Session 13,14 - Respiratory I + II Flashcards
1
Q
Three routes into the lung
A
Aerogenous
Hematogenous
Direct extension
2
Q
What tends to enter the lung aerogenously?
A
Infectious pathogens + Toxins
3
Q
What tends to affect the lungs through a hematogenous mechanism?
A
Speticemia
Bacteremia
Parasites
Neoplasia
4
Q
What is involved in the direct extension mechanism of lung routes?
A
Bites
Penatrating wounds
Migrating FB’s
Neoplasia
5
Q
Where do particles larger then 2 um tend to get stuck?
A
Nasal Turbinates + Tracheal/Bronchial bifurcations
6
Q
What are the methods of clearance in the upper respiratory tract (URT)?
A
Destruction + Neutralization + Removal
7
Q
What are the four ways the lungs can remove things from the airway?
A
Sneezing + Coughing + Phagocytosis + Mucociliary transport
8
Q
Where is the mucociliary transport present in the airways?
A
Bronchi to Pharynx
9
Q
What are the layers of the mucous within the URT?
A
Gel + Sol
10
Q
What cells produce the mucous in the URT?
A
Goblet + Serous + Submucosal
11
Q
What are the cell-associated defenses within the nose, trachea, and bronchi (aka URT)?
A
AB’s + Lysozymes + Mucus
12
Q
What are the cell-associated defenses within the bronchioles?
A
Clara cells + Antioxidants + Lysozymes + Antibodies
13
Q
What is a special structure that is present in the bronchial bifurcations?
A
APC’s
14
Q
Where do the APC’s take the inhaled particles they come across at the bronchial bifurcations?
A
BALT
15
Q
What is BALT?
A
Bronchial associated lymphoid tissue
16
Q
What are clara cells?
A
Non-ciliated cells present only in the bronchioles
17
Q
What are the functions of the clara cells?
A
Cytokine inhibitor
Produce antibacterial + Antioxidant molecules
Surfactant production
Secretion of mixed function oxidase-containing granules
18
Q
What can be a problem associated with clara cells?
A
Create toxic metabolites that can damage the bronchiolar epithelium and therefore create an environment for a secondary infection
19
Q
What are three bovine viruses that allow for viral-bacterial synergism?
A
BHV-1 + PI-3 + BRSV
20
Q
What is a common canine virus that allows for viral-bacterial synergism?
A
Canine distemper virus
21
Q
What are two feline viruses that allow for viral bacterial synergism?
A
Feline herpesvirus + Feline calicivirus
22
Q
What are two gases that tend to causes damage to the respiratory defenses?
A
Ammonia + Hydrogen sulfide
23
Q
What are some sequela that occur when regional structures allow chronic rhinitis and sinusitis to spread to other areas?
A
Septal deviation
Osteomyelitis
Meningitis
Otitis media/interna
24
Q
What is does catarrhal describe?
A
Exduate that forms on surfaces
Will be irregular and tan
Viscous + Necrotic material that is often mucopurulent
25
What are two common nasal parasites?
Oestrus ovis
| Cuterebra spp.
26
What animal does Oestrus ovis tend to infect?
Sheep
27
How do Oestrus ovis tend to develop?
In the nostrils then maggots will migrate into the sinuses
28
What pathology is seen with a Oestrus Ovis infection?
Mucopurulent rhinitis + Sinusitis
29
What animals does Cuterebra spp. tend to infect?
Rabbits + Rodents + Cats
30
What Equine Influenza type is most severe?
Type A
31
What are common symptoms seen with Equine Influenza Type A?
Nasal discharge + Fever + Conjunctivitis
32
What happens with serious infections caused by Equine Influnenza Type A?
Pneumonia
| Bronchointerstitial penumonia
33
What does Pneumonia caused by equine influenza type A suggest?
The horse is immunocompromised
34
What are the two equine herpes viruses that cause viral rhinopneumonitis?
1 + 4
35
What is seen in fowls with EHV-1,4 infections?
Mild respiratory disease
36
What are severe pathologies that can occur with EHV-1,4 infections?
Myeloencephalopathy
| Mare abortions
37
Where can the herpes virus remain latent in the body?
Trigeminal ganglia
38
What is strangles caused by?
Streptococcus equi ssp. equi
39
What age is strangles most commonly seen?
Young horses
40
What lymph nodes are affected in strangles?
Mandibular + Retropharyngeal
41
What symptoms are seen with strangles?
Suppurative rhinitis, nasal discharge
Lymphadenitis
Cough
Conjunctivitis
42
What happens when there is hematogenous spread of strangles?
Bastard strangles - goes to other organs
43
What are common sequela seen with strangles?
Bronchopneumonia
Nerve compression
Purpura hemorrhagica
Guttural pouch empyema
44
What two nerves can be affected by strangles?
Recurrent laryngeal + Sympathetic nerve
45
What is the effects of the compressed sympathetic nerve in strangles?
Facial paralysis + Horner's
46
What is the triad in horner's?
Miosis + Partial ptosis + Loss of hemifacial sweating
47
What causes purapura hemorrhagica?
