Pulmonary Pathology
Terms
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- Acute Bronchitis
- Infection of airway caused by virus, Manifests like pneumonia with fever, chills, cough,
- Cause of respiratory failure
- any cause including lung disease, postoperative complication, etc...
- Emphysema
- Permanent enlargement of gas exchanged airways with destruction of alveolar walls. Loss of elasticity, poor compliance
- Cause and effects of Chronic bronchitis
- Smoking, decreases defense mechanisms of lungs, increase risks for infections
- Respiratory tract malignancies
- uncontrolled growth in other structures, lip-exposure, sun, wind, Laryngeal ETOH and smoking
- Cheyne-stokes respirations
- tidal volume gradually increases followed by gradual decrease and period of apnea before returning to a normal respiratory pattern. From conditions that slows blood flow to the brainstem
- Respiratory acidosis
- an increase in the acidity of blood due to retention of CO2 resulting from pulmonary insufficiency
- Lung Cancer
- Non small cells vs. small cells, small cell very rapid growing and metastasizes early, difficult to treat, rarely can do surgery because so advanced,
- Croup
- viral laryngealtracheobronchitis, 6 months to 5 years, edema and mucous cause airway to narrow, barking cough
- Cause of Restrictive lung disease
- scar tissue, autoimmune, or substances ie coal dust
- Symptoms of Lung cancer
- cough, hemoptasis, pleural effusion, obstruction of airway
- Hypocapnia
- decreased amount of CO2 in the blood resulting from respiratory alkalosis
- Atelectasis
- Lung tissue collapses due to external pressure or to the removal of air due to absorption of hypoventilation
- Clubbing
- the selective bulbous enlargement of the end of a finger or toe
- Pneumothorax
- Gas or air enters pleural space separating lung from rib cage and destroying the negative pressure gradient. Can be open, tension. Can be spontaneous or secondary.
- Chronic Bronchitis
- Hypersecretion of mucous and chronic cough, chronic airway inflammation with chronic edema, increase in size and number of mucous glands, narrowed airways
- Cystic Fibrosis
- Autosomal recessive inherited disease on chromosome #7, causes abnormal expression of a protein affecting airwaY, bile ducts, pancreas, sweat ducts and vas deferens
- Hemoptysis
- coughing up of blood or bloody secretions
- Asthma
- runs in families 20 genes, exposure to allergen/irritant causes hyperresponsiveness with release of inflammatory
- Bronchpulmonary dysplasia
- neonatal lung injury usually a result of premature birth or respiratory support during perinatal period, poor formation of alveoli, alveolie are large and fewer with decrease surface area for gas exchange hypoxemia and hypercapnea, pulmonary hypertension
- Cause and effects of Emphysema
- Smoking or air pollutants, stimulation of inflammation and increases proteases causing alveolar destruction and loss of elastic recoil. Hyperexpansion.
- signs of dyspnea
- flaring of nostrils, reaction, retraction of tissue between ribs
- most common pulmonary disorders
- exercise, dyspnea on exertion
- Cause of pulmonary edema
- often from heart disease where fluid is backing up from L side of hear into lungs.
- Bronchiectasis
- abnormal dilation of the bronchi, often associated with obstruction and plugs, loss of elasticity
- Empyema
- pleural effusion where fluid is pus. Secondary to pneumonia, surgery etc...
- Hypoxemia
- reduced oxygenation of arterial blood
- Bronchiolitis
- inflammatory obstruction
- Restrictive lung disease
- Pulmonary fibrosis-excessive fibrous or connective tissue in lung. Long term exposure to stomach reflux can cause fibrosis
- Hypocapnia occurs with
- severe anxiety, acute head injury and in response to conditions causing insufficient oxygenation of the blood
- Characteristics of Asthma
- Wheezing, first expiratory then both inspiratory and expiratory, dyspnea, coughing, prolonged expiration, acidosis, low pulse oximetry
- Chest wall restriction
- diaphragm can't move down, caused by problem with ventilation. congential or other deformity. Trauma, neuromuscular disease, decreases tidal volume
- Kussmaul respiration (hyperpnea)
- deep, rapid respiration commonly seen in conditions causing acidosis
- Hyperventilation
- alveolar ventilation exceeding metabolic demands. Lungs remove CO2 faster than it is produced
- Respiratory failure
- inadequate gas exchange where either oxygen is to low or carbon dioxide is to high.
- Resting ventilatory rate
- 8-16 breathes/min and 400-800 ml
- Flail chest
- Fractures cause instability of chest wall, paradoxic movement, impairs gas exchange
- Hypoventilation
- inadequate alveolar ventilation in relation tot metabolic demands. CO2 removal doesn't keep up with CO2 production and the level of CO2 in arterial blood increases causing hypercapnia
- Pathology of Tuberculosis
- Phagocytes engulf bacilli form granulomatous tubercle, changing to cheeselike caseation necrosis and scar tissue
- Obstructive Lung Disease
- airway obstruction worse with expiration emptying of lungs is slowed, thereby increasing dead air space Ex: asthma, COPD chronic bronchitis, emphysema
- Pulmonary Edema
- Excess water in the lung, diminishes gas exchange
- Cyanosis
- Bluish discoloration, increased amounts of desaturated or reduced hemoglobin in the blood, decreased aterial oxygenation pulmonary of cardiac right-to-left shunts, caridac output, cold environment, or anxiety
- Aspiration
- Fluid or solids that have gotten into the lungs, seen with swallowing disorders, changes in consciousness, abuse, sedation, seizures
- Cough
- protective reflex that cleanses the lower air-ways, explosive expiration
- 3 Causes of Hypoxemia
- oxygen delivery to the alveoli, diffusion of oxygen from the alveoli into the blood, perfusion of pulmonary capillaries
- dyspnea
- the subjective sensation of uncomfortable breathing, the feeling of being unable to get enough air
- Tuberculosis
- Caused by mycobacterium tuberculosis, MDR strains, increase with HIV, airborn transmission, can be dormant, can move to other organs
- Pulmonary embolism
- occlusion of the pulmonary vascular bed by emboli, effect-size, can cause lung infarction, chest pain, dyspnea, tachycardia, tachypnea, unexplained anxiey
- Pleural effusion
- presence of fluid in the pleural space (no breath sound). Usually results from fluid coming through capillaries, overwhelm lymphatic system, can be blood, hemothorax, or pus