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Questions and Answers
What is a common treatment requirement for acute tonsillitis to prevent complications?
What is a common treatment requirement for acute tonsillitis to prevent complications?
Which of the following pathogens is NOT commonly associated with the common cold?
Which of the following pathogens is NOT commonly associated with the common cold?
Which type of acute rhinitis is characterized by a type 1 allergic reaction?
Which type of acute rhinitis is characterized by a type 1 allergic reaction?
Which condition is most likely to result from severe nasal obstruction due to inflammation?
Which condition is most likely to result from severe nasal obstruction due to inflammation?
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Which type of tonsillitis involves purulent exudate that covers the tonsils, forming a membrane?
Which type of tonsillitis involves purulent exudate that covers the tonsils, forming a membrane?
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Which symptom is primarily associated with allergic rhinitis?
Which symptom is primarily associated with allergic rhinitis?
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Acute sinusitis is most commonly a complication of what condition?
Acute sinusitis is most commonly a complication of what condition?
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What are nasal polyps typically associated with?
What are nasal polyps typically associated with?
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What is the most common type of laryngeal carcinoma?
What is the most common type of laryngeal carcinoma?
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Which factor is NOT associated with an increased risk of laryngeal carcinoma?
Which factor is NOT associated with an increased risk of laryngeal carcinoma?
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In which part of the larynx do glottic tumors primarily occur?
In which part of the larynx do glottic tumors primarily occur?
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Which of the following is NOT a local cause of epistaxis?
Which of the following is NOT a local cause of epistaxis?
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What type of cell predominantly lines the respiratory tree up to the bronchus?
What type of cell predominantly lines the respiratory tree up to the bronchus?
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Which of the following is not considered a cause of epistaxis?
Which of the following is not considered a cause of epistaxis?
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What is the composition of the acinus in the lung structure?
What is the composition of the acinus in the lung structure?
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In comparison to supraglottic and subglottic laryngeal tumors, glottic tumors have what notable characteristic?
In comparison to supraglottic and subglottic laryngeal tumors, glottic tumors have what notable characteristic?
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Which type of atelectasis occurs as a result of an obstruction preventing air from reaching the distal airway?
Which type of atelectasis occurs as a result of an obstruction preventing air from reaching the distal airway?
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What is a common cause of resorption atelectasis?
What is a common cause of resorption atelectasis?
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What is the main difference between compression and contraction atelectasis?
What is the main difference between compression and contraction atelectasis?
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Atelectasis caused by mechanical withdrawal of air is known as which type?
Atelectasis caused by mechanical withdrawal of air is known as which type?
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Which of the following accurately describes atelectasis in premature infants?
Which of the following accurately describes atelectasis in premature infants?
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What role do Type 2 pneumocytes play in the alveoli?
What role do Type 2 pneumocytes play in the alveoli?
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What is a consequence of inadequate expansion of air spaces in the lungs?
What is a consequence of inadequate expansion of air spaces in the lungs?
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Which statement is true about pulmonary surfactant?
Which statement is true about pulmonary surfactant?
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Study Notes
Upper Respiratory Tract and the Lung
- Course Objectives: Students will understand the pathologic changes in respiratory diseases, and the role of genetics, environment, and socioeconomic factors. Students will learn to diagnose likely causes of illness.
Respiratory Tract
- Structure: The respiratory tract includes the nasal cavity, pharynx, larynx, trachea, primary bronchi, and lungs, progressing from upper to lower respiratory portions.
Lung Diseases
- Categories: Obstructive and restrictive diseases, pulmonary vascular diseases, pulmonary infections, pulmonary neoplasia (tumors), and diseases of the pleura.
Lesions of the Upper Respiratory Tract
- Acute Infections: Acute rhinitis, acute sinusitis, acute tonsillitis, acute pharyngitis, acute epiglottitis, and acute laryngitis.
- Nasal Polyps: These are growths in the nasal passage.
Acute Rhinitis
- Definition: Inflammation of the nasal mucosa.
- Types: Common cold (caused by viruses like corona, rhinoviruses, influenza, &RSV) and Allergic rhinitis (type 1 allergic reaction).
- Viral Phase: Virus attaches to cell surfaces, enters cells reproducing, causing inflammation, edema, and congestion.
- Bacterial Phase: Invasion of bacteria leads to typical inflammation.
Acute Sinusitis
- Location: Inflammation of maxillary sinuses.
- Causes: S. pneumoniae or S. aureus.
- Complications: Excess mucous, purulent discharge, and potential spread to the brain.