Step. Equi Ag/Ab complexes form in small vessels of the skin and mucosa
48
What can Bovine herpesvirus 1 (BoHV-1) cause?
Infectious bovine rhinotracheitis
49
What are the pathogens that can cause porcine atrophic rhinitis?
Bordetella bronchoseptica
Pasteurella multocida
Haemophilus parasuis
Porcine cytomegalovirus
50
What causes porcine atropic rhinitis?
increased osteoclastic activity and osteopenia due to the pathogen present leading to the loss of nasal conchae
51
What causes bovine necrotic laryngitis?
Fusobacterium necrophorum
52
What are the possible outcomes of bovine necrotic laryngitis?
Endotoxemia +/- Bacteremia
Laryngeal Obstruction
Aspiration
53
What causes infectious laryngotracheitis of chickens?
Herpes virus
54
What happens in infectious laryngotracheitis of chickens?
mild laryngitis that can lead to thick diphtheritic membranes and eventually necrotic plugs
55
What symptoms are seen with severe laryngotracheitis?
Dyspnea + Gasping + Coughing
56
Where do cats tend to get nasal polyps?
Nasopharynx + Eustachian tubes
57
Where do horses tend to get nasal polyps?
Ethmoid
58
What are nasal polyps associated with?
Chronic rhinitis + Sinusitis
59
What are nasal polyps composed of?
Inflammatory vascular stroma covered by squamous or pseudostratified epithelium
60
What is the gross presentation of equine ethmoid hematoma?
Non-neoplastic
| Dark red, pedunculated mass
61
How do equine ethmoid hematomas present?
Unilateral nasal bleeding
62
What side is most common to have laryngeal hemiplegia?
Left
63
What structures (nerve, muscle, etc) are involved in laryngeal hemiplegia?
Arytenoid cartilages
Dorsal and Lateral cricoarytenoid muscles
Recurrent laryngeal
64
What dogs are most commonly affected by laryngeal hemiplegia?
Siberian husky
Bouvier des Flandres
Older dogs
65
What is another name for laryngeal hemiplegia in horses?
Roaring
66
What can roaring be a sequela to in horses?
Strangles
67
What causes the roaring in strangles?
Lymph node enlargement compresses the nerve
68
What are the three pathogens that can cause kennel cough?
Bordetella bronchoseptica
Canine Adenovirus 2
Canina Parainfluenza 2
69
What is seen with kennel cough?
```
Mucopurulent rhinitis
Conjuncitivits
Tonsillitis
traacheobronchitis
Cough, dry hacking
```
70
What is the medical terminology for kennel cough?
Canine infectious tracheobronchitis
71
What are the factors that make up brachycephalic airway disease?
Long soft palate
Small nares
Evereted laryngeal saccules
+/- narrow/collapsing trachea
72
What are the sequela to brachycephalic airway disease?
Exercise intolerance
Cyanosis
Collapse
73
What are the two pathogens most commonly the cause of equine guttural pouch disease?
Aspergillus fumigatus
| Streptococcus sp.
74
What is happening in equine guttural pouch disease?
Infection of large diverticula on ventral portion of eustachian tube of horses
75
What are the cellular defenses in the alveoli?
Alveolar/Intravascular macrophages
Opsonizing antibodies
Surfactant
Antioxidants
76
What is a specialized cell type in the alveoli besides the macrophages?
Type 2 pneumocytes
77
What do the type 2 pneumocytes do?
Produce surfactant
78
How are pulmonary macrophages specialized?
Can withstand the aerobic environment of the lungs
79
What part of the immune system do the pulmonary macrophages belong to?
Innate
80
What do the pulmonary macrophages do?
Phagocytose particles and remove them via mucocilary transport
81
What are the bacterium that are most commonly resistant to the pulmonary macrophages?
Mycobacterium tuberculosis
Listeria monocytogenes
Brucella abortus
Salmonella (some)
82
Where are the intravascular macrophages? What do they do?
Reside in pulmonary capillaries
| Remove circulating pathogens
83
What is the most vulnerable part of the lung?
Alveoli
84
Why are the alveoli the most vulnerable part of the respiratory system?
Poor clearance
Long, skinny particles can pass through barriers
Large amount of vascularity
85
Why is there poor clearance in the alveoli?
No cilia or mucous producing cells
86
What does atelectasis mean?
Deflation of alveoli leading to partial or complete lung collapse of the lung
87
What is occurring with emphysema?
Hyperinflation of alveoli, leading to septal rupture and fusion of air spaces
88
What do you see in a radiograph that could suggest a bronchial pattern?
Doughnuts and railroad tracts
| Small vessel walls remain sharp and distinct
89
What gross changes would you see with a bronchial disease pattern?
Thick, white, firm airway walls
90
What can cause a bronchial disease pattern?
Chronic bronchitis
Feline asthma
Eosinophilic pulmonary infiltrates
Parasitic infestations
91
Where are changes seen with chronic bronchial inflammation and damage?
```
Bronchial gland
Goblet cell
Smooth muscle
Fibrosis
Squamous cells
Bronchiectasis
Bronchiolitis obliterans
```
92
What happens with hypertrophy and metaplasia of the bronchial glands and goblet cells?
