COPD — The Two Faces

Chronic Bronchitis vs Emphysema · Week 12
COPD comes from an irritant or toxin, like smoke or pollution. It is not an infection, and the damage is permanent. It shows up in two ways. Chronic bronchitis means clogged, mucus-filled airways. Emphysema means destroyed, floppy air sacs (alveoli). Click each one to see what breaks.

Inside the airway & alveoli

Here is a bronchiole, the tube, leading to a cluster of alveoli, the air sacs. Watch what goes wrong in each disease.
Pick a state to see the damage.
Pick a stateNormal · Chronic Bronchitis · Emphysema

👆 Which face of COPD?

What's happening

Side by side

Chronic Bronchitis

An airway problem. Too much mucus clogs the tubes. You get a long-lasting wet cough, low O₂, and high CO₂. Those last two are hypoxemia and hypercapnia.

Emphysema

An air-sac problem. The walls of the alveoli are destroyed and the springy elastic recoil is lost. Air gets trapped, so the patient cannot fully breathe out. That gives a barrel chest and a long, slow exhale.
Oxygen is a drug here: in advanced COPD, CO₂ is often high all the time. Too much oxygen can push the CO₂ even higher, mostly through V/Q mismatch and the Haldane effect, with only a small drop in the drive to breathe. So titrate oxygen to the ordered target, usually an SpO₂ of 88 to 92 percent. Never withhold oxygen from a patient who needs it. Watch for growing drowsiness or confusion.