协和医学院病理呼吸系统课件_PPT幻灯片
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Irregular Emphysema
15
normal central
panacinar
Distal Irregular
16
阻塞性肺气肿的关键环节:
小气道炎症
肺泡间隔断裂
17
18
Oxidant-antioxidant imblance
19
Lobular septum
Centrilobular emphysema
Goblet cell metaplasia, mucous plugging, inflammation, and fibrosis.
6
The distinctive feature of chronic bronchitis :
Hypersecreton of mucus:
goblet cell hyperplasia mucous gland hyperplasia
30
chronic cor pulmonale
31
Bronchiectasis
Bronchiectasis is the permanent dilatin of bronchi and bronchioles caused by destruction of the muscle and elastic supporting tissue, resulting from or associated with chronic necrotizing infections.
3
Chronic bronchitis morphology(与支扩 比较)
Bronchial epithelium degeneration： desquamation（脱落）, squamous metaplasia goblet cell hyperplasia
mucous gland hyperplasia inflammation Fibrosis and smooth muscle hyperplasia chronic bronchioles:
Chronic Obstructive Pulmonary Disease
Chronic bronchitis Emphysema Bronchiectasis asthma
1
Chronic bronchitis
persistent cough with sputum production for at least 3 months in at least 2 consecutive years.
27
Clinical :
dyspnea barrel-chested,
breath sound↓, percussion note is hyperreaonant X-ray: hyperinflation
28
Complications:
chronic cor pulmonale Spontaneous pneumothorax Acute inflammatory
Complications:
Bronchiectasis emphysema （最主要的） chronic cor pulmonale bronchopneumonia
12
Emphysema
a condition of the lung
characterized by abnormal permanent enlargement of the airspaces distal to the terminal bronchiole, accompanied by destruction of their wall.（过度充 气+管壁破坏）
2
Forms of Chronic bronchitis
simple chronic bronchitis productive cough mucoid sputum no airflow obstruction.
Chronic asthmatic bronchitis Chronic obstructive bronchitis
chronic bronchioles (small airway disease): goblet cell metaplasia mucous plugging, inflammation, fibrosis.
10
Clinical : Cough mucoid sputum Wheezing
11
29
chronic cor pulmonale --pulmonary morphology
Smaller arteries and arterioles thickening internal/medial hypertrophy Lumina narrow
muscularization of arterioles
--Also the morphologic basis of muciod sputum（未感染的白色黏痰）
7
REID INDEX = b-c/a-d >0.5
(Normally 0.4)
8
9
In Chronic obstructive bronchitis, the morphologic basis of airflow obstruction :
20
Long time smoker
21
22
a1-AT deficency Intravenous drug abuse
23
24
25
Panacinar emphysema
26
Paraseptal (Distal Acinar) Emphysema
Subpleural upper lobes Fibrosis bullae
Bullae lung(>2cm)
14
Type of Acinar Emphysema
Centroacinar Emphysema (Centrilobular )
Panacinar பைடு நூலகம்mphysema (Panlobular)
Periacinar Emphysema (Distal acinar)
compensatory Emphysema
Overinflation
Senile （老年性）Emphysema （过度膨胀） 13
Type of Emphysema
Acinar (alveolar) Emphysema obstructive Emphysema
Interstitial Emphysema Paracicatrial Emphysema
15
normal central
panacinar
Distal Irregular
16
阻塞性肺气肿的关键环节:
小气道炎症
肺泡间隔断裂
17
18
Oxidant-antioxidant imblance
19
Lobular septum
Centrilobular emphysema
Goblet cell metaplasia, mucous plugging, inflammation, and fibrosis.
6
The distinctive feature of chronic bronchitis :
Hypersecreton of mucus:
goblet cell hyperplasia mucous gland hyperplasia
30
chronic cor pulmonale
31
Bronchiectasis
Bronchiectasis is the permanent dilatin of bronchi and bronchioles caused by destruction of the muscle and elastic supporting tissue, resulting from or associated with chronic necrotizing infections.
3
Chronic bronchitis morphology(与支扩 比较)
Bronchial epithelium degeneration： desquamation（脱落）, squamous metaplasia goblet cell hyperplasia
mucous gland hyperplasia inflammation Fibrosis and smooth muscle hyperplasia chronic bronchioles:
Chronic Obstructive Pulmonary Disease
Chronic bronchitis Emphysema Bronchiectasis asthma
1
Chronic bronchitis
persistent cough with sputum production for at least 3 months in at least 2 consecutive years.
27
Clinical :
dyspnea barrel-chested,
breath sound↓, percussion note is hyperreaonant X-ray: hyperinflation
28
Complications:
chronic cor pulmonale Spontaneous pneumothorax Acute inflammatory
Complications:
Bronchiectasis emphysema （最主要的） chronic cor pulmonale bronchopneumonia
12
Emphysema
a condition of the lung
characterized by abnormal permanent enlargement of the airspaces distal to the terminal bronchiole, accompanied by destruction of their wall.（过度充 气+管壁破坏）
2
Forms of Chronic bronchitis
simple chronic bronchitis productive cough mucoid sputum no airflow obstruction.
Chronic asthmatic bronchitis Chronic obstructive bronchitis
chronic bronchioles (small airway disease): goblet cell metaplasia mucous plugging, inflammation, fibrosis.
10
Clinical : Cough mucoid sputum Wheezing
11
29
chronic cor pulmonale --pulmonary morphology
Smaller arteries and arterioles thickening internal/medial hypertrophy Lumina narrow
muscularization of arterioles
--Also the morphologic basis of muciod sputum（未感染的白色黏痰）
7
REID INDEX = b-c/a-d >0.5
(Normally 0.4)
8
9
In Chronic obstructive bronchitis, the morphologic basis of airflow obstruction :
20
Long time smoker
21
22
a1-AT deficency Intravenous drug abuse
23
24
25
Panacinar emphysema
26
Paraseptal (Distal Acinar) Emphysema
Subpleural upper lobes Fibrosis bullae
Bullae lung(>2cm)
14
Type of Acinar Emphysema
Centroacinar Emphysema (Centrilobular )
Panacinar பைடு நூலகம்mphysema (Panlobular)
Periacinar Emphysema (Distal acinar)
compensatory Emphysema
Overinflation
Senile （老年性）Emphysema （过度膨胀） 13
Type of Emphysema
Acinar (alveolar) Emphysema obstructive Emphysema
Interstitial Emphysema Paracicatrial Emphysema