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Flashcards in Pulmonary conditions - Pathology 1 Deck (69)
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1

what is an acinus (terminal respiratory unit)

- this is a functional unit, the part of the respiratory tract distal to terminal bronchioles
- where the gas exchange occurs

2

for normal gas exchange what should only be allowed to be there structurally

- flat epithelial cell that forms the lining of the alveoli sac
- basement membrane of that
- blood

3

describe the structure of the trachea

- c shaped cartilage rings
- mucous glands

4

Describe the structure of the bronchi

- discontinuous cartilage plates
- mucous glands

5

describe the structure of bronchioles

- No cartilage or mucous glands
- terminal bronchioles are less than 2mm in diameter
- respiratory bronchioles is where the gas exchange begins

6

describe the structure of alveolar ducts

- flat epithelium
- no glands or cilia

7

Describe the structure of the alveolar sacs

- no glands
- no cilia

8

What is the definition of pulmonary oedema

- accumulation of fluid in the paraenchyma and interstitial of the lung

9

What is the usual cause of pulmonary oedema

- haemodynamic - usually cardiogenic due to a problem in the heart

10

What does pulmonary oedema look like on autopsy

- heavy wet lungs
- alveolar pink granular fluid in the alveoli - may contain haemosiderin-laden macrophages
- resolution or brown induration if long standing

11

What is diffuse alveolar damage (ARDS; Shock lung)

- oedema caused by injury to alveolar capillary endothelium
- rapidly developing life-threatening respiratory insufficiency

12

What can cause diffuse alveolar damage (ARDS; Shock lung)

- shock
- trauma
- sepsis
- viral infection
- noxious gases
- radiation

13

What does diffuse alveolar damage (ARDS; Shock lung) look like on microscopy

- oedema fluid and fibrinous membranes lining the alveoli
- does not resolve but proceeds to severe scarring and lung parenchyma is often lost

14

Name two types of pulmonary emboli

- large saddle emboli
- smaller emboli

15

What are large saddle emboli

- immediately fatal
- lodge at the bifurcation of pulmonary trunk

16

What are smaller emboli

- these lodge peripherally and result in characteristic wedge shaped infarcts

17

How do the pulmonary arteries become occluded

- pulmonary arteries occlusion by circulating clots usually from the lower limb veins in bed-ridden

18

What can cause pulmonary hypertension

- COPD
- left heart valvular disease
- recurrent thromboembolism

19

What can pulmonary hypertension cause to happen to the heart

- this can cause right ventricular hypertrophy and failure = chronic cor pulmonale

20

describe what happens to the airway in obstructive pulmonary disease

- increased resistance to airflow at any level
- this is due to airway narrowing or loss of recoil

21

Describe what happens to total lung capacity and FEV1 in obstructive airway

- there is no decrease in lung capacity
- reduced FEV1

22

What happens to cause a restrictive lung disease

- reduced expansion of lung parenchyma
- caused by chest wall disorders or interstitial/infiltrative diseases

23

What happens to total lung capacity and FEV1 in restrictive pulmonary diseases

- Decreased total lung capacity
- reduced TLC with proportionate reduction in FEV1

24

define chronic obstructive airway disease

- a group of disease characterised by obstruction to airflow - this obstruction can be intermittent, reversible or irreversible and at any level of the respiratory tract

25

Name examples of COPDs

- chronic bronchitis
- emphysema
- bronchial asthma
- bronchiectasis

26

what two COPDs are always co existent

- chronic bronchitis and emphysema

27

What causes chronic bronchitis and emphysema

- almost always entirely due to smoking

28

what is the Clinical definition of chronic bronchitis

- productive cough for longer than 3 months in 2 consecutive years

29

describe what happens to the structure of the lung in chronic bronchitis

Effects of smoking:
- mucous gland hypertrophy due to smoking
- mucus hyper secretion due to the hypertrophy
- this leads to obstruction of the airway
- this can then become infected which causes more mucus secretion and can become worse
- therefore it is a progressive disease

30

Describe the characteristics of chronic bronchitis

- hypoxia
- hypercapnia (excess carbon dioxide)
- cyanosis prone