The Respiratory System

- goblet cells
- cilliated bronchii epithelial cells

- 3rd to 17th bronchii
- medium-large bronchii

- hypertrophy of the goblet cells
- metaplasia of the ciliated bronchii epithelial cells which causes cilia to be destroyed

1. bacterial infection from accumulation of secretions from goblet cells which causes obstruction
2. obstruction of ventilation caused by the remodelling of the bronchii which causes narrowing of the airways in which the excessive amount of sputum gets caught

- elastin
- alveolar wall composition

1. Centrilobular - bronchioles in the central part of the respiratory lobule (often seen in smokers)
2. Panlobular - absence of α1-antitrypsin - peripheral alveoli and later extend to central bronchioles (familial)

- destruction of elastin fibres causing a loss of lung elasticity
- destruction of alveolar walls and capillary beds

- chest structure changes (barrel chest)
- difficulty of forcing expiration

- goblet cells
- muscle cells

- medium to larger bronchii

- hypertrophy of goblet cells which causes inflamed, thick airways
- production of mucous - mucous plugging

1. periodic difficulty breathing
2. tightness in chest

- collagen
- interstitium

in the interstitium

- fibrosis of the interstitium due to extra collagen being laid down
- less oxygen saturation in the blood due to diffculty in respiration (exchange of oxygen across the interstitium)

1. difficulty in inflating the lungs (shallow breathing) due to increased collagen in the interstitium from fibrosis
2. irritation from fibrosis causes a dry cough

- thrombi that arise from deep vein thrombosis

- thrombi usually from the lower extremities
- thrombi travel to the right side of the heart
- obstructs pulmonary artery?

1. acute chest pain
2. dyspnea

- M. Tuberculosis
- inflammatory cytokines
- macrophages
- giant cell

- anywhere in the body, not neccessarily in the lungs
- in lungs: upper apices

- inflammation of 100s of 1000s of cells, may cause a granuloma
- single macrophage is not able to combat infection, therefore a multi-nucleated giant cell is created in attempt to kill the bacillus

1. increased thermoregulatory set point (fever)
2. productive cough and blood streaked sputum

- bacteria that cause infection
- pleural cavity
- inflammatory cytokines
- macrophages

Pleural cavity

- inflammation of the pleural cavity due to bacterial infection
- accumulation of fluid in the lungs which may cause tracheal deviation to the unaffected side

- pain upon inspirations
- bad fever

- lung
- visceral pleura
- parietal pleura

The thoracic cavity

- deflation of the lung - breaking off of the lung from the visceral and parietal pleura
- tracheal deviation to the affected side due to the inflated lung increases a little more in size to compensate for the collapsed lung

1. hyper resonance on percussion of back
2. slight dyspnea causing reduced exercise tolerance

- bacteria causing infection
- inflammatory cytokines
- macrophages
- ciliated endothelial cells that line the respiratory tract

- vigorous inflammation of one lobe of the lung
- destruction of cells in the bronchii
- dilation of blood vessels to increase permeability and flood the lungs with fluid exudate in attempt to kill the bacteria

1. green purulent productive cough
2. high fever from vigorous immune response

- viral infection
- respiratory tract epithelium
- inflammatory cytokines
- macrophages

- patchy involvement of the lung
- largely confined to the alveolar septum and pulmonary interstitium

- damage to the repiratory tract epithelium
- impairment of respiratory tract defences (predisposing patient to bacterial pneumonia)

1. fever from inflammatory response
2. non-productive dry cough

1. Emphysema
2. Chronic Bronchitis

- cause decreased blood flow to a particular area, causing increase blood pressure

- hypertrophy of the right side of the heart, causing the heart walls to become thinner

- as it decrease perfusion and blood pressure

- hypertrophy of the right side of the heart, eventually leads to cor pumonale due to the increased work load

- usually lugs maintain an equal balance of air and blood through the lung tissue
- chronic obstruction cause chronic compensation of the blood vessels
- chronic obstruction of blood vessels in the lung leads to a hypertrophy of the right side of the heart and eventually right sided heart failure

A condition in which the surfactant in the alveolus is not present include respiratory distress syndrome in adults, and a condition in which infants do not have the type II alveolar cells that produce surfactant

No surfactant causes collapsed alveoli that are difficult to pull apart on inspiration causing laboured breathing

When dust enters the lungs, an immune response occurs where macrophages are sent out to grab the dust particles and transport them to the hilar lymph nodes via the nearest major lymphatic vessel. If the hilar lymph nodes become too inundated they become backed up, resulting in difficulty in getting fluid out of the lungs, causing pulmonary oedema

the events that occur in the red hepatisation stage of typical lobar pneumonia include vasodilation of the blood vessels which increases their permeability. The increased permeability of the blood vessels allows flooding of the interstitial space with numerous cells of the immune response such as macrophages and neutrophils, to combat the bacterial infection

The main type of damage seen in the lung of a patient with interstitial lung disease is fibrosis within lymphatic vessels and the interstitial space. The laying down of collagen due to fibrosis may also cause a narrowing of the vessels, which may lead to blockages.

Cyanosis is a bluish colouration of the skin caused by a lack of oxygen in the blood.

It usually occurs in the extremities of the body (i.e. lips, fingers, toes) in response to cold temperatures, heart failure, and lung disease.

- anaemia where there is a low amount of blood cells but they are all full saturated with oxygen
- saturation of haemoglobin with the wrong gas - for example, carbon monoxide poisoning would result in carbon monoxide being bound with haemoglobin.

- because the body is trying to deliver blood to where it is needed the most
- for example, the respiratory system disorders where there is not an adequate amount of oxygen bound to haemoglobin, blood would be sent in that direction to help this