13 - The Lung Flashcards
Loss of lung volume cause by inadequate expansion of airspaces, resulting in shunting of inadequately oxygenated blood from pulmonary arteries into veins.
Atelectasis (TOPNOTCH) Robbins Basic Pathology, 8th Ed. p. 480
Atelectasis which occurs when an obstruction prevents air from reaching distal airways.
Resorption atelectasis (TOPNOTCH) Robbins Basic Pathology, 8th Ed. p. 480
Atelectasis usually associated with accumulation of fluid, blood, or air within the pleural cavity, which mechanically collapse the adjacent lung.
Compression atelectasis (aka passive or relaxation atelectasis) (TOPNOTCH) Robbins Basic Pathology, 8th Ed. p. 481
Atelectasis which occurs when either local or generalized fibrotic changes in the lung or pleura hamper expansion and increase elastic recoil during expiration.
Contraction or cicatricial atelectasis (TOPNOTCH) Robbins Basic Pathology, 8th Ed. p. 481
Lungs are dark red, firm, airless and heavy. There is capillary congestion, necrosis of alveolar epithelial cells, interstitial and intra-alveolar edema and hemorrhage and neutrophils in capillaries. Hyaline membrane is also characteristic, lining the alv
Acute Respiratory Distress Syndrome (TOPNOTCH) Robbins Basic Pathology, 8th Ed. p. 482
Diffuse pulmonary disease characterized by limitation of airflow, usually resulting from an increase in resistance caused by partial or complete obstruction at any level.
Obstructive pulmonary disease (TOPNOTCH) Robbins Basic Pathology, 8th Ed. p. 483
Diffuse pulmonary disease characterized by reduced expansion of lung parenchyma accompanied by decreased total lung capacity.
Restrictive lung disease (TOPNOTCH) Robbins Basic Pathology, 8th Ed. p. 483
Lung volumes in obstructive lung disease: FEV1 FVC FEV1:FVC ratio
FEV1 – decreased, FVC - normal / increased, FEV1:FVC ratio - decreased (TOPNOTCH) Robbins Basic Pathology, 8th Ed. p. 483
Lung volumes in restrictive lung disease FEV1 FVC FEV1:FVC ratio
FEV1 – normal/decreased, FVC – decreased, FEV1:FVC ratio - near normal (TOPNOTCH) Robbins Basic Pathology, 8th Ed. p. 483
Characterized by abnormal permanent enlargement of the airspaces distal to the terminal bronchioles accompanied by destruction of their walls without obvious fibrosis. There is thinning of the alveolar walls and loss of elastic tissue.
Emphysema (TOPNOTCH) Robbins Basic Pathology, 8th Ed. p. 485
Type of emphysema involving the central or proximal parts of the acini, formed by respiratory bronchioles, while distal parts are spared. Lungs deep pink and less voluminous, affecting the upper 2/3 of the lungs. Occurs in smokers.
Centriacinar (centrilobular) Emphysema (TOPNOTCH) Robbins Basic Pathology, 8th Ed. p. 485
Type of emphysema wherein the acini are uniformly enlarged from the level of the respiratory bronchiole to the terminal alveoli. Occurs more commonly in the lower lung zones. Occurs in a-antitrypsin deficiency.
Panacinar (panlobular) emphysema (TOPNOTCH) Robbins Basic Pathology, 8th Ed. p. 485
Type of emphysema wherein only the distal part is primarily involved. Lesion is adjacent to the pleura along the lobular connective tissue septa and at the lobe margins. More severe at the upper half of the lungs, forming bullae.
Distal acinar (paraseptal) emphysema (TOPNOTCH) Robbins Basic Pathology, 8th Ed. p. 486
Barrel-chested, dyspneic, prolonged expiration, sits forward in a hunched-over position, adequate oxygenation of oxygen. “Pink puffers”.
COPD predominantly emphysema (TOPNOTCH) Robbins Basic Pathology, 8th Ed. p. 489
History of recurrent infections with purulent sputum, less prominent dyspnea and respiratory drive, becomes hypoxic and are often cyanotic and obese. “Blue bloaters”.
COPD predominantly chronic bronchitis (TOPNOTCH) Robbins Basic Pathology, 8th Ed. p. 489
Defined as persistent productive cough for at least 3 consecutive months in at least 2 consecutive years.
Chronic bronchitis (TOPNOTCH) Robbins Basic Pathology, 8th Ed. p. 489
Mucosal lining of the larger airways is usually hyperemic and swollen with edema fluid, often covered by a layer of mucinous or mucopurulent secretions. Trachea and bronchi have enlarged mucus-secreting glands.
Chronic bronchitis (TOPNOTCH) Robbins Basic Pathology, 8th Ed. p. 489
Characterized by goblet cell metaplasia, mucus plugging, inflammation and fibrosis, and sometimes complete obliteration of the lumen due to fibrosis.
Chronic bronchiolitis (small airway disease) (TOPNOTCH) Robbins Basic Pathology, 8th Ed. p. 489
Most important underlying risk factor for chronic bronchitis.
Cigarette smoking (TOPNOTCH) Robbins Basic Pathology, 8th Ed. p. 489
Triad of 1.intermittent and reversible airway obstruction 2.chronic bronchial inflammation with eosinophils 3.bronchial smooth muscle cell hypertrophy and hyperreactivity
Asthma (TOPNOTCH) Robbins Basic Pathology, 8th Ed. p. 489
Collections of crystalloids made up of eosinophil proteins.
Charcot-Leyden crystals (TOPNOTCH) Robbins Basic Pathology, 8th Ed. p. 492
Whorls of shed epithelium found in mucus plugs.
Curschmann spirals (TOPNOTCH) Robbins Basic Pathology, 8th Ed. p. 492
Curshmann spirals and Charcot-Leyden crystals are found histologically in this disease.
Asthma (TOPNOTCH) Robbins Basic Pathology, 8th Ed. p. 492
Permanent dilation of bronchi and bronchioles caused by destruction of the muscle and elastic supporting tissue, resulting from chronic necrotizing infections.
Bronchiectasis (TOPNOTCH) Robbins Basic Pathology, 8th Ed. p. 493
An autosomal recessive disorder frequently associated with bronchiectasis and sterility in males.
Kartagener syndrome (TOPNOTCH) Robbins Basic Pathology, 8th Ed. p. 493
Refers to a pulmonary disorder of unknown etiology characterized patchy interstitial fibrosis. Grossly, pleural surfaces of the lung have the appearance of cobblestones because of retraction scars along the interlobular septa.
Idiopathic Pulmonary Fibrosis (TOPNOTCH) Robbins Basic Pathology, 8th Ed. p. 495
A thrombus that lodges astride a pulmonary artery bifurcation, which causes pulmonary hypertension, which can lead to hypoxia and cor pulmonale.
Saddle embolus (TOPNOTCH) Robbins Basic Pathology, 8th Ed. p. 505
Most common symptom of pulmonary embolism.
None, asymptomatic 60-80% of the time. (TOPNOTCH) Robbins Basic Pathology, 8th Ed. p. 506