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Pathology > Lung 1 > Flashcards

Lung 1 Flashcards

1
Q

right lung bud develops into

A

3 branches of lobar bronchi

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2
Q

respiratory system is an outgrowth from

A

ventral wall of the foregut

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3
Q

left lung bud develops into

A

2 lobar branches

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4
Q

conducting airways

A

nasal, mouth, pharynx, larynx, trachea, bronchi, bronchioles

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5
Q

respiratory tissues

A

terminal respiratory bronchiole, alveolar ducts and sacs

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6
Q

lobar bronchi are lined by

A

columnar ciliated epithelium

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7
Q

distal to terminal bronchioles

A

pulmonary acinus (7mm)

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8
Q

A cluster of three to five terminal bronchioles with its

appended acinus is referred to as

A

pulmonary lobule

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9
Q

distinguished by lack of cartilage and submucosa glands

A

bronchioles

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10
Q

alveolar tissue total weight and surface

A

250g, 75 sqm

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11
Q

true vocal cords are lined by

A

stratified squamous epithelium

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12
Q

entire respiratory tree (larynx, trachea, bronchioles)

A

pseudostratified tall columnar ciliated epithelium

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13
Q

express high levels of the cystic fibrosis transmembrane conductance regulator (CFTR) and
appear to modulate the ion content and viscosity of bronchial secretions

A

ionocytes

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14
Q

bronchial mucosa contains neuroendocrine cells

A

serotonin, calcitonin, bombesin

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15
Q

are the ones also
producing mucus, it usually traps inhaled
foreign body like dust or inhaled microbes
and so they stick there, so it’s also a sort of
protection, preventing these smaller particles
from going directly to the pulmonary alveoli

A

goblet cells

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16
Q

an intertwining network of anastomosing capillaries lined with endothelial cells

A

alveolar walls

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17
Q

These pores allow gas exchange from one alveolus to another alveolus.

A

pore of Kahn

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18
Q

carbon particles in the lungs

A

anthracosis

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19
Q

amount of air inhaled and exhaled with each resting breath

A

tidal volume (70kg: 350-400ml)

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20
Q

amount of air remaining in the lungs at the end of a maximal exhalation

A

residual volume

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21
Q

total amount of air that can be exhaled following maximal inhalation

A

vital capacity

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22
Q

total lung capacity

A

vital capacity + residual volume

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23
Q

amount of gas in the lungs at the end of a resting tidal breath

A

functional residual capacity

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24
Q

lesser pleural pressure on the apex causes __________ expansion of the apical alveoli

A

greater

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25
Q

PaO2 falls below 60mmHg

A

respiratory failure

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26
Q

normal PaO2

A

80-100mmHg (10.7-13.3kPa)

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27
Q

normal PaCO2

A

35-45mmHg (4.7-6.0)

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28
Q

PaO2 is low but PaCO2 is within normal range

A

type 1

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29
Q

Type 2 resp failure

A

PaO2 is low but PaCO2 is raised

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30
Q

the only direct clinical sign of resp failure

A

central cyanosis (PaO2 is 50mmHg or lower)

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31
Q

less than 30mmHg PaO2

A

loss of consciousness

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32
Q

hypercapnia when severe causes

A 
tremor
bounding pulse
vasodilation
increased CO
confusion leading to coma
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33
Q

2 main causes of chronic hypoxemia

A

pulmonary hypertension

polycythemia

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34
Q

Due
to
pulmonary
vasoconstriction. This occurs when the PaO2 falls below 60mmHg

A

Pulmonary hypertension

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35
Q

Due to stimulation of

erythropoietin release from the kidney when there is low oxygen

A

polycythemia

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36
Q

Provide anatomic assistance in reducing the

surface tension of alveoli

A

surfactant (type 2 pneumocytes)

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37
Q

phospholipids and proteins in a surfactant

A

Dipalmitoylphosphatidylcholine
Surfactant apoproteins
Calcium ions

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38
Q

what is the surface tension of water

A

72 dynes/cm

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39
Q

surface tension of alveolar fluid without surfactant

A

50 dynes/cm

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40
Q

surface tension of alveolar fluid with surfactant

A

5-30 dynes/cm

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41
Q

steroids which increase the prod of surfactant

A

thyroxin and cortisol

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42
Q

biochemical defenses

A 
proteinase inh (alpha 1 protease inh)
Antioxidants (transferrin, lactoferrin, glutathione)
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43
Q

main disease of the airways and the lungs

A

infection
inflammation
obstruction

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44
Q

incomplete expansion of the lungs

A

atelectasis (neonatal) (-) surfactant

45
Q

collapse of previously inflated lungs

A

atelectasis (acquired)

