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Respiratory > Histology and Pathology > Flashcards

Histology and Pathology Flashcards

1
Q

Name the functions of the respiratory system

A
  • supplies oxygen to the blood for delivery to cells throughout the body
  • removes carbon dioxide that has been accumulated in the blood from the tissues of the body
  • phonation
  • olfaction
  • lungs function in blood pressure control via renin-angiotensin system
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2
Q

Describe the lining of the nasal cavity

A
  • the initial part of the nasal cavity, the vestibule, is lined by keratinised stratified squamous epithelium
  • deeper into the nasal cavity, the keratin is lost and deeper still it changes again to respiratory epithelium
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3
Q

What is respiratory epithelium?

A

Pseudostratified ciliated columnar epithelium with goblet cells

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4
Q

What is underneath the respiratory epithelium?

A

The lamina propria

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5
Q

What is the lamina propria?

A

A band of loose connective tissue containing seromucous glands and thin-walled venous sinuses which can quickly engorge with blood and block the nose

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6
Q

What is the oropharynx lined with?

A

Non-keratinised stratified squamous epithelium

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7
Q

Describe the lining of the epiglottis

A
  • anterior surface is lined with squamous epithelium

- posterior surface transitions to respiratory epithelium

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8
Q

Describe the lining of the larynx

A

The walls are made up of cartilage and muscles with respiratory epithelium lining its surfaces with the exception of the vocal cords and adjacent structures

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9
Q

How many c shaped cartilages does the trachea have?

A

15 to 20

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10
Q

What is the open side of the ‘c’ shaped cartilage composed of?

A

Fibroelastic tissue and smooth muscle (trachealis muscle)

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11
Q

The rings of hyaline cartilage are replaced by what in the bronchi?

A

Irregularly shaped cartilage plates

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12
Q

The smallest bronchioles that lack respiratory function as referred to as what?

A

Terminal bronchioles

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13
Q

The smooth muscle of the bronchioles respond to what?

A

Parasympathetic innervation, histamine and other factors by contracting and constricting the diameter of the bronchiole

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14
Q

What are terminal bronchioles lined with?

A

Cuboidal ciliated epithelium and contain non-ciliated club cells that project above the level of adjacent ciliated cells

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15
Q

Name the functions of club cells

A
  • stem cells
  • detoxification
  • immune modulation
  • surfactant production
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16
Q

What is responsible for the spongy nature of the lungs?

A

The alveoli

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17
Q

Alveoli are lined with an epithelium which contain what?

A

Type 1 and type 2 alveolar cells (pneumocytes)

18
Q

Describe type 1 alveolar cells

A
  • simple squamous epithelium that lines the alveolar surfaces covering 90% of the alveolar surface
  • these cells provide a barrier of minimal thickness that is permeable to gases
19
Q

Describe type 2 alveolar cells

A
  • polygonal in shape the free surface is covered by microvilli and the cytoplasm displays dense membrane bound lamellar bodies which contain surfactant
20
Q

How is surfactant released?

A

Through exocytosis.

21
Q

Define pneumonia

A

Infection involving the distal airspaces usually with inflammatory exudation, localised oedema. Fluid filled spaced lead to consolidation

22
Q

How can pneumonia be classified?

A
  • by location eg. hospital acquired or community acquired
  • by organism eg. mycoplasma, pneumococcal etc
  • by morphology eg. lobar pneumonia, bronchopneumonia
23
Q

Describe lobar pneumonia

A
  • confluent consolidation involving a complete lung lobe
  • most often due to streptococcus pneumoniae
  • can be seen with other organisms (klebsiella, legionella)
24
Q

Describe the pathology of pneumonia

A
  • a classical acute inflammatory response; exudation of fibrin-rich fluid, neutrophil infiltration, macrophage infiltration leading to resolution
  • immune system play a part, antibodies lead to opsonisation, phagocytosis of bacteria
25
Q

Name the complications of scarring

A
  • organisation (fibrous scarring)
  • abscess
  • bronchiectasis
  • empyema
26
Q

Define bronchopneumonia

A
  • infection starting in the airways and spreading to adjacent alveolar lung
  • most often seen in the context of pre-existing disease, doesn’t develop as an epidemic
27
Q

Name the organisms associated with bronchopneumonia

A
  • strep. peumoniae
  • haemophilus influenza
  • staphylococcus
  • anaerobes
  • coliforms
28
Q

Describe lung abscesses

A
  • localised collection of pus, mass lesion
  • tumour like
  • chronic malaise and fever
  • context- aspiration
29
Q

Define bronchiectasis

A
  • abnormal fixed dilation of the bronchi
  • usually due to fibrosis scarring following infection (pneumonia, TB, cystic fibrosis)
  • also seen with chronic obstruction
  • cystic fibrosis in children- repeated bronchopneumonia’s leading to bronchiectasis
30
Q

Describe immunity and hypersensitivity in relation to TB

A
  • T cell response to organism enhances macrophage ability to kill mycobacteria, this ability constitutes immunity
  • T cell response causes granulomatous inflammation., tissue necrosis and scarring, this is hypersensitivity (type 4)
  • commonly both processes occur together
31
Q

Why is the TB pathogen able to avoid phagocytosis?

A

Due to its waxy coat

32
Q

Describe the tissues changes that occur in TB

A
  • primary; small focus (ghon focus) in periphery of mid zon of lung
  • large hilar nodes (granulomatous)
  • secondary; fibrosing and cavitating apical lesion
33
Q

Why does the TB pathogen reactivate?

A
  • decreased T cell function; age, coincident disease (HIV), immuno-suppressive therapy (steroids, cancer chemotherapy)
  • reinfection at high dose or with more virulent organism
34
Q

Names some causes of interstitial lung disease

A
  • environmental; minerals, drugs, radiations, post-ARDS, hypersensitivity
  • unknown (idiopathic); connective tissue diseases, idiopathic pulmonary fibrosis
  • diagnosis based on clinical features often with biopsy
35
Q

What is the late stage of interstitial lung disease characterised by?

A

Fibrosis

36
Q

Name some chronic interstitial disease

A
  • idiopathic pulmonary fibrosis
  • sarcoidosis
  • hypersensitivity pneumonitis
  • pneumoconiosis
  • connective tissue diseases
37
Q

Describe idiopathic pulmonary fibrosis

A
  • aka cryptogenic fibrosing alveolitis, usual interstitial pneumonia
  • progressive interstitial fibrosis of unknown cause
  • variable associated inflammation
  • finger clubbing `
38
Q

Describe the pathology of idiopathic pulmonary fibrosis

A
  • subpleural and basal fibrosis, affects peripheral areas of the lung
  • inflammatory component variable
  • terminal lung structure replaced by dilated spaces surrounded by fibrous walls
39
Q

Describe hypersensitivity pneumonitis

A
  • chronic inflammatory disease

- allergic origin

40
Q

Describe the causes of hypersensitivity pneumonitis

A
  • thermophilic bacteria; farmers lung
  • avian proteins; bird fanciers lung
  • fungi; malt workers lung
  • precipitins (antibodies) often detectable in serum. Unusual cases come to biopsy
41
Q

Describe sarcoidosis

A
  • multisystem granulomatous disorder of unknown cause (defined by histological means)
  • pulmonary involvement is common
  • most cases mild and self-limiting
42
Q

Name the other manifestations of sarcoidosis

A
  • uveitis
  • erythema nodosum
  • lymphadenopathy
  • hypercalcaemia

Respiratory (7 decks)

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