Turning Blue - Respiratory disease - Emphysema

11 important questions on Turning Blue - Respiratory disease - Emphysema

What is the anatomic distribution for emphysema?

acinus- a cluster of cells (usually epithelial)- structure distal to the terminal bronchiole.
Unit of lung that is supplied by the respiratory bronchioles.

What are the four different types of emphysema?

Centri-acinar, Pan-acinar, Distal-acinar, Irregular:

What is centri-acinar emphysema?

Enlargement of the central and proximal portion of the acinar (the respiratory bronchioles) whilst the alveoli remain unaffected.
Therefore, both normal and disease airspace can exist in the same acinar or lobule.
Mostly affects the upper lobe of the lungs.
Most common type of emphysema.
The walls of the affected area are usually slightly black in pigmentation.
Common in heavy smokers.
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What is pan-acinar emphysema?

Emphysema of the entire acinar- from the respiratory bronchioles to the alveoli.
Less common.
Severe airflow limitation and Va/Q mismatch.
Common in individuals with an alpha1-antitrypsin deficiency.
Common in the lower lobes of the lung.

What is distal-acinar emphysema?

Emphysema of the most distal portion of the acinar- the distal end of the alveoli- near the septum/connective tissue/pleura.
Common in patients who suffer from spontaneous pneumothorax.   
Presence of multiple enlarged airspaces= cyst called a bullae.

What is irregular emphysema?

Irregularly involved. Invariable scarring. Common. Asymptomatic.

What is a lobule?

a cluster of 3-5 acini.

What happens to the capillary bed as the walls of the alveoli are destroyed?

There is a decrease in the capillary bed

When do bullae form?

During advanced stages of emphysema.
Characteristic to irregular and distal acinar emphysema.

What is a bullous emphysema?

Localised acceutuations of emphysema. Enlargement of the alveoli which are separated by a thin septa, forming a 'blister'. Should this blister rupture, air can leak into the pleural cavity and a pneumothorax can develop.

What are the treatment options available for emphysema?

lung transplant
bullectomy
bronchodilators
steroids

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