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COT Part II > Lecture 14: Respiratory System > Flashcards

Lecture 14: Respiratory System Flashcards

1
Q

Clinical divisions of respiratory tract

A
  1. Upper
  2. Lower
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2
Q

Functional divisions of respiratory tract

A
  1. Conducting (respiratory epithelium)
  2. Respiratory (alveolar epithelium)
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3
Q

Nasal cavity

A

-Divided into 3 regions (meatuses) by inf., middle, superior conchae (turbinates)
-Conduct + condition air and contains olfactory sensory neurons (OSNs)
-Mid. meatus = larynx, upper meatus backwater region

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4
Q

Nasal conditioning of air

A

Nasal cavity slows, warms, and humidifies incoming air through the meatuses.

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5
Q

Olfactory epithelium

A

Part of upper concha, contains OSNs, sustentacular (support) cells, microvillar cells, Bowman’s small olfactory glands

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6
Q

Olfactory sensory neurons

A

OSNs are part of CNS and regenerate via basal progenitor cells. Blood-olfactory barrier is extension of BBB. Loss of regeneration leads to olfactory metaplasia, presbyosmia. Olfactory receptors embed in mucus layer w/ ciliated surface.

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7
Q

Respiratory epithelium cells

A

Psueodstratified, ciliated conducting airways.
-Ciliated cells
-Mucous cells
-Brush (tuft) cells
-Small granule (neuroendocrine) cells
-Basal cells
-In distal bronchioles: club cells, ionocytes

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8
Q

Mucociliary escalator

A

Cilia in respiratory epithelium pushes mucus up towards the throat to clear microbes, debris.

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9
Q

Brush cells

A

Rare; have microvillous border and may play some immune function

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10
Q

Basal cells

A

Resident SCs of respiratory epithelium

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11
Q

Ciliated cells

A

Most numerous cell of respiratory epithelium. Contains many ACE2 receptors (COVID-19 path.)

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12
Q

Conducting portion of respiratory tract

A

Nose -> trachea -> bronchi -> bronchiole -> terminal bronchiole

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13
Q

Respiratory portion of respiratory tract

A

Respiratory bronchiole -> alveolar duct -> alveolar sac -> alveolus

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14
Q

Trachea

A

-Contains submucosal glands and Bronchial Assoc. Lymphoid Tissue (BALTs)
-No muscularis mucosae
-C-shaped hyaline cartilage rings; incomplete ring allows contraction/dilation
-Trachealis muscle (contract/dilate)

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15
Q

Bronchus

A

Plate-shaped hyaline cartilage. Divided into extra and intrapulmonary regions; first branching of airway.

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16
Q

Bronchioles

A

Smallest branches of conducting airways. Contains club cells and ionocytes

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17
Q

Club cells

A

Form modified epithelium of bronchioles. Secretory protein + surfactant-LIKE substance for epithelial production/airway patency. Non-ciliated domed apical aspect.

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18
Q

Ionocytes

A

Small subset of club cells; express Cl- transporter gene to thin airway mucus. LoF -> cystic fibrosis

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19
Q

Terminal bronchioles

A

End of conducting airway; smooth transition into respiratory bronchioles, which have both conduct. and respiratory functions.

20
Q

Respiratory epithelium immune functions

A

-Thick basement membrane (lucida + densa); thickens more w/ chronic particulate exposure
-Local metaplasia to SSNK response to chronic insult; islands (“hillocks”) more resistant to chem. degradation; also causes impaired mucous removal + increase in mucus gland size -> coughing (e.g. smoker’s cough). Reversible w/ irritant removal.

21
Q

Alveolus/alveolar sac/alveolar duct

A

Alveoli = basic respiratory units of lung, several share walls in alveolar sac. Alveolar duct connects shared airway w/ distal bronchioles. Outer rim of alveoli lined w/ elastic fibers for resting contractility

22
Q

Alveolar epithelium

A

Alveolar epithelium/alveolar septum lines entire respiratory portion of lung. Maintains blood-air barrier

23
Q

Interalveolar septum (alveolar wall) features

A

Mostly as thin as possible, but thickens to include ECM, CT cells, (elastic) fibers. Thin = air-blood barrier, capillaries
Thick = pulmonary interstitum: collagen, elastin, capillaries/lymphatics; fibroblasts, immune cells

24
Q

Pleural space

A

Space surrounding lungs. Inspiration creates negative pressure to passively expand lungs.

