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Year 3 Pathology > Respiratory > Flashcards

Respiratory Flashcards

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
Q

What are two examples of bacterial URT infections?

A

Streptococcus equi in horses- strangles

Pasteurella multocida in pigs- atrophic rhinitis

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26
Q

Briefly describe a strangles and atrophic rhinitis infection

A

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

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27
Q

What type of infection is aspergillus fumifatis?

What species does it affect?

What can predispose it?

What type of inflammation does it cause?

A

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

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28
Q

What are the complications of gutteral pouch mycosis?

A

Damage to cranial nerves- paralysis of facial muscles, tongue, pharynx, larynx

Erosion of blood vessels- internal carotid- could be fatal

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29
Q

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?

A

Most common in middle-aged to elderly animals

>80% malignant

Breeds- airdales, bassets, OESD, shetland sheep dog, german short hair pointer

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30
Q

What are the different tissues of the URT that can become neoplastic and what is the neoplasia called?

A

Epithelial tissues-
lining- squamous cell carcinoma,
glands- adenocarcinoma

Mesenchymal-
cartilage- chondrosarcoma
bone- osteosarcoma
connective tissue- fibrosarcoma

Lymphoid tissue- lymphoma

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31
Q

What are the two developmental abnormalities of the trachea and larynx and briefly describe them?

A

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

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32
Q

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?

A

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

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33
Q

What can cause laryngeal oedema?

A

Local trauma- intubation

Irritant- smoke

Acute respiratory infections

Laryngeal chrondritis

Anaphylaxis/allergic reactions

EMERGENCY

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34
Q

What do these three photos show?

A

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

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35
Q

What can cause tracheitis and laryngitis?

A

Infectious agents- IBR, Influenza, Feline and equine herpes, bordatella

Trauma

Irrirants

Foreign bodies

Parasites

Neoplasia- rare

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36
Q

What causes calf diptheria?

What can cause the calf to die?

A

Opportunistic infection of fusobacterium necrophorum seccondary to mucosal dammage

Ulcerative necrosis to larynx- death tue to toxaemia and asphyxiation

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37
Q

What does this image show?

A

Oslerus osleri (Filaroides osleri) - dog

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38
Q

What different neoplasia could affect the trachea?

A

Lining epithelium- squamous cell carcinoma

Cartilage- chondroma/sarcoma

Striated muscle- rhabdomyoma

Lymphoid tissue- lymphoma

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39
Q

Why are broncioloes vunerable to insult?

A

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

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40
Q

What can cause bronchitis/bronchiolitis?

A

Infectious agents- extension of upper or lower

Irritants

Allergens

Foreign bodies

Parasites

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41
Q

What is the difference between trachea inflammation and bronchiolitis/bronchitis?

A

Severe inflammtion can cause bronchiolitis obliterans

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42
Q

What is bronchiolitis obliterans and how does it occur?

A

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

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43
Q

What are the effects of bronchitis and bronchiolitis?

A

Bronchial gland hyperplasia- increased mucus production

Epithelial hyperplasia- }

Smooth muscle hyperplasia- } thickening of mucosa

Inflammatory cells and fibrosis- }

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44
Q

What can cause bronchiolitis obliterans?

A

Chronic or repeated bacterial infections

Parasitic disease

Allergic disease

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45
Q

Why does chronic broncitis or bronchiolitis result in increased mucus secretion?

A

Bronchial goblet cell hyperplasia

Bronchial gland hyperplasia

Goblet cell metaplasia in bronchioles

Increasing mucus production

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46
Q

How can you tell this animal has had chronic bronchiolitis?

A

Hyperplasia of goblet cells- top arrows

Hyperplasia of bronchial gland- bottom arrows

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47
Q

How is chronic inflammation of bronchi/bronchioles presented clinically?

A

Dyspnoea/ Cough

Increased respiratory noise

Collapse/over inflation of lung

Reduced blood oxygenation

48
Q

What is bronchiectesis?

A

Obstruction of the lumen by exuadate

Necrosis of the bronchial wall

Can cause permanent dilation of the bronchus

49
Q

What does a successfull infection of cattle lung worm lead to and how?

A

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
Q

What is RAO, what is it alternatively referred to as?

A

Recurrent Airway Obstruction disease

AKA Heaves

51
Q

What is ROA and what is most severly affected?

What does it cause?

What are the clinical signs?

A

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
Q

Which species has poor collateral ventilation?

A

Cattle

Degree varies in species?

53
Q

What seperates lobules in the lungs and how does it vary between species?

What is the relevance of this

A

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
Q

How common are developmental abnormalities of the lung parenchyma?

Name 3 examples?

