3. Etiology:
1-Rhinoviruses,
2-Exposure to cold is an important predisposing factor.
Pathology: Catarrhal inflammation.
Complications: Spread of infection sinusitis, pharyngitis,
adenoids, laryngitis, otitis media, bronchitis,
bronchopneumonia...
Rehab Sharaf, MD
Acute Catarrhal Rhinitis
(Common Cold)
4. Acute Allergic Rhinitis
Type I hypersensitivity caused by inhalation of certain
antigens (as pollens) allergic inflammation rich in
eosinophils.
Repeated attacks(chronicity) of allergic rhinitis &
sinusitis nasal polyps
Rehab Sharaf, MD
5. NASAL POLYPS
Etiology: Repeated attacks of allergic rhinitis and sinusitis.
Complications:
1-Nasal obstruction
2-Epistaxis.
Rehab Sharaf, MD
6. Adenoids &Tonsils
Rehab Sharaf, MD
Both are collections of lymphoid tissue
The tonsils are located in the back of the throat
The adenoids are positioned behind the soft palate
7. ACUTE TONSILLITIS
AETIOLOGY:
Bacterial infection; most commonly streptococcus hemolyticus
PATHOLOGY: Three types:
1-Catarrhal Tonsillitis
2-Follicular (suppurative) Tonsillitis: Remarkably enlarged tonsils + pus
at the tonsillar crypts.
3-Membranous Tonsillitis: a membrane covering the tonsils.
Rehab Sharaf, MD
14. Rehab Sharaf, MD
Restrictive Lung Diseases
Obstructive Lung Diseases
Reduced expansion of lung
parenchyma
More difficulty with exhaling air from
the lungs due to narrowing of the
airways
exhaled air comes out more slowly
than normal.
Eventually, an abnormally high
amount of air remains in lungs
Classification of lung diseases
15. Rehab Sharaf, MD
Restrictive Lung Diseases
Obstructive Lung Diseases
The Main Symptom: shortness of breath with exertion, cough, chest
pain.
CAUSES:
1- Lung stiffness e.g. interstitial
lung disease, sarcoidosis,
pulmonary fibrosis
2- Chest wall stiffness, or due to
weakened muscles or damaged
nerves.
CAUSES:
1- COPD
2- Asthma
3- Bronchiectasis
4- Bronchiolitis
5- Cystic fibrosis
Classification of lung diseases
pulmonary function tests are often needed to make a diagnosis
16. Chronic Obstructive Pulmonary Diseases
A) Chronic bronchitis
It is persistent productive cough for at least 3 consecutive
months in at least 2 consecutive years.
Rehab Sharaf, MD
17. Continuous exposure to irritants as smoking or infection chronic
inflammation & mucous gland hyperplasia Mucous hyper secretion
& narrowing of the bronchi.
Rehab Sharaf, MD
Pathogenesis
Chronic bronchitis
18. Chronic Obstructive Pulmonary Diseases
B) Emphysema
Permanent over-distension of air spaces distal to terminal
bronchioles accompanied by destruction of their walls.
Rehab Sharaf, MD
19. Pathogenesis of Emphysema:
1-Excessive Protease (Elastase) Activity:
Rehab Sharaf, MD
The main sources of protease are the
Neutrophils & Macrophages
Protease causes destruction of the elastic
tissue of air spaces
22. Rehab Sharaf, MD
Normal lung M/E: Emphysema
The left of image shows severe
emphysema (large empty spaces). The
lung tissue on the right of the image has
relative preservation of the alveoli.
23. 2-Bronchial asthma
DEFINITION:
Asthma is a chronic lung disease that reversibly narrows the
airways and characterized by periods of wheezing, expiratory
dyspnea, coughing and chest tightness.
Rehab Sharaf, MD
24. Rehab Sharaf, MD
Types of bronchial asthma
1-Extrinsic Asthma:
Type I hypersensitivity reaction
exposure to an extrinsic antigen.