25
Q

Atelectasis

A

Lack of expansion in lungs; complete/partial collapsed lung e.g. w/ pulmonary edema (fluid in alveoli)

26
Q

Alveolar cells

A
  1. Alveolar Type 1 pneumocytes (AT1)
  2. Alveolar Type 2 pneumocytes (AT2)
27
Q

AT1 cells

A

Thin squamous cells bounding capillaries; primary gas exchange site. Form occluding junctions.

28
Q

AT2 cells

A

Thicker cuboidal/spherical minority cells in alveoli, usually at corners of alveolar walls. Contain lamellar bodies to secrete surfactant, GM-CSF cytokines. High ACE2, TMPRSS2 receptor amount (Covid-19)

29
Q

Serous surfactant in alveoli

A

Lipid monolayer which reduces surface tension in alveoli to promote gas exchange. Mostly p-tidylcholine, produced from AT2 lamellar bodies

30
Q

Alveolar SCs

A

Resident SCs for AT1, AT2 cells

31
Q

2 main types of lung capillary endothelial cells

A
  1. Aerocytes
  2. General capillary (gCap)
32
Q

Aerocytes

A

Underlie all thin regions of alveolar wall and some of the thick regions too. Mediate gas exchange and leukocyte diapedesis (capillary diapedesis unique to lungs).

33
Q

gCap cells

A

Aerocyte progenitors (endothelial cells) which only border thick alveolar wall, contacting CT elements (pericytes, ECM, etc.). Produce compounds for vasomotor tone.

34
Q

5 types of lung macrophages

A
  1. Alveolar
  2. Interstitial
  3. Systemic monocytes
  4. Airway
  5. Pleural
    Dust cell = generic term for old lung mΦ’s
35
Q

Alveolar mΦ’s

A

Reside on luminal epithelial surface, w/in alveoli. Fetally seeded and less immunogenic than other mΦ’s. Either retain particles for life in CT (dust cells) or exit by mucociliary elevator

36
Q

Interstitial mΦ’s

A

Coordinate local/systemic immunity w/ DCs. Found in large numbers in collagenous CT w/ supravital staining

37
Q

Systemic monocytes

A

Resident marginal pool found in lung vasculature stuck to endothelium; “on demand”. Lung vessels also contain the largest neutrophil marginal pool

38
Q

Airway mΦ’s

A

Found in bronchial/bronchiolar lumens

39
Q

Pleural mΦ’s

A

Majority cell found in pleural fluid. Phagocytose debris.

40
Q

2 lung circulations

A
  1. Pulmonary (oxygenation of blood from right heart; low P)
  2. Bronchial (small systemic supply to lung)
41
Q

3 main functions of respiratory system

A
  1. Air conduction
  2. Air filtration/conditioning
  3. Gas exchange (respiration)
42
Q

Pleural surface

A

Continuum forming closed pleural space. Visceral/parietal pleura lubricated and coupled via serous fluid for free, rapid lung movement relative to chest wall.

43
Q

Pulmonary circulation

A

Functional vessels that run ALONG airway tissue; arteries within the alveoli and travel alongside bronchi, veins in CT septum adjacent to lungs

44
Q

Bronchial circulation

A

Systemic vessels that run WITHIN airway walls; branch from aorta. Venous return w/ rest of systemic circulation OR anastamosis w/ pulmonary circulation

45
Q

Blood-air barrier components

A

Thinnest part of alveolar membrane.
1. Thin surfactant
2. Alveolar epithelium (AT1s)
2. Fused alveolar/endothelial basement membranes
4. Endothelial cell aerocytes

46
Q

Pores of Kohn

A

Alveolar pores, Equalize alveolar P and enable collateral ventilation, mΦ migration

COT Part II (12 decks)

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