A

Generally very rare

Congenital melanosis

Agenesis of one or more lung lobes

Ectopic lung tissue

55
Q

What is atelectasis and what can cause it?

A

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
Q

What is emphysema what causes it?

A

Emphysema is over inflation of the lungs

Causes-

Forcer respiratory efforts- pneumonia

Obstructive airway disease- partial

57
Q
A
58
Q

How does partial bronchiole obstruction cause emphysma?

A

Lobule remains partially expanded therefore on next inspiration the lung will over inflate

59
Q

What is interstitial emphysema?

A

Trapped air- breaks alveolar wall and enters intersitium and septa

60
Q

What are the consequences of empysema?

A

Loss of lung elasticity- increased dead space

Loss of pulmonary capillaries

Fibrosis of remaining alveolar walls- inhibits gas exchange, reduces compliance

61
Q

What circulatory disturbances can occur in the lung parenchyma?

A

Pulmonary oedema

Pulmonary embolism

Pulmonary haemorrhage

62
Q

What does pulmonary oedema cause in the animal?

A

Dyspnoea- tachypnoea

Hypoxia- cyanosis if severe

Cough- moist

63
Q

Why is it unusual for alveoli to flood and therefore what must occur for pulmonart oedema?

A

Alveolar is less permeable then capillary

Damage must have occured of increased interstitial fluid

64
Q

What can the damage to alveoli that causes oedeama be?

A

Infectious agents

Toxins

Irritants

65
Q

What does this of lung show?

A

Eosinophillic homogenous material diffuselly present throughout the alveoli

Oedema

66
Q

Other then damage- what causes pulmonary oedema?

A

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
Q

What can be used to treat pulmonary oedema?

A

Diurretics to treat

68
Q

What can be a pulmonary embolism?

A

Thromboemboli

Tumour cells- metastases

Fat

Air

Good site as fine capillary network and good blood supply

Effect depends on nature of embolism

69
Q

What does this image show?

A

Infarction- usually requires blockage of a mjore vessel

70
Q

Describe this image of lung parenchyma

What are common causes of this?

A

Wedge or cone shaped area of haemoglobin and necrosis due to infarction

Common sources- right heart bacterial endocarditis, joint/navel infections, liver abscesses

71
Q

What do different sources of thromboembolism cause?

A

Sterile- fibrninolytic breakdown, fibrotic scarring

Infected thromboemboli- vasculitis, thrombosis, abscess

72
Q

What are the different causes of pulmonary haemorrhage?

A

Pulmonary thromboembolism

Trauma

Inflammation

Abscesses/tumour (erode vessels)

73
Q

What is EIPH?

A

Excercise induced pulmonary haemorrhage

Occurs in 75% of racehorses

74
Q

What are the 4 classes of pneumonia?

A

Bronchopneumonia

Interstitial pneumonia

Embolic pneumonia

Granulomatous pneumonia

75
Q

What classifies different pneumonias and why is it useful to know?

A

Distribution
Appearance
Texture

Improved diagnosis and treatment

76
Q

What are common causes of bronchopneumodia?

A

Bacteria- mycoplasms

Aspiration of food- GI contents

Viruses

77
Q

What is the distribution of bronchopneumonia and why?

A

Cranioventral- key

Cranioventral due to greater deposition of particles and organisms, gravitational effects, regional variations in defence mechanisms- efficiency, perfusion, ventilation

78
Q

What is the difference between supprative and fibrinous bronchopneumonia?

A

Supprative- purulent or mucopurulent exudate confinded to lobules

Fibrinous- fibrinous exudate, spreads rapidly between lobules

79
Q

What are some common causes of bronchopneumonia?

A

Bacteria- pasturalla multocida, bordatella bronchiseptica, truerella pyogenes, streptococcus, trueperella pyogenes, e.coli

Inhalation of bland material (milk)

Mycoplasmas- bovis, hyponeumoniae, dispae

Viruses

80
Q

Describe the pathogenesis of bronchopneumonia?

A
  • 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
Q

Which of these two pictures is fibrinous and supprative bronchopneumonia?

A

A) Fibrinous

B) Supprative

82
Q

What can cause fibrinous bronchopneumonia?

A

Bacteria- mannheima haemolytica in cattle

Inhalation of highly irritant material- Gastric HCl

83
Q

Describe the pathogenesis of a mannheima haemoltyica infection in cattle

A

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
Q

What are the sequale of bronchopneumonia?

A

Resolution- natural or treatment

Chronic- BALT hyperplasia, goblet cell metaplasia

Bronchilitis obliterans

Bronchiectasis

Abscess formation

Pleuritis

Death

85
Q

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?

