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Chapter 12, Pathology

Terms in this set (31)

auscultation
(DIAGNOSTIC TERMS)
Listening to sounds within the body.
*Helpful to diagnose conditions of the lungs, pleura, heart and abdomen. Also to determine the condition of the fetus during pregnancy.
percussion
Tapping on a surface to determine the difference in the density of the underlying structure.
*Tapping over a solid organ produces a dull sound without resonance.
*When the lungs or the pleural space is filled with fluid and become more dense, as in pneumonia, resonance is replaced by dullness.
pleural rub
Scratchy sound produced by pleural surfaces rubbing against each other.
*Pleural rub (also called a friction rub) occurs when the pleura are roughened and thickened by inflammation, infection, scarring, or neoplastic cells.
*Can be felt by putting your fingers on the chest wall.
rales (crackles)
Fine crackling sounds heard on auscultation (during inhalation) when there is fluid in the alveoli.
*Popping or clicking sounds can be heard in patients with pneumonia, bronchiectasis, or acute bronchitis.
rhonchi (singular: rhonchus)
Loud rumbling sounds heard on auscultation of bronchi obstructed by sputum.
*Sounds sound like snoring or rumbling and are usually caused by secretions in larger bronchial tubes.
sputum
Material expelled from the bronchi, lungs, or upper respiratory tract by spitting.
*Purulent (containing pus) sputum often is green or brown.
*Comes from infection and may be seen with asthma.
*For a sputum culture, the specimen is maintained in a nutrient medium to promote growth of a pathogen.
*Culture and sensitivity (C&S) studies identify the sputum pathogen and determine which antibiotic will be effective in destroying or reducing its growth.
stridor
Strained, high-pitched sound heard on inspiration caused by obstruction in the pharynx or larynx.
*Common causes of stridor incluse throat abcess, airway injury, croup, allergic reaction, or epiglottitis and laryngitis.
wheezes
Continuous high-pitched whistling sounds produced during breathing.
*Wheezes are heard when air is forced through narrowed or obstrcted airways.
*Patients with asthma commonly experience wheezing as bronchi narrow and tighten.
croup
(UPPER RESPIRATORY DISORDERS)
Acute viral infection of infants and children with obstruction of the larynx, accompanied by barking cough and stridor.
*Most common causative agents are influenza viruses or respiratory syncytial virus (RSV).
diphtheria
Acute infection of the throat and upper respiratory tract caused by the diphtheria bacterium (Corynebacterium).
*Inflammation occurs, and a leathery, opaque membrane forms in the pharynx and trachea.
*Injections usually are given as combination vaccines with perussis and tetanus toxins and so are called DPT injections.
epistaxis
Nosebleed.
*Epistaxis is a Greek word meaning dropping.
*Commonly results from irritation of nasal mucous membranes, trauma, vitamin K deficienct, clotting abnormalities, blood-thining medications (like asprin)j, or hypertension.
pertussis
Whooping cough; highly contagious bacterial infection of the pharynx, larynx, and trachea caused by Bordetella pertussis.
*Characteried by paroxysmal (violent, sudden) spasms of coughing that ends ina loud "whooping" inspiration.
asthma
(BRONCHIAL DISORDERS)
Chronic bronchial inflammatory disorder with airway obstruction due to bronchial edema and constriction and increased mucus production.
*Signs and symptoms: dyspnea, wheezing, and cough.
*Etiology can involve allergy or infection.
*Triggers: exercise, strong odors, cold air, stress, allergens (tobacco smoke, pet dander, dusts, molds, pollens, foods) and medications (aspirins, beta-blockers).
*Treatments:
-Fast-acting agents for acute symptoms; example is an albuteol inhaler (bronchodilator).
-Long-acting agents for long term control; examples are gulcocorticoids (inhaled), oral steriods (anti-inflammatory drugs), and leukotriene blockers such as Singulair.
bronchiectasis
Chronic dilation of a bronchus secondary to infection.
Caused by chronic infection with loss of elasticity of the bronchi. Secretions puddle and do not drain normally.
Signs and symptoms: cough, fever, and expectoration of foul-smelling, purulent (pus-containing) sputum.
*Treatment is palliative (noncurative) and includes antibiotic, mucolytics, bronchodilators, respiratory therapy, and surgical resection if other therapies are not effective.
chronic bronchitis
Inflammation of bronchi persisting over a long time; type of chronic obstructive pulmonary disease (COPD).
*Infection and cigarette smoking are etiologic factors.
*Signs and symptoms: excessive secretion of often infected mucus, a productive cough, and obstruction of respiratory passages.
*Chronic bronchitis and emphysema are types of COPD.
cystic fibrosis (CF)
Inherited disorder of exocrine glands resulting in thick mucinous secretions in the respiratory tract that do not drain normally.
*Genetic disorder caused by a mutation in a gene.
*It can be diagnosed by newborn screening, blood test, sweat test, and genetic testing.
*No known cure, but therapy includes antibiotics, aerosolized medications, chest physciotherapy, and replacement of pancreatic enzymes.
atelectasis
(LUNG DISORDERS)
Collapsed lung; incomplete expansion of alveoli.
*The bronchioles and alveoli (pulmonary parenchyma) resemble a collapsed balloon.
emphysema
Hyperinflation of air sacs with destruction of alveolar walls.
*Loss of elasticity and the breakdown of alveolar walls result in expiratory flow limitation.
*Strong association between cigarette smoking and emphysema.
*Destrcution of lung parenchyma, including blood vessels, pulmonary artery pressure rises and the right side of the heart must work harder to pump blood.
