Lung Pathology I Flashcards
aspiration
down right lung - straight bronchus
lying down
aspiration to left upper lobe
conducting vs. respiratory
respiratory - where alveoli gas exchange occurs
size of particles
less than 10 microns - alveolar damage
less than 5 microns - real bad damage to alveoli
bronchus
cartilage
AND submucosal glands
bronchiole
no cartilage
clara cells
in bronchioles
dome shaped cells with short microvilli
surfactant
type II pneumocytes
pores of kohn
intraalveolar macrophages
lobule
cluster of terminal bronchioles and all attached acini
acinus
resp bronchiole and all attached alveolar ducts and alveolar sacs
canals of lambert
openings between bronchi and alveoli
pulmonary hypoplasia
lungs don’t develop fully
-oligohydramnios - uterus squeeze fetus
TE fistula
most common - blind pouch
bloated belly - trachea connect to esophagus
blind pouch - can cause oligohydramnios during pregnancy
respiratory epithelium midline cyst in mediastinum or hilar location
bronchogenic congenital foregut cyst
squamous mucosa midline cyst
esophageal congenital foregut cyst
intestinal mucosa midline cyst
enteric congenital foregut cyst
congenital cystic adenomatoid malformation
hamartoma lesion with abnormal bronchiolar tissue
adenomatoid - confined to bronchioles
resp difficulty or recurring infection
type I - large good prognosis
type II - smaller , bad, other congen anomalies
bronchopulmonary sequestrations
area of lung not connected to airways
blood supply - systemic arteries
extralobar bronchopulmonary sequestrations
no connection to pulmonary circulation or bronchiole tree
intralobar bronchopulmonary sequestrations
acquired - recurrent infection
-scarring of bronchi - stenotic
true nuchal cord
neck wrapped with umbilical cord
-see compression strangulation marks
hyaline membrane disease
neonatal respiratory distress syndrome
deficient surfactant - immature lungs
need to stress baby - more surfactant
- stess = delivery
- also - high insulin inhibits secretion
glandular
20 weeks
saccular
30 weeks
- not good air exchange
- no surfactant
alveolar
term
-but at birth, lung still not mature
measure of surfactant
L/S ration > 2 mature
<1 immature
gold standard
foam stability index
shake to see suds
mechanism of hyaline membrane disease
no surfactant > atelectasis > hypoxemia > acidosis > endo and epi damage > plasma leak > fibrin and necrotic cells deposited = hyaline
occurs after birth**
preterm baby, mom DM, C section, low APGAR, become cyanotic, rales, reticulonodular ground glass
respiratory distress syndrome
-O2 therapy needed
RDS clinical
artifical surfactant
steroids
O2 therapy - risks of retinopathy and bronchopulmonary dysplasia
bronchopulmonary dysplasia
criteria - 28 days O2 therapy and 36 weeks post menstrual age
alveolar hypoplasia and thick walls
high O2 - decreases lung maturity
arrest at SACCULAR stage
mucoviscidosis
cystic fibrosis
disorder of epithelial transport
mutation in CFTR genes
Dx of cystic fibrosis
history in sibling
positive newborn screening result
and
- increased sweat chloride two or more occasions**
- two CFTR mutations
- abnormal epithelial nasal ion transport
delta508
mutations in CF
Tx of CF
pancreatic insufficiency vit deficiency pulmonary disease antibiotics hypertonic saline high dose ibuprofen
heart/lung transplant
-cor pulmonale
antibiotics in CF
cover pseudomonas aeruginosa
ALTE
apparent life threatening event
infants who have one are increased risk of future resp failure