A
  1. Alveolar epithelium and capillary endothelium
  2. Viruses, bacteria, protozoa, helminths, irritants, allergy, toxins
  3. Inhalation, haematogenous
  4. Mainly diffuse, sometimes dorsocaudal
86
Q

How can intersitial pneumonia be described macroscopically?

A

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
Q

Describe the 3 phases of interstitial pneumonia pathogenesis?

A

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
Q

What are the functional consequences of acute interstitial pneumonia?

A

Disruption of alveolat walls leads to hypoxia

89
Q

What are some common causes of interstitial pneumonia?

A

Infections- viruses, septicaemic salmonellosis

Acute hypersensitivity reactions

Toxins- tryptophan- fog fever, paraquat

90
Q

What happens when intersitial pneumonia is resolved?

A

Macrophages remove alveolar fluid and cells, type II pneumocytes convert to type I

91
Q

What are some causes of chronic intersitial pneumonia?

A

Infections- ovine lentivirus

Hypersensitivity reactions

Toxins

Irritants

92
Q

What chronic changes can occur if injury causing interstitial pneumonia persists?

A

Interstitial fibrosis

Chronic inflammatory cells

Persistence of type II pneumocytes

Smooth muscle hyperplasia

93
Q

What are the consequences of chronic interstitial pneumonia?

A

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
Q

What two types of pneumonia are these images showing?

A
95
Q

What happens to cause bronchointerstitial pneumonia?

A

Exudate fill interstitial tissue, bronchioles, bronchi and alveoli

Interstitial alveolar supprative exudate

Type II pneumocyte hyperplasia

96
Q

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?

A

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
Q

Briefly describe what this image is showing?

A

This image shows lungs

The lungs have random disseminated rasied lesions yellow/orange in colour

Embolic pneumonia

98
Q

What causes granulomatous pneumonia?

What are the routes of entry?

Describe the distribution of granulomatous pneumonia

A

Caused by agents that persist in tissues- induce chronic inflammation

ROE- inhaled, haematogenous

Distribution- variable, nodular foci

99
Q
A
100
Q

What are the different common causes of granulomatous pneumonia?

A

Bacterial- mycobacteria, actinobacillus, actinomyces, nocardia

Parasites- migrating parasites, lung worm, angiostrongylus vasorum

Viral- FIP

Fungi

Foreign bodies

101
Q

What do these two images from the same animal show?

A

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
Q

What different types of neoplasia can originate in the lung and what tissue is most common?

A

Carcinoma- bronchioloavleolar, squamous cell

Adenocarcionma- papillary, acinar

Chrondrosarcoma

Grannular cell tumour

Most primary originate from the epithelium

103
Q

What is pulmonary adenomatotsis aka driving sickness?

A

Affects intensely housed sheep

Retro-viral induced neoplasia

Multicentric bronchioalveolar carcinoma

Cuboidal columnar cells resembling type II pneumocytes

104
Q

How can pulmonary adenomatosis be identified in PM and in a clinical case?

A

PM- lungs are heavy with small grey to white nodules

Clinical case- wheel barrow test- mucoud fluid dribbles out

105
Q

Why is metastatic neoplasia of the lung common?

What neoplasias are commonly metastatic in the lungs?

A

Good blood supply and fine capillary network

Mammary tumours, oestosarcoma, haemangiosarcoma

106
Q

What are common causes of pneumothorax?

A

Spontaneous rupture of abscesses, emphysematous bulla

Traumatic rupture or perforation of lung/trachea

Penetrating injury of thoracic wall

107
Q

What diseases affectthe pleural cavity?

A

Pneumothorax

Circulatory diseases- effusions

Pleuritis- inflammatory conditions

Neoplasia

108
Q

What different pleural effusions are common?

What do they all cause and why?

A

Hydrothorax-oedema fluid

Haemothorax- blood

Cylothorax-lymph

Pyothorax- pus

109
Q

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?

A

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
Q

How is pleuritis classified?

A

Fibrinous

Supprative

Granulomatous

111
Q

What can be the problem with chronic pleuritis?

A

Adhesions of fibrin reduces compliance of the lungs

112
Q

What are causes of pleuritis?

A

Pneumonia

Bacteraemia

Pyothorax

FIP virus

113
Q

What are the three neoplasias of the pleural cavity?

A

Primary

Mediastinal

Metastases

114
Q

Whats an example of a primary neoplasia of the pleural cavity and what are the risk factors?

A

Mesothelioma

Asbestos or spontaneous
Boviers, irish setters, german shepards
More in males

115
Q

What are some examples of mediastinal tumours of the pleural cavity?

A

Thymoma

Lymphoma

Year 3 Pathology (21 decks)

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