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pathophysiology > EXAM 4 Upper Airway > Flashcards

EXAM 4 Upper Airway Flashcards

1
Q

Inflammation of the nasal mucosa results in

A
  • Mucosal vasodilation (erythema)
  • Mucous membrane edema (coryza)
  • Mucous secretion (rhinorrhea)
  • Mucosal tissue proliferation (polyps) with chronic inflammation (non-allergic)
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2
Q

Infectious rhinitis (common cold) caused by ______

A

Infectious rhinitis (common cold) caused by viruses

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3
Q

types of viruses causing infectious rhinitis

A

Adenoviruses, echoviruses, and rhinoviruses

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4
Q

Infection of _____ _____ cells in nasal mucosa (lose ability to clear mucous) results in _______ (swelling, erythema, increased local production of mucus and clear to purulent exudate)

A

Infection of ciliated epithelial cells in nasal mucosa (lose ability to clear mucous) results in inflammation (swelling, erythema, increased local production of mucus and clear to purulent exudate)

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5
Q

Initially the nasal mucosa is _____, edematous, and red; the nasal cavities are ______; and the turbinates are _______

A

Initially the nasal mucosa is thickened, edematous, and red; the nasal cavities are narrowed; and the turbinates are enlarged

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6
Q

enhances the inflammatory reaction and produces mucopurulent exudate, including increased risk for bacterial sinusitis

A

secondary bacterial infection

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7
Q

caused by hypersensitivity (allergy) to allergens

A

allergic rhinitis

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8
Q

Allergic rhinitis affects ~__% of the US population (common)

A

Affects ~20% of the US population (common)

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9
Q

An IgE–mediated immune reaction with early- and late-phase responses (Type I Hypersensitivity)

A

allergic rhinitis

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10
Q

Allergic rhinitis is characterized by marked mucosal edema (“_____”), redness, and mucus secretion, accompanied by a ______ infiltration in which _______ are prominent

A

Characterized by marked mucosal edema (“boggy”), redness, and mucus secretion, accompanied by a leukocytic infiltration in which eosinophils are prominent

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11
Q

focal hyperplastic protrusions of the mucosa

A

nasal polyps

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12
Q

Frequently related to recurrent rhinitis (perennial non-allergic rhinitis, asthma, intolerance of aspirin (acetylsalicylic acid) / NSAIDs, allergic fungal rhinosinusitis, cystic fibrosis, and primary ciliary dyskinesia – NOT IgE mediated allergic)

A

nasal polyps

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13
Q

Nasal polyps consist of _______ mucosa having a loose ____ with hyperplastic or cystic mucous glands, infiltrated with _____ and ______

A

Consist of edematous mucosa having a loose stroma with hyperplastic or cystic mucous glands, infiltrated with neutrophils and eosinophils

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14
Q
  • May obstruct the airway and impair sinus drainage

- May be large or small

A

nasal polyps

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15
Q
  • Frequently preceded by acute or chronic viral rhinitis

- Characterized by facial pain, nasal mucopurulent exudate

A

acute bacterial sinusitis

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16
Q

Usually caused by proliferation of oral cavity bacteria in sinuses (often trapped in sinuses by swelling, reducing diameter of sinus ostia)

A

acute bacterial sinusitis

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17
Q

May develop from acute sinusitis when there is interference with exudate drainage (e.g., polyps)

A

chronic bacterial sinusitis

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18
Q

Fungal forms may be very severe (consider immunosuppression)

A

chronic bacterial sinusitis

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19
Q

______ syndrome, caused by defective ____ action, can result in chronic sinusitis (among other problems)

A

Kartagener syndrome, caused by defective ciliary action, can result in chronic sinusitis (among other problems

20
Q

inflammation and discomfort of the upper and posterior pharynx

A

pharyngitis

21
Q

Frequently occurs with upper respiratory infections:

