病理学英文课件：呼吸系统疾病
病理学-呼吸系统疾病课件
肺肿瘤 ●
（Lung tumors）
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本章学习内容
慢性支气管炎 肺气肿 慢性肺源性心脏病 大叶性肺炎 小叶性肺炎 病毒性肺炎 支气管扩张症 肺硅沉着病 肺癌
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慢性支气管炎（Chronic bronchitis）
●临床诊断标准：
反复发作咳嗽、咳痰，或伴有喘息，每年持续3 个月，连续2年或2年以上。
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慢支炎急性发作
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临床分型及症状
●单纯型：咳嗽、咳黏液痰。 ●黏液化脓型：咳黏液脓痰，可伴发热、 畏寒。 ●喘息型：哮喘样发作时表现气急、喘息 伴有哮鸣音。 ●阻塞型：小气道狭窄，气流阻塞，通气 障碍，表现缺氧症状。
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●肺泡性/阻塞性肺气肿
腺泡中央型 √
（Centriacinar emphysema）
全腺泡型 √
（ Panacinar emphysema）
腺泡周围型（Periacinar emphysema）
不规则型 （Irregular emphysema）
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其它肺气肿类型
并发症
慢性肺源性心脏病 呼吸衰竭 自发性气胸 急性肺感染
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肺心病（Cor pulmonale） ●分急性和慢性。
急性肺心病常见于突发性、广泛性肺 血管栓塞引起的急性右心衰竭。
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慢性肺心病 (Chronic cor pulmonale）
病理学呼吸系统疾病课件
•病理学呼吸系统疾病
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病因及发病机理
• 病因：＞95%为肺炎链球菌，esp. Ⅲ型毒力最 强
• 诱因：寒冷、疲劳、醉酒、感冒、麻醉、糖 尿病、肝、肾疾病
•病理学呼吸系统疾病
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机理
诱因
呼吸道防御功能被
削弱，机体抵抗力
细菌感染 含菌痰液
肺泡 过敏反应 肺泡壁Capi.通透性
细菌大量繁殖
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•病理学呼吸系统疾病
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思考题：
1、试述大叶性肺炎发展过程的分期 及各期的镜下病理特点。
2、试述小叶性肺炎的病理特点。 3、大叶性肺炎红色肝样变期的临床
表现及病理联系。
•病理学呼吸系统疾病
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(3)病灶周围肺组织充血，浆液渗出或伴程度 不等的肺泡扩张(代偿性肺气肿)。
•病理学呼吸系统疾病
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•病理学呼吸系统疾病
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临床病理联系
咳嗽：炎性渗出物刺激支气管引起。 咳痰：化脓性炎时，脓性渗出物 气喘：病变重者，肺换气功能障碍，缺
氧，而致呼吸困难。 发热：炎症的全身反应。 听诊：可闻及湿性啰音。 X线：不规则斑片状阴影。
咳铁锈痰：红细胞破坏与崩解→Hb变性 胸痛：病变波及胸膜 缺氧和紫绀：肺实变区范围大，淤积在实变
区内的大量静脉血未能氧合便流入左心→动 脉血氧分压和氧饱和度↓
叩诊浊音：病变肺叶实变 听诊支气管呼吸音 实验室检查：渗出物中检出多量肺炎球菌 X线：大片致密阴影
•病理学呼吸系统疾病
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三、灰色肝样变期
肺泡间孔 呼吸细支气管
邻近肺组织
整个大叶
带菌渗出液 叶支气管
大叶之间蔓延
•病理学呼吸系统疾病
病理-呼吸系统疾病(全套206页PPT课件)
–理化性因數 吸入性，放射性, 過敏性
1. 細菌性肺炎(bacterial)
1)大葉性肺炎 (Lobar pneumonia) 主要由肺炎鏈球菌引起的累及肺
大葉範圍、以肺泡內彌漫性纖維素滲 出為主的急性炎症
病因及發病機制
病因：肺炎鏈球菌 (90%以上) 少見的有肺炎桿菌、金黃葡球菌、 溶血鏈球菌等
肉眼：實變的肺組織質地變軟， 病灶消失，漸近黃色，擠壓切面可見 少量膿樣混濁液體溢出; 中性粒細胞 壞死 → 釋放蛋白溶解酶將纖維素溶 解、病原體被吞噬溶解
臨床特點
• 青壯年 • 起病急 • 寒戰發燒、咳嗽、胸痛、
呼吸困難 • 咳痰，痰呈鐵銹色 • 肺實變體征, 外周WBC↑
併發症(complications)
Pneumonia
• Pneumonia is pulmonary infectious diseases caused by different etiologic agent invasion of the lung parenchyma. Many variables, such as the specific agent, the host reaction, and the extent of involvement, determine the precise form of pneumonia. Thus, classification can be made according to etiologic agent, (e.g., pneumococcal or staphylococcal pneumonia), the nature of the host (e.g., suppurative, or fibrinous), or the gross anatomic distribution of the disease (lobar pneumonia vs lobular or bronchopneumonia).
