Chapter7Diseases of Respiratory/System
Chapter 7 Diseases of Respiratory System
肺巨噬细胞基膜RI型肺泡细胞毛细血管弹性纤维肺泡孔肺巨噬细胞（尘细胞）Ⅱ型肺泡细胞成纤维细胞肺泡及肺泡孔模式图
肺静脉小支气管呼吸性细支气管肺泡管5肺泡囊肺泡终末细支气普肺泡菜肺动脉
MajoretiologicalfactorsinrespiratorydiseaseDiseaseEtiological factorGenetical-antitrypsin deficiencySome asthmaEnvironmentalSmokingLung cancerChronic bronchitis andemphysemaSusceptibility to infectionChronic bronchitisAirpollutionSusceptibility toinfectionOccupationSilicosisAsbestosisInfluenzaInfectionBacterial pneumonias
Major etiological factors in respiratory disease Etiological factor Disease Genetic а1-antitrypsin deficiency Some asthma Environmental Smoking Lung cancer Chronic bronchitis and emphysema Susceptibility to infection Air pollution Chronic bronchitis Susceptibility to infection Occupation Silicosis Asbestosis Infection Influenza Bacterial pneumonias
7.1 Infection of respiratory tractAcutetracherobronchitisAcute bronchiolitisPneumonia
7.1 Infection of respiratory tract Acute tracherobronchitis Acute bronchiolitis Pneumonia
AcutetracheobronchitisAcute catarrhal tracheobronchitis. The inflammatoryexudate on the mucosal surface is chiefly a stringy,basophilic mucus only scantily mixed with leukocytes.Acute suppurative tracheobronchitis. There is a significantelement ofleukocytic infiltration.Acute ulcerative tracheobronchitis. The inflammatoryreactionis more intense, with necrosis of the mucosa inareas, it constitutes an ulcerative form
Acute tracheobronchitis Acute catarrhal tracheobronchitis. The inflammatory exudate on the mucosal surface is chiefly a stringy, basophilic mucus only scantily mixed with leukocytes. Acute suppurative tracheobronchitis. There is a significant element of leukocytic infiltration. Acute ulcerative tracheobronchitis. The inflammatory reaction is more intense, with necrosis of the mucosa in areas, it constitutes an ulcerative form
AcutebronchiolitisThe bronchioli mucosa is hyperemia and swellingwith a lymphomonocytic and leukocyticinfiltration of the submucosa accompanied byoverproduction of mucous secretions.Bronchiolitis obliterans is characterized bypolypoid masses of organizing inflammatoryexudates and granulation tissue extendingfrom alveoli into bronchioles
Acute bronchiolitis The bronchioli mucosa is hyperemia and swelling with a lymphomonocytic and leukocytic infiltration of the submucosa accompanied by overproduction of mucous secretions. Bronchiolitis obliterans is characterized by polypoid masses of organizing inflammatory exudates and granulation tissue extending from alveoli into bronchioles
PneumoniaBacteria pneumonia1.Lobarpneumoniaan acute bacterialinfection of alarge portion of a lobe or of anentire lobefibrinous inflammationincludeSymptomscough,afever and production of “rusty"图8-10大叶性肺炎（X-Bay）sputumFig8-10 Lobar pneumonta (X-Ray)
Pneumonia Bacteria pneumonia 1. Lobar pneumonia • an acute bacterial infection of a large portion of a lobe or of an entire lobe • fibrinous inflammation • Symptoms include a cough, fever and production of “rusty” sputum
Etiologystreptococcus-pneumonia,pathogens:pneumobacillusinducing factors: cold, excessive tired, anethesiaPathogenesisbacteria :alveoliproliferate, capillarydilate, serious exudateskohn's poresspreading → entire lobe
Etiology pathogens： streptococcus-pneumonia, pneumobacillus inducing factors: cold, excessive tired, anethesia Pathogenesis bacteria alveoli proliferate , capillary dilate, serious exudates kohn’s pores spreading entire lobe
Pathologic changes(1)congestion stage:1st-2nd daysthe outpouring of a protein-rich exudateintoalveolar spaces and rapid proliferation of bacteria.heavy, boggy, redgrossLMalveolar wall: cap. dilate congestionalveolar space: proteinaceous edema fluid, fewneutrophils, RBC, and numerous bacteria
Pathologic changes （1）congestion stage：1st-2nd days the outpouring of a protein-rich exudate into alveolar spaces and rapid proliferation of bacteria. gross heavy, boggy, red LM alveolar wall: cap. dilate congestion alveolar space: proteinaceous edema fluid, few neutrophils, RBC , and numerous bacteria