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47 Cards in this Set
- Front
- Back
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The right lung has how many lobes?
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3
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The left lung has how many lobes?
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2
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The right bronchus is what compared to the left?
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shorter and wider
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Which side of the bronchus is more horizontal?
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left
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Which side of the bronchus is a forgein body most likely to get stuck in?
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right bronchus
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What type of epithelium is found in the bronchi of the lung?
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pseudostratified columnar ciliated epithelium
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the acinus is
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portion of the lung that starts from the terminal bronchiole & ends in the terminal alveoli
where gas exchange mainly occurs |
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95% of the alveoli are lined by?
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Type I pneumocytes
flat |
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What reducest the surface tension of the lung & what type of cell secretes it?
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surfactant
Type II Pneumocytes |
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Atelactasis is defined as?
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a state in which the lung, in whole or part, is collapsed or without air
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What are 3 types of aquired atelactasis (colapse)?
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resorption (obstruction)
compression contraction |
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What causes resorption atelectasis?
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complete airway obstruction without impairment of blood flow
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The mediastinum shifts which way in resorption atelectasis?
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toward the collapsed lung
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do you see necrosis in resorption atelectasis?
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no, preservation of blood flow
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What can cause resorption atelectasis?
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bronchial asthma - spasm
chronic bronchitis - spasm & secretion Bronchiectasis - puss aspiration of forgein bodies |
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Is resorption atelectasis reversible?
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yes with removal of obstruction
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What causes compression atelctasis?
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something fills the pleural cavity with exudates, blood or air & compresses the lung
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What direction does the mediastum shift with compression atelectasis?
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away from the compressed lung
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What pts do you see compression atelectasis in?
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CHF causing pleural effusion & neoplastic effusions
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Is compression atelctasis reversible?
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yes, if compression is removed
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What causes contraction atelctasis?
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fibrotic changes in lung or pleura make lung infelxible & it prevents full expansion
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Is contraction atelctasis reversible?
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no
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What are some consequences of atelectasis?
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reduced oxygenation
predisposition to infection |
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Acute lung injury starts as injury to?
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**endothelial cells
epithelial cells both |
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Response and prognosis of acute lung injury can be influenced by?
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genetics
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is acute lung injury a genetic disorder?
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no
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What are mediators of injury?
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Cytokines
oxidants TNF IL 1, 6, 10 TGF B |
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Which mediator plays a role in later stages of acute lung injury?
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TGF B
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What are some manifestations of acute lung injury?
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Pulmonary edema
Difuse Alveolar Damage (DAD) organizing pneumonia |
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What 2 ways can pulmonary edema be mediated?
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hemodynamic changes
mivrovascular injury |
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Hemodynamic disturbances in pulmonary edema
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cardiogenic (CHF) causes wet lung due to backup (inc hydrostatic pressure). Initially at the base with accumulation of heart failure cells. These macrophages have hemosiderine making them 'brown induration'
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what type of cell is the heart failure cell?
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macrophage
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what accumulates in heartfailure cells & what is it called?
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hemosiderin
brown induration |
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Microvascular injury in pulmonary edema
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injury to capillary in alveolar septa causing inc permeablitiy w leakage of P & fluid into the interstitial space
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Localized microvasuclar injury in pulmonary edema
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predisposes to infection
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diffues microvascular injury in pulmonary edema
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can lead to diffuse alveolar damage
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What is the clinical syndrome caused by Difuse alveolar damage?
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acute respiratory distress syndrome (ARDS)
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Severe ARDS may cause...
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1. life-threatening insufficiency, cyanosis
2. arterial hypoxemia refractory to O2 therapy 3. multi-organ system failure |
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The 4 main conditions associated with ARDS/DAD (more that 1/2 ARDS has all 4)
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1. sepsis
2. diffuse lung infections 3. gastric aspriation 4. mechanical trauma/head injury |
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What do you see on CXR in DAD?
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diffuse alveolar infiltration
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What accumulates in DAD and why?
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Hyaline membrane due to destruction and reconstruction
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What cell type becomes prominent due to attempts at repair?
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Type II pneumocytes
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is interstitial fibrosis reversible?
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NO
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What happens in the 1st 24 hrs of ARDS?
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edema - exudative stage
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What happens day 2 - 7 in ARDS?
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hylane membrane - exudative stage
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What happens in the proliferative stage (week 1 and on)?
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interstitial inflammation & fibrosis
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What is acute interstitial pneumonia?
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ARDS with unknown etiology
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