Animal Fisiology I

EMPHYSEMA
ANNA ATIQA PRIYADI (11A08005) ANA DIAN RAHAYU (11A08006) SAFIKA RAHMAWATI (11A08007) TITIN SOLIKHAH (11A08008)

PGBI BIOLOGY EDUCATION 2012

Human Respiratory System

 Paru-paru merupakan salah satu organ vital bagi kehidupan manusia yang berfungsi pada sistem pernapasan.

Bertugas sebagai tempat pertukaran oksigen yang dibutuhkan

manusia dan mengeluarkan karbondioksida. Paru-paru (pulmo) merupakan organ pernapasan utama dan dibantu oleh alat-alat pernapasan lain. Jalur udara pernapasan untuk menuju sel-sel tubuh adalah :

rongga hidung faring (rongga tekak) laring trakea

(batang tenggorok) bronkus paru-paru alveolus sel-sel tubuh.

 Tercemarnya udara yang kita hirup serta berbagai bibit penyakit yang berkeliaran di udara dapat menimbulkan

berbagai penyakit paru-paru.

Salah satu contoh penyakit yang menyerang sistem pernapasan manusia yaitu Emfisema.

PPOK (Penyakit Paru Obstruktif Kronik) or COPD (Chronic Obstructive Pulmonary Disease)
Penyakit Paru Obstruktif Kronik (PPOK) : sekelompok penyakit paru paru yang berlangsung lama dan ditandai oleh obstruksi aliran udara sebagai gambaran patofisiologi utamanya. Gangguan yang bersifat progresif ini disebabkan inflamasi (radang) kronik akibat pajanan partikel atau gas beracun yang terjadi dalam waktu lama dengan gejala utama sesak napas, batuk dan produksi sputum. Bentuk utama PPOK : Emfisema paru, Bronkitis Kronis, Asma Bronchial Material paparan yang menjadi faktor risiko kejadian PPOK ialah : -Asap rokok -Polusi udara (gas buangan kendaraan bermotor, gas beracun, bahan kimia, dsb.) -Infeksi saluran napas bawah berulang

What is Emfisema ?
Emfisema adalah jenis penyakit paru obstruktif kronik yang melibatkan kerusakan pada kantung udara (alveoli) di paru-paru. Emfisema disebabkan karena hilangnya elastisitas alveolus. Pada penderita emfisema, volume paru-paru lebih besar dibandingkan dengan orang yang sehat karena karbondioksida yang seharusnya dikeluarkan dari paru-paru terperangkap didalamnya. Emfisema membuat penderita sulit bernafas. Penderita mengalami batuk kronis dan sesak napas. Penyebab paling umum adalah merokok.

TYPES OF EMPHYSEMA
Panacinar emphysema destroys the entire alveolus uniformly and is predominant in the lower half of the lungs (from respiratory bronchiole to alveoli) . Panacinar emphysema generally is observed in patients with homozygous alpha1-anti trypsin (AAT) deficiency. In people who smoke, focal panacinar emphysema at the lung bases may accompany centriacinar emphysema. Centriacinar emphysema begins in the respiratory bronchioles and spreads peripherally. Also termed centrilobular emphysema, this form is associated with long-standing cigarette smoking and predominantly involves the upper half of the lungs. Paraseptal emphysema, also known as distal acinar emphysema, preferentially involves the distal airway structures, alveolar ducts, and alveolar sacs. The process is localized around the septae of the lungs or pleura. Although airflow frequently is preserved, the apical bullae may lead to spontaneous pneumothorax. Giant bullae occasionally cause severe compression of adjacent lung tissue. http://emedicine.medscape.com

Gambar kiri. Paru-paru sehat

Gambar

kanan.

Paru-paru

sehat dan paru-paru penderita Emfisema

Alfa 1-anti tripsin (ATT)

Penyempitan saluran nafas terjadi pada emfisema paru. Yaitu penyempitan saluran nafas ini disebabkan elastisitas paru yang berkurang. Penyebab dari elastisitas yang berkurang yaitu defisiensi Alfa 1-anti tripsin. AAT merupakan suatu protein yang menetralkan enzim proteolitik yang sering dikeluarkan pada peradangan dan merusak jaringan paru. Dengan demikian AAT dapat melindungi paru dari kerusakan jaringan pada enzim proteolitik. Didalam paru terdapat keseimbangan paru antara enzim proteolitik elastase dan anti elastase supaya tidak terjadi kerusakan. Perubahan keseimbangan menimbulkan kerusakan jaringan elastik paru. Arsitektur paru akan berubah dan timbul emfisema. Sumber elastase yang penting adalah pankreas. Asap rokok, polusi, dan infeksi ini menyebabkan elastase bertambah banyak. Sedang aktifitas system anti elastase menurun yaitu system alfa- 1 protease inhibator terutama enzim alfa -1 anti tripsin (alfa -1 globulin). Akibatnya tidak ada lagi keseimbangan antara elastase dan anti elastase dan akan terjadi kerusakan jaringan elastin paru dan menimbulkan emfisema.

