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Year 3 Pathology > Respiratory > Flashcards

Respiratory Flashcards

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1
Q

What are three respiratory tract defence against inhaled particles?

A

Defending against inhaled particles:
Filters particles from inhaled air
Prevents particles contacting and damaging inhaled surfaces
Removal of particles

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2
Q

What are the 6 airway defence mechanisms?

A

Aerodynamic filtration

Mucociliary escalator

Antibacterial agents

IgA

Protective reflexes

Leucocytes

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3
Q

How does the mechanism of aerodynamic filtration work?

A

Coiled turbinates leads to turbulence causing particles above 10um to impact on the airway mucosa (think workshop filters)

Bronchi filter anything over 3um

Particles 1-5um are deposited in the bronchioles and alevoli

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4
Q

Describe the process of the mucociliary escalator

A

Layer of mucous then cilia surrounded by aqeous solution allowing them to beat

Goblet cells produce mucuous

Traps and transports particles from airways to pharynx

Acts as a physical barrier, prevents dehydration, dilutes soluble gases and contains anti-bacterials

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5
Q

What two anti-bacterials does mucus contain?

A

Lysozome- bacteriolytic protein that hydrolyzes peptidoglycan

Lactoferrin- Fe-binding protein synthesised by neutrophils and ep cell, retarding bacterial and fungal growth

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6
Q

What factors affect mucocilliary carpet function?

A

Changes in viscocity of mucous- temperature, dehydration, inflammation

Injury to epithelium- trauma, infections, irritation

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7
Q

What can cause respiratory epithelial metaplasia?

A

Secondary to chronic irritation- bronchitis

Ciliated columnar to stratified squamous

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8
Q

What does IgA do in airways?

A

transports through mucus and precipitates antigens for phagocytosis

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9
Q

What are the protective reflexes?

A

Coughing, sneezing

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10
Q

What are the different alveolar defences?

A

Macrophages- alveolar, intersitial, intravascular

Phagocytose- particles and agents

Recruit neutrophils

Coordinate inflammation

Ascend mucocilary escalator

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11
Q

What agents cause cat flu and what does it cause?

A

Feline herpes virus and feline calicivirus

Causes conjunctivitis, rhinits

Conjuncitivis can lead to pus which is a secondary bacterial product- virus damages epithelial cells (impairs clearence) causing secondary bacterial infection

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12
Q

What are 3 examples of developmental abnormalities of the upper airways and their effects?

A

Cleft palate- failure of two palatine shelves to close, can cause aspiration of the food- aspiration pneumonia

Guttural pouch tympany- nasopharyngeal opening defect- air in guttural pouch leads to dyspnoea and dysphagia (difficulty swallowing) and aspiration pneumonia

Brachiocephalic airway syndrome- combination of anatomical problems- stenotic nares, everted laryngeal saccules, elongated soft palate, causes airway obstruction- cyanosis and syncope (fainting)

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13
Q

What is epistaxis and what are the sources and potential causes?

A

Epistaxis is bleeding from the nose

Sources- upper airways and lower respiratory tract

Causes- inflammation, infection, trauma, neoplasia, clotting defects

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14
Q

What ate the 5 typical signs of inflammation?

A

Redness- vasodilation and congestion/haemorrhage

Swelling- infiltration of cells and fluid

Heat- increased blood supply

Pain- due to compression of tissue sensors

Loss of function- depends on site

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15
Q

What is the difference between actue and chronic inflammation?

A

In both acute and chronic there is the same processes- serous, catarrhal, purulent but in acute there is healing and resolution where is in chronic the insult persists and causes pathological changes

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16
Q

How is inflammation classified?

A

By the type of exudate

Serous- clear watery discharge, mild, increased production from mucoserous glands, hyperaemia and oedema

Catarrhal- viscous mucoid, increased mucoserosal secretions, minor numbers of inflammatory cells

Fibrinous- thick, fibrinous and haemorrhagic- many inflammatory cells and haemorrhagic discharge, increased vascular permeability with or without necrosis

Purulent- thick, white, green, brown- many inflammatory cells, especially neutrophils and cell debris

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17
Q
A
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18
Q

What pathological changes does chronic inflammation cause in the respiratory tract?

