire lung and spread it out it would be about the size of a tennis court. It’s pretty big. These bronchioles of course allow the air
that you breathe in to go down and cause gas exchange. Now C.O.P.D. affects 2 main areas. It affects this bronchus, the small bronchial
and it also affects the alveolus in a bad way. What happens, is because the elastic fibers
are destroyed, we’ll get into that later, is that that airway becomes very collapsible
and essentially it becomes very small, and that’s where the obstruction in C.O.P.D. comes
from. Furthermore, you’re also going to get destruction
of the alveoli and you lose a lot of surface area, so instead of having a nice tennis court
you end up with maybe a badminton court or even a table tennis court here that you’re
working with. The surface area becomes much smaller and
all these changes happen throughout the lung, but mostly in the upper regions of the lung. As a result of that it’s hard to get the air
out. There’s an obstruction, that’s the key point
there is that air cannot get out of the lungs. That’s why it’s called chronic obstructive
pulmonary disease. In addition to that because these alveoli
are all destroyed and become areas of large balloons if you will, the long actually increases
in size and as a result of that you get these patients with large lungs but they’re full
of air and they can’t get the air out and that’s basically C.O.P.D.. The way that we diagnose C.O.P.D. is based
on this obstruction. We set them down in front of a spirometer,
that’s basically a machine where you breathe into it and it measures how much you breathe
out. We asked them to basically breathe out after
taking a deep breath in, breathe out as much air as they possibly can and we measure it. This represents how much air they can blow
out given enough time to blow it out, so we give them 6 to 10 seconds to blow it out enough
time that they need to blow everything that they possibly can out in the lung. We call that, by the way, the forced vital
capacity. Otherwise known as the FVC. That’s how much air they can blow out completely. We said that C.O.P.D. is an obstructive lung
disease so what we’re really looking for is how fast can they get that air out, because
if there’s an obstruction that’s going to impede their ability to get that air out as
fast as they possibly can. The next thing that we do is that we have
them do the same maneuver, but we measure how much comes out in 1 second, so there’s
kind of a timed proportion to this. How much can you blown out given an infinite
amount of time? And how much can you blow out in just 1 second? There’s a little bit of a velocity factor
involved there. What we do is, we call that by the way, the
forced expiratory volume in 1 second. This is otherwise known as the FEV1. Then we do a very simple calculation, we measure
and we see. We take this number, the forced expiratory
volume and we divide it by the forced vital capacity number and we come up with a fraction. This is known as the FEV1 divided by the FVC
ratio. The definition that’s come up in the literature
is that .70, 0.70 is the cutoff. If the FEV1 divided by the FVC ratio is less
than .70 that means that you could get less than 70% of the air that you could normally
get out, given an infinite amount of time, out in the first second. That means you’ve got obstructive lung disease. If you can get more than .7 out that means
you don’t have obstructive lung disease. The question here is, can you get out at least
70% of the air that you could normally blowout in the first second, and if the answer is
yes then you don’t have obstructive lung disease. If the answer is no and it’s less than .7,
then you have obstructive lung disease. Of course, the lower this number is, the FEV1,
the worse your C.O.P.D. is going to be. Let’s review. C.O.P.D. is 1) common, it costs a lot; 2)
it’s the third leading cause of death and is the only 1 of the 5 that are actually increasing
in frequency; 3) causes difficulty with breathing out, that’s obstruction; 4) reduces the cross-sectional
surface area, causes drops in oxygen; 5) you diagnose it by spirometry, and then finally
6) the diagnosis is the FEV1 divided by the FVC is less than .7
Thank you for joining us.

100 thoughts on “COPD (& Emphysema) Explained Clearly – Pathophysiology & Treatment

  1. hi everyone I think interesting topic with amazing learning method but I think we need more details inclouding radiological diagnostic images and the suspected questions modalities and key word for solving highly appreciate thank u very much

  2. huge help , thanks you ! Love the videos I have 30-40 % lung function am a COPD stage 3 or the new term is COPD C whichever it is BAD.

  3. Really appreciate all the videos in these series.  Would you be able to do a set on types and diagnosis of anemias?  Thanks!

  4. hi i just came out of the hospital and my doctor gave me my test results back i got early signs of epysema and C.O.P.D and im only 38 my doctors was amazazed by that they never saw that in a young age but i have the signs of c.o.p.d it really opened my eyes amd i am a smoker just very differcalt to stop i am little afraid now that i have it my parents and family very scared i lost my two aunts who had epysema sorry for the wrong spelling of it but im taking inhalers for it for now and going to get more tests . and i have a qusetion for you, i was caughing up blood is that normal or is that a part or another spymtom to c.o.p.d?

