回帖：Chapter 7 Diseases of Respiratory System
§1. Pneumonia
1. Bacteria pneumonia
(1)Lobar pneumonia
·Etiology: pathogens: pneumococcus
inducing factors: cold, excessive tired, anaesthesia
·Pathologic changes
①Congestion stage: Gross: swollen, red
LM: alveolar wall: capillary: diffuse dilation and congestion
alveolar space: serous exudate, a few RBC, neutrophils, macrophages, numerous bacteria
②Red hepatization: Gross: red, solid, liver-like consistence
LM: alveolar wall: capillary: dilation and congestion
alveolar space: full of fibrin, lots of RBC, a few neutrophils and macrophages, numerous bacteria
fibrinous nets pierce through cohn's pores from one alveolus into adjacent alveoli
③Gray hepatization: Gross: gray-white, solid, liver-like consistence
LM: alveolar wall: capillary: compressed
alveolar space: fibrin↑, connection among fibrinous nets↑, lots of neutrophils
④Resolution stage: enzymatic digestion of fibrin
·Complication
①Pneumonary carnification: neutrophils↓ → incomplete resolution → organization of exudate → diffuse fibrosis
②Lung abscess and empyema
③Thickening and adhesion of pleura: fibrinous pleurisy
④Septicemia or pyemia
⑤Infectious shock
(2)lobular pneumonia (bronchopneumonia)
·Etiology: pathogens: staphylococcus, pneumococcus
·Pathologic changes: Gross: scattered gray-yellow foci of consolidation are centered on bronchioles
severe: Confluent bronchopneumonia
LM: suppurative, neutrophil-rich exudate fills the bronchi, bronchioles and adjacent alveolar spaces
·Complication
①Respiratory failure
②Heart failure
③Pyemia
④Lung abscess and empyema
2. Viral penumonia
·Etiology: pathogens: influenza virus
·Pathologic changes: LM: interstitial pneumonia
alveolar septum: widen obviously, edema, dilation and congestion of blood vessels, infiltrated with lymphocytes and monocytes
Hyaline membrane
Viral inclusion: round or oval, erythrocyte-like in size, surrounded with a transparent halo
§2. Chronic obstructive pulmonary disease (COPD)
1. Chronic bronchitis
(1)Etiology
①Infection: virus, bacteria
②Smoking
③Air pollution and allergic reaction
④Internal factors
(2)Pathologic changes
①Bronchial epithelium: degeneration and necrosis, goblet cells↑, squamous metaplasia
②Hypertrophy and hyperplasia of submucosal glands, mucous glandular metaplasia, secretion of mucus↑
③Bronchial wall: congestion and edema, infiltrated with lymphocytes and plasma cells
④SMC, cartilage
2. Bronchial asthma
Pathologic changes
·Gross: mucous plugs
·LM: BM: thicken obviously, hyaline degeneration
submucosa: edema, hyperplasia of mucous glands, goblet cells↑
SMC: hypertrophy and hyperplasia
infiltrated with eosinophils, monocytes, lymphocytes and plasma cells
Charcot-Leyden crystals
3. Bronchiectasis
Pathologic changes
·Gross: bronchi: dilation, purulent exudate
·LM: bronchial wall: thicken obviously, destroyed, fibrosis
submucosa: dilation and congestion of blood vessels, infiltrated with lymphocytes, plasma cells, even neutrophils
4. Pulmonary emphysema
(1)Etiology and pathogenesis
①Obstructive ventilative dysfunction
②Elasticity of respiratory bronchioles and alveolar wall↓
③α1-antitypsin↓
(2)Types
①Alveolar emphysema (Obstructive emphysema)
·Centriacinar emphysema
·Periacinar emphysema
·Panacinar emphysema
②Interstitial emphysema
③Oth