Obstructive and Restrictive Pulm Disease Flashcards
What is emphysema
A lung disease where the lungs increase in size beyond normal.
What is this increase in airway size caused from basically
Either destrucition of alveolar walls or dilation of alveoli
What pattern of emphysema is most characteristic of smoking
Centrilobular pattern
Panlobular pattern of emphysema development is characteristic of
alpha-1-antitrypsin deficiency
Whats an Acinus
All the alveoli served by one terminal bronchiole. The functional unit of the lung
Centriacinar emphysema
Initially affects the respiratory bronchioles
Panacinar emphysema
Initially affects the peripheral structures (the alveolus and alveolar duct) then moves to the resp bronchiloes
The other type of emphysema you may need to know
Bullous…Damaged alveoli that form huge airspaces especially in the UPPERMOST portions of the lungs. Can happen in healthy young adults. Airspace may rupture and leak into pleural space causing the lung to collapse.
Clinical definition of chronic bronchitis
Persistant productive cough for at least 3 months over 2 consecutive years.
Buckets of mucous, usually smoking associated
Bronchiectasis
Permanant abnormal dilation of airways
Bronchial asthma definition
Chronic INFLAMMATORY disorder caused by bronchospasm/constriction due to hyperactive airways.
Gross pathology
Pulmonary hyperexpansion and bronchial mucus plugs
Microscopic pathology
Bronchial mucus, eosinophils, neutrophils
Creola bodies, Cruschman spirals, Charcot Leyden Crystals, Airway remodelling includes smooth muscle hyperplasia, hypertrophy, submucosal gland expansion, Thick BM, fibrosis
Pneumoconioses
Non-neoplastic lung reaction to inhalation of mineral dusts, organic and inorganic particulates, chem fumes and vapors
Common types of pneumoconioses
coal miner’s lung, asbestos, silicosis
Most common chronic occupational disease is silicoses
true
Inhaled asbestos particles usually ingested by…
macrophages…become encrusted with iron salts and form ferruginous bodies which show up in sputum.
Sarcoidosis characterized by what>
Noncaseating granulomas in many tissues and organs.
Sarcoid girl looks like
Young- middle age black female
Can affect any organ, but in 90%, sarcoidosis effects
intrathoracic lymph nodes, pulm involvement, skin or ocular signs or symptoms, or some combo….so lymph, lungs, skin or eyes. This distribution suggests that something in the environment causes it
What macrophage alleles contribute to sarcoid susceptibility
HLA and BTNL2…these are involved in antigen presentation, processing, and cytokine realease…three processes believed to be at the core of sarcoidosis
What other type of immune cell is important in sarcoidosis
CD4 T cells….interact with antigen presenters to initiate the formation and maintenance of granulomas
SARCOIDOSIS = NONCASEATING GRANULOMAS
.
What is one big difference between emphysema and bronchitis
minimal sputum in emphysema.
other differences: very thin, not cyanotic because they can exhale with pursed lips to retain oxygenation and exhale completely. This leads to the wt. loss b/c they are basically exercising.