Acute Tonsillitis
- Cause: Streptococcus hemolyticus (bacteria).
- Types: Catarrhal (enlarged and red tonsils). Follicular (pus over tonsil tissue). Membranous (pus forms a membrane).
Acute Pharyngitis
- Cause: EBV and adenovirus (most common, 70%). Beta-hemolytic streptococci (30%).
- Complications: Retropharyngeal abscess and Adenoid hyperplasia (enlarged adenoids), leading to an adenoid face (characteristic facial features).
Acute Epiglottitis
- Cause: H. influenzae.
- Symptoms: Rapid onset, pain, and airway obstruction (potentially fatal).
- Prevention: Vaccination reduces incidence.
Acute Laryngitis
- Causes: Inhalation of irritants (chlorine) or agents causing the common cold..
- Rare Forms: Tuberculous laryngitis (infected sputum) and diphtheric laryngitis (exotoxin-induced pseudomembrane formation).
Diphtheric Laryngitis
- Affects: Children (2-5 years)
- Rarity: Rare due to vaccination.
- Cause: Corynebacterium diphtheriae.
- Symptoms: Exotoxin causes mucosa necrosis and membrane formation, leading to potential life-threatening complications (like asphyxia).
Nasal Polyps
- Cause: Recurrent nose infections lead to mucosa thickening.
- Structure: Located in the middle turbinate, they're bilateral, rounded, gelatinous masses with a smooth surface, composed of loose edematous connective tissue covered by ciliated respiratory epithelium.
Upper Respiratory Tract Tumors
- Nose Tumors: Rare, can present at advanced stage. Benign (like sinonasal papilloma) or malignant (like squamous cell carcinoma and lymphomas).
- Nasopharyngeal Carcinoma: Viral oncogene (EBV, particularly in Chinese populations) is a contributing factor, more common in children and older adults.
- Laryngeal Tumors: Vocal cord polyps (in smokers and singers) are benign. Squamous papilloma (HPV) is benign but precancerous in adults. Carcinoma is malignant and common.
Laryngeal Tumors (more detail)
- Glottic Tumors: 70% of laryngeal cancers are in the glottis.
- Supraglottic Tumors: 25% are in the supraglottis.
- Subglottic Tumors: Only 5% are subglottic.
- Morphology: Appear as gray, rough plaques on the mucosa which may ulcerate.
- Most Common Type: 95% of laryngeal cancers are squamous cell carcinomas.
- Clinical Course: Tumors can interfere with vocal cord mobility, causing persistent hoarseness. Spread is less common in glottic tumors vs. supraglottic or subglottic cancers.
- Treatment: Surgery and radiation.
Causes of Epistaxis (Nosebleeds)
- Local: Trauma, tumors, nasal polyps.
- General: Hypertension, leukemia, hemorrhagic blood disorders, vitamin C/K deficiencies.
Normal Lung
- Right Bronchus: More vertical than left, so aspirated foreign bodies, vomit, and blood more often go to right lung first.
- Blood Supply: Pulmonary and bronchial arteries.
- Function: Exchange of gases in alveoli.
Alveoli
- Structure: Multiple, small air sacs.
- Wall Structure: Contain capillary endothelium, Type 1 pneumocytes (thin and covering 95% of surface),Type 2 pneumocytes (rounded, granular, surfactant producers), Pulmonary interstitium , and alveolar macrophages.
- Pores of Kohn: Perforations in alveolar walls, allow for fluid and bacteria passage.
- Surfactant: Layer beside alveolar cell membrane, crucial for normal lung function
Normal Respiratory Tree
- Bronchi to bronchioles to alveoli: The respiratory tree progresses in branching from larger to smaller airways.
- Bronchioles: Have no cartilage or submucosal glands.
- Epithelial changes: Becoming less columnar (simple, short, and thinner) as the airways branch to the smallest.
Atelectasis
- Types: Resorption (obstruction), Compression (passive collapse), Contraction (scarring).
- Causes of obstruction: Mucous plugs, foreign bodies, blood clots, and tumor blocks.
- Microatelectasis: Premature infants may suffer from weak respiratory action leading to atelectasis, due to surfactant deficiency.
Normal Structure:
- Diagrams and images included for structural understanding of the respiratory tract, lungs and associated elements
Historical notes
- There are mentions of vaccination contributing to reduced cases of some infectious forms.
Important Note:
This summary is based on the images provided. Medical professionals should be consulted for diagnosis and treatment.
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