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19 Cards in this Set
- Front
- Back
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what is the definition of emphysema?
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- permanent dilation of airspaces distal to terminal bronchioles
- destruction of their walls - no obvious fibrosis |
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what is centriacrinar emphysema? panacinar?
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- Centriacinar is right around the respiratory bronchiole, associated with smoking
- Panacinar is distal to the respiratory bronchiole, A1AT deficiency |
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where is distal acinar (paraseptal) emphysema?
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- distal aspect of acinus
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where is irregular emphysema?
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- focal, near scars
- clinically insignificant |
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what does emphysema look like histologically?
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- hyperinflated lungs
- tissue destruction = cystic spaces (holes) in lung - free floating alveolar septa |
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where does centriacinar emphysema occur? what is is associated with?
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- occurs in upper lobes, terminal bronchioles
- associated with cigarette smoking |
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where does panacinar emphysema occur? what is is associated with?
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- occurs in lower lobes, distal to terminal bronchioles in acinus
- associated with A1AT deficiency |
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where does distal acinar emphysema occur? what is is associated with?
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- distal aspect of acinus, near pleura
- may give rise to cystic like spaces (called bullae >1cm) --> bullae rupturing may give rise to pneumothorax |
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what is the pathogenesis of emphysema?
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- neutrophile come into lung b/c of cigarettes free radical release --> release elastase = damage
- free radicals hurt A1AT = "functional deficiency" - macrophages increased in smokers lung --> release elastase & MMPs |
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what is the definition of chronic bronchitis?
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- cough w/ sputum for >3 months during 2 years
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what are the histological changes with bronchitis?
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- increase in size & number of submucosal glands (Reid index = thickness of glands/bronchial wall)
- goblet cell hyperplasia - chronic inflammation |
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what is the reid index?
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- thickness of glands/bronchial wall
- chronic bronchitis |
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how does small airway disease contribute to chronic bronchitis?
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- may contribute to the obstruction b/c small airway disease = fibrosis + inflammation
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what is asthma airway remodeling?
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- goblet cell & submucosal hyperplasia
- thickening of BM - hypertrophy of SM - inflammatory cells w/ eosinophils & mast cells - mucus plugs w/ eosinophils - Curschmann spirals - mucus plugs shed epithelium |
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what are Curschmann spirals?
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- mucus plugs containing shed epithelium in asthma
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what is Charcot-Leyden crystals?
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- eosinophil membranes in asthma
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what might bronchiectasis be caused by?
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- obstruction: tumor, foreign objects
- infections: necrotizing pneumonias, immunodeficiencies, repeated infections - hereditary conditions: CF, immotile cilia syndrome - others: SLE, RA, post-transplant |
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where do you tend to see bronchiectasis?
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- lower lobes
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what is the histology of bronchiectasis?
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- fibrosis of bronchial wall
- inflammation of bronchial wall - squamous metaplasia (from respiratory --> squamous cells) - involvement of bronchioles (fibrosis) may lead to obstruction |