  5. I'm a newly qualified nurse in the UK (7 months in) and I'm constantly coming home to read up on situations that I need to understand more. Thank you so much for your videos. Even my tired mind gets it! You're a very gifted teacher. Of course, it goes without saying that I'm a new SUBBIE!!

  6. The fibrolin or Filiggrin is relative to Ecxema in Emphysema and Asthma both. Then the connection to these three diseases and the liver damage due to Loss of Alpha1 Antitrypsin. So then once the Chromosomal Lab does an examination with a small bool test they determine that the alleles have become shorter due to the damage from "live" SV40 in various vaccines made from 1940 – 1972. The correct vector is still the SV40 for adenovirus repairitive methodology and the chromosomes for repair are Chromosome 19 and the other three chromosomes for respiratory methodology. Once yo determine the link between these three things Asthma, Emphysema, Eczema then you will be able to loo the wr that already been accomplished and their cure rate is 95%.

  7. Use Tiffenau index, fev1: static vital capacity(not forced), it is corrected by age. Using 0,7 as threshold you overstate an obstruction in elderly people and understate in young people. Anyway good explanation

  8. Use Tiffenau index, fev1: static vital capacity(not forced), it is corrected by age. Using 0,7 as threshold you overstate an obstruction in elderly people and understate in young people. Anyway good explanation

  9. What about people like FireFighters, who suffer a burn to their lungs? Is there a different name for that? Are there different symptoms and treatments?

  10. But this is only talking about emphysema, which is only one of the C.O.P. diseases — what about chronic bronchitis, which is not caused by smoking?

  11. I think I have COPD. I feel like running out of air, I inhale hardly and not enough, I can barely yawn. But I don't cough any kind of mucus. When i'm laying in bed, the breathing seems to come to normal, but once I start having activity, it gets really annoying taking deep breaths every couple of minutes.

  12. just found out about this channel. thank you so much for taking out the time to do these videos. i hit the subscribe button

  13. See the whole series at along with other top quality videos including reviews in pulmonary, cardiology, infectious disease, and hematology!

  14. I was diagnosed with congestive heart failure in January. I have also been diagnosed with lung issues. Are the two intertwined?

  15. 34 years old just got told today i have emphysema news hit me hard as i have a young child hard to wrap my head around it

  16. Great video .. keep posting new topics plz .. I am RN and used your video to reinforce my medical knowledge.

  17. i just realized your ending credits song is the same as the intro for wreckless eating…i was expecting a "lets go princess" at the end hahaha

  18. Do you guys have sources for this? I'm not doubting the information, I'm writing a presentation and want to check the source material to make sure I'm understanding everything properly.

  19. I am 59 now. I was diagnosed with COPD in March of 2013. I had been a heavy smoker, got a cold I couldn't get rid of, ended up in the hospital, on a ventilator. I should have known it was coming, but like most smokers, thought it would never happen to me. I don't smoke now and never will again, but, I still want to. My life has changed drastically. I had to stop working, sold my home (couldn't afford it without a salary),the COPD disease has kept down since diagnosed if not for the herbal formula of Total cure herbal foundation i would have been in hospital with the use oxygen managing my condition,total cure herbal foundation finally get rid of my disease with their natural herbal products in just 14 weeks of usage which i have been on other medication for ages but am really glad now that my lungs has return to it normal position.
    [email protected]

  20. Excellent information. Additional resources, including breathing exercises for those with COPD, can be found here:

  21. Please don't use black background screen. If you use white background then I will watch your all video

  22. My name is George I have COPD in and lawn disease I wanted to know could anybody tell me do it breaks sores on your face and on your body some time cuz I have wash my face and 7 my skin came off my face

  23. 肺の悪い部分を綺麗に切除すれば進行は止めるのでは?

  24. The comment about if your FEV1/FVC isnt < 0.70 then you don't have COPD is not necessarily true. I have a number of 0.90ish and I have COPD as confirmed by a CT scan. My FEV1 is 2.4ltrs and my FVC is 2.64ltrs.

