Eupnea
Dyspnea
Apnea
- Eupnea- normal breathing
- Dyspnea- difficult breathing
- Apnea- cessation of breathing
Obstructive Lung disease
- Hard to get air out
- Airway related disease
- Limitation of airflow, increased resistance
Restrictive lung disease
- Hard to get air in
- Reduced expansion of parenchyma, decreased lung capacity
Obstructive lung disease examples
Emphysema, chronic bronchitis, bronchiectasis
Asthma
Restrictive lung disease examples
ARDS, pneumoconoises, interstitial fibrosis, sarcoidosis
Atlectasis
- Collapse or incomplete expamsion of lung
- Types
- Contraction: scarring
- Resorption: Obstruction of airway
- Compressive: pleural edema or pneumothorax (loss of cohesive forces)
Acute Ling Injury
Diffuse Alveolar damage
- Injury to pneumocytes and endothelial cells
- Oxygen-derived free radicals
- Activated neutrophils and macrophages
- loss of surfactant
- Etiology
- Infections, Gas inhalation, liquid inhalation
- drugs chemicals radiation
- hypotension, sepsis, trauma
- Patho
- Exudative stage–> proliferative organizing stage
*
- Exudative stage–> proliferative organizing stage
Bronchial Asthma
- Chronic inflammation of airways resulting in contraction of bronchial miscle and smooth muscle proliferation
- Extrinsic (allergies atopic)
- Allergens
- Intrinsic (Non-atopic)
- Initiated by irritant
Asthma (Atopic) Clinical manifestations
- Vascular edema and permeability
- Recruitment of pro0nflammatory cells
- Increased mucus production
- Irreversible airway remodeling(thicj muscle wall in vessels)
- Eosinophils release mediators, epithelial death,
- Collagen deposition
- Goblet cell hyperplasia
Asthma (Non atopic)
- Viral infections
- Elicit inflammatory response mediated by eosinophils and IgE
- Drug and occupational induced possible as well
Chronic Obstructive Pulmonary Disease
- 2 components- irreversible airflow
- Emphysema
- Destruction of acinus alveoli
- Chronic bronchitis and chronic bronchiolitis
- Emphysema
Emphysema
- Destruction of alveolar tissue
- Larger but fewer
- Reduced surface area for gas exchange
- Collapse of bronchioles
Chronic Bronchitis
- Pathology
- Airways inflammation
- Goblet cell hyperplasia
- Squamous hyperplasia
- Injury to cilia
- Smoking, pollutants
Bronchiectasis
Diseases associated with
DILATION of bronchi
Diseases associated:
Obstruction
Cystic fibrosis
Immotile cilia syndrome
Necrotizing pneumonia
Idiopathic Pulmonary Fibrosis**
Diffuse interstitial fibrosis of unknown cause
Hypoxia and cyanosis
3 yrs or less expectancy
Cor pulmonale
Pneumoconioses
- Inhalation of metals(Carbon, silicosis, abestos)
- Injury determined by length of exposure, physiochemical, and host factors
*
Pulonary Edema
- Non-cardiogenic
- severe infection
- upper airway obstruction
- Inhaling water, toxic gases
- blood transfusions
- Trauma
*
Pulmonary Embolism
- Most arise in veins from the legs
- large=death
- small and mediaum= infarctions
Pneumonia pathology and pathogenesis
- Pathology
- alveolar
- patchy, Bronchopneumonia
- Lobar, complete lobe (only S pneumonia)
- Interstitial
- alveolar
- Pathogenesis
- Inhalation of water, infected secretions, hematogenous spread
Classification of Lung Carcinomas and frequencies
- Adenocarcinoma 35%
- Squamous cell carcinoma 30%
- Small cell carcinoma 25%
- Large Cell carcinoma 10%
Adenocarcinoma
whos affected, survival
Smoking increases risk x 3
More common in females
Survival, 15-20%
Peripheral
Small cell carcinoma
95% of smokers
Males more than women
Survival 1-5%
Large cell carcinoma
- Peripheral lesion
- 15-20% survival
Bronchoalveolar Carcinoma
Smoking related
Equal amongst females and males
survival 25-40%
Single or multiple tumors, miliary tumor, pneumonic form
