Emphysema

Question 1

What is it?

Answer 1

increase in alveolar spaces distal to the terminal bronchiole due to damage/dilation to the walls of the alveoli with little or no fibrosis

Question 2

Causes and explanations

Answer 2

1- smoking
reduced antielastase
increased neutrophils
more elastase  so more tissue damage
2- alpha-trypsin 1 deficiency
no antielastase
3-protease-antiprotease imbalance

Question 3

Types

Answer 3

Centriacinar: Most proximal alveoli to the bronchiole involved.
-associated with smoking
-associated with the upper lobes
Panacinar: Whole alveoli involved
-Associated with alpha-anti-tripsin deficiency
-lower lobes
Periacinar : distal alveoli involved
-periphery of lobes involved-if they rupture leads to pneumothorax

Question 4

Bernoulli principle

Answer 4

Where there is a high velocity of air movement there is a low pressure

Question 5

How does it develop?

Answer 5

inflammatory response to chemicals contained in cigarettes

• increase in proteases- break down elastin and collagen
• loss of tissue elasticity- walls of the alveoli can no longer withstand high pressure and collapse
• when air flows through the vessels at high velocity the vessels collapse and the air gets trapped.

Question 6

Which inflammatory mediators are involve in the damage to the alveoli?

Answer 6

IL-8, TNK-alpha, Leukotreine-8