Lung Pathology II Flashcards
atelectasis
collapsed lung
risk for infection
resorption atelectasis
airway obstruction with mediastinal shift toward involved lung
pressure drops distal to obstruction
compression atelectasis
something outside of lung in thoracic cavity
mediastinal shift away from involved lung
contraction atelectasis
secondary to fibrosis of lung or pleura
irreversible
hemodynamic pulmonary edema
left sided heart failure
-increased hydrostatic pressure
basal lower lobes
heart failure cells
brown induration of lung
microvascular pulmonary edema
increased permeability
- due to infection, toxic
- if diffuse - leads to ARDS
brown induration
hemodynamic pulmonary edema
edema of undetermined origin
high altitude
CNS trauma
acute lung injury
non-cardiac pulmonary edema
criteria for acute lung injury
- acute onset of dyspnea
- hypoxemia
- b/l infiltrates
- absence of left side HF
may lead to ARDS
diffuse alveolar damage
adult acute respiratory distress syndrome
pt with severe disease
diffuse damage to alveolar cap walls
> lead to neutrophil migration
secondary loss of surfactant
ex/ formaline
50% of cases of acute RDS
sepsis
diffuse pulmonary infection
gastric aspiration
mechanical trauma
sick patient with rapid onset dyspnea and tachypnea, cyanosis, resp failure, diffuse bilateral infiltrates on xray
acute respiratory distress syndrome
acute interstitial pneumonia
like ARDS but no associated causative disorder
59yo
acute resp failure following illness of < 3 weeks resembling infection
mortality dead within 2 months
aka hamman-rich syndrome
obstructive disease
FEV1/FVC reduced < 0.7
due to resistance increase
emphysema
chronic bronchitis
bronchiectasis
asthma
restrictive disease
limited total lung capacity and residual volume
FEV1/FVC near normal
chest wall disorders obesity ARDS interstitial fibrosis pneumoconioses
chronic bronchoitis
mucus gland hyperplasia and secretion
cough and sputum production
obstructive
emphysema
acinus airway enlargement
tobacco smoke
dyspnea
bronchiolitis
small airway disease - scarring and inflammation
cough dyspnea
centriacinar emphysema
SMOKING
predominantly upper lobes
majority**
affects respiratory bronchioles
panacinar emphysema
alpha1 antitrypsin, smoking
lower lobes, anterior
affect alveolus and alveolar ducts
alpha-1 anti-trypsin
inhibits neutrophil elastase
deficient pt - early emphysema - due to proteolytic digestion of alveolar walls
barrel chest, dyspnea, cough, wheezing, low FEV1, high TLC and RV
emphysema
formation of bullae
pink puffers
forward leaning and pursed lips
emphysema
compensatory hyperinflammation
occurs because of loss of adjacent tissue
obstructive overinflammation
overexpansion of trapped air
object forming one way valve
interstitial emphysema
air in emphysema
increased air in soft tissues
after trauma - rip in lung
chronic bronchitis
3 months of productive cough/year for 2 consecutive years
hypersecretion of mucus
increased reid index
can lead to bronchiolitis obliterans
red index
ratio of submucosal glands
thickness of gland / thickness of wall
> 0.4 - hyperplasia
increased in chronic bronchitis
blue bloaters
chronic bronchitis
- gas exchange impaired
- cyanosis
- hypercapnia
- hypoxemia
co pulmonale
asthma
episodic partially reversible bronchoconstriction
nighttime, early morning
causes - allergens, exercise, cold, etc.
status asthmaticus
acute severe asthma
type I hypersensitivity
IgE Abs to allergens
Th2 resonse with increased IgE and eosinophils
mast cell release histamine
stimulation of vagal - bronchoconstriction PS
RAST testing
for allergens
-high false positives
non-atopic asthma
pulmonary infection and air pollutant
no eosino or IgE
infection lowers threshold for vagal responses
drug induced asthma
aspirin - classic cause
-inhibit COX pathway - favored leukotriene production - favor bronchoconstriction
asthma morphology
epithelial injury fibrosis eosinos hypertrophy/plasia of glands smooth m hypertrophy/plasia increased vascularity
curschmann spiral
strips of dead epithelium
in asthma
-as well as charcot leyden crystals (eosino-rich)
bronchiectasis
permanent dilation of bronchi and bronchioles
secondary to infection
foul smelling sputum
also CF and kartagener
and aspergillosis
