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Systemic Pathology (Spring 2015) > L2: Resp. Path: Bronchitis, Bronchiolitis, Atelectasis, Emphysema (Castleman) > Flashcards

L2: Resp. Path: Bronchitis, Bronchiolitis, Atelectasis, Emphysema (Castleman) Flashcards

1
Q

2 main components of bronchi

A

cartilage (to prevent collapse) and glands

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2
Q

T/F: very small changes in bronchi diameter increases resistance markedly

A

T

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3
Q

chronic inflammation of bronchi –> dilation or shrinkage?

A

dilation

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4
Q

role of THICK connective tissue in bronchi

A

prevents infection spread into surrounding alceolar parenchyma

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5
Q

T/F: ciliated cells are terminally differentiated

A

T

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6
Q

which cells have capacity for regenerating bronchi epithelium?

A

mucous cells, basal cells, other nonciliated cells (Clara cells)

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7
Q

Do bronchioles have cartilage or glands?

A

NO

-patency maintained by interalveolar septa on bronchiolar wall

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8
Q

chronic inflammation –> bronchioles

A

stenosis of lumen

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9
Q

infection spread in bronchioles vs. bronchi

A

THIN CT of bronchioles allows spread to surrounding alveoli

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10
Q

Clara cells rich in what enzyme

A

cytochrome monooxygenase (cytochrome P450)

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11
Q

primary lobule

A

pulmonary tissue supplied by terminal bronchiole

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12
Q

secondary lobule

A

composed of many primary lobules. Constitute grossly visible lobules
-cattle have most

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13
Q

components of interalveolar septa

A
  • epithelial cells (type 1 and 2)
  • capillary endothelium
  • fibroblasts (composed of elastin and collagen)
  • macs
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14
Q

chars. of type 1 epithelial cells

A
  • large SA
  • susceptible to damage
  • incapable of division
  • terminally diff.
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15
Q

chars. of type 2 epithelial cells

A
  • cuboidal
  • produce surfactant and other mediators**
  • effect epithelial repair
  • stem cells
  • diff. into type 1 cells
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16
Q

Q: Which of the following is NOT a stem cell for epithelial repair in bronchi/bronchioles?

a) mucous cells
b) ciliated cells
c) nonciliated cells

A

ciliated cells

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17
Q

Q: which serve as stem cells for epithelial repair in the interalveolar septum?

a) type 1
b) type 2
c) mucous cell

A

type 2

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18
Q

causes of bronchitis and bronchiolitis

A
  • infectious (viral, bacterial, fungal, parasitic)
  • toxic (plant toxins)
  • hypersensitivity
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19
Q

functional consequences of bronchitis/iolitis

A
  • inc. airway resistance –> obstruction, ventilation/perfusion abnormality –> hypoxemia
  • dec. mucociliary clearance –> 2ary bacterial infection
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20
Q

sequelar of bronchitis/iolits

A
  • resolution/repair
  • extend to alveoli –> pneumonia
  • chronic localized inflamm. in bronchi –> bronchiectasis or bronchioles –> bronchiolitis obliterans
  • post-obstructive atelectasis
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21
Q

bronchiectasis

A

dilation of bronchi beyond normal physiological limits due to destruction of the bronchial wall

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22
Q

path. of bronchiectasis

A

1) chronic infection (usually bact.)

2) neut-mediated tissue destruction of glands/cartilage, fibrosis

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23
Q

gross morphology of bronchiectasis

A

1) airway dilation (saccular or cylindrical)
2) thick wall
3) luminal exudate

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24
Q

fx significance of bronchiectasis

A

1) inc. airway resistance
2) poor mucociliary clearance
3) aspiration of infective material to alveoli

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25
Q

sequelae of bronchiectasis

A
  • irreversible!

- progression of inflamm. –> continued bronchial damage, pneumonia

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26
Q

bronchiolitis obliterans

A

obstruction of the bronchiolar lumen by fibrous connective tissue

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27
Q

atelectasis

A

collapse of the lung

28
Q

2 types of atelectasis

A

1) neonatal (inadequate surfactant)

2) acquired (compressive or obstructive)

29
Q

compressive atelectasis

A

fluid, air, mass compress lung or results in loss of neg. pleural pressure

30
Q

why are cattle most easily affected by obstructive atelectasis?

A

don’t have collateral circulation in lungs.

post-obstructive atelectasis most common in cattle

31
Q

path. significance of atelectasis

A
  • segment of lung underventilated

- if widespread –> hypoxemia

32
Q

sequelae of atelectasis

A

1) resolution of cause: reinflation
2) alveolar edema
3) secondary bacterial pneumonia
4) fibrosis and irreversible collapse

33
Q

pulmonary emphysema

A

enlarged gas-filled space in the lung

-can be alveolar or interstitial

34
Q

path. significance of alveolar emphysema

A
  • decreased alveolar/capillary SA
  • loss of radial support for airways: early closure
  • decreased elastic properties; increased compliance and residual lung capacity
  • pulmonary hypertension
35
Q

which type of emphysema is irreversible?**

A

alveolar

36
Q

interstitial emphysema

A

excess gas in the pulmonary interstitium

-occurs in species w/ extensive interlobular septa

37
Q

pathogenesis of interstitial emphysema

A

1) forced expiration against obstructed airways

2) gas dissects into interstitial tissue (interlobular septa, perivascular areas, subpleural tissues)