Starts in the first 2 decades
Family history
+++ Serum level of IgE
antibodies & eosinophils
2-Intrinsic Asthma:
Non-immune mediated disease
triggered by a number of
stimuli in a susceptible person.
Usually in adult life
Usually no family history
Normal serum levels of IgE
25. 3-Bronchiectasis
Definition: persistent dilatation of medium sized bronchi &
bronchioles together with chronic suppurative inflammation of their
walls.
Etiology:
-Septic bronchopneumonia
-Bronchial obstruction
-Congenital lesions
Rehab Sharaf, MD
28. Pneumonia
Definition:
This is patchy or diffuse inflammation of the lung with
consolidation (solidification) of the lung tissue i.e. loss of the
spongy consistency.
Rehab Sharaf, MD
30. Lobar pneumonia
Acute diffuse fibrinous inflammation of one or more lung lobes.
ETIOLOGY:
The causative bacteria: Pneumococci
Route of infection: Droplet infection.
Rehab Sharaf, MD
32. Septic Bronchopneumonia
It is patchy consolidation of the lung due to suppurative
inflammation affecting initially the bronchi & bronchioles then
spreads to the adjacent alveoli.
It is more prevalent at the extremes of age.
Rehab Sharaf, MD
33. Septic Bronchopneumonia
ETIOLOGY:
The causative bacteria:
Staphylococci, Streptococci, Pneumococci, Haemophilus
influenzae.
Route of infection:
a)Endogenous from upper respiratory tract.
b)Exogenous (droplet infection).
Rehab Sharaf, MD
34. 1. Lung abscess
2. Fibrous scar
3. Pleural complications: empyema
4. Direct spread to mediastinum (suppurative pericarditis)
5. General: Acute toxaemia, septicaemia, & pyaemia (brain
abscess, endocarditis)
Complications of both Acute Lobar Pneumonia &
Acute Bronchopneumonia
Rehab Sharaf, MD
35. LUNG ABSCESS
A cavity containing pus due to localized
suppurative inflammation of lung .
Causative organisms:
staph., strept., & gram-negative organism
Rehab Sharaf, MD
36. 1-Inhalation (aspiration) of septic material
2-Septic emboli derived from septic thrombi pyaemic abscesses
3-Bacterial pneumonia (lobar pneumonia or bronchopneumonia)
4-Bronchiectasis.
5-Bronchial obstruction accumulation of mucus secondary bacterial
infection
6-Direct spread of septic infection e.g. from subphrenic abscess.
7- Penetrating chest injuries.
Rehab Sharaf, MD
Etiology of lung abscess:
37. Lung Collapse (Atelectasis)
An airless condition of the lung which has previously
been inflated.
Etiological Types:
1. Compression collapse
2. Resorption collapse Reversible
3. Contraction collapse irreversible
Rehab Sharaf, MD
48. Note the clusters of dilated air spaces which are conspicuous in the
middle and lower lobes of the right lung and the lower lobe of the left
lung. Both lungs are markedly enlarged.
Lung emphysema: markedly dilated air spaces
systemic pathology
Rhinitis is inflammation and swelling of the mucous membrane of the nose
which may be followed by secondary bacterial infection
Gross: Multiple soft pink polyps, projecting from the mucosa of the nose and sinuses. : obstruction predisposes to infection leading to chronic rhinitis and sinusitis.
Membrane is formed of mucosal necrosis + exudate
quinsy, is an accumulation of pus due to an infection behind the tonsil……..uncommon complication
(partial or complete obstruction). (difficult to fill lungs with air)
In obstructive lung diseases, As the rate of breathing increases (during increased activity or exertion), there is less time to breathe all the air out before the next inhalation.
α1-AT is protease inhibitor. Excess protease activity destruction of the elastic tissue of the air spaces diminished elastic recoil progressive distension of the air spaces.
Dilated airspaces, the emphysematous process is one of loss of lung parenchyma, not fibrosis. Large subpleural bullae
e.g. respiratory tract infection, chemical irritant or drugs
Symptoms typically include a chronic cough with mucus production
