Path- Respiratory 3

untimely's version from 2015-04-20 14:00


Question Answer
*what is Atelectasis? what are the two types?Meaning empty alveoli which do not contain air. It can be congenital or acquired.
*what are two reasons for CONGENITAL atelectasis?(1) obstruction of airways due to muconeum, aspirate, amniotic fluid (2) hyaline membrane disease (foals and piglets).
*what are two reasons for ACQUIRED atelectasis?(1) compressive- (pneumothorax, hydrothorax, bloat, neoplasm) (outside of lung) (2) obstructive (exudate, parasites, neoplasms, foreign material). (inside of lung)
*what is the gross appearance of atelectasis? The lung tissue in atelectasis is dark red, flabby and depressed below the surface of surrounding lung
*what is the microscopic appearance of atelectasis?Microscopically, the alveolar walls are congested and are in close opposition.
*what is Emphysema? what are the two types?when there is air in the tissues. The two types are alveolar and interstitial.
*explain what is going on in alveolar emphysema? gross appearance?excessive air in the alveoli, causing abnormal and permanent enlargement of alveoli with destruction of alveolar walls. Emphysematous areas are raised, pale or white, dry and can be easily compressed with finger. It usually alternates areas of atelectasis.
*what is the cause of alveolar emphysema?It develops under the pressure of inhaled air--> due to Incompletely closed bronchioles.
*explain the difference in the bronchioles between atelectasis and emphysemain atelectasis, the bronchioles are completely obstructed. in emphysema, it is incomplete closure
*explain Interstitial emphysema. How does it appear grossly?When air collects in the connective tissue of lungs-interalveolar septa, interlobular septa, below the pleura, around the bronchi and blood vessels. Septa becomes thick, shiny, filled with bubbles.
*who gets interstitial emphysema the most, and why?Mostly seen in cattle, because of developed interlobular septa and lack of collateral ventilation in adjacent lobules
*what are the three conditions which cause interstitial emphysema?Forced respiratory efforts, seen in following conditions: (1) When death is followed by violent efforts in anoxia (2) During quick loss of blood in trauma, slaughter of fully conscious animal. (3) Death after protracted illness (air going in, animal is weak/sick, cant expell the air. )
what is the Most commonly encountered pulmonary abnormality?pulmonary edema
what are the two types/causes of pulmonary edema?(1) NON-INFLAMMATORY: caused by factors increasing capillary hydrostatic pressure (2) INFLAMMATORY: caused by Factors increasing permeability of the air-blood barrier
*what are some Factors increasing capillary hydrostatic pressure causing non-inflammatory pulmonary edema? (3)(1) Increased left atrial pressure in left sided or bilateral cardiac failure (cardiogenic edema) (2) In excessive fluid transfusion (3) Pulmonary venous occlusion
*what are some Factors increasing permeability of the air-blood barrier causing inflammatory pulmonary edema? (4)(1) 1. Inhalation of corosive gases-SO2, Cyanides, smoke (damage to epithelial cells) (2) Infectious agents (mycoplasma, viruses) (damage to endothelial cells) (3) Systemic toxins (damage to endothelial cells) (4) Anaphylaxis in certain species as horse and cow (damage to epithelial cells)
which species can have pulmonary edema from anaphylaxis, and why?horses and cows, because for them fluid pools in the lungs instead of the portal system
what are the gross lesions of pulmonary edema?Lungs are wet, heavy and do not collapse when thorax is opened. Interlobular septa is edematous and distended. Foam mixed fluid present in trachea and bronchi. Clear, colorless or slightly yellow or turbid blood mixed fluid Which oozes out from cut surface of the lung. Color of edema fluid varies depending on the type of edema. (clear if non-inflam, inflam will be turbid and maybe blood)
whats the prognosis of pulmonary edema?usually fatal
*Acute respiratory distress syndrome (ARDS)--> why does this happen? (3)because of diffuse alveolar damage…. Due to: (1) systemic dzs (2) direct injury to lungs (3) Lesions in other organ systems, like sepsis, multiple trauma, extensive burns and pancreatitis.