A

Causes mucosal hyperplasia- goblet cell hyperplasia, seromucous gland hyperplasia

Epithelial metaplasia

Chronic inflammatory cells- macrophages, lymphocytes

Fibroplasia

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19
Q

What can be found secondary to chronic inflammation in horses and cats?

A

Polyps

Seen in horses and cats

Cat- arise in the auditory tube or tympanic bulla extend into pharnx or along ear canal

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20
Q

What are some common causes of airway inflammation?

A

Pollen

Dust

Fomites

Foreign bodies

Parasites

Infectious agents

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21
Q
A
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22
Q

What viral agents are associated with inflammation of the URT?

A

BEEF FCCC

Bovine herpes virus 1 (IBR)
Equine herpes virus 1/4
Equine influenza virus
Feline herpes virus 1- cat flu

Feline calicivirus- cat flu
Canine distemper virus
Canine adenovirus 2- kennel cough
Canine parainfluenza virus- kennel cough

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23
Q

What is needed for an infectious disease?

Julian’s favourite phrase

A

An infectious disease is an aetiological agent, on a susceptible host, in a favourite environment

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24
Q

What is an example of a viral URT infection- give a brief overview

A

IBR- bovine herpes virus 1

Infection of nasal and conjunctiva epithelial cells leadind to serous or catarrhal exudate

Can spread throughout respiratory tree and damage mucociliary escalator leading to impaired defenses

Secondary bacterial infection can cause influx of neutrophils and putulent discharge- usually resolved

