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shmvii
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hypoplasia
under-development of lungs (one or both) due to impeded dev of thoracic cavity
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diaphragmal hernia
partial or total absence of diaphragm---> herniation of abdominal contents into thoracic cavity
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bronchogenic cysts
- peribronchial cysts, lined by bronchial epithelium
- may contain air or snot
- may ---> abscess formation or rupture into bronchi or pleural cavity
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bronchopulmonary sequestration
presence of lung tissue that's not connected to the bronchial system
can be extralobar or intralobar (outside or within visceral pleura)
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what do hypoplasia, diaphragmal hernia, brochogenic cysts, and brochopulmonary sequestration have in common?
they're all congenital abnormalilites
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atelectasis refers to...
incomplete expansion of alveoli
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primary atelectasis
- results from lungs failing to ventilate at time of birth
- due to birth trauma, bronchial obstruction, immaturity
dead baby who never breathed won't float
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secondary atelectasis may be due to...?
- deficiency of surfactant
- loss of neg intrapleural pressure
- obstruction of airways
- direct pressure on lungs w focal, segmental, or massive distribution
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bronchiectasis
def
due to
symptoms
- permanent dilation of bronchi and bronchioles
- due to destruction of muscle and elastic supporting tissues, often resulting from chronic necrotizing infections or mechanical obstruction of bronchi
- symptoms: cough and spitting
- an OLD
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pulmonary infections in the form of pneumonia are responsible for __ deaths in the US
1/6 of all deaths
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pneumonia broad def
the specifics depend on..?
- any infection in the lung
- details of the pathological changes depend on the agent and the host's response
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viral pneumonia
where are the lesions?
peribronchiolar and within the alveolar walls, which are widened by edema
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viral pneumonia -- where don't you see much exudate?
alveolar spaces are generally free of sgnificant cellular exudate
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viral pneumonia - hallmark symptom?
a persistant nonproductive cough,
also seen: rare chest pain and dyspnea
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bacterial pneumonia refers to..?
inflammation and solidification of pulmonary parenchyma
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2 classes of bacterial pneumonias
- 1 - bronchopneumonia = patchy inflammatory consolidation
- 2 = lobar pneumonia - extensive inflam consol in a lobe, usually due to strept pneumonia
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pneumococcal pneumonia 4 stages of dev
- 1 - congestion - bacterial proliferation and inflam response and serous exudation into alveolar space
- 2 - red hepatization - outpouring of neutrophils and precipitated fibrin into alveolar space ---> look and feel of the liver
- 3 - grey hepatization - disintigration of neutrophis and erythrocytes w accumulation of fibrin
- 4 - resolution - digestion and reabsorption of exudate and restoration of pulm parenchyma to normal
- sooo... 1 - congestion = bacteria and body start to fight
- 2 - red hepatization = neutrophils & fibrin come along and we start looking liver-y
- 3 - gray hepatization = the fighters die, the fibrin stays
- 4 - resolution = eating up the casualties, getting back to normal,
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fungi as antigens
they're weak, so the tissue damage they cause is mostlly due to the hypersensitivity reaction against the fungi proteins
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lung abscess
basic def
more detailed def
usually where
- accumulation of pus in lung tissue
- localized suppuration and liquefaction necrosis of lung parenhcyma due to inhaling shmutz
- right side due to shallow angle of R bronchus
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2 categories of diffuse pulmonary disease (think of Amy Hess)
- 1 - obstructive - increased resistance to airflow due to obstruction
- 2 - restrictive - reduced expansion of lung parenchyma and decreased total lung capacity
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4 major OLDs
- asthma
- emphysema
- chronic bronchitis
- bronchiectasis
(and there's also tumors and inhaling shit)
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when does a pulm pt have normal lung capacity but decreased expiratory flow rate?
OLD
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asthma is what type of hypersensitivity reaction
I (extrinsic
there's also intrinsic, and he writes "nonimune: viurs infections, cold, stress..."
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asthma is characterized by...?
results from ...?
- episodic reversible bronchoconstriction
- increased responsiveness (inflammation) of trachobronchial tree to various stimuli
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in OLD which part of breathing is more affected
exp is more affected than insp
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centrilobar emphysema
changes to bronchioles of upper lobe due to neutrophil elastases -- seen in smokers
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panacinar emphysema
- lower lobe
- in smokers w alfa-1-antitrypsin deficiency
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what's going on w alveoli in emphysema
alveoli break and what's left merges, so now you have a few big alveoli instead of many small one ---> decreased surface area and gas exchange
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what do you have if there's reduced compliance, reduced capacity, normal flow rates?
RLD!
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the extrapulmonary disorder flavor of RLD
affects the abiliity of chest wall to act as bellows (kypho-skoliosis, neuromuscular disorders)
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RLD -- an acute syndrom and 2 chronic
- acute - adult respiratory distress syndrome
- chronic - pheumoconiosis, sarcoidosis,
there's also intersitial lung diseases, but he gives no ex.
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sleep apnea is due to...?
- inspiratory obstruction by walls of pharynx (chest moves, but no airflow)
- when inspiratory efforts succeed finally, you'll get a loud snore
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hypothesis on cause of sudden infant death syndrome
(happens in US in 2/1000 babies)
prolonged apnea, followed by cardiac arrhythmia, and the kid's too small and weak to wake himself
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adult respiratory distress syndrome is a life-threatening disorder char by:
acute onset of dyspnea, hypoxemia, cyanosis
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etiology of ARDS
- factors that produce diffuse alveolar damage (DAD)
- injury of alveolar capillary endothelium
- this triggers inflam response and alveolar accumulation of fibrinous exudate & dyspnea
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bronchogenic carcinoma
fun facts
etiology
begins where
- 90% of primary malignant lung tumors
- leading cause of cancer deaths in US
- smoking, occupation (exposure to bad stuff)
- begins in hilar regions and then metastesizes
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4 classes of bronchogenic carcinomas
- a - squamous cell carcinoma
- b - adenocarcinoma
- c - bronchoalveolar
- d - small cell carcinoma
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three flavors of emphysema
- centrilobular - in upper lobes due to neutrophil elastases
- panacinar - in lower lobes
- localized
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