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Robbins Study Guide Chapter 15 The Lung

Terms in this set (60)

what are the two principal cell types of alveolar epithelium
type 1 pneumocytes

type 2 pneumocytes
Type ____ pneumocytes are flattened, platelike, covering 95% of the alveolar surface
1
type ____ pneumocytes are rounded, synthesize pulmonary surfactant, main cell type involved in the repair of alveolar epithelium
2
what phospholipid decreases surface tension within the alveoli, thus maintaining the stability of the alveoli
surfactant
the most common hemodynamic mechanism of pulmonary edema is caused by __________ and most frequently occurs in
increased hydrostatic pressure

left sided congestive heart failure
what is the pathogenic mechanism of adult respiratory distress syndrome
the integrity of the alveolar capillary membrane barrier is compromised by either endothelial or epithelial injury or both
the classic pathologic change seen in adult respiratory distress syndrome is __________
hyaline membranes
describe the stages of ARDS
initial injury to the capillary endo or epithelium and both are eventually affected

cell damage leads to increased caillary permeability, interstitial and then intraalveolar edema, fibrin exudation, and formation of hyaline membranes
_____________ refers to either incomplete expansion of the lungs or to the collapse of previously inflated lung, producing areas of relatively airless pulmonary parenchyma
atelectasias
what are the two types of acquired atelectasias
obstruction/resorption

compression
___________ atelectasia is a consequence of an airway leading to resportion of oxygen trapped in the alveoli and examples include bronchial asthma, chronic bronchitis, aspiration of a foreign body
obstruction/resorption
____________ atelectasia result whenever the pleural cavity is partially or completely filled with a fluid exudate, tumor, blood or air and examples include tension pneumothorax and pleural effusion
compression
what 5 disorders are in the spectrum of chronic obstructive pulmonary disease (COPD)
chronic bronchitis

bronchiectasis

asthma

emphysema

small airway disease
_________ is characterized by abnormal permanent enlargement of the airspaces distal to the terminal bronchiole accompanied by destruction of their walls, and without obvious fibrosis
emphysema
what are the 4 types of emphysema
centriacinar

panacinar

paraseptal

irregular
In ____________ emphysema the central and proximal parts of the acini, formed by respiratory bronchioles are affected and distal alveoli are spared
centriacinar
In __________- emphysema acini are uniformly enlarged from the level of the respiratory bronchiole to the terminal blind alveoli
panacinar
In ____________ emphysema the proximal portion of the acinus is normal, but the distal part is dominantly involved
paraseptal
In __________ emphysema the acinus is irregularly involved, almost invariably associated with scarring
irregular
panacinar emphysema is frequently associated with a deficiency of what protein
alpha 1 antitrypsin
subpleural, dilated, and confluent alveoli are known as _________ or _________
blebs/bullae/bullous emphysema
__________ is when the entrance of air into the connective tissue stroma of the lung, mediastinum, or subcutaneous tissue
interstitial emphysema
what is a possible cause of interstitial emphysema
alveolar tears in pulmonary emphysema providing entrance of air into the stroma of the lung
what is the name of the spiral shaped mucus plugs in patienta with asthma
curschmann spirals
__________ is a disease characterized by permanent dilation of bronchi and bronchioles caused by destruction of the muscle and elastic tissue, resulting from or associated with chronic necrotizing infections
bronchiectasis
what syndrome is bronchiectasias common
kartagener syndrome
________ is a fibrinosuppurative consolidation of a large portion of a lobe or entire lobe
lobar pneumonia
what is the most common etiologic agent of lobar pneumonia
s. pneumoniae
bronchopneumonia is also known as __________
lobar pneumonia
what are the 4 stages of the inflammatory response to lobar pneumonia
congestion

red hepatization

gray hepatization

resolution
primary atypical pneumonia is characterized by inflammatory changes primarily confined to the ________ and ________
alveolar septa and pulmonary interstitium
the most common organism which causes interstitial pneumonitis is
mycoplasma pneumoniae
what are 4 mechanisms responsible for the development of lung abscesses
aspiration of infective material

antecedent primary lung infection

septic embolism

neoplasia

trauma
a fungal infection by coccidioides prominent in southwest united states characterized by lung lesions, fever, cough, pleuritic pain, and erythema nodosum or erythema multiforme is also known as ________
san joaquin valley fever
______________ describes a spectrum of immunologically mediated, predominantly interstitial lung disorders caused by intense often prolonged exposure to inhaled organic dusts and related to occupational antigens
hypersensitivity pneumonitis
what are two examples of hypersensitivity pneumonitis
farmers lung, pigeon breeders lung
what are 2 characteristic findings associated with goodpasture syndrome
rapidly progressive golmerulonephritis

necrotizing hemorrhagic interstitial pneumonitis
the major morphologic correlate of chronic lung transplant rejection
bronchiolitis obliterans
what are the 4 common types of bronchogenic carcinoma
squamous cell carcinoma

adenocarcinoma

small cell carcinoma

large cell carcinoma
what is the most common broncogenic carcinoma in women
adenocarcinoma
what is the most common bronchogenic carcinoma
squamous cell carcinoma
most "scar cancers" are _____
adenocarcinoma
lung cancers most frequently disseminate by which pathways
lymphatic and hematogenous
what is the term used for multiple discreet nodules scattered throughout all lobes in the setting of metastatic tumors
cannonball lesions
which lung carcinoma occurs in the pulmonary parenchyma in the terminal bronchioloveolar regions at the peripheral portions of the lung
bronchioloalveolar carcinoma
the tumor most commonly associated with a history of smoking
squamous cell carcinoma
which tumors of the lungs are thought to be derived from cells of the neuroendocrine system
tumorlets, carcinoid, and aggressive small cell carcinoma and large cell neuroendocrine carcinoma
lung paraneoplastic syndrome
...
apical lung cancers that invade the cervical sympathetic plexus giving rise to horner syndrome on the same side as the tumor are also known as ________ tumors
pancoast tumors
what 4 entities comprise horner syndrome
enopthalmos, ptosis, miosis, anhidrosis
what type of carcinoma resembles lobar pneumonia and is less likely to be cured by surgery
mucinous adenocarcinoma
carcinoids that produce little intraluminal mass but penetrate the bronchial wall to pan out in the peribronchial tissue produce
collar button lesion
what are 3 classic clinical signs associated with the carcinoid syndrome
intermittent attacks of diarrhea

flushing

cyanosis
a noninflammatory collection of serous fluid within the pleural cavities is called
hydrothorax
___________ is an intrapleural fibrinosuppurative reaction
empyema
___________ is an accumulation of milky fluid usually of lymphatic origin in the pleural cavity
chylothorax
what causes chylothorax
thoracic duct trauma
what are the 3 types of pneumothorax
spontaneous

traumatic

tension
what is the best way to detect pneumothorax during autopsy
careful opening of the thoracic cavity to detect the escape of gas or air bubbles
what pleural tumor is related to asbestos exposure
malignant mesothelioma
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