*explain the pathogenesis of ARDS (Acute respiratory distress syndrome)first there is the cause (systemic dz/direct injury/lesions like sepsis, mult trauma, extensive burns, pancreatitis leading to diffuse alveolar damage) and this triggers a large amount of macrophages to be released--> they release a large amount of cytokines--> Cytokines prime neutrophils stationed in the lung capillaries to release enzymes and free radicals-->Which causes diffuse endothelial/epithelial damage-->Permeability edema-->Results in accumulation of inflammatory cells, formation of hyaline membrane and fibrosis
how does ARDS (Acute respiratory distress syndrome) present clinically?Sudden onset of severe dyspnea
what are the 5 main lesions of ARDS (Acute respiratory distress syndrome)?(1) Diffuse damage to alveolar wall epithelium and /or endothelium (2) Congestion and edema (3) Hyaline membrane formation (4) Alveolar epithelial hyperplasia (5) Interstitial emphysema
which cells in the alveoli are responsible for healing/repairing emboli?type II pneumocytes
Pulmonary hypertension--> due to a what?Increase in pulmonary vascular resistance
what are three reasons there would be an increase in pulmonary vascular resistance leading to pulmonary hypertension?(1) Vasoconstriction of pulmonary arterioles: mostly hypoxic (high altitude- brisket disease), chronic bronchitis or bronchiolitis (equine heaves). (2) Vascular obstruction: thromboemboli including Dirofilaria immitis, arteriosclerosis, pulmonary vasculitis. (3) Vascular volume overload
pulmonary hypertension is Almost always secondary to what two things?cardiac dzs and lung dzs
what are some cardiac dzs which lead to secondary pulmonary hypertension? (3)(1) Left sided heart failure (2) septal defects such as mitral insufficiency or stenosis, subaortic stenosis, cardiomyopathy. (3) Left to right shunt- Ventricular septal defect, Patent ductus arteriosus
what is a lung dz which can lead to secondary pulmonary hypertension?chronic interstitial pneumonia with fibrosis and occlusion of pulmonary vessels.
**Sustained pulmonary hypertension results in??increased pressure load to right ventricle with compensatory *right ventricular hypertrophy*, and ultimately right heart failure.
Inflammation of lungs is?Pneumonia, Pnemonitis.
what are three way inflammation of the lungs (Pneumonia, Pnemonitis) can be classified?Etiological, Morphological, or Based on site and pattern of spread of lesions
what are the two morphological classifications of pneumonia (lung inflammation)exudative or proliferative
what are the 4 classifications Based on site and pattern of spread of lesions of pneumonia?I. Bronchopneumonia II. Interstitial pneumonia III. Embolic pneumonia, IV. Granulomatous pneumonia.
Infectious bronchopneumonia occurs when...when the risk factors tip the balance: Exposure, crowding, dehydration, other infections and chronic disease.....**STRESS!!*
bronchopneumonia starts where and ends where?origin of lesion in bronchi, and it moves into the alveoli
what are the two main TYPES of CAUSES of bronchopneumonia?(1) Bacteria and mycoplasma (2) Aspiration of feed and gastric contents.
hepatization of lungs is what, and occurs in what condition?when the lung kinda looks/feels like a liver instead of a lung, and this occurs in BRONCHOPNEUMONIA
what do gross and microscopic lesions of bronchopneumonia depend on?the stage of the disease
what are the 4 stages of bronchopneumonia?(1) the stage of congestion (2) stage of red hepatization (3) stage of grey hepatization (4) stage of resolution
which dz has a CRANIO-VENTRAL distribution in the lungs?BRONCHOPNEUMONIA
what is the distribution of bronchopneumonia in the lungs?CRANIOVENTRAL
**what are the two TYPES of bronchopenumonia (and their alternative name)(1) suppurative/lobular (suppurative is usually lobULAR) (2) fibrinous/LOBAR (fibrinous is usually lobAR)
4 possible Reasons for restrictions of bronchopneumonia to cranio ventral part of the lung are...(1) Shortness and abrupt branching of bronchus (2) Gravitational sedimentation of the exudate (3) Deposition of infectious agent in the 1st bronchus (4) Regional differences in ventilation
*Bronchopneumonia is irregular consolidation of___region of lung cranioventral
which viral infection can cause a cranioventral pattern of brochointerstitial pneumonia, mistaken easily for bronchopneumonia?Viral infection by Bovine respiratory syncytial virus
Lesions of bronchopneumonia can be caused by what two bacteria? which lobes are affected?Actinobacillus pleuropneumonia and Actinobacillus suis. Affect middle and caudal lobes
which two species can have bronchopenumonia that is cranioventral, but ALSO a patchy distribution throughout the lung is not common?cat and dog
which dz has a "mosaic" appearance?suppurative bronchopneumonia
SUPPURATIVE bronchopnemonia--> where in the lungs is affected? what kinda exudate? what's the pattern like? how would you describe the appearance of it?CRANIOVENTRAL part of lungs. suppurative OR mucopurulent exudate. lobULAR in pattern, with a MOSAiC appearance (with red and grey color)
how does suppurative bronchopneumonia appear microscopically?neutrophils, macrophages, cell debris in alveoli and lumen of air passages.
