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Respiratory Pathophysiology > Innervation of the Airways and Obstructive and Restrictive Disease > Flashcards

Innervation of the Airways and Obstructive and Restrictive Disease Flashcards

1
Q

what does the parasympathetic nervous system provide innervation to?

A

all of tracheobronchial tree

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2
Q

what does the parasympathetic nervous system specifically innervate in the lungs?

A

airway smooth muscle
submucosal glands

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3
Q

what does the sympathetic nervous system innervate in the lungs?

A

larger airways, not smaller airways
B2 receptors respond to circulating epinephrine

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4
Q

what does the eNANC (nonadrenergic noncholinergic) system lead to?

A

smooth muscle contraction
increased mucous
vasodilation, microvascular leakage, inflammatory cell activity

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5
Q

what does the iNANC (nonadrenergic noncholinergic) system lead to?

A

smooth muscle relaxation
decreased smooth muscle proliferation
decreased platelet aggregation and adhesion

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6
Q

what do eNANC nerves innervate?

A

airway smooth muscle
submucosal glands
blood vessels
form diffuse network immediately below the epithelium

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7
Q

what are the major neurotransmitters of the eNANC system?

A

tachykinins, including neurokinin and substance P

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8
Q

what fibers contain the major neurotransmitters of the eNANC system?

A

C fiber afferents mainly

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9
Q

what is the iNANC system probably critical for?

A

proper function of the lower airways

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10
Q

what are the major neurotransmitters of the iNANC system?

A

nitric oxide
VIP also involved

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11
Q

why is nitric oxide an ideal local transcellular messenger?

A

small
lipophilic
very short duration of action

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12
Q

what does nitric oxide do?

A

antagonizes actions of acetylcholine: smooth muscle relaxation, decreases airway smooth muscle proliferation, and decreases platelet aggregation and adhesion

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13
Q

what are some inflammatory mediators?

A

histamine
serotonin
prostaglandins
leukotrienes
platelet activating factor
reactive oxygen species
cytokines

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14
Q

what does histamine on the H1 receptor cause?

A

smooth muscle contraction, microvascular leakage and edema

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15
Q

what does histamine on the H2 receptor cause?

A

bronchodilation, negative feedback of histamine release
minor

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16
Q

what does serotonin cause?

A

mast cell degranulation
vasoconstriction
bronchoconstriction
microvascular leakage

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17
Q

what do prostaglandins mediate?

A

bronchoconstriction
airway hyperreactivity
bronchodilation
chemoattraction

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18
Q

what do leukotrienes cause?

A

slow reactive substance (anaphylaxis)
contraction
increased microvascular permeability
mucous production
eosinophil and neutrophil chemoattraction

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19
Q

what is platelet activating factor formed secondarily to?

A

membrane phospholipase A2 activation

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20
Q

what does platelet activating factor do?

A

airway constriction
microvascular leakage
eosinophil, platelet chemotactant
sustained bronchial hyper-responsiveness

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21
Q

what do reactive oxygen species do?

A

destruction of microorganisms and neoplastic cells
inflammatory mediator release

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22
Q

what happens in restrictive disease?

A

lungs cannot expand fully because of disease of the lung itself, the pleura, or the chest wall
compliance reduced

23
Q

what are common causes of restrictive disease?

A

pleuropneumonia
pneumonia
pulmonary edema
obesity

24
Q

what happens in obstructive disease?

A

lungs cannot fully empty

25
Q

what are common causes of obstructive disease?

A

canine bronchitis
feline asthma
equine inflammatory lung disease
equine recurrent airway obstruction

26
Q

in restrictive diseases, ______________, which is the inverse of ______________, is increased

A

elastance
compliance

27
Q

what affects the neuromuscular system that can cause restrictive disease?

A

myasthenia gravis
botulism

28
Q

do animals with restrictive diseases have a hard time breathing in or breathing out?

A

in

29
Q

why do patients with restrictive disease tend to breathe rapidly and shallowly?

A

elastic work is increased, will be even more increased if breathe deeper
non-elastic work component is higher when breathing faster

30
Q

what characterizes an obstructive lung disease?

A

increase in resistance

31
Q

what affects airway resistance?

A

parasympathetic stimulation
sympathetic stimulation
nonadrenergic noncholinergic
obstruction
compression of airways

32
Q

what does loss of tethering result in?

A

airway obstruction: not held open

33
Q

what are some common histopathologic features of chronic bronchitic diseases?

A

goblet cell hypertrophy and hyperplasia
mononuclear cell infiltration
increased connective tissue within the lamina propria
epithelial hyperplasia

34
Q

what causes asthma-type diseases?

A

allergen-mediated mechanisms

35
Q

what are some common histopathologic features of airway hyperreactivity?

A

increased mucus production
mucosal edema
thickening of the epithelial basement membrane
infiltration of the airway walls by inflammatory cells

36
Q

do eosinophils predominate in equine inflammatory airway disease?

A

very rarely

37
Q

what is the predominant cell type in recurrent airway obstruction?

A

neutrophils

38
Q

postganglionic parasympathetics: ganglionic transmission is mediated via _____________________, whereas actual smooth muscle contraction is mediated via _____________________

A

acetylcholine through nicotinic receptors
acetylcholine via muscarinic receptors

39
Q

how does an M3 receptor in airway smooth muscle lead to contraction?

A

phospholipase C activated, which forms IP3, which causes release of calcium ions

40
Q

what do M2 receptors mediate?

A

inhibit release of acetylcholine
downregulate its own response

41
Q

norepinephrine is the principle neurotransmitter for ____________, whereas epinephrine is for the ________________

A

nerves
adrenal medulla

42
Q

what does activation of B2 receptors in the sympathetic nervous system lead to?

A

improved mucus clearance
adenylate cyclase leads to accumulation of intracellular cAMP: decreased levels of calcium through protein kinase A

43
Q

when are eNANC nerves particularly important?

A

viral-induced airway hyperresponsiveness
injured respiratory epithelium exposes nerves

44
Q

what is serotonin thought to be important in?

A

feline asthma

45
Q

what prostaglandins mediate bronchoconstriction?

A

PGD2
PGF2alpha
TXA2

46
Q

what prostaglandins mediate airway hyperreactivity?

A

TXA
TGD

47
Q

what prostaglandin mediates bronchodilation?

A

PGE2

48
Q

in obstructive disease, the animal must generate a __________________ for a given amount of _______

A

higher driving pressure
flow

49
Q

what is resistance like in restrictive diseases?

A

normal or lower than normal
hard to take in, but easy to get rid of

50
Q

why do patients with restrictive disease tend to breathe rapidly and shallowly?

A

with increases breathing rates, the non-elastic work component is higher
with deeper breaths, the elastic work is greater
they already have a higher elastic work due to the disease

51
Q

what does beta-2 sympathetic activation lead to?

A

bronchodilation
circulating beta-2 stimulation is what causes it (not innervation)

52
Q

why is airway resistance lower at high lung volumes?

A

airways are tethered open to greater extent

53
Q

is there usually a primary infectious component to chronic bronchitis?

A

no

Respiratory Pathophysiology (22 decks)

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