Emphysema (2 of 2 COPD)

Question 1

emphysema

Answer 1

walls of vessels adjoining alveoli and the alveoli themselves become damaged

Question 2

destruction of the alveolar beds and capillary beds causes what..

Answer 2

• enlarged distal airspaces

- l/o compliance

Question 3

enlarged distal air spaces consequences

Answer 3

by destroying the walls adjoining the millions of little alveoli, fewer & larger alveoli are created –> dec SA for gas exchange

Question 4

l/o compliance consequence

Answer 4

dec elastic tissue of the alveoli –> reduced stretch and recoil when filling/emptying

Question 5

etiology

Answer 5

• smoking

- genetic deficiency of a1 antitrypsin (<1%)

Question 6

trypsin (protease)

Answer 6

Es that breaks down proteins in gut + aging structures for regeneration of tissue

Question 7

a1 antitrypsin (antiprotease) Fx

Answer 7

opposes the breakdown of protein so that trypsin does not excessively break down useful tissue –> protects the lungs from breakdown

Question 8

deficiency in a1 antitrypsin causes what to happen

Answer 8

breakdown of alveolar walls & capillaries d/t trypsin & dec function of resp tract

Question 9

patho

Answer 9

• cigarette smoke inhibits a1 antitrypsin & attracts inflm cells to lung
• trypsin destroys the alveolar walls

Question 10

inflammatory cells to the lungs cause what to happen

Answer 10

• inflammatory damage (on top of damage caused by trypsin)

- inc release of more trypsin

Question 11

trypsin destroys the alveolar walls causing what to happen

Answer 11

• larger air pockets and less SA for gas exchange (irreversible damage)
• permanent distended air spaces where there is no gas exchange
• air becomes trapped in the alveoli –> inc in WOB

Question 12

bullae

Answer 12

air spaces

Question 13

blebs

Answer 13

smaller air spaces

Question 14

why do pts w/ emphysema have a normal ventilation:perfusion ratio

Answer 14

b/c BOTH ventilation and perfusion is impaired

Question 15

how is ventilation impaired

Answer 15

d/t inc of dead space

Question 16

how is perfusion impaired

Answer 16

d/t capillaries that adjoin alveoli being damaged

Question 17

types

Answer 17

• acinus
• acini
• centrilobular
• panacinar

Question 18

acinus

Answer 18

functional unit of the respiratory system including the terminal bronchioles, respiratory bronchioles & alveoli

Question 19

acini

Answer 19

lobed sacs containing groups of alveoli

Question 20

centrilobular (aka centracinar or proximal acinar)

Answer 20

when most damage occurs in the terminal and respiratory bronchioles, while the alveoli are mostly intact

Question 21

panacinar

Answer 21

when there is damage to the entire acinus (branches + alveoli)

Question 22

mnfts

Answer 22

• dyspnea
• inc ventilatory effort evidenced by use of accessory muscles
• barrel chest

Question 23

why does dyspnea manifest

Answer 23

d/t dec gas exchange, hypoxia, dec lung vol by destr + inc dead space

Question 24

accessory muscles

Answer 24

sternocleidomastoid, scalene muscles, pectoralis major and minor, serratus anterior and latissimus dorsi

Question 25

barrel chest

Answer 25

the chest becomes fixed in an inspiratory position b/c air is trapped b/w alveoli