38
Q

pathological significance of interstitial emphysema

A

compression of lobules decreases ventilation (restrictive lung disease)

39
Q

interstitial emphysema sequelae

A

1) resolution
2) progression: mediastinum and subcutis (gas bubbles)
3) secondary infection of pockets
4) fibrosis and parenchymal loss

40
Q

5 most common things that lead to edema in the lung

A

1) inc. hydrostatic pressure assoc. w/ CV abnormalities
2) inc. permeability of vessels assoc. with inflamm. or injuries
3) obstruction of lymphatics
4) hypoalbuminemia/decreased oncotic pressure
5) increased sodium

41
Q

Q: most common cause of bronchiectasis

a) viral infection
b) chronic dust inhalation
c) chronic bacterial infection

A

C)chronic bacterial infection

42
Q

Q: which is reversible?

a) bronchiectasis
b) bronchiolitis obliterans
c) atelectasis
d) alveolar emphysema

A

c) atelectasis

43
Q

pneumonia

A

inflamm. of the pulmonary gas exchange parenchyma

- causes: infectious, toxic, immunologic, mixed

44
Q

distr. of aspiration pneumonia

A

cranioventral

45
Q

4 distribution types of pneumonia

A

focal
multifocal
locally-extensive
diffuse

46
Q

4 main morphologic classifications of pneumonia

A

1) bronchopneumonia
2) interstitial pneumonia (rare)
3) focal or multifocal (embolic)
4) mixed (ie bronchointerstitial)

47
Q

slide 26 chart

A

:)

48
Q

pathogenesis of bronchopneumonia

A
  • deposition of causative agent in terminal bronchioles and alveoli
  • early damage in proximal acinar areas w/ spread into surrounding alveolar parenchyma
49
Q

gross morph. of bronchopneumonia

A

-cranioventral
+/- fibrinous pleuritis, lobar distribution
-chronic –> fibrosis and lymphadenomegally

50
Q

histo of bronchopneumonia

A
  • abundant exudate in alveoli including neuts, fibrin, necrotic debris
  • airway oriented lesions initially
51
Q

pathophysiologic significance of bronchopneumonia

A
  • airway obstruction
  • infiltration of walls and filling of alveoli –> stiffer lungs
  • exudate and alveolar wall thickening –> dec. diffuse capacity
  • pleuritis may contribute to restrictive disease
52
Q

bronchopneumonia sequelae

A
  • resolution
  • death
  • septicemia
  • chronic bronchopneumonia w/ bronchiolitis obliterans and bronchiectasis +/- pleural adhesions
53
Q

interstitial pneumonia pathogenesis

A
  • primary injury to elements of the interalveolar septum: epithelial, endothelial
  • causes: infectious, toxic, hypersensitivity
54
Q

gross morph. of interstitial pneumonia

A

diffuse or locally extensive firm, large, red

55
Q

histo morph. of interstitial pneumonia

A
  • acute: type 1 epithelial necrosis
  • subacute: type 2 hyperplasia, alveolar septa thickening, mononuclear cells
  • chronic: fibrosis
56
Q

pathophys. significance of interstitial pneumonia

A
  • -> decreased compliance, increased stiffness

- dec. diffusion capacity –> hypoxemia

57
Q

interstitial pneumonia sequelae

A
  • resolution
  • death
  • fibrosis of interalveolar septa and progressive restrictive lung dz
58
Q

Q: if distr. of pneumonia is cranioventral, it is most likely:

a) aspiration pneumonia
b) fungal pneumonia
c) viral pneumonia
d) bronchopneumonia
e) interstitial pneumonia

A

d) bronchopneumonia

59
Q

Q: most likely causes of bronchopneumonia

a) bacteria
b) virus
c) aspiration
d) A and B
e) A and C

A

A and C

60
Q

Q: if pneumonia is diffuse, the least likely cause is:

a) virus
b) protozoa
c) toxins
d) aspiration
e) bacterial septicemia

A

d) aspiration

61
Q

if it ain’t firm…

A

…it ain’t pneumonia

62
Q

pathogenesis of acute viral pneumonia

A
  • virus replicates in resp. airway and alveolar epithelial cells
  • induces inflamm. and immune response
  • inflamm. in parenchyma is focused on interalveolar septa
  • viral replication is effectively halted before diffuse interstitial pneumonia develops
63
Q

morph. features of acute viral pneumonia

A

virus-induced epithelial injury and inflamm. manifesting as:

  • rhinitis
  • tracheitis/bronchitis
  • bronchiolitis
  • patchy interstitial pneumonia
64
Q

chars. of chronic viral pneumonia

A
  • assoc. with viruses that replicate in macs and/or depress or escape antiviral immunologic mechs.
  • virus spreads throughout the lung and induces diffuse interstitial pneumonia
65
Q

ex. of chronic viral pneumonia viruses

A

ovine progressive pneumonia

canine distemper virus

Systemic Pathology (Spring 2015) (10 decks)

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