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Systems Pathology 2 > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

When thinking about the lungs, what is a collapse of the lungs called?

A

Atelectasis (collapse)

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2
Q

What happens to the bronchioles during cases of Emphysema? (hint: dilation or constriction)

A

Dilation of the bronchioles (bronchiectasis)

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3
Q

What is the term used for dilation of the bronchioles? And which bronchioles does this usually effect?

A
  • Bronchiectasis

- Medium sized bronchioles

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4
Q

How many lobes and bronchi does the RIGHT lung have?

A

3 lobes and 3 main bronchi

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5
Q

How many lobes and bronchi does the LEFT lung have?

A

2 lobes and 2 main bronchi

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6
Q

Looking at the right main bronchus, what is the orientation of this bronchus? (hint: vertical or horiz)

A

Vertical, yo

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7
Q

Where do the bronchi receive arterial blood from?

A

Pulmonary and bronchial

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8
Q

Great (Type 2) cells secrete _______ , to help facilitate _______.

A

Surfactant, Surface tension

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9
Q

The LARYNX, TRACHEA, BRONCHIOLES are lined with what type of epithelium?

A

Pseudostratified columnar epithelium (This goes all the way from the nose to the terminal bronchioles)

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10
Q

What are the true vocal cords lined with?

A

Stratified squamous epithelium

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11
Q

What three histologic structures/substances does a normal bronchus consist of?

A
  1. Respiratory epithelium (pseudostratified)
  2. Sub mucosal glands (mucus secretion)
  3. Cartilage (hyaline)
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12
Q

Bronchial mucosa has neuroendocrine cells that secrete what substances? (hint: 3 things)

A
  1. Calcitonin
  2. Serotonin
  3. Gastrin releasing Peptides
    (C-S-G-P)
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13
Q

What do Type 1 pneumocytes facilitate?

A

facilitates gas exchange

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14
Q

If Type 1 pneumocytes are lost, what will help to replace them?

A

Type 2 pneumocytes multiply and differentiate to form new Type 1 cells

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15
Q

Which of the cells in the alveoli are more prone to injury (type 1 or type 2)?

A

Type 1

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16
Q

What is the shape of Type 2 pneumocytes?

A

CUBOIDAL

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17
Q

What do Type 2 pneumocytes produce?

A

Surfactant

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18
Q

What is the other type of cells that are commonly found in the alveoli?

A

Alveolar macrophage

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19
Q

Where are large particles that enter the through the nose deposited?

A

In the nose

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20
Q

Where are intermediate-sized particles deposited?

A

Bronchi, bronchioles

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21
Q

How are these intermediate-sized particles removed?

A

Mucociliary action

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22
Q

When smaller particles get through the airway and are deposited where? What removes them?

A

Deposited in the alveoli

Alveolar macrophages remove them

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23
Q 
Congenital anomalies Stages
4wk - Embryonic
7-17wk - Pseudoglandular
17-27wk - Canalicular
27-40wk - Saccular
40wk-... - Alveolar
A

Anomalies
Embryo - Laryngeal/Tracheal stenosis, fistula, pulmonary sequestration, bronchogenic cysts
Pseudoglandular - pulmonary hypoplasia, malacia, adenomatoid malformation
Canalicular - pulmonary hypoplasia, arteriovenous malformations
Saccular - pulmonary hyperplasia
Alveolar - Lobar emphysema, lymphatic anomalies

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24
Q

Bronchial artesia, what lobe commonly involved?

A

Apical posterior segment of the left upper lobe

25
Q

Later on in life what can happen to the over expansion of the lung lobe?

A

Can become emphysematous

26
Q

Hypoplasia of the lung (aka agenesis) seen in what?

A

Trisomies 13, 18, 21

27
Q

What are two other causes of hypoplasia?

A
  1. chest wall abormalities, ascites, pleural effusion

2. Oligohydramnios (inadequare volume of amniotic fluid)

28
Q

Lungs bigger or smaller than the heart?

A

MUCH smaller

29
Q

Bronchogenic cysts, when are they usually seen?

A

First 2 year of life

30
Q

Where are bronchogenic cysts found?

A

Middle mediastinum

31
Q

In newborns what can a BRONCHOGENIC CYST cause, and why?

A

Respiratory distress by compression of major airway

32
Q

What can happen when there is a secondary infection of the cyst?

A

Hemorrhage and perforation

33
Q

How many types of morphology are bronchogenic cysts divided into?

34
Q

What are the 3 types of bronchogenic cysts?