呼吸系统疾病英文PPT课件
Based on anatomy or X-ray manifestation
❖ Bronchopneumonia ❖ Lobar or Lobular Pneumonia ❖ Interstitial Pneumonia
Based on etiology
❖ Bacterial pneumonia ❖ Viral Pneumonia ❖ Mycoplasma Pneumonia ❖ Chlamydia Pneumonia
Classification of Respiratory Infections
According to the level of the respiratory tree most involved:
❖ Upper respiratory tract infection
❖ Lower respiratory tract infection
❖ Pneumonia remains the most common cause of morbidity in China.
Question
How to classify pneumonia in clinic?
Classification
❖ Anatomy ❖ Pathogens ❖ Severity ❖ Duration ❖ Onset site
What are the signs and symptoms of pneumonia?
The clinical signs and symptoms of pneumonia depend primarily on the age of the patient, the causative organism, and the severity of the disease.
《呼吸系统疾病英文》课件
Explore the world of respiratory diseases and learn how to prevent them. Join us on a journey to discover the causes, symptoms, and treatments of common respiratory illnesses.
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Treatment
Inhalers, steroids, and bronchodilators
Idiopathic pulmonary fibrosis (IPF)
Symptoms
• Shortness of breath • Dry cough • Gradual onset
Risk factors
Chronic obstructive pulmonary disease (COPD)
Symptoms
Breathlessness, cough and sputum production
Risk factors
Smoking, air pollution, and genetics
Treatment
2 Prevention and
Treatment
Prevention and early treatment are important
3 Lifestyle Changes
Lifestyle changes, such as quitting smoking, can reduce the risk of developing respiratory diseases.
Smoking cessation, bronchodilators, steroids, and oxygen therapy
病理学第七章呼吸系统疾病
统称，主要包括：
慢性支气管炎、肺气肿 支气管哮喘和支气管扩张症等。
临床常见，重要，老年多发。
医学ppt
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一、慢性支气管炎
（Chronic bronchitis） ▪ 概念：是指支气管、气管粘膜及粘膜下层以
增生为主的慢性非特异性炎症。
▪ 临床：以反复咳嗽、咳痰或伴喘息为特征， 每年持续约3月，连续2年以上。
病毒、细菌
削弱呼吸道防御功能→呼吸道常居菌发挥致病作用
3. 过敏因素
医学ppt
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▪ 二、内因：抵抗力↓局 全部 身：呼吸系统防御 能功 受损
•机制:
致病因素长期作用
支气管分泌粘液增加 纤毛上皮细胞受损，纤毛派送功能削弱
粘液潴留，支气管腔内阻塞或半阻塞
影响支气管esp.小气道的通气，为细菌侵入和继发感染创造条件
医学ppt
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支气管炎（医b学rppot nchitis）
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慢性支气管炎（chronic bronchitis）
慢性支气管炎：
粘液腺增生，浆
液腺粘医液学pp化t
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临床病理联系
▪ 杯状细胞、粘液腺增多→粘液分泌亢进→ 1. 痰，白色泡沫状 2. 并发感染→脓性痰 3. 听诊：肺部干、湿性罗音 ▪ 痰液、炎症刺激支气管粘膜→咳嗽 ▪ 支气管粘膜肿胀、痰液阻塞＋细、小支气
管平滑肌痉挛→ 1. 哮喘样发作、哮鸣音 2. 呼吸急促，不能平卧
医学ppt
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（四）并发症 支气管肺炎 肺气肿 肺心病 支气管扩张
三、支气管扩张症（bronchiectasis）
▪ 概念：支气管或小支气管持久不可复性 扩张并伴有长期反复感染的肺部慢性疾 病。
▪ 病变特点：支气管的慢性化脓性炎症。 ▪ 临床：长期咳嗽、大量脓痰、反复咯血。 ▪ 成年人，大多起于儿童期支气管炎。
病理学-呼吸系统学习课件
Diseases of Respiratory System9.1.1 Acute tracheobronchitisAcute 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 inareas, it constitutes an ulcerative form.9.1.2 Acute bronchiolitisThe bronchioli mucosa is hyperemia and swelling with a lymphomonocytic and leukocyticinfiltration of the submucosa accompanied by overproduction of mucous secretions. Bronchiolitis obliterans is characterized bypolypoid masses of organizing inflammatoryexudates and granulation tissue extendingfrom alveoli into bronchioles1. Bacteria pneumonia (1) Lobar pneumoniaan acute bacterial infection of alarge portion of a lobe or of an entire lobe•fibrinous inflammation •Symptoms:abrupt onset,high fever,shaking chills,pleuritic chest pain,a productive