Pathology, Etiology, and Respiratory System Overview

Vocab

• Pathology refers to the study of diseases causing organ system abnormalities.
• Pathogenesis is the disease's sequence of events and its development.
• Etiology is the cause or reason for a disease and the factors enabling it.
• Infarct refers to localized area of ischemic necrosis.
• Hematoma means accumulation of blood trapped within body tissues.
• Inflammation is the body's initial response to local injury.
• Transudate is fluid leaking through membranes into extracellular space due to pressure imbalance.
• Signs are what healthcare providers observe.
• Symptoms are what the patient feels.

Respiratory Anatomy + Physiology

• The alveoli are essential structures in the respiratory system where gas exchange occurs, converting O2 into CO2.
• The right bronchus is wider, more vertical, and shorter, causing foreign bodies to tend to lodge there.
• The left bronchus is longer, narrower, and more horizontal due to the heart's position.
• Lungs and diaphragm work together to aid with breathing
• During inhalation, the diaphragm contracts and moves downward, which increases chest cavity space and allows more room to breathe in air.
• During exhalation, the diaphragm relaxes and moves up, which reduces chest cavity space and forces air out of the lungs. Lungs and diaphragm function with inverse relationship
• Diaphragm shrinks, more chest space
• Diaphragm relaxes, less chest space
• The pleura is a double-walled, serous membrane sac. Its layers include the outer parietal pleura, inner visceral pleura, and pleural cavity in between.
• The trachea divides into the right and left bronchi at the carina.

Respiratory Diseases

• Pulmonary metastases is malignant growth in the lungs that originates elsewhere in the body.
• The four types of spread are:
  • Hematogenous spreads through the bloodstream, it involves cells entering the bloodstream, being filtered by the lungs, and forming metastatic deposits.
  • Lymphatic spreads through lymph vessels, causing diffuse interstitial/peribranchial infiltration.
  • Direct involves primary tumors from nearby structures invading the lungs.
  • Airway allows tumor cells to spread through the bronchi but is rare
• Cystic Fibrosis is identified by a specific mutation of the CFTR gene.
  • It does not allow respiration because of mucous build-up and is additive due more mucus/fluid.

Cystic Fibrosis Specifics

• The pathogenesis of cystic fibrosis stems from gene mutation
• The etiology is genetic inheritance
• Signs include cough, wheezing and enlarged fingertips
• Symptoms are difficulty breathing with abdominal pain
• The organ(s) affected are the lungs and the bronchi
• The structure impact is mucus build up
• The function impact is the obstruction of affecting respiration, O2 cannot flow well, and CO2 cannot leave properly.
• Imaging appearance shows increased lung markings, dirty chest, hyperinflation that flattens the diaphragm, mucus plugging
• It is additive

Pneumothorax

• The air in the pleural space disrupts the negative pressure.
• The pathogenesis is blunt force trauma combined response to an underlying condition.
• The etiology can be trauma, underlying disease, or iatrogenic.
• Signs include reduced or absent breath sounds and decreased chest wall movement.
• Symptoms are sharp chest pain
• It affects the lungs by collapsing lung tissue on the affected side
• This causes functional impact impairing ventilation and oxygenation, and reducing cardiac output due to venous return.
• The imaging appearance includes absent lung markings, lung collapse and a visible pleural line
• It is destructive

Croup

• Croup, or laryngotracheobronchitis, primarily affects children ages 6 months to 3 years, causes upper airway inflammation at subglottic location, and is additive.
• The steeple sign, inverted V, can be seen on an AP soft tissue neck X-Ray
• The pathogenesis of croup stems from airborne pathogens and droplet transmission/direct transmission.
• The etiology includes a viral infection
• Pt signs include barking cough, inspiratory stridor, and hoarseness. Symptoms are difficulty breathing and anxiety.
• Croup affects the larynx, trachea, and bronchi. The structural impact includes a swelling of the mucosal lining that leads to the narrowing of the subglottic regio.

Croup Specifics

• Functional impact includes reduced airflow, impaired voice production, and accumulation of mucus, leading to obstruction.
• The imaging appearance could highlight steeple sign, and narrowing of the trachea
• It is additive.

Epiglottitis

• Pt notes on epiglottis "The Sopranos loved the value meal menu" and also means supraglottic location.
• Sopranos can "get it from virtually anything"
• Epiglottis is acute and a medical emergency as it is very med emergency
• Lateral soft tissue neck is shown with the thumbprint sign
• The pathogenesis can stem from airborne or direct transmission, or swallowing of hot liquids as well as intubation or foreign bodies.
• The etiology includes viral or bacterial infections, or thermal, chemical, or traumatic injuries.
• Pt signs consist of; drooling, inspiratory stridor, and hot potato voice.
• Symptoms are sore throat, difficulty and painful swallowing, as well as anxiety.
• Epiglottitis affects the epiglottis
• Structure impact creates a swollen + red
• Functional impact shows obstruction of airflow to the trachea, impaired swallowing
• The imaging appearance shows a thumbprint sign

