Lecture 6- Pulmonary Pathology I Flashcards
each lung is … grams
200-250 (R. heavier)
lungs have a … blood supply
dual (pulmonary and bronchial)
the vocal cords are lined by
stratified squamous epithelium
the large airways (larynx, trachea bronchi) are lined by… with mucus glands, neuroendocrine cells and cartilage
pseudostratified ciliated columnar epithelium
what are the 2 cell types of alveoli?
which produces surfactant?
type 1- flat, 95%
type 2- cuboidal (produce surfactant)
4 pulmonary defenses
upper resp tract- filtering
lower resp tract- mucociliary units
lymphoid tissues- cellular and humoral immunity
alveolar macrophages
…is coughing up blood
hemoptysis
… is diff. of breathing (SOB)
dyspnea
… is collapse of the lung
atelectasis
… is air in the pleural space leading to collapse
pneumothorax
… is suppuration in pleural cavity
empyema
pleural effusion is fluid in the … space and it can be filled with either … or …
pleural
transudate (low protein fluid caused by increased venous pressure)
exudate (high protein fluid caused by increased vascular permeability)
In pulmonary edema, accumulation of fluid in the lungs is first in the … tissues then ultimately filling up the … air spaces
interstitial
distal
3 causes of pumonary edema
increased intravascular pressure (CHF)
hypoproteinemia
vascular damage (infections, autoimmune disease)
2 main problems of pulmonary edema
inhibits normal oxygen exchange
predisposes to infection
4 predisposing factors of thrombo-emboli
chronic illness
prolonged bed rest
hypercoagulable state (factor V leiden)
DVTs
COPD is the combination of… and …
emphysema
chronic bronchitis
4 classic disorders in obstructive pulmonary diseases
emphysema
chronic bronchitis
bronchiectasis
asthma
… is the permanent enlargement of the distal small air spaces due to destruction of alveolar septal walls
emphysema
Clinical presentation of emphysema
dyspnea
cough
prolonged exhalation
“pink puffers” (their oxygenated but need to really force air out because elastic walls have been destroyed)
pathogenesis of emphysema
imbalance between protease and anti-protease enzymes
what is the major cause of the imbalance between protease and anti protease enzymes in emphysema?
smoking
2 forms of emphysema
centriacinar
panacinar
… emphysema involves the central portion of the acini and usually affects the upper lobes and is most often related to smoking
centriacinar
… emphysema involves the entire acinar unit from the respiratory bronchioles to terminal alveoli, usually affects lower lobes
panacinar
which kind of emphysema is seen in patients with alpha antitrypsin deficiency
panacinar
… is defined by a cough with sputum for 3 consecutive months in 2 consecutive years
chronic bronchitis
patients with … may have hypoxemia and cyanosis “blue bloaters”
chronic bronchitis (have trouble getting air in)
pathogenesis of chronic bronchitis
chronic irritation (smoking) and infections
pathology of chronic bronchitis
increased mucus gland layer, chronic inflammation, fibrosis and narrowing of airways
predisposing factors for chronic bronchitis and emphysema (4)
smoking
atmosphere pollutants
infections
genetic factors (CF, alpha 1 at deficiency)
smoking causes mucus gland …, increases … muscle tone, inhibits … and …. and induces squamous…
hypertrophy
smooth muscle tone
cilia and phagocytosis
metaplasia
… is defined as chronic infection with permanent major airway dilation; secondary to obstruction, infection or both
bronchiectasis
clinical presentation of bronchiectasis
severe cough
bloody mucoid expectoration
dyspnea
complications of bronchiectasis
abscess
pneumonia
bronchopleural fistula
empyema
predisposing factors of bronchiectasis
obstructive tumors
foreign bodies
CF
other COPD
suppurative
necrotizing pneumonua
pathology of bronchiectasis
dilated distal bronchi and bronchioles
chronic infection with inflamm. and variable purulence
…. is defined as increased irritability and prominence of smooth muscle in bronchi and bronchioles marked with reversible episodes of contraction and irway constriction
asthma
initiating factors of asthma
allergies infections exercise drugs emotions
is asthma common?
yes affects 5% of adults and 7-10% of kids especially inner city children
clinical presentation of asthma
wheezing
long exhalation
hyperinflation of lungs
types of asthma
atopic and non-atopic
3 causes of atopic (extrinsic) asthma
type I hypersensitivity (IgE mediated)
environmental antigen
positive FH
cause of non-atopic
( intrinsic) asthma
may be initiated by viruses or air pollutants
Either atopic or nonatopic an be triggered by
emotional stress
exercise
cold temps
what disorder has the following pathology?
increased mucus glands, smooth muscle hypertrophy, inflammation with eosinophils and type 2 helper T cells
asthma
Pathogenesis of asthma: antigen binds to surface …. on mast cells releasing a large number of mediators including … and …
IgE
histamine
leukotrienes
asthma tx
inhalation bronchodilators for immediate relief (albuterol)
controller medications (corticosteroids)