mucopurulent cough(“rusty”sputum)congestion stage（2）red hepatization:3rd-4th days gross●the lobe distinctly red, firm, and airless with a liver-like consistency●an overlying fibrinous or fibrinosuppurative pleuritisLMalveolar space: a flock of RBC, packed with fibrin nets which stream from one alveolus through the pores of kohn into adjacent alveoli, neutrophilsLobar pneumonia (gray hepatization). The upper lobe is uniformly consolidated.Lobar pneumonia(gray hepatization).Lobar pneumonia (resolution stage) exudates within the alveoli are enzymatically digested and either resorbed or expectorated, leaving the basic architecture intact.Lobar pneumonia（carnification）(2) Lobular pneumonia( Bronchopneumonia )●clinic: infants, the aged, illness (much more prevalent at the extremes of age)●patchy distribution,a purulent inflammation that centered bronchiolesEtiology and pathogenesisPathogens: staphylococci, pneumococci, streptococci, influenzae haemophilusInduce factors: cold, heart failureInfection ways: respiratory tract, bloodLobular pneumonia (Scattered foci of consolidation are centered on bronchi and bronchioles)Foci of inflammatory consolidation are distributed in patches through one or several lobes, in severe cases the foci may confluent, producing the appearance of a lobar consolidationlobular pneumonia (A suppurative, neutrophil-rich exudates fills the bronchi, bronchioles, and adjacent alveolar spaces)lobular pneumoniaInterstitial pneumonia. The alveolar septa are widened and edematous and infiltrated with mononuclear cells.viral inclusion body is round or oval shape, erythrocyte-like in size, eosinophilic cytoplasmic or nuclearSARS (severe acute respiratory syndrome)Pathogen: SARS associated cornonavirusLM:diffuse alveolar damage in varying phages oforganization3. Mycoplasmal pneumonia4. Pneumocystis pneumoniapneumocystis9.2 Chronic obstructivepulmonary diseaseA group of conditions that share a major symptom dyspnea and are accompanied by chronic or recurrent obstruction to airflow within the lung9.2.1 Chronic bronchitisA persistent productive cough forat least 3 consecutive months in at least 2 consecutive yearsEtiology1. Infectionvirus/ bacteria2. Physical chemical factors（1）smoking （2）air pollution（3）cold （4）others: neuroendocrine, nutritionChronic bronchitis (degeneration, necrosis of the bronchial epithelium with loss of ciliated cells)Mucous glandular metaplasia9.2.2 Pulmonary emphysemaA condition of the lung characterized byabnormal permanent enlargement of the airspaces distal to the terminalbronchioles accompanied by destruction of their walls.Alveolar emphysema. Pale, voluminous.Alveolar emphysema (marked enlargement of airspaces, with thinning and destruction of alveolar septa. )2.interstitial emphysema3.others:paracicatrical emphysema bullae lung emphysema senile emphysema compensatory emphysema。
呼吸系统(中英文)PPT课件
Treatment
不能根治 控制症状
No cure relieving
symptoms
防止并发症 preventing complications
小细支气管炎
病理学 Pathology
NMU博学至精 明德至善
Clinical features
支气管粘膜炎症、粘液分泌旺盛
咳痰
支气管痉挛，渗出物阻塞
喘
病理学 Pathology
NMU博学至精 明德至善
晚期表现 Late stage menifestation
血氧饱和度低 insufficient oxygenation of blood (hypoxemia)
肺间质、肺泡间隔 ：cap. , f, Mφ
病理学 Pathology
NMU博学至精 明德至善 Histology of the Airways
Components Functions
Bronchi are distinguished from bronchioles primarily by the presence of cartilage in their walls. Bronchioles also lack submucosal glands.
