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Diseases of the lung parenchyma Flashcards

1
Q

What are the two types of pneumocytes (alveolocytes) and what do they do?

A

Type I - gas exchange

Type II - produce surfactant

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2
Q

Can type I and type II cells differentiate?

A

Type I - fully differentiated

Type II - can differentiate into more type I or type II if tissue damaged

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3
Q

How do the shape of type I and type II cells differ?

A

Type I - thin, squamous cells

Type II - more cuboidal

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4
Q

Blocks of alveoli form lobules. The degree of collateral ventilation is poor in cattle/pigs/sheep - why is this?

A

Cattle/sheep/pigs have thick complete septa in-between lobules

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5
Q

Do horses have good collateral ventilation?

A

Ok as incomplete thick septa between lobules

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6
Q

Do carnivores/rabbits/rodents have good collateral ventilation?

A

Yes as no distinct septa between lobules

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7
Q

Developmental abnormalities of the lung parenchyma are rare. Give examples of this

A

Agenesis of lung lobe
Ectopic lung tissue
Congenital melanosis

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8
Q

What are 2 abnormalities of inflation?

A

Atelactasis

Emphysema

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9
Q

What is atelectasis?

A

Collapse or closure of lung

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10
Q

What can cause atelectasis?

A

Internal obstruction of airway
External compression of airway or lung
Pneumothorax
Defective surfactant production

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11
Q

What is hypostatic atelectasis?

A

Atelectasis due to recumbency

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12
Q

What is emphysema?

A

Over-inflation of the lungs

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13
Q

What causes emphysema?

A

Forced respiratory effort e.g. pneumonia or COPD

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14
Q

With emphysema, are both inhalation and exhalation affected?

A

No - can inhale normally

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15
Q

What problems does emphysema cause during exhalation?

A

Expiratory effort puts pressure on lobule and bronchiole
Collapses partially obstructed airways - cannot expel air properly
Lobule remains partially expanded

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16
Q

What is the effect of emphysema on the lung parenchyma?

A

Damage
Loss of area for gas exchange
Can rupture alveolar walls

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17
Q

Emphysema can cause rupture of alveolar walls. What are the consequences of this? (3)

A

Loss of elasticity - early airway collapse, increased dead space
Loss of pulmonary capillaries - reduced perfusion
Fibrosis of alveolar walls (horse only)

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18
Q

Alveolar wall rupture due to emphysema can cause fibrosis of the remaining walls in horses. What are the consequences of this?

A

Inhibits gas exchange
Reduced compliance
Greater respiratory effort

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19
Q

Give 3 examples of circulatory disturbances of the lung parenchyma

A

Pulmonary oedema
Pulmonary embolism
Pulmonary haemorrhage

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20
Q

Pulmonary oedema is common and caused by many diseases. What are the symptoms of this?

A 
Dyspnoea 
Tachypnoea 
Hypoxia 
Cyanosis (if severe) 
Moist cough
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21
Q

How do lungs with pulmonary oedema appear (grossly)?

A 
Lungs heavy
Enlarged interlobular space
Appear wet, ooze fluid 
Increased fluid in pleural cavity 
Foamy fluid in upper airways
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22
Q

How do lungs with pulmonary oedema appear histologically?

A

Faintly pink stained

Eosinophilic homogenous material

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23
Q

Pulmonary oedema usually does not cause the alveoli to flood. Why is this? (2)

A

Alveolar epithelium more permeable than capillary endothelium
Interstitial fluid drained by lymphatics

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24
Q

Pulmonary oedema is common with many diseases, but what actually causes it to occur? (2)

