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Obstructive Respiratory Diseases - Emphysema
|Two types of respiratory/ventilation diseases:
|Obstructive or Restrictive.
|What are obstructive respiratory diseases?
|Interfere with flow of air to or from lungs.
|What is the Bradley definition of addiction?
|Dependence that causes problems.
|Emphysema is defined not so much by symptoms but by what?
|Structure - change in lung structure.
|Emphysema is a chronic, progressive condition that is associated with what? What does emphysema result in?
|The destruction of alveolar tissue (lung parenchyma), resulting in fewer, larger alveoli.
|Is emphysema reversible?
|No - chronic and progressive. Will always progress.
|Emphysema increases your risk of what 3 things?
|Lung cancer, respiratory diseases and cardiovascular diseases.
|A reduction in alveolar number reduces _______________________________ and reduces ____________________.
|Reduces surface area for gas exchange and reduces the ability of bronchioles to remain open during expiration.
|The collapse of terminal bronchioles during expiration causes ____________, which decreases ______________.
|Causes air trapping which decreases gas exchange.
|Why is emphysema an obstructive disease?
|The collapse of bronchioles makes it obstructive.
|Does fibrosis occur in emphysema?
|No fibrosis occurs.
|Explain what happens to the alveoli in emphysema:
|Lose walls of the alveoli, and get much larger sacs (surface to volume ratio). The larger your alveoli get, the less surface area you have for exchange and blood vessels.
|Emphysema increases resistance in the _________________.
|Pulmonary pathway. Your lungs are full of air and cannot get air out.
|Cigarette smoking stimulates release of _____________ which do what?
|inflammatory cytokines which attract macrophages and leukocytes that secrete enzymes that destroy tissues.
|What other things can cause emphysema?
|1) Inhaling welding fumes for an entire career. 2) Asbestos fibers.
|Emphysemics are often called what? Why?
|Pink puffers - they have near normal ventilation/perfusion ratios until very late in the disease, but they have to work at moving air in and out (mostly out). Pink (not cyanotic) and puffers (work harder to move air out).
|Why are emphysemics considered whistlers?
|They have to work very hard to get air out - back pressure to lips causes whistling.
|With a loss of alveolar tissue, what is reduced?
|Pulmonary capillary extent is greatly reduced, which doesn't help exchange.
|When we exhale, we increase pressure on ____________ and _________ withstand the pressure. In emphysemics, what happens?
|When we exhale, we increase pressure on lungs. Respiratory bronchioles withstand the pressure. In emphysemics, respiratory bronchioles cannot withstand pressures.
|When you lose alveoli, what do you get in their place? Explain.
|Bullae: small alveoli are replaced with much larger sacs/cysts.
|In emphysema, the ____________________ really makes it difficult to keep small airways open, and results in ___________________.
|loss of radial traction makes it difficult to keep these small airways open, and results in them collapsing during exhalation (thus obstructing airflow).
|What are 2 types of emphysema?
|Centriacinar (centrilobular) and Panacinar (panlobular)
|What is centriacinar (centrilobular) emphysema?
|Involves/destroys respiratory bronchioles.
|What is panacinar (panlobular) emphysema?
|alveoli are destroyed (perhaps in addition to respiratory bronchioles).