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What are examples Strutural Congential abnormalities?
- Agensis
- Aplasia
- Hypoplasia (not common)
- Tracheal, bronchi and vascualr abnomalies
- stenosis (common)
- tracheo esophageal fistula (gagging bad for lung- can destroy lung, needs to be corrected
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What are examples of Congenital Cysts?
Detachment of the primitive foregut
They are mostly Bronhogenic: lined by bronchial type epithelium and contain mucinous secreation
infection abscess
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What are examples of Bronchopulmonary sequestration?
Lung lobes or segment without connection to the airways and with blood supply from the acortic brances not from the arteries
such as extralobar or intra lobar masses
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What is Extralobar Mean?
Mediastinal mass
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what does intralobar mean?
Mass within the lung parencyma
Can be mistaken for cancer
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How common is Hypoplasia and what does it mean?
Very common
- very small lung
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What are some of the feature of Congenital Cycsts?
- Detached frgament of primitive forgut
- often located in hilum or middle mediastinum
- Bronchogenic lined by epithelum and contain mucinous secreation
- looks like cancer but not
- Infection--> abscess
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What is Atelectasis?
Refers to incomplete expansion of the lung or to collapse of previosuly inflated lung substance
reduces oxygenation and predisposes to infection
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What are the types of Atelectasis?
- 1. Resorption- caused by complete abstruction- collapse distal to point of obstruction
- -Can be caused by asthama and chronic bronchitis
2.Compressive-- caused by fluid or air in the pleural cavity-- Pneumotrhoax (leaking lung air rushs in from outside)-pushs lung down
3. Patchy--not important
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Where does the mediastinum shit if resoprtion Ateclectasis?
towards effective side
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Where do the mediastinum shit in compression?
air in plura space, shift to opposite side
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If you see blood in the lung what do you think?
Atelectasis
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What are the cuases of Pumonary Edema?
- Hemodynamic disturbances
- Hemodynamic Causes
- Microvascular injury--> ARDS
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Hemodynamic distrubances--what is it?
Increased capillary hydrostatic fluid, or incrase in microvasuclar injury with cap permeability:ARDS
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What are hemodynamic cuases of edema?
- Hydrostatic pressure as in L. Heart failure
- Heart failure
- fibroisis
- Hypoalbuminemia--Liverdeagae bec of liver disfunction
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What are example of microvascular injury?
- ARD
- infections
- gases aspiration
- drugs
- heroin
- paraquat
- shock
- trauma
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What is ARDs?
- Adults resoportory Distress syndrmoe- diffuce alveolar caps damage, pumlmonary edema
- 50% mortality rate
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What are some of the features of ARDS?
- Diffuce alveolar caps damage
- life threating resp insufficiency
- cyanosis and severe aterial hypozemia
- may progress to organ falure
- resistant to Oxygen therpy
- severe pulmomary edema, hyaline membrane
- severe infection gastirci aspiration
- O2 toxicity
- septic shock
- trauma
- association with shock and DIC
Can be found in alcholoics
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What would you in a histo seciton for pumnoary edema if chronic
See pick fluid in Alveoli=Pumonary Edema
If chronic you can see brown segement by dying RBC which are picked up by marcrophages
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What is a pumonary Embolism?
- Almost always thrmoboemoblus
- 95% arise in deep veins of the legs
Large emboli-- sudden death or acutre CHF
Small Emboli- may be silent or cause pumonary hemmorrhage or infarcation
Multiple small emboli--pumonary hypertension with vascular sclerosisi or cor pumonale
over 2/3 of cases of PE are not diagnoses before death
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gass associated with pumonary Embolism in deep divers is?
Nitrogen
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What happens to people after large surgery? ( when it comes to pathology of lung?)
can produce a massive embolim after surgery because laying in bed
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What is pumonary Hypertension?
Mean pumonary pressure increase to 1/4 from a system pressure. usually 1/8 much smaller
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What is Pumonary Hypertension caused by?
COPD, Chronic interstitial lung diease, left sideded HF and reccurent pumonary emobolism
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What are some of the effects of Pumlmary Hypertension?
- 1. large arteries, atherosclerosis
- 2. Medium sized and small muscluar arteries: inteimal fibroissi, hypertrophy or musculo elastic tissue
- 3. Plexogenic arteripahty
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What is Primary Pumonary Hypertension?
- RARE
- Plexogenic arteriopthaty can lead to this
- Idopathic disease seen in childern or women below 40 year
may show vascular changes
Athersclerosisi thicking of bronchi wall
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What are mechanism pleural effusions?
Transudars or exudates
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What does Transuardes look like?
Watery clear fluid, in the plura space
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What does exudates look like?
Infection, pulling H20 in , bloody looking.
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What are some of the types of pleural effusions?
Serous, serofibrinous, suppurative, hemorrahagic and chylous, meothroax and pneumotroax
Fluid in the Pluera space
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