Respiratory System Flashcards
What structures are in the 1. Upper 2. Middle 3. Lower respiratory tract?
- Nasopharynx, oropharynx, larynx, paranasal sinuses
- Trachea
- Left and right primary bronchi, bronchioles, alveoli
What type of epithelium is in the
- Upper resp tract
- Middle resp tract
- Lower resp tract
- Pleura
- Nose and paranasal sinuses are resp epithelium, pharynx and larynx are squamous epithelium
- Resp epithelium
- Everything resp epithelium except alveoli (pneumocytes)
- Mesothelium
Respiratory epithelium
Cubodial epithelium wiht 4 cell types (ciliated cells, mucus producing cells, neuroendocrine cells, reserve/progenitor cells)
Has a protective role - removes particles and bacteria
Under stress, progenitor cells can proliferate and undergo metaplasia into squamous epithelium
2 types of pneumocytes
Type I: air exchange cells
Type II: surfactant producing cells (keeps alveoli open)
Upper respiratory tract infections
“Common cold”
Caused by viruses (rhinoviruses, influenza, parainfluenza)
Self-limited and do not need antibiotics
Characterized by acute inflammation of nose, paranasal sinuses, larynx, pharynx
Occasionally extends to lungs (viral pneumonia) and can extend to middle ear in children to get otitis media
Middle respiratory tract infections and 3 infections in children
Infection of larynx, trachea, and (mainstem bronchi)
Results from extension of URTI and may be associated with pneumonia
3 examples in children:
1. croup (laryngitis) - inflammation of larynx causing stridor and barking cough (parainfluenza virus)
2. Acute epiglottitis
3. Viral tracheobronchitis
Lower tract infections (pneumonia)
causes, 2 patterns
Mostly bacterial, but can be viruses and fungi
- Alveolar (bacterial, focal or diffuse, neutrophils and exudate in alveoli)
- Interstitial (viral or mycoplasma pneumoniae, diffuse and bilateral, alveolar septal thickening with macrophages and lymphocytes)
Dyspnea, tachypnea and hemoptysis defintions
D: shortness of breath
T: rapid breathing
H: bloody cough
4 complications of pneumonia
- Scar tissue
- Pus in pleural space
- Large collection of neutrophils with destruction of tissue
- Chronic changes in lung parenchyma
Intrinsic/Non-atopic vs Extrinsic/Atopic asthma stimuli
I: heat/cold, exercise, chemical irritants, psychological stress, infection
E: exposure to allergens
Histamine causes 2 things in asthma
Contraction of smooth muscles
Mucus production
4 histological changes due to asthma
- Mucus in lumen
- Inflammation and basement membrane thickening
- Enlarged mucus glands
- Smooth muscle hyperplasia
2 main entities of COPD
Chronic bronchitis
Emphysema
Chronic bronchitis
Excessive production of bronchial mucus causing productive cough
Must be at least 3 months over 2 years
Over time, permanent dilation of bronchi from persistent inflammation = bronchiectasis
Mucus material stagnates and cannot be cleared by coughing = recurrent pneumonias
Blue bloater (scarring of lungs causes right sided heart failure)
Emphysema
Enlargement of air spaces distal to the terminal bronchioles with destruction of alveolar walls
Exact mechanism of smoking induced alveolar injury is unknown
Pink puffer
No productive cough, tachypnea, SOB, barrel chest
Pneumoconioses
Lung diseases caused by inhalation of dust, fumes, and inorganic/organic matter
3 things lung injury from occupational exposure depends on
- size/qualities of particle
- concentration of particles
- duration of exposure
4 main lung lesions associated with asbestos
- Pulmonary fibrosis - SOB
- Pleural fibrosis, pleural plaques - asymptomatic
- Lung cancer
- Mesothelioma (cancer of the pleura)
Carcinoma of the Larynx (4 risk factors, sites, tumor type)
RF: older age, male, smoking, alcohol
S: vocal chords
TT: squamous cell carcinoma
Lung carcinoma (risk factor, tumor types, prognosis)
RF: smoking
TT: small cell carcinoma, non-small cell carcinoma, all cell types
P: poor
How does smoking cause lung cancer?
Tobacco smoke has polycyclic hydrocarbons
These are carcinogenic and act as irritants
Metastatic cancer TO lungs
Even more common than primary lung cancer
May present as solitary lesion, multiple lesions, diffuse involvement of the lungs
Can come from colorectal, kidney melanoma, or breast
4 pleural diseases
Pneumothorax (spontaneous or not)
Pleural effusion
Empyema
Mesothelioma
Mesothelioma
Rare tumor arising from pleural cells (either layer)
Linked to asbestos exposure, but many are sporadic
Poor prognosis
Ghon’s complex
Localized lung lesion from primary infection of M. tuberculosis
Granulomas and enlarged lymph nodes
Clinical features of lung cancer (4)
Bronchial irritation = cough (+/- bloody)
Local extension into pleural cavity = pleural effusion = shortness of breath
Distant metastases = presentation depends on site of involvement
Systemic effects of cancer = weight loss, malaise