A

Damaged alveolar epithelium or

Increased interstitial volume

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25
Damage to the alveolar epithelium can cause oedema. What can cause damage to the epithelium?
Infectious agents Toxins Irritants
26
How does damage to the alveolar epithelium by infectious agents, toxins and irritants cause oedema?
Increase capillary permeability Increase hydrostatic pressure Increase pulmonary interstitial fluid Causes inflammation, passive congestion and circulatory overload
27
How can hypoproteinaemia or over-transfusion lead to pulmonary oedema?
Reduced capillary osmotic pressure Reduced drainage of interstitial fluid Blockage of lymphatics by inflammation or tumours
28
What is a pulmonary embolism?
Fragments of tissue within blood stream blocking lung capillaries Can be tumour cells, fat, air thromboemboli (blood clot)
29
Why is the lung a common place to have a pulmonary embolism?
Has fine capillary network
30
What are the effects of a pulmonary embolism?
Depends on site and nature | Can cause infarction - if blockage of major vessel
31
What are the sequelae (resulting pathological changes) from a sterile thromboemboli?
Fibrinolytic breakdown of thrombus OR | Fibrotic scarring
32
What are the sequelae (resulting pathological changes) from an infected thromboemboli?
Vasculitis OR Thrombosis OR Abscess
33
What are common sources of an infected thromboemboli?
Joint ill/navel ill Liver abscesses Right heart bacterial endocarditis
34
How does a hepatic abscess cause a thromboemboli?
Hepatic abscess causes venal canal thrombosis | Pulmonary septic thrombolemboli, arteritis and aneurysm formation
35
What is an aneurysm? When can these be fatal?
Weakening of vascular wall, creates a bulge | If ruptures, causes a fatal haemorrhage
36
What are the causes of pulmonary haemorrhage?
``` Pulmonary thromboembolism Trauma Inflammation Abscesses/tumours Exercise induced haemorrhage ```
37
Which animals are most likely to experience an exercised induced pulmonary haemorrhage (EIPH)?
Racehorses | Unknown cause
38
What is a symptom of EIPH in racehorses? Is this a fatal condition?
Epistaxis | Can be fatal
39
Inflammation of the alveoli is called pneumonia. What are the 4 types of this?
Bronchopneumonia Interstitial pneumonia Embolic pneumonia Granulomatous pneumonia
40
What is the entry route for bronchopneumonia?
Inhalation | Of bacteria, aspiration of food/GI contents, mycoplasmas, viruses
41
Give examples of pathogen that can cause bronchopneumonia
``` Pasteurella (milk inhalation) Bordatella bronchiseptica E.coli Streptococcus Mycoplasma Distemper ```
42
Where are the lesions caused by bronchopneumonia? Why?
Cranioventral | Due to gravity, variations in defence mechanisms, deposition of organisms
43
Describe the pathogenesis of bronchopneumonia
Inhaled pathogen causes injury at bronchiolar-alveolar junction Causes inflammatory response Alveoli and bronchioles fill with exudate Infection and inflammation spreads to adjacent lung
44
What are the 2 subdivisions of bronchopneumonia? Which is more severe?
Suppurative Fibrinous - severe inflammation (Can get both occurring at same time)
45
What causes fibrinous bronchopneumonia?
Inhalation of high irritant material
46
How does the exudate differ between suppurative and fibrinous bronchopneumonia?
Suppurative - purulent or mucopurulent exudate | Fibrinous - fibrinous exudate
47
How does the distribution differ between suppurative and fibrinous bronchopneumonia?
Suppurative - confined to lobules | Fibrinous - spreads rapidly between lobules
48
What is bovine shipping fever properly known as?
Bovine pneumonic pasteurellosis
49
What type of pneumonia does bovine pneumonic pasteurellosis (shipping fever) cause? Is it acute or chronic?
Acute | Fibrinous bronchopneumonia
50
Bovine pneumonic pasteurellosis typically affects which cattle?
Recently weaned suckled calves
51
What bacteria causes bovine pneumonic pasteurellosis?
Mannheimia haemolytica
52
What does bovine pneumonic pasteurellosis cause?
Acute fibrinous bronchopneumonia | Toxaemia
53