  25. I like how you simplify those confusing concepts into simple diagrams… 😃😃 It really helps in terms of understanding and memorising 😀

  26. So sorry to hear about you mom, I feel your pain. I also lost 4 family members, mom, dad, brother and sister so I can relate to the pain you feel. I was not trying to say that COPD was only caused from smoking, however many people get it from smoking. I thought I may have had COPD but thank goodness I do not. I have silent reflex, but that's another story. I was trying to tell everyone who smokes to quit now not once its too late, you can't stop it once it starts. Live life as healthy as you can. It is hard to quit, but its harder to die. Please do whatever you have to to quit quit quit NOW… Please God help these people who need you now. Pay it forward to those who are not strong right now but will be once they quit. Good luck to all of you, ask God to help and believe he will.

  27. Smokin anything will cause one problem or another. Breathing in smoke from cigarettes, weed, diesel fuel, smoke from a camp fire, fumes from bleach, all of it will damage your body. Road pavers, railroad workers, firemen, truck drivers, all will suffer from what they inhale daily. Hey face it your health is the most valuable thing you will ever possess, and time is the second most valuable thing you will ever have. Live a long life.. do your body the very best, stay away from smoke……

  28. We were taught COPD is a combination of Emphysema and Chronic Bronchitis, has the definition changed from 2014 to now?

  29. A good healthy diet( make sacrifices for your health), exercise, use eucalyptus, drink water and use a good quality air filter, to clean your house from dust, dust mites, fungus, mold, bacteria… ask me @ [email protected]

  30. hello mister,my name is salah ,i'm copd so would you like to answers me if after a fund treatment which has improve your spirometry to normal level and your share tiffeneau will be 95% THE POURCENTAGE of obstruction of copd,after that resulth what is your futur therapy in purpose to kept this good state,my medecine actuel is symbicort 400 ug/2 per day and spiriva 1/ per day

  31. At 16 years old I was in Surgical labs at Harvard & Tufts from 1970- 73 , very advanced for my age , But eventually (9 years ) later I was Testing computers on special Projects for The moon , but Medical at H.P. (ultra sound ) SEAMENS ( Heart monitors) , ALLERGAN EYE Surgery and HOLOGIC ( BONE DENSITY , X-RAY , ULTRASOUND ) was more for Me , In fact I worked in 5 DEPARTMENTS , Running Cust, Ser on FLUOROSCAN , Help every third Month and Do a BONE DENSITY "A" System a DAY when No One did ONE a WEEK , Plus The ULTRA SOUND BOOT you may have Seen in a Will SMITH Movie , All This was Easy , so Much that New Management was UNHAPPY , But Then again I AM GOOD WILL HUNTING !!! They Just should Have Made the MOVIE with my NAME !!!

  32. Great video!!. The first time I took the test my Dr said I was at -60% lung capacity. 2 years of being on different inhalers I feel no better. I quit smoking and took the test 2 weeks later. She said I was at 81%. So does this mean I still have copd?? My Dr isn't very helpful when it comes to telling me what I need to do to fix what iv done to myself over the past 30years. She did however tell me. " U quit smoking and I'll have u breathing like a teenager again". Is that BS or can it be done??

  33. There's something I just don't understand. Its been proven that stem cell therapy dramatically helps people with copd. Along with a good diet and exercise people could stay out of the hospital and cut down on medications. If this is the case then why won't the FDA help to pass the procedure for stem cells therapy. I just don't get it. This has been going for years and years. It's time to do something.

  34. If you have C.O.P.D there is help Have you heard of Salt Rooms they are rooms with salt like beach sand beautiful relaxing too Some places call them salt baths but no they are chairs and salt all around.
    you will get a cough first few tries maybe four tries then you will notice you can walk further without stopping.
    They are very reasonable in price about 16$ for 45 minutes. Try one book in for 6 sessions. I know it helps me.

  35. I know it's an incurable disease at the moment will that always be the case it looks medically impossible to cure no matter how far medicine evolves

  36. It costs the health care system 50, 000, 000, 000, 000 dollars? I don't think so! the lying establishment likes to throw that "billion" word around a lot, like it is a normal currency. There's not even that much money in the world. You're a parrot programmer; you repeat the propaganda (bullshit) that you were programmed to repeat.

  37. nbice diagrams dude im English and the doctors havent said anything. i thought it was nothing to worry about

  38. I have COPD but it took the doctors quite awhile to find it because the blockage was not in my lungs had to go to a specialist no cough lungs clear the blockage was in my legs so have the doc check your blood pressure in your legs

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