9) COPD (chronic obstructive pulmonary disease)

➡️ Characterized by chronic airflow obstruction, an abnormal inflammatory response of the lung to noxious particle/gases.Most common risk factor is cigarette smoking.


  • symptoms tend to be progressive
    • exertional dyspnea is the most common early symptom
    • chronic cough and sputum production
    • less commonly wheezing and chest tightness

▪️Chest radiograph

• Possible findings include:

1) Flattening of diaphragm

2) Hypertranslucent lung fields

3) Pumonary artery shadows

4) bulla (round focal lucency over 1 cm)


  • Smoking cessation
  • Bronchodilators with or without inhaled corticosteroids
  • Oxygen therapy may be required in severe cases
  • Treatment of the underlying chest infection
  • Pulmonary Rehabilitation

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10) EMPHYSEMA (Barrel shaped Chest)

Emphysema is a pathological term defined as destruction of the alveoli walls; this is one of the structural abnormalities that can be present in patients with COPD but can also be found in persons with normal lung function.

▪️Presentation: Dyspnea, fevers.

Chest Radiograph (⬆️ Vertical Dimension)

The lungs are hyperexpanded with coarse bronchovascular markings in keeping with COPD. There is increased AP diameter and increased retrosternal airspace but the diaphragms have a near normal contour.

▪️Barrel-shaped chest features:

Figure 1: A – Normal Adult ; B – Barrel chest
  • Increased AP diameter, wide subcostal angle
  • Sternum more arched
  • Spine – concave
  • Ribs – less oblique

Page 10 of 14

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