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25
What are two examples of bacterial URT infections?
Streptococcus equi in horses- strangles Pasteurella multocida in pigs- atrophic rhinitis
26
Briefly describe a strangles and atrophic rhinitis infection
Strangles- streptococcus equi colonises nasopharyngeal mucosa, serous to purulent, spreads to lymph nodes, abscesses within parotid lymph node can rupture, can rupture into guttural pouch Atrophic rhinitis- pigs- pasturella multocida, types A and D and calcium imbalende and bad genetics, causes atrophy and distortion of turbinates
27
What type of infection is aspergillus fumifatis? What species does it affect? What can predispose it? What type of inflammation does it cause?
Fungal infection- URT Affects dogs, horses and birds Usually immunosuppressed animals Fibronecrotic/granulomatous inflammation and bone lysis due to cytolytic enzymes- can cause guttural pouch mycosis
28
What are the complications of gutteral pouch mycosis?
Damage to cranial nerves- paralysis of facial muscles, tongue, pharynx, larynx Erosion of blood vessels- internal carotid- could be fatal
29
In what age of dogs is URT neoplasia more common? What kind of tumour is it 80% of the time? What dog breeds have an increased risk?
Most common in middle-aged to elderly animals \>80% malignant Breeds- airdales, bassets, OESD, shetland sheep dog, german short hair pointer
30
What are the different tissues of the URT that can become neoplastic and what is the neoplasia called?
Epithelial tissues- lining- squamous cell carcinoma, glands- adenocarcinoma Mesenchymal- cartilage- chondrosarcoma bone- osteosarcoma connective tissue- fibrosarcoma Lymphoid tissue- lymphoma
31
What are the two developmental abnormalities of the trachea and larynx and briefly describe them?
Hypoplastic trachea- decreased tracheal lumninal diameter- reduced diameter also increases the resistance. This leads to exertional dyspnoea and excercise intolerance Tracheal collapse- dorsoventral flattening of cartilage rings, minature and toy breeds affected- causes dyspnoea depending on severity
32
What degenerative diseases affect the trachea and larynx? How does it affect different species? What can cause the degenerative disease? What is the problem with this disease?
Laryngeal paralysis Horses- unilateral on left side (hemiplegia-roaring), dogs bilateral Can be inherited (huskies and bouviers) or choke chain trauma Laryngeal paralysis leads to atrophy of the cricoarytenoid muscles and therefore failure of the arytenoid cartilages to abduct during inspiration
33
What can cause laryngeal oedema?
Local trauma- intubation Irritant- smoke Acute respiratory infections Laryngeal chrondritis Anaphylaxis/allergic reactions EMERGENCY
34
What do these three photos show?
They all show tracheitis/laryngitis A) mucosal hyperaemia, oedema, ulceration with a serous or catarrhal exudate B) Fibrinous inflammation- severe damage to mucosa and blood vessels C) Necrotic inflammation- extensive necrosis danger or airway obstruction and inhalation of debris
35
What can cause tracheitis and laryngitis?
Infectious agents- IBR, Influenza, Feline and equine herpes, bordatella Trauma Irrirants Foreign bodies Parasites Neoplasia- rare
36
What causes calf diptheria? What can cause the calf to die?
Opportunistic infection of fusobacterium necrophorum seccondary to mucosal dammage Ulcerative necrosis to larynx- death tue to toxaemia and asphyxiation
37
What does this image show?
Oslerus osleri (Filaroides osleri) - dog
38
What different neoplasia could affect the trachea?
Lining epithelium- squamous cell carcinoma Cartilage- chondroma/sarcoma Striated muscle- rhabdomyoma Lymphoid tissue- lymphoma
39
Why are broncioloes vunerable to insult?
Lack supporting cartilage Have very few cilia and mucous- poor mucociliary defenses Has clara cells which produce reactive metabolites Neutrophils and macrophages on escalator from alveoli release radicals which may damage bronchioles
40
What can cause bronchitis/bronchiolitis?
Infectious agents- extension of upper or lower Irritants Allergens Foreign bodies Parasites
41
What is the difference between trachea inflammation and bronchiolitis/bronchitis?
Severe inflammtion can cause bronchiolitis obliterans
42
What is bronchiolitis obliterans and how does it occur?
The formation of a polyp which is then a permanent obstructive lesion in bronchiolar lumen Purulent exudate and inflammation Damage to the epithelium and exudate binds to basement membrane WBCs penetrate and resolve and results in fibroblasts Fibroblats from a polyp which is covered by epithelium
43
