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Pulmonary > Intro- pulm anatomy, histology, etc > Flashcards

Intro- pulm anatomy, histology, etc Flashcards

pg 1-20

1
Q

Lung lobes and segments

A

Right Upper Lobe: apical, posterior, anterior
Right middle lobe: medial, lateral
Right lower lobe: superior, anterior basal, medial basal, lateral basal, posterior basal

Left Upper Lobe:
(Upper division): apical-posterior, anterior
(Lingula): superior, inferior

Left lower lobe: superior, antero-medial basal, lateral basal, posterior basal

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2
Q

Cartilage shape in trachea and bronchi

A

trachea + mainstem bronchi: C-shaped rings

Segmental and lower bronchi: plates of cartilage

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3
Q

Kartagener’s syndrome

A

Primary ciliary dyskinesia
Often have mirror image of a normal chest
with dextrocardia and reversal of the normal branching pattern of the lungs (with a “left middle lobe” and a “right ligula”

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4
Q

Aspirated foreign bodies usually lodge where?

A

In the right lung

Left mainstem bronchus is longer than the right and more actuely angled at the trachea

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5
Q

Conducting airways

A

Airways without alveoli directly attached

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6
Q

How do you distinguish bronchi from bronchioles?

A

Bronchioles have no cartilage in their walls

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7
Q

Respiratory bronchioles

A

Arise from the terminal bronchioles (~generation 16)

Have alveoli budding directly off their walls

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8
Q

Alveolar ducts

A

Make up the final 3 or so generations of airways.

Made up of alveoli with BANDS OF SMOOTH MUSCLE in their walls.

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9
Q

Acinus

A

Comprised of a respiratory bronchiole and all of its branches and alveoli

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10
Q

Epithelial cell type in the trachea, bronchi, bronchioled, alveoli

A

Trachea and bronchi: Pseudostratified Columnar
Bronchioles: Cuboidal
Alveoli: Squamous

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11
Q

Where are these found:

  • Cilia
  • Sub-mucosal glands
  • Goblet Cells
A

Cilia: between the bronchioles and trachea
Sub-mucosal glands: in the trachea and bronchii
Goblet cells: in all airway levels down to the terminal bronchiole

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12
Q

Cells on the alveolar surface

A

93% Type I epithelial cells (squamous pneumocytes)
-terminally differentiated

7% Type II (granular pneumocytes)

  • more numerous, but rounded shape, take up less surface area.
  • can differentiated into Type I cells in cases of lung injury
  • produce surfactant
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13
Q

Capillary endothelium metabolic activities

A
  • Converts Angiotensin I to angiotensin II
  • Produces factor 8
  • Inactivates prostaglandins E2 and F2a, leukotriene, and serotonin
  • Principal site of liquid and solute filtration with net outward flow of 10-20 ml/hr in adults (fluid removed via pulmonary lymphatics)
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14
Q

In order to get to a rbc in the capillary, a molecule of O2 must traverse:

A 
Surfactant
Type 1 pneumocyte
Fused basement membrane
Endothelial Cell
Plasma
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15
Q

Lung Blood Supply

A

Two separate blood supplies:

  1. Pulmonary arteries (carry desaturated blood to capillary bed for reoxygenation)
  2. Bronchial arteries (carry arterial blood to nourish the bronchi)
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16
Q

Pulmonary lymphatics

A

Drains into mediastinal lymph nodes.

Lymph flow ~20 ml/hr

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17
Q

Pulmonary Interstitium

A

Portion of the lung btw the alveolar epithelium and capillary endothelium
Composed of non-cellular components (collagen and elastin), some fibroblasts and macrophages

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18
Q

Respiratory muscles

A 
Main muscle of inspiration: diaphragm
Accessory muscles of inspiration:
-external intercostals
-scalene muscles
-sternomastoid muscles

Accessory muscles of expiration:

  • Rectus abdominus
  • Obliques
  • Transverse abdominal muscles
  • Internal intercostals
19
Q

Respiratory System innervation

A

Motor:
Diaphragm: phrenic nerves (C3, C4, C5)
Intercostals: intercostal nerves (thoracic segmental nerves)

Autonomic:
Sympathetic- (upper thoracic ganglia) Stim results in bronchodilation, constriction of pulmonary blood vessels, inhibition of glandular secretion

Parasympathetic- (vagus nerve) Stim results in
airway constriction, dilatation of pulmonary circulation, increased glandular secretion

Non-adrenergic, non-cholinergic pathway: (NANC) possibly mediated via NO

20
Q

Receptor types

A

Pulmonary stretch receptors (slowly adapting)
-assoc. w/smooth muscle of intra-pulmonary airways. React to lung inflation and increased transpulmonary pressure.

Irritant, rapidly adapting. Epithelial, larynx and intrapulmonary. React to irritants, mechanical stim, etc.

C-fiber receptors:

  1. Pulmonary C-fiber receptors:
    - found in alveolar wall
    - sense increased pulmonary interstitial congestion, chemical injury, microembolism
  2. Bronchial C-fiber receptors.
    - Stim results in bronchoconstriction

C-fibers responsible for sensation of dyspnea in many pulmonary diseases.

21
Q

Conducting Airways

A

nasal cavities, pharynx, larynx, trachea, bronchi, bronchioles

22
Q

Respiratory airways

A

respiratory bronchioles, alveolar ducts, alveolar sacs

23
Q

As air moves distally into the lung, what happens to air flow, air turbulence, humity & warmth?