*Leads to right ventricle hypertrophy and right heart failure (cor pulmonale).
*Emphysema and chronic bronchitis are both forms of COPD.
lung cancer
Malignant tumor arising from the lungs and bronchi.
*Often associated with cigarette smoking, is the most frequent fatal malignancy.
*Lung cancers are divided into two general catergories: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC).
*NSCLC
-Accounts for 90% of lung cancers and comprises three main types: adenocarcinoma (derived from mucus-secreting cells), squamous cell carcinoma (derived from the lining cells of the upper airway), and large cell lung cancer.
-If nodes are negative, the patient is a good canidate for surgery.
-If nodes are positive, multimodality treatment (chemotherapy and irradiation), with or without surgery, is an option.
-In some patients, often nonsmokers, NSCLC may be caused by a mutation (change) in epitherlial lung tissue; example EGFR inhibitors.
*SCLC
-Derives from small, round ("oat" cells) cells found in pulmonary epithelium.
-It grows rapidly early and quickly spreads outside the lung.
-Treatment with radiation therapy and chemotherapy may lead to remissions.
pneumonconiosis
Abnormal condition caused by dust in the lungs, with chronic inflammation, infection, and bronchitis.
*Various forms are named according to the type of dust particle inhaled
-anthracosis: coal (anthrac/o) dust (black lung disease)
-asbestosis: asbestos (asbest/o) particles (in shipbuilding and construction trades)
-silicoles: silica (silic/o = rocks) or glass (grinder's disease)
pneumonia
Acute inflammation and infection of alveoli, which fill with pus or products of the inflammatory reaction.
*Infection damages alveolar membrane so that an exudate (fluid, blood cells, and debris) consolidates the alveoli (sacs become "glued" together, making air exchange less effective).
*An infiltrate is a fluid-filled area within the lungs as seen on a chest x-ray or CT scan.
*Lobar pneumonia involves an entire lobe of a lung.
*Bronchopneumonia is a limited form of infection that produces patchy consolidation (abcesses) in the lung parenchyma.
*Treatment: appropriate antibiotics and, if necessary, oxygen and mechanical ventilation in severe cases.
*Community-acquired pneumonia results from a contagious respiratory infection, caused by a variety of viruses and bacteria.
-It usually is treated at home with oral antibiotics.
*Hospital-acquired pneumonia or nosocomial pneumonia is acquired during hospitalization.
-Ex: Patients may contract pneumonia while on mechanical ventilation or as a hospital-acquired infection.
*Aspiration pneumonia is caused by material, sucha as food or vomitus, lodging in bronchi or lungs.
-It is danger in the elderly, Alzheimer disease patients, stroke victims, and people with esophageal reflux and feeding tubes.
pulmonary abcess
Large collection of pus (bacterial infection) in the lungs.
pulmonary edema
Fluid in the air sacs and bronchioles.
*Condition most often is causd by the inability of the heart to pump blood (congestive heart failure).
*Blood backs up in the pulmonary blood vessels, and fluid seeps out into the alveoli and bronchioles.
*Acute pulmonary edema requires immediate medical attention, including drugs (diuretics), oxygen in high concentrations, and keeping the patient in a sitting position (to decrease venous return to the heart).
pulmonary embolism (PE)
Clot or other material lodges in vessels of the lung.
*The clot (embolus) travels from distant veins, usually in the legs.
*Pulmonary infaraction: an area of dead (necrotic) tissue.
*PE often causes acute pleuritic chest pain (pain on inspiration) and may be associated with blood in the sputum, fever, and respiratory insufficiency.
pulmonary fibrosis
Formation of scar tissue in the connective tissue of the lungs.
*This may be the result of chronic imflammation or irritation caused by tuberculosis, pneumonia, or pneumoconiosis.
sarcoidosis
Chronic inflammatory disease in which small nodules (granulomas) develop in lungs, lymph nodes, and other organs.
*The cause is unknown.
*Corticosteriod drugs are used to prevent progression of the illness.
tuberculosis
Infectious disease caused by Myobacterium tuberculosis; lungs usually are involved, but any organ in the body may be affected.
*Rod-shaped bacteria called bacilli invade the lungs, producing small tubercles of infection.
*Early TB usually is asymphatic and detected on routine chest x-ray stduies.
*Signs and symptoms of advanced disease: cough, weight loss, night sweats, hemoptysis, and pleuritic pain.
*It is important and often necessary to treat TB with several drugs at the same time to prevent drug resistance.
*The PPD skin test is given to most hospital and medical employees because TB is highly contagious.
-A positive PPD test, in the absense of infection, requires treatment with isoniazid.
mesothelioma (PLEURAL DISORDERS)
Rare malignant tumor arising in the pleura.
*Mesotheliomas are derived from mesothelium, which forms the lining of the pleural surface.
*These tumors are caused by asbestos exposure.
pleural effusion
Abnormal accumulation of fluid in the leural space (cavity).
*Two types of pleural effusions are exudates (fluid from tumors and infections) and transudates (fluid from congestive heart failure, pulmonary embolism, or cirrhosis).
pleurisy (pleuritis)
Inflammation of the pleura.
*This condition causes pleurodynia and dyspnea and, in chronic cases, pleural effusion.
pneumothorax
Collection of air in the pleural space.
*May occur in the course of a pulmonary disease (emphysema, carcinoma, tuberculosis, or lung abscess) when a break in the lung surface releases air into the pleural space.
*Pleurodesis: the artificial production of adhesions between the parietal and visceral pleura for treatment of persistent pneumothorax and severe pleural effusion.
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