What are the effects of bronchitis and bronchiolitis?
Bronchial gland hyperplasia- increased mucus production Epithelial hyperplasia- } Smooth muscle hyperplasia- } thickening of mucosa Inflammatory cells and fibrosis- }
44
What can cause bronchiolitis obliterans?
Chronic or repeated bacterial infections Parasitic disease Allergic disease
45
Why does chronic broncitis or bronchiolitis result in increased mucus secretion?
Bronchial goblet cell hyperplasia Bronchial gland hyperplasia Goblet cell metaplasia in bronchioles Increasing mucus production
46
How can you tell this animal has had chronic bronchiolitis?
Hyperplasia of goblet cells- top arrows Hyperplasia of bronchial gland- bottom arrows
47
How is chronic inflammation of bronchi/bronchioles presented clinically?
Dyspnoea/ Cough Increased respiratory noise Collapse/over inflation of lung Reduced blood oxygenation
48
What is bronchiectesis?
Obstruction of the lumen by exuadate Necrosis of the bronchial wall Can cause permanent dilation of the bronchus
49
What does a successfull infection of cattle lung worm lead to and how?
Larval migration through the alveoli can cause acute pneumonia and blockage of bronchioles with exudate Adult worms in the bronchi cause irritation and mucus production, thickened mucosa and chronic bronchitis Airway obstruction leads to wedges of collapsed lung- cough dyspnoea
50
What is RAO, what is it alternatively referred to as?
Recurrent Airway Obstruction disease AKA Heaves
51
What is ROA and what is most severly affected? What does it cause? What are the clinical signs?
Astma-like condition- type 3 hypersensitivity to inhaled allergens in mould of hay Bronhioles most severly affected Causes- increased mucus, mucosal thickening, peribronchial fibrosis, bronchospasm Clinical signs- cough, mucopurulent exudate, excercise tolerant, forecul expiration, abdominal muscle hypertrophy
52
Which species has poor collateral ventilation?
Cattle Degree varies in species?
53
What seperates lobules in the lungs and how does it vary between species? What is the relevance of this
Lobules are seperated by septa Cattle, pigs and sheep have thick complete septa Horses have incomplete thick septa Cats, dogs, rabbits and rodents have no distinct septa Septa can prevent the spread of disease
54
How common are developmental abnormalities of the lung parenchyma? Name 3 examples?
Generally very rare Congenital melanosis Agenesis of one or more lung lobes Ectopic lung tissue
55
What is atelectasis and what can cause it?
Incomplete distension of the lung Causes- Complete internal obstruction External compression of airway/lung Pneumothorax- partial pressure v elastic recoil Recumbancy in LA -hypostatic atelectasis Defective surfactant production- neonates
56
What is emphysema what causes it?
Emphysema is over inflation of the lungs Causes- Forcer respiratory efforts- pneumonia Obstructive airway disease- partial
57
58
How does partial bronchiole obstruction cause emphysma?
Lobule remains partially expanded therefore on next inspiration the lung will over inflate
59
What is interstitial emphysema?
Trapped air- breaks alveolar wall and enters intersitium and septa
60
What are the consequences of empysema?
Loss of lung elasticity- increased dead space Loss of pulmonary capillaries Fibrosis of remaining alveolar walls- inhibits gas exchange, reduces compliance
61
What circulatory disturbances can occur in the lung parenchyma?
Pulmonary oedema Pulmonary embolism Pulmonary haemorrhage
62
What does pulmonary oedema cause in the animal?
Dyspnoea- tachypnoea Hypoxia- cyanosis if severe Cough- moist
63
Why is it unusual for alveoli to flood and therefore what must occur for pulmonart oedema?
Alveolar is less permeable then capillary Damage must have occured of increased interstitial fluid
64
What can the damage to alveoli that causes oedeama be?
Infectious agents Toxins Irritants
65
What does this of lung show?
Eosinophillic homogenous material diffuselly present throughout the alveoli Oedema
66
Other then damage- what causes pulmonary oedema?
Increased hydrostatic pressure- inflammaiton, passive congestion, circulatory overload (renal failure) Increased capillary permeability- endothelial damage by toxins, shock, inflammation Reduced capillary osmotic pressure- hyperproteinaemia, over transfusion Reduced drainage of interstitial fluid
67
What can be used to treat pulmonary oedema?
Diurretics to treat
68
What can be a pulmonary embolism?
Thromboemboli Tumour cells- metastases Fat Air Good site as fine capillary network and good blood supply Effect depends on nature of embolism
69
What does this image show?
Infarction- usually requires blockage of a mjore vessel
