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Respiratory Pathophysiology > Defense of the Respiratory System and Response to Injury > Flashcards

Defense of the Respiratory System and Response to Injury Flashcards

1
Q

what makes the lungs a vulnerable site for pathogen entry into the tissues?

A

minimal thickness of air/blood barrier

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2
Q

what is the common pulmonary response to antigens?

A

non-inflammatory Th2-mediated

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3
Q

what is pneumonia?

A

an overgrowth of pathogenic species and loss of normal microbiome organisms followed by host inflammation

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4
Q

what are the major host defenses?

A

upper respiratory expulsions
mucociliary escalator
neutrophils and macrophages
soluble mucus contents
inflammatory cells
immune response

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5
Q

what microorganism factors can affect the outcome of infectious agents entering the respiratory system?

A

number of organisms
pathogen virulence
whether or not they are “host adapted”

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6
Q

what does it mean for something to be “host-adapted”?

A

microorganism has evolved mechanisms to infect only one or a few species

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7
Q

what are the humoral defenses in the lungs against microorganisms?

A

plasma proteins with antibodies
complement proteins
C-reactive protein
surfactant proteins A and D
pentraxin-3

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8
Q

the mucus blanket functions as a _______________, _______________, _________________ barrier in the airways

A

mechanical
chemical
biological

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9
Q

what can decrease mucociliary function?

A

dehydration thickens fluid
atropine
physical airway injury
chemical injury
bacterial attachment to airway cells
viral infection
inflammatory mediators
allergen challenge

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10
Q

what species have intravascular macrophages in small pulmonary capillaries?

A

horses
ruminants
swine

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11
Q

why does loss of goblet or club cells result in impaired defense mechanism?

A

airway mucus has factors that can directly injure pathogens, block attachment of bacteria to mucosal surfaces, opsonize bacteria/viruses/fungi

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12
Q

phagocytosis of bacteria by alveolar macrophages results in _____________________

A

recruitment of neutrophils (chemotactic mediators and diapedesis of neutrophils)

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13
Q

true/false: it is normal to find neutrophils in a TTA or BAL sample

A

false: if present indicates inflammation and often infection

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14
Q

what does the specific immune response involve?

A

dendritic cells sampling antigens and migrating through lymph to present to antigen-specific T cells

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15
Q

what cells are involved in the innate immune response?

A

macrophages
dendritic cells
neutrophils

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16
Q

where does bronchus-associated lymphoid tissue develop?

A

after birth at sites of particle deposition- airway bifurcations

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17
Q

what cells overlay BALT?

A

M cells

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18
Q

what synthesizes IgA and why?

A

committed plasma cells in BALT and submucosa
after stimulation by receptor-mediated uptake and transport through epithelial cells

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19
Q

what is IgA important in?

A

virus and toxin neutralization, prevention of bacterial and viral attachment to epithelial surfaces, bacterial entrapment/agglutination

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20
Q

where is IgG primarily found in the respiratory tract?

A

alveolar lining fluid

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21
Q

what does IgG do in the respiratory tract?

A

opsonization of bacteria to enhance phagocytosis
complement fixation
antibody-dependent cytotoxicity

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22
Q

where do IgA and IgG predominate in the respiratory tract?

A

IgA in upper
IgG in lower

23
Q

what do epitheliotropic viruses do?

A

infect and injure airway or alveolar epithelial cells: loss of integrity of the epithelial barrier and exposure deeper tissues

24
Q

how can viruses alter the mucociliary excalator?

A

attach to cilia
alter mucous layer composition

25
Q

how can viruses impact macrophages?

A

apoptosis or suppress their phagocytic and bactericidal function
infect: cytotoxic activity directed against

26
Q

what are two pathogenic microorganisms that target the respiratory epithelium by binding between sialic acid-containing receptors on the ciliary membrane and surface adhesion proteins on the pathogen?

A

Mycoplasma and Bordatella spp

27
Q

how long does it take after mechanical trauma for healing to take place?

A

14 days for epithelium replaced
28 days for full function

28
Q

what does chronic injury of the epithelium and then continued injury lead to?

A

goblet cell hyperplasia
squamous metaplasia

29
Q

when does acute bronchitis take place?

A

following irritation or airway infection with viruses
parasitic bronchitis is important in ruminants

30
Q

what is purulent bronchitis characterized by?

A

neutrophil-rich exudate in airway lumen

31
Q

what is chronic bronchitis morphologically?

A

hyperplasia and hypertrophy of goblet cells and mucous glands with increased mucous production

32
Q

what is bronchiolitis obliterans?

A

bronchial lumen is obliterated by proliferation of connective tissue and epithelium- dogs

33
Q

what can happen in swine, sheep, cattle, or rodents with chronic mycoplasma infection?

A

obstruction due to hyperplasia of the bronchus associated lymphoid tissue

34
Q

what is bronchiestasis?

A

sequela of long-term airway infection and inflammation

35
Q

what are two ways injurious agents can reach the lungs? what results?

A

airways or circulation
aerogenous or hematogenous pneumonia

36
Q

what do we see with an aerogenous route of pathogen in quadropeds?

A

cranioventral pneumonia

37
Q

what is bronchopneumonia?

A

extension from distal airways to alveoli

38
Q

how does pneumonia affect pulmonary function?

A

reduces area of effective gas exchange
disruption of surfactant
hypoxic vasoconstriction
ventilation-perfusion mismatching

39
Q

what can chronic pneumonia result in?

A

fibrosis, bronchiectasis, abscess formation

40
Q

what can diffuse alveolar injury result from?

A

severe gram negative sepsis, burn injury, severe tissue trauma, or pancreatitis

41
Q

what is acute lung injury?

A

exudation of protein-containing fluid into the alveolar space and recruitment of activated neutrophils into the alveoli

42
Q

what does the repair phase of injury begin with?

A

formation of hyaline membranes

43
Q

how does pulmonary fibrosis lead to restrictive lung diseases?

A

decreased lung volumes and decreased compliance
diffuse interstitial fibrosis

44
Q

how is pulmonary arterial hypertension manifested clinically?

A

increase in pulmonary vascular resistance and increased pulmonary arterial pressure

45
Q

what is alveolar emphysema?

A

enlargement of air spaces distal to terminal bronchioles resulting from destruction of alveolar and capillary tissue by proteolytic enzymes

46
Q

what is interstitial emphysema?

A

presence of air in connective tissue septa of lung and in subpleural tissue
cattle and swine primarily, otherwise rarely of clinical significance

47
Q

what is secretory IgA important in?

A

virus/toxin neutralization
prevention of bacterial and viral attachment to epithelial surface
bacterial agglutination

48
Q

what can mucus hypersecretion be due to?

A

increased synthesis and release by goblet or submucosal glands
goblet cell hyperplasia

49
Q

why does squamous metaplasia occur?

A

continued injury

50
Q

in whom can obstruction due to extensive hyperplasia of the bronchus associated lymphoid tissue occur?

A

swine
sheep
cattle
rodents
chronic mycoplasma infection

51
Q

what is diffuse alveolar injury often caused by?

A

gram negative sepsis
burn injury
severe tissue trauma
pancreatitis

52
Q

what strategies do bacteria that are specialized to invade without prior viral infection use?

A

surface adhesions
IgA-specific bacterial proteases
bacterial products that inhibit ciliary motion

53
Q

who is embolic pneumonia common in?

A

ruminants and swine

54
Q

what causes the consolidation that occurs with pneumonia?

A

neutrophil exudates first
neutrophils, lymphocytes, and fibrin

Respiratory Pathophysiology (22 decks)

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