46
Q

3 main types of atelectasis

A

resorption
compression
contraction

47
Q

complete obstruction of an airway

A

resorption atelectasis

48
Q

Mediastinum shifted towards the atelectatic lung

A

resorption atelectasis

49
Q

Significant amount of fluid (transudates,
exudate- infection: pneumonia, or blood),
tumor or air (pneumothorax) accumulate
within the pleural cavity

A

compression atelectasis

50
Q

mediastinum is shifted away from the affected lung

A

compression atelectasis

51
Q

type of atelectasis whch is more common in traumatic patients like stabbed wounds

A

compression atelectasis

52
Q

Focal or generalized pulmonary or pleural

fibrosis prevents full lung expansion.

A

contraction atelectasis

53
Q

presence of
fibrous tissue in between the alveolar
spaces, so in the alveolar septa, that will
prevent the lungs from expanding fully

A

interstitial fibrosis

54
Q

also called non cardiogenic pulmonary edema

A

acute lung injury

55
Q

Characterized by abrupt onset of significant hypoxemia and bilateral
pulmonary infiltrates in the absence of cardiac failure

A

Acute lung injury

56
Q

histologic manifestation of ALI and ARDS

A

diffuse alveolar damage

57
Q

made up of alveolar fluid rich in proteins that has precipitated.

A

Hyaline membrane

58
Q

lining hyaline membrane surrounds the alveolar spaces which makes it difficult for gas exchange to happen

A

hyaline membrane disease

59
Q

increase resistance to airflow due to partial or complete obstruction at any level from trachea and larger bronchi to the terminal and respiratory bronchioles

A

Obstructive diseases

60
Q

reduced expansion of lung parenchyma and decreased total lung capacity

A

restrictive disease

61
Q

Obstructive and Restrictive lung dse types

A

emphysema
Chronic bronchitis
asthma
bronchiectasis

62
Q

irreversible enlargement of the airspaces distal to terminal bronchiole accompanied by destruction of their walls without obvious fibrosis

A

emphysema

63
Q

Central or Proximal parts of the acini formed by

respiratory bronchioles are affected

A

CENTRIACINAR (CENTRILOBULAR) EMPHYSEMA

64
Q

Both emphysematous and normal airspaces exist within the same acinus and lobule.

A

CENTRIACINAR (CENTRILOBULAR) EMPHYSEMA

65
Q

more common and severe (CENTRIACINAR (CENTRILOBULAR) EMPHYSEMA)

A

upper lobes

66
Q

Acini are uniformly enlarged from the level of the
respiratory bronchiole to the terminal blind
alveoli

A

Panacinar emphysema

67
Q

Panacinar emphysema tend to occur more in the _______________

A

lower zones

68
Q

Panacinar emphysema is associated with ______________ deficiency

A

alpha 1 antitrypsin

69
Q

Proximal portion of the acinus is normal and the

distal part is predominantly involved

A

Paraseptal/ DIstal acinar emphysema

70
Q

Distal Emphysema is more striking adjacent to the pleura,

more on the

A

upper half of the lung

can sometimes form cyst-like structures

71
Q

Usually in small foci and is clinically significant

A

irregular emphysema

72
Q

most common cause of emphysema

A

Inhaled cigarette smoke

73
Q

Factors (emphysema)

A

o Inflammatory mediators and leukocytes
– released from resident epithelial cells
and macrophages.

o Protease-antiproteases imbalance

o Oxidative stress

o Infection

74
Q

Symptoms of emphysema do not appear until atleast __

A

1/3 of the functioning lung parenchyma is damaged.