70
Describe this image of lung parenchyma What are common causes of this?
Wedge or cone shaped area of haemoglobin and necrosis due to infarction Common sources- right heart bacterial endocarditis, joint/navel infections, liver abscesses
71
What do different sources of thromboembolism cause?
Sterile- fibrninolytic breakdown, fibrotic scarring Infected thromboemboli- vasculitis, thrombosis, abscess
72
What are the different causes of pulmonary haemorrhage?
Pulmonary thromboembolism Trauma Inflammation Abscesses/tumour (erode vessels)
73
What is EIPH?
Excercise induced pulmonary haemorrhage Occurs in 75% of racehorses
74
What are the 4 classes of pneumonia?
Bronchopneumonia Interstitial pneumonia Embolic pneumonia Granulomatous pneumonia
75
What classifies different pneumonias and why is it useful to know?
Distribution Appearance Texture Improved diagnosis and treatment
76
What are common causes of bronchopneumodia?
Bacteria- mycoplasms Aspiration of food- GI contents Viruses
77
What is the distribution of bronchopneumonia and why?
Cranioventral- key Cranioventral due to greater deposition of particles and organisms, gravitational effects, regional variations in defence mechanisms- efficiency, perfusion, ventilation
78
What is the difference between supprative and fibrinous bronchopneumonia?
Supprative- purulent or mucopurulent exudate confinded to lobules Fibrinous- fibrinous exudate, spreads rapidly between lobules
79
What are some common causes of bronchopneumonia?
Bacteria- pasturalla multocida, bordatella bronchiseptica, truerella pyogenes, streptococcus, trueperella pyogenes, e.coli Inhalation of bland material (milk) Mycoplasmas- bovis, hyponeumoniae, dispae Viruses
80
Describe the pathogenesis of bronchopneumonia?
* Inhaled agent- pathogen- causes injury at bronchiole-alveolar junction * Exudation of fluid and plasma proteins, recruitment of alveolar macrophages and immigration of neutrophils * Filling of alveoli and bronchioles with exudate, cells and debris * Infection and inflammation spreads to adjecent lung then along airways to other lobules and interlobar septae if severe
81
Which of these two pictures is fibrinous and supprative bronchopneumonia?
A) Fibrinous B) Supprative
82
What can cause fibrinous bronchopneumonia?
Bacteria- mannheima haemolytica in cattle Inhalation of highly irritant material- Gastric HCl
83
Describe the pathogenesis of a mannheima haemoltyica infection in cattle
Shipping fever Stress, viral infections and other factors impair respiratory defence mechanisms M.haem colonisation of lower respiratory tract- laucotoxin production Lysis of alveolar macrophages and neutrophils- releases lysosomal contents Acute damage to blood vessels to fibrinous bronchopneumonia and toxaemia
84
What are the sequale of bronchopneumonia?
Resolution- natural or treatment Chronic- BALT hyperplasia, goblet cell metaplasia Bronchilitis obliterans Bronchiectasis Abscess formation Pleuritis Death
85
1) Where are the primary sites of injury in interstitial pneumonia? 2) What are the common causes? 3) What are the routes of entry? 4) Describe the distribution?
1. Alveolar epithelium and capillary endothelium 2. Viruses, bacteria, protozoa, helminths, irritants, allergy, toxins 3. Inhalation, haematogenous 4. Mainly diffuse, sometimes dorsocaudal
86
How can intersitial pneumonia be described macroscopically?
Can be diffucult to detect- no contract Heavy rubbery or elastic texture, red, grey mottles Often lack of visible exudate Lungs often fail to collapse on opening of thorax, costal impression on pleural surface
87
Describe the 3 phases of interstitial pneumonia pathogenesis?
Injury- to type I pneumocytes or capillary endothelium, expansion of the interstitial tissue (oedema, inflammatory exudate) Exudative phase- leakage of fluid and plasma protein in the alveolar space, may see hyaline membrane Proliferative phase- macrophage population expands- phagocytose and remove exudate, type II pneumocytes proliferate to replace type I cells
88
What are the functional consequences of acute interstitial pneumonia?
Disruption of alveolat walls leads to hypoxia
89
What are some common causes of interstitial pneumonia?
Infections- viruses, septicaemic salmonellosis Acute hypersensitivity reactions Toxins- tryptophan- fog fever, paraquat
90
What happens when intersitial pneumonia is resolved?
Macrophages remove alveolar fluid and cells, type II pneumocytes convert to type I
91
What are some causes of chronic intersitial pneumonia?
Infections- ovine lentivirus Hypersensitivity reactions Toxins Irritants
92
What chronic changes can occur if injury causing interstitial pneumonia persists?