  • Most commonly viral infections (rhinoviruses, echoviruses, adenoviruses, respiratory syncytial viruses, influenza virus)
  • Bacterial infections (β-hemolytic streptococci or other pathogens)
A

pharyngitis

22
Q
  • (β-hemolytic streptococci or other pathogens)

- More likely to present with tonsillar exudates

A

bacterial pharyngitis

23
Q

signs of pharyngitis

A
  • Acute inflammatory response results in erythema and slight mucosal edema
  • May produce mucopurulent to pseudo-membranous exudates
  • Enlargement of the tonsils and cervical chain lymph nodes
24
Q

enlargement and erythema of the tonsils (exudate may be produced from the tonsillar crypts)

A

tonsillitis

25
Q

Risk of developing ______ abscess if you have tonsillitis

A

Risk of developing peritonsillar abscess if you have tonsillitis

26
Q

the vocal folds become inflamed (edema, exudate)

A

laryngitis

27
Q
  • Causes include allergic, viral, bacterial, traumatic, or chemical irritation (stomach acid, smoke)
  • Most infections are self-limited
A

laryngitis

28
Q

In infancy or childhood, mucosal congestion, exudation, or edema may cause ______ obstruction

A

In infancy or childhood, mucosal congestion, exudation, or edema may cause laryngeal obstruction

29
Q

caused by respiratory syncitial virus, Haemophilus influenzae, or β-hemolytic streptococci

A

Laryngoepiglottitis

30
Q

inflammatory narrowing of the airway produces inspiratory stridor (parainfluenza virus)

A

Laryngotracheobronchitis (croup)

31
Q

develop on the laryngeal folds in response to chemical irritation (e.g., heavy smoking) or chronic strain (e.g., singers nodules)

A

reactive nodules/polyps

32
Q

Laryngeal folds covered by ______ epithelium, may become keratotic, ______, or even dysplastic, with a core of edematous ______ tissue

A

Laryngeal folds covered by squamous epithelium, may become keratotic, hyperplastic, or even dysplastic, with a core of edematous connective tissue

33
Q

a few millimeters in size, located usually on the true vocal cords

A

Smooth, rounded, sessile or pedunculated lesions

34
Q

Singers nodules are _____ lesions and polyps are ______

A

Singers nodules are bilateral lesions and polyps are unilateral

35
Q

Usually cause progressive hoarseness

Rarely become cancerous

A

Reactive nodules/polyps

36
Q

Laryngeal squamous papillomas are _____ neoplasms

A

Laryngeal squamous papillomas are benign neoplasms

37
Q

Usually located on the true vocal cords

A

Laryngeal squamous papillomas

38
Q

Laryngeal squamous papillomas: Soft, _____-like growths (usually < 1 cm) which may be caused by ____ (6, 11), other viruses

A

Laryngeal squamous papillomas: Soft, raspberry-like growths (usually < 1 cm) which may be caused by HPV (6, 11), other viruses

39
Q

Central fibrovascular cores and covered by an orderly stratified squamous epithelium, may bleed when ulcerated

A

Laryngeal squamous papillomas

40
Q
  • Usually single, when multiple called papillomatosis, sometimes regress spontaneously
  • Rarely become cancerous
A

Laryngeal squamous papillomas

41
Q

range from hyperplasia, atypical hyperplasia, dysplasia, carcinoma in situ, to invasive carcinoma

A

laryngeal neoplasms

42
Q

About __% of laryngeal cancers are ______ cell carcinomas

A

About 95% of laryngeal cancers are squamous cell carcinomas

43
Q
  • Usually develops directly on the vocal cords, but it may arise above or below
  • Carcinoma of the larynx manifests itself clinically by persistent hoarseness
A

SCC

44
Q

Larynx neoplasia: Risk factors include cigarette smoking and alcohol consumption, Caucasian and African ancestry, HPV infection

A

SCC

45
Q

SCC larynx: At presentation, about __% are confined to the larynx

A

SCC larynx: At presentation, about 60% are confined to the larynx

pathophysiology (4 decks)

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