What are the sequela of bovine pneumonic pasteurellosis?
``` Resolution Chronic pneumonia Bronchiolitis obliterates Bronchiectasis Abscess formation Pleuritis Death ```
54
What can cause acute interstitial pneumonia?
Distemper Salmonellosis Lungworm Smoke
55
What can cause chronic interstitial pneumonia?
Ovine lentivirus Farmer's lung (hypersensitivity to fungal spores) Toxins Asbestos
56
What are the entry routes for interstitial pneumonia?
Haematogenous or inhalation
57
What is the distribution of interstitial pneumonia?
Mainly diffuse | Can be caudodorsal
58
How do lungs with interstitial pneumonia appear grossly?
Heavy, rubbery, elastic texture Red/grey and mottled Lack of visible exudate
59
When opening the thorax post-mortem, what is a sign of interstitial pneumonia?
Lungs fail to collapse when opening thorax | Leaves costal impression on pleura
60
What are the 3 phases of acute response to interstitial pneumonia?
Injury Exudative phase Proliferative phase
61
What happens in the first phase of the acute response to interstitial pneumonia?
Injury to type I pneumocytes or capillary endothelium
62
What happens in the second phase of the acute response to interstitial pneumonia?
Exudative phase - oedema and inflammatory exudate leake into alveolar space
63
What happens in the final phase of the acute response to interstitial pneumonia?
Proliferative phase - macrophage population expands to phagocytose exudate Type II pneumocytes proliferate to replace type I cells
64
With acute interstitial pneumonia, what microscopic changes happen if injury persists?
Interstitial fibrosis Chronic inflammatory cells Persistance of type II pneumocytes Smooth muscle hyperplasia
65
What are the consequences of acute interstitial pneumonia?
Disruption of alveolar walls - oedema and exudate | Causes hypoxia
66
What are the consequences of chronic interstitial pneumonia?
Same as acute - disrupted alveolar walls, oedema and exudate, hypoxia AND thickened alveolar walls (increased effort, decreased compliance, tachypnoea)
67
What are the consequences of thickened alveolar walls?
Impaired diffusion and gas exchange Hypoxia which leads to vasoconstriction Pulmonary hypertension
68
What is the entry route for embolic pneumonia?
Haematogenous
69
What is the distribution of embolic pneumonia?
Random, disseminated foci
70
What are some causes of embolic pneumonia?
Hepatic abscesses Right heart valve endocarditis Joint/navel ill Bacteria - staph aureus, strep equi
71
What are the sequelae of embolic pneumonia?
Formation of abscesses Fibrosis and resolution Chronic pneumonia Or rupture into thorax (prothorax, pneumothorax)
72
What are some causes of granulomatous pneumonia?
``` Mycobacteria Parasites (lungworm) Viral (FIP) Fungi Foreign bodies ```
73
What are the routes of entry for granulomatous pneumonia?
Inhalation or haematogenous
74
What is the distribution of granulomatous pneumonia?
Variable, nodular foci
75
Secondary lung tumours are very common. Why?
Good blood supply | Fine capillary network
76
Give 2 examples of primary lung tumours seen in epithelial tissues
Carcinoma | Adenocarcinoma
77
What are the 2 types of carcinoma seen in the lung?
Bronchioalveolar | Squamous cell
78
What are the 2 types of adenocarcinoma seen in the lung?
Papillary | Acinar
79
Give 2 examples of primary lung tumours seen in mesenchymal tissues
Chondrosarcoma | Granual cell tumour (neuroendocrine)
80
What is pulmonary adenomatosis also known as?
Ovine pulmonary carcinoma | Driving sickness
81
What is pulmonary adenomatosis?
Retroviral induced neoplasia | Causes multi centric bronchioalveolar carcinoma
82
What shape cells are seen in pulmonary adenomatosis?
Cuboidal or columnar cells | resemble type II cells
83
How do the lungs appear grossly with pulmonary adenomatosis?
Heavy Small grey to white nodules Lots of mucoid fluid
84
What is the wheelbarrow test used to identify? What is this test?
Pulmonary adenomatosis | Hindquarters raise when head is simultaneously lowered

Respiratory (PATH) (6 decks)

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