Patogenesis
Terdapat 4 perubahan patologik yang dapat timbul pada klien emfisema, yaitu : 1. Hilangnya elastisitas paru 2. Hyperinflation Paru 3. Terbentuknya Bullae 4. Kollaps jalan nafas kecil dan udara terperangkap

Factors that increase your risk of developing emphysema include:

Smoking. Emphysema is most likely to develop in cigarette smokers, but cigar and pipe smokers also are susceptible. The risk for all types of smokers increases with the number of years and amount of tobacco smoked. Age. Although the lung damage that occurs in emphysema develops gradually, most people with tobacco-related emphysema begin to experience symptoms of the disease between the ages of 40 and 60. Exposure to secondhand smoke. Secondhand smoke, also known as passive or environmental tobacco smoke, is smoke that you inadvertently inhale from someone else's cigarette, pipe or cigar. Being around secondhand smoke increases your risk of emphysema. Occupational exposure to fumes or dust. If you breathe fumes from certain chemicals or dust from grain, cotton, wood or mining products, you're more likely to develop emphysema. This risk is even greater if you smoke.

Exposure to indoor and outdoor pollution. Breathing indoor pollutants, such as fumes from heating fuel, as well as outdoor pollutants car exhaust, for instance increases your risk of emphysema.
http://www.mayoclinic.com/health/emphysema

Etiologi
1. 2. 3. 4. 5. 6. 7. Faktor Genetik Hipotesis Elastase-Anti Elastase Rokok Infeksi Polusi Faktor Sosial Ekonomi Pengaruh usia

COMPLICATION
People who have emphysema are also more likely to develop: Collapsed lung (pneumothorax). A collapsed lung can be life-threatening in people who have severe emphysema, because the function of their lungs is already so compromised. Heart problems. Emphysema can increase the pressure in the arteries that connect the heart and lungs. This can cause a condition called cor pulmonale, in which a section of the heart expands and weakens. Large holes in the lungs (giant bullae). Some people with emphysema develop empty spaces in the lungs called bullae. Giant bullae can be as large as half the lung. In addition to reducing the amount of space available for the lung to expand, giant bullae can become infected and are more prone to causing a collapsed lung (pneumothorax).
http://www.mayoclinic.com/health/emphysema

Prevention
To prevent emphysema, don't smoke and avoid breathing secondhand smoke. Wear a mask to protect your lungs if you work with chemical fumes or dust.

http://www.mayoclinic.com/health/emphysema

Tests and Diagnosis

Imaging tests Chest X-ray. A chest X-ray can help confirm a diagnosis of advanced emphysema and rule out other causes of shortness of breath, but an X-ray alone isn't enough to make an accurate diagnosis. Computerized tomography (CT). CT scans combine X-ray images taken from many different directions to create cross-sectional views of internal organs. Your doctor may want you to have a CT scan if you're considering lung surgery. Lab tests Blood taken from an artery in your wrist can be tested to determine how well your lungs transfer oxygen into, and remove carbon dioxide from, your bloodstream. Lung function tests These noninvasive tests measure how much air your lungs can hold and how well the air flows in and out of your lungs. They can also measure how well your lungs deliver oxygen to your bloodstream. One of the most common tests uses a simple instrument called a spirometer, which you blow into.
http://www.mayoclinic.com/health/emphysema

Treatments and Drugs

1. Medications Smoking cessation drugs. Prescription medications, such as bupropion hydrochloride (Zyban) and varenicline (Chantix), can help you quit smoking. Bronchodilators. These drugs can help relieve coughing, shortness of breath and trouble breathing by relaxing constricted airways, but they're not as effective in treating emphysema as they are in treating asthma or chronic bronchitis. Inhaled steroids. Corticosteroid drugs inhaled as aerosol sprays may help relieve shortness of breath. But prolonged use can weaken your bones and increase your risk of high blood pressure, cataracts and diabetes. Antibiotics. If you develop a bacterial infection, like acute bronchitis or pneumonia, antibiotics are appropriate.

2. Therapy Pulmonary rehabilitation. A pulmonary rehabilitation program can teach you breathing exercises and techniques that may help reduce your breathlessness and improve your ability to exercise. You'll also receive advice about proper nutrition. In the early stages of emphysema, many people need to lose weight, while people with late-stage emphysema often need to gain weight. Supplemental oxygen. If you have severe emphysema with low blood oxygen levels, using oxygen regularly at home and when you exercise may provide some relief. Many people use oxygen 24 hours a day. It's usually administered via narrow tubing that fits into your nostrils.

3. Surgery Depending on the severity of your emphysema, your doctor may suggest one or more different types of surgery, including: Lung volume reduction. In this procedure, surgeons remove small wedges of damaged lung tissue. Removing the diseased tissue helps the remaining lung tissue work more efficiently and helps improve breathing. Lung transplant. Lung transplantation is an option if you have severe emphysema and other options have failed.
http://www.mayoclinic.com/health/emphysema

THANKYUUU..