A

Type 1 - 50% - large, ciliated epithelium
Type 2 - 40% - multiple small cysts, ciliated epithelium
Type 3 - 10% - solid, bulky lesion, MEDIASTINAL SHIFT

35
Q

In bronchopulmonary sequestration… where is the pulmonary tissue situated?

A

Outside lung parenchyma

36
Q

Where does the blood supply to the sequestered area arise from?

A

Aorta or its branches

37
Q

What other congenital anomalies are often associated with extra-lobar pulmonary sequestrations? (hint: 4 things)

A
  1. Diaphragmatic hernia
  2. Diaphragmatic defect
  3. Cardiopulmonary anomalies
  4. Abnormal communication with foregut
38
Q

What are the two types of bronchopulmonary sequestration?

A

Intra-lobar sequestrations - (90% on LEFT SIDE!)

Extra-lobar sequestrations

39
Q

What does bronchopulmonary sequestration look like microscopically?

A
  • Cystic spaces lined by CUBOIDAL or COLUMNAR epithelium

- Lumen contains FOAMY MACROPHAGES and EOSINOPHILIC material

40
Q

Clinical features of sequestrations…

A

Dyspnea and Cyanosis occur in 90% of extra-lobar sequestration cases, in CHILDREN

41
Q

Majority of extra-lobar sequestrations occur where?

A

77% - close to diaphragm

90% - in left suprarenal area

42
Q

CASE:

  • A female infant is born prematurely at 28 weeks gestation
  • Shortly after birth, she shows signs of dyspnea, cyanosis, tachypnea
  • She is placed on a ventilator for assisted breathing, and diagnosis of neonatal respiratory distress syndrome (hyaline membrane disease) is made
  • -Which of the following is the cause of this syndrome?–
A

a) Bronchopulmonary dysplasia
b) Intraventricular brain hemorrhage
c) Lack of Fetal pulmonary maturity and deficiency of surfactant

ANS: C - Lack of fetal pulmonary maturity and deficiency of surfactant

43
Q

Neonatal respiratory distress syndrome (hyaline membrane disease) is the most common cause of respiratory failure in what population? What does this result from?

A

Newborns

Deficiency of surfactant and immature development of the lungs

44
Q

What is an indicator of fetal pulmonary maturity?

A
  • Lecithin: Sphingomyelin ratio - 2:1

- This is measured in the amniotic fluid

45
Q

What are some predisposing factors of fetal pulmonary maturity?

A
  • Prematurity
  • Maternal diabetes mellitus
  • C-section birth
46
Q

What is important to know to diagnose such cases as discussed previously? (eg. fetal pulmonary maturity)

A
  • History
  • Age
  • Gender
47
Q

Pursed lip breathing

A

partial closing of lips to allow air to be expired slowly; used by patients with COPD

48
Q

Kussmal breathing

A

deep gasping respiration associated with SEVERE DIABETIC ACIDOSIS and COMA

49
Q

Barrel chest (eg. bronchitis, emphysema)

A

condition characterized by increased AP chest diameter caused by INCREASED FRC due to AIR TRAPPING from SMALL AIRWAY COLLAPSE

50
Q

What test do you use to palpate for fremitus?

A
  • “99-test”
  • Normally present on both sides equally
  • Fremitus is a vibration
51
Q

Bronchial breath sounds are abnormal where?

A
  • PERIPHERAL AREAS where only vesicular (soft and rustling) sounds should be heard
52
Q

If there are bronchial sounds heard in area distant from where they normally occur, the patient may have what condition? (hint: 2 things)

A
  • Consolidation (occurs in pneumonia)

- Compression of the lung

53
Q

Presence of adventitious sounds indicates what?

A
  • ABNORMALITY
54
Q

What are the three different adventitious sounds?

A
  • Pleural rib
  • Rhonchi
  • Crackles or crepitations
55
Q

What does localized rhonchi suggest?

A
  • Obstructive etiology (eg. Tumor, foreign body, mucous)

Note: mucous secretions disappear with coughing, so would rhonchus

56
Q

While rhonchi are very uncommon in COPD, what disease/disorder are they common in…

A

ASTHMATICS

57
Q

When auscultating the chest, what would rhonchi sound like?

A
  • Crackles

- produced by air passing over airway secretions

58
Q

High pitched rhonchi are called what?

A

SIBILANT rhonchi

59
Q

Low pitched rhonchi are called what?

A

SONOROUS rhonchi

Systems Pathology 2 (1 decks)

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