Respiratory Pathology - Non-Neoplastic. Flashcards
What does the upper airways consist of?
Nose, accessory air sinuses, nasopharynx, larynx.
What does the lower airways consist of?
Trachea, bronchi, bronchioles, terminal bronchioles, alveoli.
What is the job of the upper airway?
To warm, humidify, and filter air.
What infections can occur in the respiratory tract?
Sinusitis, Flu, Pneumonia, Rhinitis, Laryngitis, Tonsilitis
Define infections of the upper airway
Acute inflammatory process that affects mucous membranes of the respiratory tract.
What are the symptoms of upper airway infections?
Malaise, headache, sore throat, discharge. Commonly viral.
How do these infections occur?
Virus attaches itself firmly to respiratory mucosa, invades the tissue, causing necrosis, inflammation and swelling. Virus spreads along continuous mucosa invading ears, sinuses or bronchi and lungs.
Define pneumonia.
Inflammation of the lung parenchyma.
What are the causes of pneumonia?
Infectious agents, inhalation of chemicals, chest wall trauma.
What are the symptoms of pneumonia?
Fever, rigours, SOB, Pleuritic chest pain, purulent sputum, cough.
What is community acquired pneumonia?
Relatively common, especially in elderly. Caused by strep. pnuemoniae and haemophilus influenzae.
What is hospital acquired pneumonia?
Any pneumonia contracted by patient at least 48-72 hours after admission. Usually bacterial - gram negative bacilli and staph aureus.
What are the symptoms of hospital acquired pneumonia?
fever, increased WCC, cough with purulent sputum, chest x-ray changes.
What is aspiration pneumonia?
Develops after inhalation of foreign material. Common in: Elderly, strokes, dementia and anaesthetic. Caused by oral flora +/- other bacteria.
What are the 3 main obstructive disorders?
COPD - bronchitis/emphysema. Asthma. Bronchiectasis.
Define obstructive disease.
Characterised by partial or complete obstruction at any level from the trachea to respiratory bronchioles.
Define restrictive disease.
Characterised by reduced expansion with decreased total lung capacity.
What is COPD - Emphysema?
Irreversible enlargement of the airspaces distal to the terminal bronchiole - destruction of their walls without obvious fibrosis.
How is emphysema caused?
Mild chronic inflammation throughout the airways. Role of smoking and genetics. Imbalance of oxidants and antioxidants.
What are the symptoms of emphysema?
dyspnoea, cough, wheezing, weight loss, expiratory airflow limitation, congestive heart failure, pneumothorax.
What is COPD - chronic bronchitis?
Persistent cough with sputum production - for at least 3 months in at least 2 consecutive years.
What are the causes of chronic bronchitis?
Long-standing irritation by inhaled substances (smoking, dust from grain, cotton, silica). Hypertrophy of submucosal glands in trachea and bronchi. Mucus hyper secretion and alterations in the small airways - chronic airway obstruction.
How does chronic bronchitis impact the respiratory structures?
Mucous membrane swelling and oedema, excessive mucous excretions, narrowing of the bronchioles.
What are the symptoms of chronic bronchitis?
Persistent cough with sputum, dyspnoea or exertion, hypoxemia, mild cyanosis, cardiac failure.
What is asthma?
Chronic inflammatory disorder of the airways.
What are the symptoms of asthma?
Recurrent episodes of wheezing, breathlessness, chest tightness and cough, particularly at night and/or early in the morning.
What are the 3 stages of asthma production?
- genetic predisposition and exposure to environmental triggers.
- early phase reaction: bronchoconstriction, increased mucus production, vasodilation.
- late phase reaction: inflammation, epithelial damage, more bronchoconstriction.
What is bronchiectasis?
Permanent destruction and dilatation of the airways associated with severe infections or obstructions e.g TB
What are the symptoms of bronchiectasis?
persistent cough, purulent sputum ++, haemoptysis (coughing up blood)
What are restrictive disorders?
inflammation and fibrosis of the pulmonary connective tissue.
What are the symptoms of restrictive lung disease?
Dyspnoea, tachypnoea, eventual cyanosis, secondary pulmonary hypertension, right-sided heart failure
What are the 2 types of vascular disorders?
Pulmonary oedema, pulmonary embolism.
What is a pulmonary embolism?
Blockage of a main or branch pulmonary artery by an embolus. Usual source of emboli are DVT of the legs.
What are the symptoms of a pulmonary embolism?
abrupt onset of pleuritic chest pain, SOB, hypoxia, increased pulmonary vascular resistance.
What is pulmonary oedema?
Accumulation of fluid in the air spaces and parenchyma of the lungs.
How is pulmonary oedema caused?
Increased venous pressure e.g liver failure. Alveolar injury from infections, shock or trauma.
What are the symptoms of pulmonary oedema?
SOB, pink frothy sputum, CXR findings.
What are expansion disorders?
Pneumothorax - air in the pleural cavity.
Atelectasis - incomplete expansion of the lungs.
