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Flashcards in Pulmonary conditions - Pathology 1 Deck (69)
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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


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


describe the structure of the trachea

- c shaped cartilage rings
- mucous glands


Describe the structure of the bronchi

- discontinuous cartilage plates
- mucous glands


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


describe the structure of alveolar ducts

- flat epithelium
- no glands or cilia


Describe the structure of the alveolar sacs

- no glands
- no cilia


What is the definition of pulmonary oedema

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


What is the usual cause of pulmonary oedema

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


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


What is diffuse alveolar damage (ARDS; Shock lung)

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


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

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


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


Name two types of pulmonary emboli

- large saddle emboli
- smaller emboli


What are large saddle emboli

- immediately fatal
- lodge at the bifurcation of pulmonary trunk


What are smaller emboli

- these lodge peripherally and result in characteristic wedge shaped infarcts


How do the pulmonary arteries become occluded

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


What can cause pulmonary hypertension

- left heart valvular disease
- recurrent thromboembolism


What can pulmonary hypertension cause to happen to the heart

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


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


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

- there is no decrease in lung capacity
- reduced FEV1


What happens to cause a restrictive lung disease

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


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

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


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


Name examples of COPDs

- chronic bronchitis
- emphysema
- bronchial asthma
- bronchiectasis


what two COPDs are always co existent

- chronic bronchitis and emphysema


What causes chronic bronchitis and emphysema

- almost always entirely due to smoking


what is the Clinical definition of chronic bronchitis

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


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


Describe the characteristics of chronic bronchitis

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