Lung pathology Flashcards
What makes up the upper respiratory tract? anatomy (3)
Nose, nasopharynx, larynx
What makes up the lower respiratory tract? (anatomy) (4)
Trachea, bronchi, bronchioles and lungs
What is the carina?
Where the trachea bifurcates into the right and left bronchus.
The right bronchus has more vertical orientation, so if foreign body inhaled, likely to end up in right bronchus.
What epithelial lines the nasopharynx to the bronchioles?
psuedostratified, columnar ciliated epithelium.
How many lobes does each lung have?
what feature does left lung have?
What are the lungs surrounded by and what is the space between lung and X called?
Left = 2 lobes - cardiac notch
Right = 3 lobes
Lungs surrounded by pleura. Space = pleural cavity.
top of lung = apex, bottom = base
What are the 2 major groups of lung pathology?
Non neoplastic
Neoplastic (tumour - benign or malignant)
> primary (developed in tissue)
> secondary (started elsewhere and metastasised to respiratory tract)
Name some non-neoplastic diseases. (9)
> infections > pulmonary embolus > pulmonary vascular disease > pulmonary oedema > COAD > Bronchiectasis > Interstitial lung disease > Others e.g. Wegner's
Are lungs good at responding to insult?
Are lungs normally sterile?
Lungs have a limited ability to respond to insult
FIBROSIS IS DOMINANT
Yes, lungs are normally sterile.
> Continuous escalator of mucocilary clearance.
What is acute bronchitis caused by?
What are common viruses?
What does acute bronchitis cause?
Most caused by virus and may be associated with laryngitis (especially children).
Common - respiratory syncytial virus (RSV) and Haemophilius Influenzae, Streptococcus pneumoniae
Inflammation with retention of secondary secretions
> predispose to secondary infection
What is pneumonia?
inflammation of the lungs
What are the 3 ways you can classify pneumonia? (3)
anatomically
aspiration
causative organism
How can you classify pneumonia anatomically?
> Lobar (limited to lobe) - strep pneumoniae, Klebsiella
> Bronchopneumonia (originates in bronchioles, spreads radially) - elderly with compromised function.
What is pneumonia caused by aspiration?
material from stomach or mouth entering lungs
list 5 acute and 5 opportunistic causative organisms of pneumonia
Acute organisms \: strep pneumonia \: klebsiella pneumonia \: haemophilus influenze \: mycoplasma pneumonia \: legionella pneumophila \: S. Aureus
Opportunistic \: gram neg bacilli (e. coli) \: aspergillus \: cryptococcus \: CMV \: pneumocytis
What bacteria can cause chronic pneumonia?
mycobacterium tuberculosis
TB
A 60 year old non-smoker presents with new cough, thick green sputum, fever, and pleuritic chest pain. What is it?
Pneumonia
- new cough
- thick green sputum
- fever
- pleuritic chest pain.
- chest x-ray. lung is white out. - lung is filled with fluid, pus, is hard to ventilate)
> need antibiotics. normally older immunocompromised pt)
(not
- bronchitis
- lung cancer (less likely to present this acutely, non-smoker, so less likely to get lung cancer. would be a chronic cough that changes, less likely to be fever.)
- pulmonary embolism (not thick green sputum. more likely to cough up blood. but would have pleuritic chest pain)
- tuberculosis
What causes a pulmonary embolus?
Mostly thrombotic origin (leg and pelvic veins)
DVT secondary to immobilisation
Travels with IVC to right heart to pulmonary vein and lodges in pulmonary arterial branch
What are the signs and symptoms of pulmonary embollus?
- small - maybe no symptoms
- large - death
: complete occlusion of circulation
: cardiac arrhythmia - pulmonary infarct (lung congestion + oedema)
What is pulmonary vascular disease?
Any condition that affects the blood vessels within the lungs.
Most common - pulmonary hypertension = high BP in pulmonary arteries/veins
What are primary causes of pulmonary hypertension?
right sided heart failure and pleural effusion
What are secondary causes of pulmonary vascular disease?
COAD
high altitude
congenital heart disease
What is pulmonary oedema?
excess fluid in the lungs
What are causes of pulmonary oedema?
HAEMODYNAMIC:
(e. g. mitral stenosis - left sided heart failure, neuphrotic syndrome)
- no lung abnormality
- imbalance btw forces pushing fluid into alveolar space + forces pulling back into circulation.
MICROVASCULAR:
‘shock lung’ or adult respiratory distress syndrome
septic shock, trauma, burns. pancreatitis, drugs, radiation
microvascular injury to the lungs
What 2 conditions are involved in COPD/COAD?
- Emphysema
2. Chronic bronchitis
