Which of the following lung compartments is NOT affected by COPD?

In the context of COPD (Chronic Obstructive Pulmonary Disease), the impact on different lung compartments is essential for understanding the pathophysiology of the disease. The bronchioles, which are the small air passages in the lungs that lead to the alveoli, are indeed affected by COPD. This condition specifically leads to inflammation and narrowing of the airways, including bronchioles, resulting in airflow obstruction.

On the other hand, the term "not affected" implies that the compartment in question remains largely intact and functions normally in the context of COPD. The other compartments listed—central airways, peripheral airways, and lung parenchyma—are all impacted by the disease process, as they undergo changes associated with inflammation, damage to lung tissue, and the loss of elastin, leading to reduced airflow and gas exchange efficiency.

In summary, due to the characteristics of COPD involving inflammation and obstruction leading to changes in the lung structure, it is crucial to understand that the bronchioles are indeed part of the pathology, making it clear why they do not qualify as a compartment that remains unaffected by the disease.