Mucosa
Submucosa
Muscles
Cartilage 病理学 Pathology
NMU博学至精 明德至善
Epithelium
Pseudostratified ciliated columnar cells Mucous (goblet) cells
《呼吸系统疾病英文》PPT课件
Pathophysiology of the common cold
sore throat
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The clinical manifestation
Common cold ➢ congestion ➢ a runny nose ➢ sneezing ➢ Cough,sore throat ➢ sometimes vomiting and diarrhea ➢ Fever,malaise,abdominal pain
The Second Affiliated Hospital of Sun Yat-sen University
Tan Wei-ping
1
Contents
▪ Upper Respiratory Infection ▪ Acute infectious Laryngitis ▪ Acute Bronchitis ▪ Bronchiolitis ▪ Pneumonia
➢ ﹤3yrs old, eczema, allergy ➢ symptoms resemble asthma ➢ recurrent episodes reduced
after 3~4yrs old.
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Treatment
➢ increased fluid intake
acetaminophen,ibuprofen, decrease the discomfort of colds. ➢Do not give aspirin (associated with Reye syndrome)
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Prevention
➢Keep your child away from a person with a cold.
Flu
病理学-呼吸系统疾病-本科-PPT课件
病理变化
肉眼 支气管呈圆柱状或囊状扩张。 镜下 支气管壁慢性炎症改变伴组织破坏。 临床病理联系
巨体：病变肺叶肿胀，重量增加，灰白色，
质实如肝，切面干燥，细颗粒状，故称灰色 肝样期。胸膜表面纤维素渗出更明显。
临床： 缺氧状况有所改善 临床症状开始减轻 痰液由铁锈色逐渐变成粘液脓痰
⑷溶解消散期：7-9天，细菌几乎完全消灭。 肺泡壁毛细血管损伤终止，渗出停止。
LM ： ⑴肺泡壁毛细血管恢复正常结构。 ⑵肺泡腔内有少量变性坏死中性白细胞、纤
机制
致病因素长期作用
支气管分泌粘液增加
纤毛上皮细胞受损，纤毛派送功能削弱 粘液潴留，支气管腔内阻塞或半阻塞 影响支气管，小气道的通气，为细菌侵入和继发感染
创造条件 粘液分泌亢进 加重粘膜上皮损伤 恶性循环 迁延不愈 反复发作.
二、病理变化
各级支气管均可受累。 早期：大中型支气管（叶、段支气管） 病变发展：细支气管
呼吸系统疾病 （Disease of respiratory system）
气管和支气管系统：
气管支气管叶支气管（左2右3）段 支气管（左右各10）小支气管细支气 管（1mm）终末细支气管（0.5mm） 呼吸性细支气管肺泡管肺泡囊肺 泡
肺
小 支 气 管
终末终细末 支细气支管气管
肺动脉
肺静脉
呼吸性 细支气 管 肺泡管
1.呼吸道粘膜上皮细胞病变
（1）上皮细胞变性坏死脱落，纤毛粘连、 倒伏、甚至脱失。
呼吸系统病理1(英文版)课件
Morphology For purposes of description, it is convenient to divide the process into four phases:
(1) Congestion (2) Red hepatizatio (consolidation) (3) Gray hepatization (4) Resolution
The disease which is often seen in previously healthy young adults has a sudden onset and is accompanied by chills, fever , cough with pink-foam sputa and chest-ache.
