Pulmonary Flashcards
What kind of epithelia line the respiratory tract?
nasal cavity and paranasal sinuses = **cuboidal **
pharynx and larynx = **squamous **
trachea and bronchi = cuboidal
What are the main functions of the respiratory system?
primary = respiration
- voice
- immune (MALT & alveolar macrophages)
- metabolic, acid-base balance
Describe the respiratory defense system.
**MALT means mucosa-assoc. lymph tissue. **
- forms tonsils in the nasopharynx and pharynx + lymphoid follicles in bronchi
Alveolar macrophages
- phagocytic cells, can be found in sputum. Pulmonary capillaries mobilize leukocytes quickly to sites of infection.
What are the main respiratory diseases?
- infectious disease
- immune diseases
- environmentally induced
- circulatory disease
- tumors
Compare the infections of the upper respiratory system with those of the so-called middle respiratory system.
**URI: **infection/inflammation of the nose, paranasal sinuses, throat, larynx . . .may spread to the middle ear, and tracheobronchial tree
**MRI: **larynx, trachea, extrapulmonary bronchi.
What could cause a “runny nose”?
Most URIs are viruses. In viral infections, lymphocytes, macrophages, and plasma cells infiltrate and cause congestion and edema.
Severe infections can cause ulceration of the mucosal epithelial lining, which allows entry of bacteria.
What is croup?
An acute life-threatening infection involving the **larynx. **
Inflammation causes swelling and laryngospasm. The vocal cords spasm and cause “barking cough”. Typically caused by _parainfluenza virus. _
Compare epiglotittis and bronchiolitis.
Epiglottitis = **h. influenzae
sudden loss of voice and hoarseness, pain with swallowing. edema and narrowing of the air passage. requires antibiotic therapy.
bronchiolitis = **RSV
wheezing, low-grade fever, SOB. virus invades epithelial cells of the bronchi and bronchioli, causing cell death and desquamation. Edema of airway and dead cells cause obstruction of the bronchi and bronchioli.
Compare alveolar and interstitial pneumonia.
aveolar
- focal or diffuse
- most often caused by bacteria
- * often superimposed on pulmonary edema of CHF*
lobar
- usually diffuse
- often bilateral
- most often caused by viruses
List the common causes of pneumonia and give specific characteristics about each of these forms of lung infection.
- upper respiratory flora
strep pneumo
H. influenzae
staph aureus
- *- enteric saprophytes**
- E. coli
p. aeruginosa*
- extaneous pathogens
legionella
TB
herpesvirus, CMV
Compare lobar pneumonia and bronchopneumonia with interstitial pneumonia.
List 3 complications of bacterial pneumonia.
-
pleuritis
inflammation commonly >> pleural effusion.
pus = pyothorax
fibrous tissue = empyema -
abscess
usually associated with highly virulent bacteria (Staph) -
chronic lung disease
pus causes destruction and bronchial dilation (bronchiectasis).
fibrosis >> honeycomb lungs
Compare community-acquired pneumonia and hospital-acquired pneumonia.
**primary (community-acquired) = **
affects previously healthy people
secondary (or nosocomial) =
affects those with pre-existing illness
What are the clinical signs of pneumonia?
systemic
- fever, chills
local irritation
- coughing, chest pain, expectoration
airway obstruction
- dyspnea, tachypnea
inflammation
- tissue destruction, bleeding
Explain the concept of atypical pneumonia and give specific examples of this clinicopathologic entity.
**atypical** = pneumonias that **do not** present with classical symptoms examples = *viruses, mycoplasma pneumo*
Compare primary and secondary tuberculosis.
Primary. . . occurs in a person not previously exposed.
symtoms = mild & lo fever
Secondary. . . is a reactivation of a dormant primary infection or a reinfection.
symptoms = dry cough, fever, loss of appetite, malaise, night sweats, weight loss
Which fungi cause pneumonia and under what circumstances?
community acquired = histoplasmosis, coccidiodomycosis
hosptial acquired (esp AIDS) = PCP, candida, aspergillus
Which pathogens cause pulmonary abscesses?
most common = s. aureus
less often = klebsiella, pseudomonas
Compare chronic obstructive pulmonary disease caused by chronic bronchitis and COPD caused by emphysema.
Chronic bronchitis = “blue bloaters”
- bouts of coughing, purulent mucus, dyspnea
- pulm. HTN, cor pulmonale
emphysema = “pink puffers”
- no bronchial obstruction, no irritation (therefore no coughing)
- tachypnea
- barrel chest
What is bronchiectasis, and how does it develop?
a permanent dilation of the bronchi
result of persistent inflammation of the airways. Enzymes from bacteria and leukocytes + mechanical pressure + fibrous scars
Compare centrilobular and panacinar emphysema.
- *centrilobular** = widening of the airspae in the center of a lobule and involves predominantly respiratory bronchioles
- most common form of emphysema, smoking*
- *panacinar **= airspaces distal to the terminal bronchioles
- alpha-1AT deficiency*
List the most important immune diseases of the respiratory tract.
- sarcoidosis
- hypersensitivity pneumonitis
- bronchial asthma
- allergic rhinitis