A

Cross-sectional area increases
Air flow velocity decreases
Air turbulence increases
Humidity & warmth increase

24
Q

Four layers that form the Trachea through bronchioles

A

Mucosa
Submucosa
Muscularis and/or cartilage
Adventitia

25
Q

The mucosa consists of?

A

Epithelium

Underlying connective tissue (lamina propria)

26
Q

“Respiratory epithelium” - location, contains what type of cells, function.

A 
Line the trachea and bronchi
Pseudostratifies columnar epithelium
-ciliated columnar cells
       -connected by tight junctions
       -contain numerous mitochondria
       -contain receptors for IgA
  • goblet cells
    - produce mucus (acid gylcoprotein)
    - many vesicles and ER

Function: produces mucociliary escalator for the trachea and bronchi
NOT SITE OF ACTUAL RESPIRATION OR GAS EXCHANGE

27
Q

Kulchitsky Cells

A

-Located at base of epithelium
-Endocrine cells
(Amine Precursor Uptake & Decarboxylase)
-Serotonin, ADH, calcitonin, somatostatin, others)
-Act as paracrine/endocrine factors that respond to
HYPOXIA
-Release agents into basal lamina, carried away by blood stream

28
Q

Lamina Propria contains?

A
  • a few lymphocytes
  • numerous mast cells
  • occasional polymorphonuclear leukocyte
  • rich capillary network
  • w/accompanying non-myelinated nerves
29
Q

Metaplasia define

A

When normal cellular constituents of mucosa or mesenchyme of a site change shape or proliferate in response to persistent or chronic irritation or injury to the lungs.

30
Q

Metaplasia types

A

Squamous metaplasia
-Psudostratified epithelium change to squamous

Goblet cell metaplasia
-Epithelium develops an abnormal number of goblet cells, which secrete more mucus

Type II cell metaplasia/bronchiolar metaplasia
-If scarring occurs in the distal lobule beyond the terminal bronchiole, type II cells and the low columnar cells of the airways will proliferate to cover the fibrous scars which have replaced normal alveolar septa

Smooth muscle cell metaplasia
-Almost all scars of the lung will elicit hyperplasia and metaplasia of the smooth muscle of the airways and vessel walls and stromal fibroblasts

31
Q

Submucosa

A

Loose area of connective tissue outside of the lamina propria
-Blood vessels
-Glands of mixed salivary type (secrete mucous and serous components)
Glands occur in bronchi, reach greatest development in 2nd to 5th generation of bronchi

32
Q

Muscularis/cartilage layer

A

Trachea: C-shaped rings of hyaline cartilage
Posterior gap in cartilage spanned by smooth muscle (the trachealis muscle) - keeps trachea open

Lobar bronchi: cartilage plates are continuous

33
Q

Adventitia. What does it contain? What does it blend into?

A 
Layer of dense connective tissue
-nerves
-lymphatic vessels
-fat
-occasional lymph nodules
Blends into general connective tissue of central mediastinum
34
Q

Changes that occur as bronchioles get smaller?

A

Lose:

  • goblet cells
  • cilia
  • seromucous glands

Goblet cells are replaced by Clara cells

35
Q

Clara cells

A

Numerous microvilli
Bases contain many mitochondria
Lamellar bodies contain CC10 (surfactant protein)
-Secrete CC10
-Secrete surfactant protein A (opsonize bacteria)
-secrete lysozyme
-transcytose immunoglobulins into the airspace

36
Q

Each terminal bronchiole supplies a unit of the lung called…

A

a lobule

37
Q

Lung acinus consists of?

A
  • Respiratory bronchiole
  • Alveolar ducts
  • Alveolar sacs
38
Q

3 Types of bronchioles and their specific features

A

Bronchioles

  • within lung segments
  • simple columnar epithelium
  • decreasing cilia and goblet cells
  • full circle of smooth muscle
  • decreasing submucosal seromucous glands
  • no cartilage

Terminal bronchioles

  • Within lung lobules
  • simple cuboidal epithelium
  • no goblet cells or cilia
  • increasing clara cells (80% of epithelial cells)
  • Patches of smooth mucles
  • No cartilage or submucosal glands

Respiratory bronchioles

  • Within lung acini
  • low cuboidal epithelium
  • interrupted with outpockets of alveoli along wall
  • first respiratory gas exchange
  • clara cells
  • patches of smooth muscle
  • lead into alveolar duct
39
Q

Walls of individual alveoli have 3 main layers

A
  • Alveolar epithelium
  • Shared basement membrane
  • Endothelium of pulmonary capillaries
40
Q

Pulmonary vasculature includes?

A 
Pulmonary arteries
Bronchial arteries
Pulmonary veins
Bronchial veins
Alveolar microvasculature
41
Q

Verhoeff’s stain emphasizes what constituent

A

Elastin (can use to see bronchioles!)

42
Q

Functional unit of the lung

A

a lung acinus

43
Q

Surfactant composition

A

50% cholesterol
40% phospholipid dipalmitoyl phosphotidylcholine
10% proteins

44
Q

Surfactant proteins

A

SP-A & SP-B
-Have carbohydrate recognition receptors that bind bacteria and aid in activation of alveolar macrophages

SP-C & SP-D
-Hydrophobic proteins that stabilize the surfactant/air interface

Pulmonary (6 decks)

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