Basic PATHOLOGY
Respiratory Diseases
Review of
the architecture of the respiratory system
PULMONARY DUCT
PULMONARY ACINUS
Bronchus
Bronchioles
Acute bronchitis
1. Congestion stage (1st-2nd days)
The affected lobe is heavy, red and boggy. A frothy blood-stained fluid can be squeezed from the cut surface.
Histologically, there is vascular congestion with
Classification of pneumonia
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Type II alveolar cell
Type I alveolar cell
capillary
Blood–air Barrier
Alveolar septum
病理学—呼 吸
Alveolar pore (Kohn’s pore) macrophage
病理学—呼 吸
Heart failure cell:
Lobule
Alveolus
Acinus
病理学—呼 吸
Trachea
病理Ep学ith—el呼ium 吸
Lamina propria Submucosa
Adventitia
Pseudostratified ciliated columnar epithelium
病理学—呼 吸
Brush cell Goblet cell basal cell ciliated cell small granular cell
Definition:
Alveolar macrophages containing hemosiderin are seen in cardiac failure.
病理学—呼 吸
The alveolar spaces contain macrophages which show brownish discoloration of their cytoplasm due to the hemosiderin content .
Pathological Change
• From trachea to bronchi and bronchioles
病理学—呼 吸
Diseases of Respiratory System
1
1
病理学—呼 吸
Anatomy and Histology
• The Upper Respiratory Tract the nose, pharynx and larynx Cricoid cartilage
• The Lower Respiratory Tract the trachea, bronchi and lungs
病理学—呼 吸
Obstructive Lung Diseases
• A group of diseases characterized by limitation of airflow, usually resulting from an increase in resistance from partial or complete obstruction at any level
3）Chronic cor pulmonale 4）Pulmonary Infections:
Community-Acquired — Acute and Atypical pneumonias Tuberculosis — Primary, Secondary 5）Tumor： Lung cancer, Nasopharyngeal carcinoma
病理学—呼 吸
正 常 肺 组 织
病理学—呼 吸
Diseases of Respiratory System
1）Obstructive Lung Diseases: Chronic bronchitis, Emphysema, Bronchiectasis Asthma
2）Restrictive Lung Diseases： acute—ARDS ，chronic—Silicosis
Etiology & Pathogenesis
• Chronic irritation by inhaled substances – Cigarette smoking — predisposes to infection
• Interfere with ciliary action • Cause direct damage to epithelium • Inhibit leukocytes function
• Major symptom – dyspnea • Major disorders
– Chronic bronchitis – Emphysema – Bronchiectasis – Asthma
病理学—呼 吸
Chronic Bronchitis
• Definition: a persistent productive cough for at least 3 consecutive months in at least 2 consecutive years
• The diagnosis is made on clinical grounds • A common disease in middle-aged heavy smokers • May progress to emphysema and chronic cor pulmonale
Chronic Bronchitis
病理学—呼 吸
Trachea & Bronchial tree 病理学—呼 吸
Trachea Bronchus
Lobar bronchus
Segmental bronchus
Bronchiole Terminal bronchiole
Lobe
Respiratory bronchiole
Alveolar duct Alveolar sac
– Air pollutants（SO2, NO2) – Cold air • Microbiologic infections – Recurrent viral infections – Secondary bacterial infections
病理学—呼 吸
Chronic Bronchitis
病理学—呼 吸
0.5-2cm
病理学—呼 吸
Lobule
Pulmon病ar理y 学—呼 吸
vein
Lung
Ter终m末inal br细on支ch气io管le
Respiratory bronchiole
Alveolar duct
Pulmonary artery
Alveolar sac
Pulmonary alveolus