You’re working in the yard at your

You’re working in the yard at your parents’ house when you see the next-door neighbor—a man in his early 70s—going to the mailbox. As you wave hello, you’re struck by his appearance. You haven’t seen him in a number of months, and in the interim he seems to have changed. His chest looks thick, like a barrel. And he seems to be working hard just to breathe. Later, you ask your mother about it. “Oh, yes, poor Mr. Tompkins. He’s had a tough time. He was diagnosed with emphysema a few months ago, and it seems to take all his effort just to breathe.” “I was looking at him sitting on his front porch,” you respond, “and he was all hunched over. Sometimes I would see him just push on his chest when he was breathing out. What’s up with that?” “Well,” your mom says, “Mrs. Tompkins told me that it’s harder for him to breathe out than it is to breathe in. Isn’t that interesting? Not sure why that is, but that’s what she said.” Questions: Why do patients with emphysema find it difficult to exhale? Explain the effect of the loss of functional alveoli on oxygen and carbon dioxide levels. Explain why Mr. Tompkins’ chest diameter would be enlarged. What is the role of alveoli in ventilation? What is the importance of recoil in ventilation, and how this is affected by emphysema? What are the reasons why it takes more effort to exhale? Explain the effect emphysema would have on blood gases.

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