Excess mucous production
93
What happens with smooth muscle changes seen with chronic inflammation of the bronchials?
Firm, non-compliant airways
94
What are ciliated cells replaced with during chronic inflammation of the bronchials?
Squamous cells
95
What is bronchiectasis?
Permanent loss of mural integrity
| Leads to dilation and dysfunction of the bronchi
96
What is bronchiolitis obliterans?
Fibrotic response to bronchiolar wall damage
| Leads to occlusion of the airway lumen
97
What disease fall under equine RAO?
Heaves
COPD
Emphysema
Chronic small airway disease
98
What are the clinical signs of RAO?
Recurrent respiratory distress
Chronic cough
Exercise intolerance
99
What is the pathologic mechanism behind RAO?
Some disease process leads to a hyper-reactive airway
Cytokine production
Leukocyte-induced bronchiolar damage
Chronic alterations of lower airway
100
What does the inflammatory infiltrates of RAO tend to be composed of?
Lymphocytes
Plasma cells
Eosinophils
Neutrophils
101
What are the clinical signs of feline allergic bronchitis?
Bronchoconstriction
Cough
Dyspnea
102
What is the pathologic mechanism for feline allergic bronchitis?
Inhaled allergen leads to Type 1 hypersensitivity
Peribronchial inflammation w/ strong eosinophilic presence
Chronic alterations of the airway structure
103
What would an alveolar pattern look like radiographically?
Dense white appearance
| Silhouetting with adjacent soft tissues = air bronchogram
104
What are the four gross changes that would cause a radiographic changes?
Bronchopneumonia
Atelectasis
Edema
Hemorrhage
105
What does bronchopneumonia look like grossly?
Meaty to firm
Red to tan tissue
Exudate: Suppurative
106
What does atelectasis look like grossly?
Fim and meaty
Red
NO INFLAMMATORY EXUDATE
107
What does Edema look like grossly?
Firm
Color variable
Exudate: Frothy fluid
108
What disease processes can lead to a radiographic alveolar pattern?
Bronchopneumonia
Pulmonary edema
Hemorrhage
Lobar collapse
109
What is bronchopneumonia?
Inflammation of the Bronchi + Bronchioles + Alveoli
110
What is the most common distribution of bronchopneumonia?
Crainoventral
111
What are the reasons for a cranioventral distribution of bronchopneumonia?
Gravity
Vascular
Short, abrupt branching of airways
112
What are the two types of interstitial patterns?
Unstructured + Structured
113
What is seen radiographically in regards to an interstitial pattern?
Diffuse opacities that obscure structures
| Small vessel walls are indistinct
114
What gross changes are seen with a structured interstitial pattern?
Obvious masses of varying appearances
115
What gross changes are seen with an unstructured interstitial pattern?
Lungs fail to collapse
| Feel air-filled but firm
116
What can be possible causes for a structured interstitial pattern?
Pulmonary masses due to neoplasia or granulomas
117
What can be possible causes for an unstructured interstitial pattern?
Fibrosis
Interstitial pneumonia
Pulmonary lymphoma
Early or resolving edema
118
What are the common bacteria in bovine that can cause embolic pneumonia?
Arcanobacterium pyogenes
Fusobacterium necrophorum
Erysipelothrix rhusiopathiae
119
What are the common bacteria in swine that can cause embolic pneumonia?
Fusobacterium necrophorum
Erysipelothrix rhusiopathiae
Streptococcus suis Type II
120
What are the common bacteria in poultry that can cause an embolic pneumonia?
Erysipelothrix rhusiopathiae
121
What are the common bacteria in canines that can cause an embolic pneumonia?
Staphylococcus aureus
| Erysipelothrix rhusiopathiae
122
What are the common bacteria in equine that can cause an embolic pneumonia?
Streptococcus equi
123
What causes lipid pneumonia in cats?
Lipids from surfactant and degenerate cells accumulate in alveolar macrophages
124
What does lipid pneumonia look like grossly?
Multifocal, white nodules
125
What is the histologic appearance of lipid pneumonia?
Vacuolated macrophages with variable degrees of mononuclear inflammation and fibrosis
126
What can the histologic appearance of lipid pneumonia be confused with?
Heart failure cells
127
What do heart failure cells look like histologically?
Hemosiderin pigment is present from the break down of red blood cells
128
What is the structural description of aspiration pneumonia?
Bronchopneumonia
129
What portion of the lung tends to be most affected with aspiration pneumonia?
Right cranial lobe
130
What can follow aspiration pneumonia?
Septic shock + ARDS
131
What occurs with ARDs?
Diffuse alveolar damage + Pulmonary hypertension + Aggregation of Neutrophils in capillaries
132
What is a sign that a cow has died of metastatic pneumonia?
Sudden death
| Acute, bright red hemorrhage from nose
133
What is the path of a venal caval thrombosis?
```
Hepatic abscess ruptures into either hepatic veins or into vena cava directly
Pulmonary artery
Secondary abcess in lung parenchyma
Necrosis of vascular walls
Ruptures --> Intra pulmonary hemorrhage
```