Interstitial fibrosis Chronic inflammatory cells Persistence of type II pneumocytes Smooth muscle hyperplasia
93
What are the consequences of chronic interstitial pneumonia?
Thickened alveolar walls Decreased wall compliance Increased respiratory effort- tachypnoea Reduced airspace Impaired diffusion Reduced gas exchange- hypoxia Obliterations of capillaries due to pressure- pulmonary hypertension Hypoxia causes vascoconstriction adding to pulmonary hypertension
94
What two types of pneumonia are these images showing?
95
What happens to cause bronchointerstitial pneumonia?
Exudate fill interstitial tissue, bronchioles, bronchi and alveoli Interstitial alveolar supprative exudate Type II pneumocyte hyperplasia
96
What is the route of entry of embolic pneumonia? Describe the distribution of embolic pneumonia What are the common causes? What are the potential sequelae?
ROE- haematogenous Distribution- random disseminated foci Common causes- hepatic abscesses, right heart valve endocarditis, joint/navel infections Sequelae- formation of abseceses- could lead to fibrosis and resolution or chronic pneumonia or rupture- pyothorax/pneumothorax
97
Briefly describe what this image is showing?
This image shows lungs The lungs have random disseminated rasied lesions yellow/orange in colour Embolic pneumonia
98
What causes granulomatous pneumonia? What are the routes of entry? Describe the distribution of granulomatous pneumonia
Caused by agents that persist in tissues- induce chronic inflammation ROE- inhaled, haematogenous Distribution- variable, nodular foci
99
100
What are the different common causes of granulomatous pneumonia?
Bacterial- mycobacteria, actinobacillus, actinomyces, nocardia Parasites- migrating parasites, lung worm, angiostrongylus vasorum Viral- FIP Fungi Foreign bodies
101
What do these two images from the same animal show?
Top image shows a cattles lung with granulomatous pneumonia Bottom image shows a slide stained with Zeihl-Neelson which shows acid fast bacteria revealing that this cow is infected with mycobacteria bovis (TB)
102
What different types of neoplasia can originate in the lung and what tissue is most common?
Carcinoma- bronchioloavleolar, squamous cell Adenocarcionma- papillary, acinar Chrondrosarcoma Grannular cell tumour Most primary originate from the epithelium
103
What is pulmonary adenomatotsis aka driving sickness?
Affects intensely housed sheep Retro-viral induced neoplasia Multicentric bronchioalveolar carcinoma Cuboidal columnar cells resembling type II pneumocytes
104
How can pulmonary adenomatosis be identified in PM and in a clinical case?
PM- lungs are heavy with small grey to white nodules Clinical case- wheel barrow test- mucoud fluid dribbles out
105
Why is metastatic neoplasia of the lung common? What neoplasias are commonly metastatic in the lungs?
Good blood supply and fine capillary network Mammary tumours, oestosarcoma, haemangiosarcoma
106
What are common causes of pneumothorax?
Spontaneous rupture of abscesses, emphysematous bulla Traumatic rupture or perforation of lung/trachea Penetrating injury of thoracic wall
107
What diseases affectthe pleural cavity?
Pneumothorax Circulatory diseases- effusions Pleuritis- inflammatory conditions Neoplasia
108
What different pleural effusions are common? What do they all cause and why?
Hydrothorax-oedema fluid Haemothorax- blood Cylothorax-lymph Pyothorax- pus
109
1) What are common causes of hydrothorax? 2) What are common causes of haemothorax? 3) What are common causes of chylothorax? 4) What are common causes of pyothorax?
1) Oedema/transudate in the pleural space: Heart failure Hypoproteinaemia Intrathoracic tumours 2) trauma and rupture of blood vessels erosion of blood vessles clotting disorders (Doberman with Von willebrands) 3) traumatic rupture or neoplastic erosion of the thoracic duct wall congenital anomaly heart disease 4) penetrating injury, lung abscess rupture
110
How is pleuritis classified?
Fibrinous Supprative Granulomatous
111
What can be the problem with chronic pleuritis?
Adhesions of fibrin reduces compliance of the lungs
112
What are causes of pleuritis?
Pneumonia Bacteraemia Pyothorax FIP virus
113
What are the three neoplasias of the pleural cavity?
Primary Mediastinal Metastases
114
Whats an example of a primary neoplasia of the pleural cavity and what are the risk factors?
Mesothelioma Asbestos or spontaneous Boviers, irish setters, german shepards More in males
115
What are some examples of mediastinal tumours of the pleural cavity?
Thymoma Lymphoma

Year 3 Pathology (21 decks)

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