Epiglottitis notes

• Narrowing of the airway occurs additively

Emphysema

• A progressive, irreversible form of COPD.
• Commonly associated with chronic bronchitis and airflow obstruction.
• Emphysema damages the alveolar walls which then destroys buildings
• Pt may have impaired gas exchange due to the fires made to breathe
• Pt shows reduced airflow (Fires spread with destroyed buidings)
• The pathogenesis is destructive of elastic recoil of alveoli
• The Etiology stems from Smoker, recurrent respiratory infections and indoor pollution
• Pt signs; Barrel chest, chronic cough, cyanosis
• Pt symptoms are SOB and fatigue
• Organs affected are Lungs and Alveoli
• Structure impact is Destruction of alveolar walls
• Functional Impact losses Elastic Recoil and Impairs Gas Exchange
• The lung lucency increases with darker lungs and causes hyperinflation, overinflated lungs w. flat diaphragm as well as Bullae + blebs, air-filled spaces w/o vascular structures visible\
• It destructive

Hyaline Membrane Disease

• Hyaline Membrane Disease is also known as Neonatal resp. distress syndrome (NRDS)
• W/ this disease pt suffers from not enough lube (surfactant in the lungs or alveoli to expand)
• Pt suffers from alveoli collapses, causing impaired gas exchange (too much CO2 not enough O2)
• Keyword: Air bronchiolegrams

Hyaline Membrane Disease continued

• The pathogenesis lacks surfactant and reduces surface tension in the alveoli
  • Pt has surfactant deficiency
• Pt will show Tachypnea, Cyanosis, Grunting during exhaling
• Lungs are affected
• It causes Alveolar Collapse
• Causes Impaired Air Exchange
• Imaging will show Ground-Glass as well as Air bronchograms where air-filled bronchi becomes visible\
• It's additive

Skeletal Anatomy + Physiology

• Compact bone = Real hardness of the bone
  • Dense, closely-knit layer
• Spongy = Softer, more absorbent
  • Porous loosely knit bone w. honey-comb appearance
  • Contain Red Bone Marrow
• The body has 206 bones
  • Axial = 80 bones , these include :
    • Skull, Vertebral Column, Ribs, Sternum
  • Appendicular = 126 bones
    • Upper + lower Limbs, shoulder, pelvic girdle
• Red bone marrow produces is RBC's and found in Spongy Bones
• Yellow bone marrow produces Fat Cells and is Found in cavity of Long Bones (marrow cavity)
• Three Main categories of Joints are;
  • Synarthrodial = Immovable
    • Skull Sutures
  • Amphiarthrodial = Somewhat Movable
    • Intervertebral Joint Spaces
  • Diarthrodial - Freeeee
    • Hinge = Elbow (1D)
    • Ball-in-Socket = hip (Cup)
    • Pivot = C1/C2 (lego Rotation)
    • Saddle = Thumb (Convex/Concave)
• Osteoblasts = Builders
  • Bone-forming cells
• Osteoclasts = Clean-up
  • Absorb + remove cells inside the bone

Types of Bones

• Irregular Bones= Vertebrae
• Flat bones= Sternum
• Short Bones = Carpals
• Sesamoid = Sesame seed under the thumb/big toe

Spina Bifida:

• Three types are
  • Occulta = Mild
    • incomplete closure of the vertebral arches
    • Looks like little black dots on Vertebras
    • Tuft of hair
  • Meningocele = Moderate
    • Visible Sac
    • Only in the membranes/meninges
    • Does not involve spinal cord
  • Myelomeningocele = Severe
    • Cyst protruding Out
    • Spinal Cord + Meninges come out
• Involves Spinal Cord

Bone Fractures

• Colles' Fracture = Bracing for a fall with outstretched hand
  • Wrist(Maybe ulna Styloid)
• Boxers' Fracture = Transverse break of the neck of the 5th metacarpal

Bone Diseases

• Osteoporosis vs, Osteopetrosis Vs. OI:
  • Osteoporosis
    • Deficiency of bone matrix
    • Increase Osteoclasts
    • Empty Hollow Box appearance
    • Older women bc lack of estrogen
    • Destructive
  • Osteopetrosis
    • Marble Bones
    • Defective osteoCLAST function
    • Dense but Sensitive bones
    • Genetic
    • Additive
  • Osteogenesis Imperfecta (OI)
    • Brittle Bone Disease
    • Defective collagen production
    • Genetic
    • Less Dense + weak
    • “The curved arm”
    • Destructive

Skeletal Diseases

• Congenital Hip Dysplasia

  • AKA Developmental Hip Dysplasia(DDH)
    • Hip Displacements allll the time Bruh
      • Hip Joints isn’t properly formed
    • Absent or smaller femoral head
    • Pathogenesis : Gene Mutation
    • Etiology : Generic Inheritance
    • Pt Signs: Hip dislocated w/ gentle pressure | limited ABD of the Impacted hip
    • Pt Symptom : Pain
    • Affects the Hip Joint
    • Structure Impact : Improper Alignment
    • Functional Impact: Abnormal Joint Movement
    • Imaging Appearance : Delayed Ossification of Femoral head
    • N/A

• Rickets:

