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Key Vocabulary
Alveoli: Tiny air sacs in the lungs where gas exchange occurs.
Anorexia: Loss of appetite, leading to weight loss.
Aspiration: The act of drawing fluid or other substances into the lungs.
Atelectasis: Collapse of lung tissue, resulting in reduced or absent gas exchange.
Bacillus anthracis: The bacteria that causes anthrax.
Bacteremia: Presence of bacteria in the bloodstream.
Bronchi: The major air passages of the lungs that diverge from the windpipe (trachea).
Bronchiectasis: Chronic dilatation of the bronchi, usually caused by infection or obstruction.
Bronchogenic Carcinoma: Lung cancer arising from the cells lining the bronchi.
Bulla: Large air-filled spaces within the lung tissue, often associated with emphysema.
Calcification: The process in which calcium accumulates in body tissue, hardening it.
Cavitation: The formation of cavities or holes, especially in the lung, due to disease.
Chemotherapy: The treatment of disease by means of chemical substances or drugs.
Consolidation: The process of becoming solid, especially the solidification of the lungs caused by pneumonia or other diseases.
Crepitation: A crackling or rattling sound heard upon palpation, often due to air in subcutaneous tissue.
Diuretics: Medications that increase urine production to reduce fluid retention.
Dyspnea: Shortness of breath or difficulty breathing.
Edema: Swelling caused by fluid accumulation in the body's tissues.
Emboli: A blood clot, air bubble, or fatty deposit that has been carried in the bloodstream to lodge in a vessel and cause an embolism.
Emphysema: A lung condition characterized by the destruction of the alveoli, leading to decreased airflow and shortness of breath.
Epithelium: The tissue that lines the surfaces of the body, both internal and external.
Expectorate: To cough up and spit out mucus or other matter from the lungs, throat, or trachea.
Exudate: A mass of cells and fluid that has seeped out of blood vessels or an organ, especially in inflammation.
Fibrosis: The thickening and scarring of connective tissue, usually as a result of injury or long-term inflammation.
Fistula: An abnormal connection between two body parts, such as an organ or blood vessel and another structure.
Hemoptysis: Coughing up blood or blood-stained mucus from the bronchi, larynx, trachea, or lungs.
Histoplasma capsulatum: A fungus that causes histoplasmosis.
Histoplasmosis: A fungal infection caused by inhaling the spores of Histoplasma capsulatum.
Hydrothorax: An abnormal accumulation of fluid in the pleural space.
Hyperaeration: Over-inflation of the lungs, often seen in conditions like emphysema.
Iatrogenic: Relating to illness caused by medical examination or treatment.
Infarct: An area of tissue death (necrosis) caused by a lack of oxygen due to obstruction of the blood supply.
Insoniazid: An antibiotic used in the treatment of tuberculosis.
Lumen: The inside space of a tubular structure, such as an artery, vein, or intestine.
Macrophages: A type of white blood cell that engulfs and digests cellular debris, foreign substances, microbes, and cancer cells.
Malaise: A general feeling of discomfort, illness, or unease whose exact cause is difficult to identify.
Miliary TB: A form of tuberculosis that occurs when the bacteria spread through the bloodstream to multiple organs, resulting in small, millet-seed-like lesions.
Mycobacterium tuberculosis: The bacteria that causes tuberculosis.
Necrotic: Relating to or affected by necrosis (the death of most or all of the cells in tissue or an organ).
Parenchyma: The functional tissue of an organ as distinguished from the connective and supporting tissue.
Peribronchial fibrosis: Scarring of the tissue around the bronchi.
Pleura: The membrane that surrounds the lungs and lines the inside of the chest cavity.
Pleural Effusion: Accumulation of fluid within the pleural space.
Pleurisy: Inflammation of the pleura.
Plumbage: An obsolete surgical procedure for treating tuberculosis by collapsing a lung.
Pneumoconioses: A group of lung diseases caused by the inhalation of certain dusts.
Pneumothorax: The presence of air or gas in the cavity between the lungs and the chest wall, causing collapse of the lung.
Pulmonary Edema: Accumulation of fluid in the lungs.
Pulmonary Embolus: A blood clot that blocks a pulmonary artery, obstructing blood flow to the lungs.
Radiopaque: Impenetrable to X-rays or other forms of radiation.
Septic emboli: Infected clots that travel through the bloodstream and lodge in small vessels.
Thoracentesis: A procedure to remove fluid from the space between the lungs and the chest wall (pleural space) with a needle.
Thoracoplasty: A surgical procedure to collapse a lung by removing ribs.
Tubercle: A small, rounded nodule produced by Mycobacterium tuberculosis.
Key Points
Anthrax
Anthrax is caused by inhaling the sporelike microbe bacillus anthracis, leading to the production of toxins that disrupt cell function.
Early symptoms resemble influenza, but progression can lead to labored breathing, shock, and death.
Lung Abscess
A lung abscess is a necrotic area of the lung containing pus, often caused by aspiration.
It frequently occurs in the right lung due to the anatomy of the right main bronchus.
Manifestations include fever, cough, expectoration of pus, and foul sputum.
Radiographically, it appears as a thick-walled capsule containing air and fluid.
Bronchiectasis
Bronchiectasis is a permanent dilatation of the bronchi due to destruction of the bronchial wall.
