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Emphysema - Research Paper Example

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Course: Instructor Name: Introduction Emphysema is a progressive and chronic lung disease in which patients complain of dyspnea or shortness of breath because of enlargement of air sacs. In emphysema there is destruction of the tissue responsible for maintaining the physical structure and function of lungs and this destruction of lung parenchyma are responsible for the symptoms that patients present with…
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Download file to see previous pages... The entrapment of the air also leads to decreased exchange of gases between pulmonary capillaries and alveoli. Since a range of similar diseases come under the heading of chronic obstructive pulmonary disease it is important to precisely define emphysema to avoid confusion. Emphysema is defined according to two standard changes noticed in the lungs; i.e. changes identified in the lung morphology as well as the anatomical distribution of involved area. Morphological changes consist of the alterations seen in the specific lung structures e.g. formation of bullae from alveoli etc. Emphysema generally affects the area of the respiratory tree which is distal to the terminal bronchioles. This area is called the acinus and consists of respiratory bronchioles which lead to the alveolar duct from which tiny air sacs called alveoli out pouch. Alveoli mark the end of the respiratory tree and are very elastic. Alveoli increase in size when a person inspires to collect the inhaled air and are lined with very thin endothelium to allow easy movement of gases between themselves and the blood in surrounding capillaries. The exact morphological and anatomical changes are discussed in more detail with their respective type of emphysema. (Schiffman 2011,emedicine) Types There are four types of emphysema seen and these types are differentiated according to the part of the acinus affected and the gross changes seen in the lungs. The four types are; panacinar emphysema, centriacinar emphysema, distal acinar emphysema and irregular emphysema. In panacinar emphysema as the name suggests the whole acinus is inflated from the distal end of terminal bronchioles till the alveoli. This type normally seen in lower lobes of the lungs and grossly the lungs appear to be large and voluminous. Panacinar emphysema is a very severe form and the patient is continuously out of breath and hyper ventilating. This type of emphysema is associated with alpha 1 anti-trypsin deficiency. In centriacinar emphysema the proximal and mid acinus are generally affected and thus both normal and damaged portions of an acinus exist together. Centriacinar emphysema is more common in upper lung zones e.g. the apices. Grossly the lungs appear less voluminous as compared to panacinar emphysema and there is weakening and destruction of alveolar walls. The weakening and destruction of alveolar walls lead to bullae formation (bullae are large air spaces with little elasticity) as ruptured alveoli coalesce with adjacent alveolus to form larger air spaces. As there is significant loss of elastic tissue with bullae formation, the reduced recoil capacity of these larger air spaces becomes an important cause of obstruction as air gets trapped in them. With destruction of alveolar wall the capillaries surrounding these walls are also damaged leading to decrease in the latter’s number and thus reduced gaseous exchange. In severe forms of centriacinar emphysema the distal acinus also gets affected and it becomes difficult to distinguish it from panacimar emphysema. Centriacinar emphysema is the type of emphysema commonly seen in smokers. In Distal acinar emphysema the distal part of an acinus is affected and bullae are seen in this type too. When Distal acinar em ...Download file to see next pagesRead More
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