75
Q

Manifestations of emphysema

A

Dyspnea, cough and expectoration, wheezing, weight loss

76
Q

Generally, in patients with smoking-related
disease, the _________ are
more severely affected

A

upper 2/3 of the lungs

77
Q

apical blebs or bullae are characteristics of

A

irregular emphysema

78
Q

Persistent cough with sputum production for at
least 3 months in at least 2 consecutive
years

A

chronic bronchitis

79
Q

most important risk factor of chronic bronchitis

A

cigarette smoking

80
Q

Dominant pathology features of chronic bronchitis

A

mucous hypersecretion

persistent inflammation

81
Q

– ratio of thickness of the mucous

gland layer to the thickness of the wall between the epithelium and the cartilage

A

reid index

82
Q

normal measure in reid index

A

not more than 0.4

83
Q

reid index: chronic bronchitis

A

> 0.4

84
Q

Is a heterogeneous disease, usually
characterized by chronic airway inflammation
and variable expiratory airflow obstruction that
produces symptoms such as wheezing,
shortness of breath, chest tightness, and cough,
which vary over time and in intensity

A

asthma

85
Q

Episodic bronchoconstriction due to increased

airway sensitivity to a variety of stimuli.

A

asthma

86
Q

2 types of asthma

A

atopic and non atopic

87
Q

Evidence of allergen

sensitization and immune activation

A

atopic (more common)

88
Q

No evidence of allergen

sensitization

A

non- atopic

89
Q

▪ IgE – mediated (type 1 hypersensitivity reaction)
▪ Usually begins in childhood and is triggered by
environmental allergens (dust, pollen, cockroach
or animal dander and food)

A

atopic asthma

90
Q

▪ Usual triggers are respiratory infections (viral),
air pollutants (smoking, sulfur dioxide, ozone,
exposure to cold and exercise).

A

non-atopic asthma

91
Q 
▪ Inhibits cyclooxygenase pathway of arachidonic 
acid metabolism leading to a rapid decrease in 
Prostaglandin E2 (aspirin)
A

Drug-induced asthma

92
Q

▪ Fumes in workplace (epoxy resins, plastics)
▪ Organic and chemical dusts (wood, cotton,
platinum)
▪ Gases (Toluene)
▪ Others: formaldehyde, penicillin products

A

occupational asthma

93
Q

Bronchoconstriction is triggered by direct

stimulation of

A

subepithelial vagal

(parasympathetic) receptors

94
Q

asthma-pharmacologic mediators

A

leukotrienes c4, d4, e4

acetylcholine

95
Q

asthma suspects

A

ILF3/IL4

IL13

96
Q

One susceptibility locus for asthma is

located on

A

chromosome 5q

97
Q

are linked to

production of IgE antibodies

A

Particular class II HLA

98
Q

may be linked to increased
proliferation of bronchial smooth muscle and
fibroblasts

A

Polymorphisms in the gene encoding

ADAM33

99
Q

IL-4 receptor gene variants are associated

with

A

atopy, elevated serum IgE, and asthma

100
Q

morphology of asthma

A

lungs are distended
Occlusion of bronchi and bronchioles by thick, tenacious mucus plugs
Charcot-Leyden crystals

101
Q

asthma-airway remodelling

A 
▪ Thickening of airway wall
▪ Sub Basement membrane fibrosis
▪ Increased in the size of submucosal glands 
and number of airway goblet cells
▪ Hypertrophy and/or hyperplasia of the 
branchial wall muscle
102
Q

severe form of asthma

A

status asthmaticus

103
Q

▪ Destruction of smooth muscle and elastic tissue
by chronic necrotizing infections
▪ Permanent dilation of bronchi and bronchioles

A

bronchiectasis

104
Q

bronchiectasis is associated with

A 
o Congenital or inherited conditions, e.g 
cystic fibrosis 
o Infections- necrotizing pneumonia
o Bronchial obstruction- tumor, foreign 
bodies
o Others: rheumatoid arthritis, SLE 
,inflammatory bowel disease, COPD and 
post transplantation
105
Q

smaller bronchioles are

progressively obliterated as a result of fibrosis

A

bronchiolitis obliterans

106
Q

is an autosomal
recessive disease. The disease causing
mutations result in ciliary dysfunction due to
defects in ciliary motor proteins

A

Primary ciliary dyskinesia

107
Q

Approximately half of patients with primary ciliary

dyskinesia have

A

Kartagener syndrome

108
Q

occurs
in patients with asthma or cystic fibrosis and
frequently leads to the development of
bronchiectasis. It is a hyperimmune response to
the fungus Aspergillus fumigatus.

A

Allergic bronchopulmonary aspergillosis

Pathology (31 decks)

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