A common symptom is a chronic cough.
CT imaging greatly improves the diagnosis of bronchiectasis.
Pulmonary Tuberculosis (TB)
TB is caused by the inhalation of Mycobacterium tuberculosis, which is spread through air droplets.
Early TB is often asymptomatic.
Diagnosis is commonly made via a TB skin test (Mantoux/PPD).
Lesions are commonly seen in the apical region of the chest.
Primary TB
Primary TB is the initial attack of TB, which is often asymptomatic.
The immune system may contain the bacteria in lymph nodes, but failure leads to active TB.
Secondary or Reinfection TB
Secondary TB involves the proliferation of dormant mycobacteria within tubercles.
It can lead to the permanent loss of lung tissue and volume.
HIV-positive patients are at higher risk due to compromised immune systems.
Miliary or Hematogenous TB
Miliary TB occurs when mycobacteria enter the circulatory system and spread throughout the body.
It produces a "bird seed" radiographic appearance in the lungs.
Multi-Drug Resistant TB
Multi-drug resistant TB is resistant to two or more anti-TB medications.
It is often found in HIV-positive patients.
TB Treatments
Plumbage was an early, ineffective treatment involving the surgical insertion of objects like ping pong balls into the pleural space to collapse the lung.
Thoracoplasty involved removing ribs to collapse the upper lobe of the lung.
Histoplasmosis
Histoplasmosis results from inhaling soil and/or bat/bird droppings infected with the fungus Histoplasma capsulatum.
It has a similar radiographic appearance to TB.
Chronic Obstructive Pulmonary Disease (COPD)
COPD includes chronic bronchitis and emphysema, both involving an obstruction of airflow in the lungs.
Smoking is the primary risk factor.
Emphysema
Emphysema is a type of COPD characterized by the destruction of bronchi and alveoli, leading to bulla formation.
It results in decreased airflow, hyperaeration, and dyspnea.
Chronic Obstructive Bronchitis
Chronic bronchitis arises from long-term smoking or exposure to industrial air pollution.
Pneumoconioses
Pneumoconioses are occupational diseases caused by inhaled dusts, leading to pulmonary fibrosis.
Silicosis is caused by inhaling silicon dioxide (sand).
Asbestosis results from inhaling asbestos dust.
Black lung disease is caused by inhaling coal dust.
Pulmonary Embolus (PE)
Pulmonary emboli are often caused by blood clots that break off from veins in the legs (deep vein thrombosis - DVT).
Symptoms include chest pain, dyspnea, cough, and hemoptysis.
A chest X-ray may show an area of consolidation known as "Hampton's Hump."
Lung Cancer
Lung cancer is a leading cause of cancer deaths.
Smokers are much more likely to develop lung cancer.
Common symptoms include coughing, hemoptysis, dyspnea, and anorexia.
Bronchogenic Carcinoma
Bronchogenic carcinoma is a primary lung cancer divided into small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC).
Pulmonary Metastasis
Pulmonary metastasis (secondary lung cancer) is more common than primary lung cancer.
It commonly originates from breast, colon, or prostate cancer.
Pulmonary Edema
Pulmonary edema occurs when air in the lungs is replaced by fluid, leading to decreased gas exchange.
It often occurs secondary to congestive heart failure (CHF) or renal failure.
Atelectasis
Atelectasis is the collapse of a portion or the entire lung due to bronchial obstruction.
Common causes include tumors, foreign bodies, and mucous plugs.
Pneumothorax
Pneumothorax occurs when air is introduced into the pleural space, causing a collapsed lung.
Causes include trauma, ruptured bulla, and spontaneous occurrences.
A tension pneumothorax is a life-threatening condition.
Treatment often includes chest tube insertion.
Subcutaneous Emphysema
Subcutaneous emphysema occurs when air escapes from the lungs into surrounding tissues, causing crepitation.
Pleural Effusion/Hydrothorax
Pleural effusion is the accumulation of excess fluid within the pleural space.
Large effusions may require chest tube insertion or thoracentesis.
Pleurisy
Pleurisy is inflammation of the pleura, often indicative of a serious condition like pneumonia, pulmonary embolism, TB, or malignant disease.
Pain is usually distributed to one side along the intercostal nerve roots.
Sinusitis
Sinusitis involves infection and inflammation of the paranasal sinuses.
Common causes include bacterial infections.
Symptoms include nasal discharge, headache, tenderness, toothache, and malaise.
CT is the modality of choice for diagnosis.
Treatment includes saline nasal sprays, antibiotics, and analgesics.
Important Data
Lung Cancer Statistics: Lung cancer represents approximately 35% of all cancer deaths.
Smoking and Lung Cancer: Smokers are 10 times more likely to develop lung cancer than non-smokers.
Bronchogenic Carcinoma Survival Rate: Bronchogenic carcinoma has a poor prognosis with a 5-year survival rate of 12 to 14%.
COPD deaths: Up to 90% of COPD related deaths are related to smoking.
Additional Critical Aspects
Hampton’s Hump: A radiographic finding sometimes associated with pulmonary embolism, indicating an area of lung consolidation.
Mantoux test: Also known as the Tuberculin Skin Test or PPD test, it is a method to determine exposure to Mycobacterium tuberculosis.