❤️ respiratory system ❤️
بنركز على :
( lung diseases)
We will begin with

🌺 congenital anomalies :

1_ forgut cyst
جزء من نسيج الGIT طبيعي موجود داخل الرئة وعامل زي الcyst
2_ hypoplasia
الرئة صغيره واحده أو الثنتين
3_ lung aplasia
واحده من الرئتين مش موجوده

🌺 lung atelectasis ( collapse of lung)
This may be congenital or aquired

1_Neonatal ( congenital) atelectasis

collapse as a result of deceased surfuctant
يعني واحده رئة أو جزء منها أو الرئتين ماراح تنتفخ أول مايولد الجنين

2_ adult
(aquired)atelectasis
Its causes are :
_ complete obstruction
_ compresion from outside
_ fibrosis

Then we have specific diseases of the lung :

🌺 inflammatory diseases(pneumonia)
We can classify it to typical ( lobar) and atypical ( bronchopneumonia)
Or we can classify it to community aquired and hospital aquired
وطبعا الاخطر هو الhospital لانو بيحصل multidrug resistance

Autoimmune disease cause interstitial pneumonia

Then we have specific diseases

🌺acute lung injury

1_ lung odema
Serious condition
الرئة ممتلئة سوائل فما بيحصلش gas exchange
Causes
_ hemodynamic causes
Which include
لها علاقه بالvascular disease
🍀increase the hydrostatic pressure or
🍀decrese osmotic pressure

_ local causes like
🍀 severe pneumonia ( infection)
🍀fluid aspiration
🍀 inhalation of toxic gases

اللي عنده lung odema يكون عنده صعوبة في التنفس ومزرق
ولازم نعطيه lasix ( furosemide)

2_ acute respiratory distress syndrome
Two types :
Neonatal and adult
المريض يحاول يأخذ نفسه مايقدرش
🍀 Neonatal
Due to lack of surfuctant
🍀Adult
Pathogenesis is
Severe diffuse alveolar damage
ويتحول إلى hyaline material
مافيش تبادل غازي ويزرق الشخص
Due to
_ shock
_ severe systemic infection
_ major trauma
_ toxic gases
_ long period surgical procedures
_ drowning الغرق


🌺 obtructive lung diseases
There is resistance to air flow
1_ COPD
Include emphysema and chronich bronchitis
جمعوهم لأن السبب واحد التدخين والalpha one antitrypsin deficiency ولأنهم يوجدو مع بعض
In emphysema there is functional obstruction so it is called obstruction

2_ asthma
Which may be
🍀atopic
بسبب عوامل تحسس بيحصل
Type 1 hypersensitivity reaction

and 🍀non atopic
Due to hyperactivity of the smooth muscles
بيكون متحسس زياده للبرد وغيره
في هذه الحاله ماتنفعش الantihistamins ولازم نعطيه bronchodilator

3_ bronchiectasis
This occure in large bronchi
Due to recurrent infection
بيتكون cavity مليان pus
There is profound productive cough


🌺 restrictive lung diseases also called interstitial lung disease
There is loss of cmpliance ( decreased total lung capacity)

The diseases include :
1_ granulomatous diseases
_ TB
_ sarcoidosis : non casiating granuloma
It's multisystemic disease

2_ fibrosing diseases
Affect the adults and include :
_ UIP ( usual interstitial pneumonia )
_ NIP ( nonspecific interstitial pneumonia )
_ COP ( cryptogenic organizing pneumonia )

All are of unknown causes they may be autoimmune diseases
They are different in histologic pecture

🍀UIP
The most dangerous and severe
Here we see All stages of inflammation at the same time :
We see inflammation of the interstitial tissue in sites and alse we see fibrosis in other site but in the same time

🍀 NIP
Here we see one stage
Either inflammation or fibrosis
The prognosis is better than UIP

🍀 COP
May idiopathic or may secondary to other diseases like tumor

There is lymphocytic infiltarate and fibrous tissue
الشيء المميز هو
The presence of fibroplastic plugs which extend to the alveolar space


3_ pneumoconiosis
موجوده كثير في صنعاء بسبب الكسارات حق الكري الاجزاء اللي تطلع من الكسارات تدخل مع الهواء تعمل granuloma
Pneumoconiosis include
_ silicosis
_ asbestosis
مثل الماده زي الألياف في الثلاجه
ماده الاسبيستوس أيضا تسبب mesothelioma

نعطيه مضاد للالتهاب ويبتعد عن المسبب

باقي الأمراض النادره مش مهمه وهي الآتي
4_ hypersensitivity pneumonitis
يشبه الasthma لكن هي تصيب الalveoli فقط
5_ smoking related interstitial lung disease

6_ alveolar proteinosis

🌺 vascular lung diseases
As the embolism and the thrombus

🌺 lung neoplasms:
The most common cancer in the lung is metastasis ( secondary)
The primary cancer is bronchogenic

The most common neoplasm in the lung is the malignant

Carcinomas include
_ squamous cell carcinoma
_ adenocarcinoma
_ small cell carcinoma
_ large cell carcinoma

Also there are also benign tumors

بهذا نكون كملنا الجانب النظري من كلام الدكتور وضاح حفظه الله

#معمل_باثو
#اللجنه_العلميه

Atelectasis ( adult aquired type )

Features :
Resorption
Compression
Contraction

Pulmonary odema
Features:
Normal alveolar wall
Accumulation of fluids in the alveolar space

Severe pulmonary odema

Features:
_ transudate in the alveolar lumen
_ dilated capillaries in the alveolar wall
_ thickened alveolar walls ( dilated capillaries and interstitial odema)

Diffuse alveolar damage:
Features:
_ death of epithelial cells
_ wall converted to hyaline membrane
_ inflammation of the wall and haemorrhage
_destruction of the alveolar wall
Lead to ARDS

Diffuse alveolar damage
Features:
_Remnants of alveoli are present
_Epithelial cells death
_wall converted to hyaline membrane
_inflammation of the wall and haemorrhage
_destruction of the alveolar

Emphysema

Features:
_ centriacinar ( dilated respiratory bronchioles)
_ panacinar (dilated alveolai)

Emphysema
Features:
Dilated alveoli
And thin walls without fibrosis

Asthma

c.f:
_hyperplasia and hypertrophy of the SMs.
_features of inflammation (odema ,neutrophils infiltarate and eosinophilic infiltrate in case of atopic asthma)
_hyperplasia of mucus glands

Bronchial asthma

Feature
Charcot laden crystals

Crushmann spiral in asthma

Chronic bronchitis

Features:
_features of inflammation ( edema in the submucosa , neutrophils infiltrate)
_ increased thickness of the wall
_ hyperplasia of the glands
_ normal smooth muscles

Bronchiectasis

Feature
Cavities filled with pus

Usual interstitial pneumonia ( UIP) or Non specific interstitial pneumonia (NIP)

Feature:
Features of inflammation ( no fibrosis : early in the inflammatory stage)

Usual interstitial pneumonia( UIP)

Features:
Sites of inflammation and sites of active fibroastic fossae ( specific feature of this disease)

Cryptogenic oranizing pneumonia ( COP)

Features:
Features of inflammation also fibrous tissue in the alveolar space ( fibroplastic plug) this is the characteristic feature

Pneumoconiosis

Features
Undigestable material surrounded by fibrosis and granuloma

Sarcoidosis

Features:
_Non casiating granuloma
_ asteroid bodies

Multinucleated gaint cell contain asteroid bodies Feature of Sarcoidosis

Hypersensitivity pneumonitis ( allergic alveolitis)

Features
Granuloma and inflammation of the alveolar wall