  • Childhood form of Osteomalasia
  • Vitamin D deficiency
    • Improper Calcification of growing skeleton bc lack of UV radiation
    • Leg Bowing + long ass epiphyseal plates
    • Pathogenesis: Defective Mineralization of Growth plates
    • Etiology: Vitamin D Deficiency
    • Pt Signs: Swelling at thee Wrists and Ankles, Bowing of the legs, Knock-knees
    • Symptoms : Pain & Muscle Weakness
    • Skeletal System is affected
    • Structure Impact: Growth plates become enlarged as Long bones get soft

• Continued Pt 2 - Functional Impact: Loss of bone function, Impaired Skeletal growth - Imaging Appearance: Bowing of the legs, Pelvis Flatten - Destructive

GI Anatomy + Physiology:

• What are the Parts of a stomach?

  • Function = Food Storage, Break it down mechanically + chemically(Enzymes)
  • CHYME = Chemically + mechanicaly altered good that leaves the stomach
  • Cardia(entrance)
    • cardia Antrum
    • cardia notch
  • Fundus

• (Most Superior Part) + Body

• (Chemical + Mechanical Digestion) - Lesser curve (on the R) - Greater curve (on the L (Lateral) - Angular notch

  • Pyloric Portion(Terminal End)
    • pyloric antrum
    • pyloric canal
    • pyloric sphincter
    • Duodenum
    • Cardia > Fundus > Body > Pyloric

Small Bowel

• Small Bowel
  • Food Digestion occurs here as well abosorption of it.
  • Starts from Pyloric Sphincter + Ends at Ileocecal Valve
  • Villi = Mucosa that aide in Digestion + Absorption
    • Duodenum
      • Duodenal Bulb = First Portion
      • Duodeojejunal flexure : Sharp - Curve Portionthat meets the Jejunum

Large Bowel

• Describe the large bowels function. - Reabsorption of fluids and ellimination of waste materials, begins ad the cecum, ends at the anus.
  • Taeniae Coli = Muscular Bands that for Haustra -Haustra = Pouches Along the large intestine that are attached to the Taeniae Coli, -Cecum - Appendix, Attached to the posteromedial side of the cecum. Appedix is Pounchline below the junction of llium + colon

Large Bowel -Colon Section

• Ascending
• the ileocecal valve is located just below the ascending area of the colon + cecum
• Transverse
• Descending
• Sigmoid
• An S-shaped loop that extends from the rectum
• level of S3
• Rectum
• Extends from Sigmoid to the Anal canal
• It’s at S3
• Terminates at the Anus

GI Diseases

• Hiatal Hernias
• Causes (GERD)
• a Portion of the stomach is protruding into the chest cavity because the esophageal sphincter isn't strong enough to keep it closed
• This not meant to be because it is very sensitive
• makes its way in the esophagus causing reflex
• Two Categories of Hilatal Hernia
• Sliding
• Paraoesophageal
• Main symptoms include the weakened esophageal sphincter from various issues
• Increased abdominal pressure may cause for the need for the organ to have surgery
• This can result in Pt Symptoms of Heartburn , Dysphasia with chest pain
• Affects The esophagus & stomach
• Results in Alteration of Gastroesophageal Junction
• Affects Imapired Esophagel Sphincter
• Ischemia
• Gastric issue
• Additive/Destructive:
• Stomach is seen above the diaphragm
• This is separate from the gastric bubble.
• Achalasia
• ABCDE ~ Achalasia , Bird-Beak, (sin) Calma,Dialed Esophagus
• Expanded top, thing bottom - Hour glass
• Failure is the esophegeal of Sphinchter to relax during swallowing.
• Idiopathic
• Includes Heartburn Dysphasia and Chest Pain
• The Functional Impact
• Esophogus cannot Emptyy into the stomach
• Additive/ destructive

Diveticulosis:

• Usually from Bad Diet
• Out- pouching/ Pimple like wall structure of the Bowel Wall
• People closer to death(Older & die from DD)
• Common in Sigmund Colon
• Intaluminal Pressure
• Hernintes SAC - Like Pouches in the wall
• Pt Symptoms
• Discomfort or cramping
• Structure Impact
• Multiple Small outpounchings
• Imapired Bowel movements
• Crohn's disease
• Malnoursihed + Young > Unkown
• Impairs Nutrients
• Chronic = Inflammatory structure @Terminal Illium
• Abnormal immune response to inestinal microbales
• Thickening of the intestine, is Narrow Fibourious & Strictures
• String of the signs
• Terminal
• Deep ulcers + eodema
• Lead sign
• Intussusception:
• I (For Intussusceptinon +Idiopathic
• Sausage + Jelly Kiddos
• Major structure
• Red jelly Stool
• Meniscus is like the knee and Telescoping the neibhor segment
• Voluvolous
• Tips/ Trixk up on it selfe
• Ceccum
• Bowel obstruction & twists around itself -
• Proximal
• Diatal is blocked
• Sign

Pathogenesis

• Sign
• Proximal is blocked
• Coffee Bean & Dialtated loops central line looking like coffee beans.
• Bent
• Large Air Loop
• Additive