in who is recovery from suppurative bronchopneumonia delayed, and WHY?in ruminants and swine, because of lack of collateral ventilation
what are 4 major complications of suppurative bronchopneumonia?(1) Death by toxemia and hypoxia (2) May cause metastatic abscesses in other organs. (3) May become chronic (4) Plugging of bronchi and resultant atelectasis.
which type of bronchopneumonia can lead to atelectasis, and why?SUPPURATIVE bronchopneumonia, because it can cause plugged bronchi which lead to atelectasis
what is the exudate like in FIBRINOUS bronchopneumonia?Predominant exudate is more fibrinous than neutrophilic
which type of bronchopenumonia results from more severe injury because of strong pathogens?FIBRINOUS because it is LOBAR (affected entire lobes)
what are three STRONG pathogens in CATTLE which can result in fibrinous bronchopneumonia?M. hemolytica (pneumonic pasteurellosis), Mycoplasma mycoides subsp mycoides, Hemophillus somnus.
what are two STRONG pathogens in PIGS which can result in fibrinous bronchopneumonia?P. multocida, Actinobacillus pleuropneumonia
what are two STRONG pathogens in sheep/goats which can result in fibrinous bronchopneumonia?M.hemolytica, Mycoplasma mycoides subsp mycoides (latter mainly in goats).
which dz has a "marbled" pattern?FIBRINOUS bronchopneumonia
where do things tend to accumulate in supppurative bronchopneumonia? fibrinous?SUPPURATIVE: alveoli and tertiary bronchiole. FIBRINOUS: pleural surfaces, septa, alveoli and thoracic cavity.
what are the three major lesions of FIBRINOUS bronchopneumonia?(1) Severe congestion, hemorrhages and exudation of fibrin which accumulates on pleural surfaces, septa, alveoli and thoracic cavity. (2) Accumulation of fibrin in interlobular septa gives a lung typical marbled appearance. (3) The inflammatory responses are more severe than suppurative pneumonia. Foci of coagulative necrosis encapsulated by connective tissue (sequestrum) are common.
Foci of coagulative necrosis encapsulated by connective tissue (sequestrum) are common in what dz?FIBRINOUS bronchopneumonia
which type of bronchopneumonia RARELY resolves?fibrinous
WHY is death more frequent in ___ bronchopenumonia?FIBRINOUS bronchopenumonia. Death is more frequent due to pleuritis and pericarditis. Fibrinous adhesions of pleura and pericardium is common sequel.
Necrosis with formation of pulmonary sequestra is common in which bronchopenumonia?FIBRINOUS
what is fibrin an index for in fibrinous bronchopneumonia? how quickly does fibrin develop?Amount is an index of degree of alveolar-capillary membrane damage. VERY ACUTE CHANGE
what are some predisposing causes for aspiration pneumonia?Any cause of dysphagia or regurgitation including pharyngeal paralysis and megaesophagus.
distribution of lesions in aspiration pneumonia depends on what three things?(a) nature of material (b) bacteria carried with it (c) distribution of material in lung.
WIDESPREAD distribution of aspiration pneumonia is seen with what types of things that were aspirated? how does it appear grossly and histologically?seen with liquid gruel or inhaled milk. Gross appearance is not characteristic. Histologically acute bronchiolitis and alveolitis is seen
when will you see a localized lesion (with what aspired) in aspiration pneumonia? what are the lesions like?A localized lesion is with plant material, including whole grain and in pigs in dry season mostly with dusty dry particulate food. Lesions are descrete foreign body granulomas, lobar pneumonia or gangrene.
Aspiration of vomitus in simple stomach animals is dangerous because why? what can develop from this?because of edema development, long standing cases can develop into fulminating bronchopneumonia.
what's fulminating bronchopneumonia and when do you see it?A quickly developing usually fatal bronchopneumonia, often seen with aspiration of vomitus