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Structures (ASV) > Lecture 21: Macro- and Micro-Structure of the Lungs > Flashcards

Lecture 21: Macro- and Micro-Structure of the Lungs Flashcards

1
Q

lobes of lungs

A

right upper, middle lower

left upper, lower

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2
Q

fissures of lungs

A

oblique fissures (2) - separate L/R upper/lower lobes

horizontal fissure - RIGHT only; divides R middle lobe

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3
Q

why no left middle lobe of lungs?

A

because need space for the heart

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4
Q

lung lymphatics

A

lymphatic channels, appear as little white lines, unless have carbon pigment within visceral pleural lymphatic channels, then appear black

channel lymph fluid through lungs, towards hilum (root of lung) and to mediastinal lymph nodes (toward midline of body)

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5
Q

pleura

A

single layer of mesothelial cells

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6
Q

visceral layer of pleura

A

layer of connective tissue over surface of lung

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7
Q

parietal layer of pleura

A

layer of connective tissue against thoracic wall

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8
Q

neumothroax/hemothorax

A

when visceral and parietal layers dissociate because of air/blood entry into lungs

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9
Q

does lung feel a puncture from inside?

A

no

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10
Q

if tear parietal pleura, nerve that detects pain/causes action?

A

intercostal and phrenic afferent nerves perceive pain

GSA pain results

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11
Q

if tear visceral pleura, nerve that detects pain/causes action?

A

vagus and sympathetics perceive pain

little/no GVA pain results

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12
Q

what does vagus nerve control innervation for in lungs?

A 
changes in: 
smooth muscle (stretch); muscosa of trachea and bronchi (irritation); C pain fibers in alveoli and bronchi (inflammation); pulmonary veins, cardiac plexus (chemical); aortic arch and wall, pulmonary arteries (pressure)
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13
Q

where does vagus nerve run re: T-E?

A

posterior to hilum of lung; on either side of esophagus and trachea

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14
Q

hilum

A

root of lung, where structures (bronchus, artery, vein) enter/leave

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15
Q

what type of fibers do phrenic nerves carry to diaphragm?

A

GSE fibers

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16
Q

where does phrenic nerve run?

A

anterior to hilum of lung

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17
Q

what kind of blood does pulmonary artery carry?

A

deoxygenated blood

originate from pulmonary trunk, go to lungs from R ventricle of heart

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18
Q

what kind of blood does pulmonary vein carry?

A

oxygenated blood

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19
Q

where does pulmonary trunk bifurcation occur?

A

to left of midline, just inferior to vertebral level TIV/V

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20
Q

what is longer- right or left pulmonary artery?

A

right

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21
Q

order of bronchus/artery/vein at hilum of lung

A

left: are brides vain? - artery, bronchus, vein
right: brides are vein - bronchus, artery, vein

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22
Q

bronchial arteries

A

part of lung’s dual blood supply system

arise from aorta, intercostal arteries, or subclavian arteries

enter lungs at hilum

are nutrient arteries supplying oxygenated blood to tissue

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23
Q

pulmonary arteries

A

follow bronchial tree to form capillaries around alveoli

provide deoxygenated blood to lungs

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24
Q

2 types of arteries that supply blood to lungs

A

bronchial arteries, pulmonary arteries

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25
Q

where bronchial veins drain

A

pulmonary veins or left atrium, and into azygos vein on R and superior intercostal vein/meiazygos vein on L

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26
Q

tracheobroncial tree divisions

A 
trachea >
intrapulmonary brunchs >
main (primary >
lobar (secondary) >
segmental (tertiary) >
bronchioles
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27
Q

divisions smaller than bronchioles bronchioles

A

terminal bronchiole, respiratory bronchiole, alveolar duct, alveolar sac, alveolus

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28
Q

bronchogram

A

old image of bronchiole tree, taken by having pt ingest metal dust

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29
Q

carina

A

cartilaginous ridge within trachea, runs between the 2 primary bronchi of the trachea where they bifurcate

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30
Q

bronchoscopy

A

image down trachea into 2 main bronchi

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31
Q

cell type in trachea

A

pseudo stratified ciliated columnar

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32
Q

layers from out > in of the trachea

A

adventitia, C-shaped rings, trachealis and longitudinal muscles, submucosa, mucosa

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33
Q

adventitia

A

connective tissue on outside of trachea

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34
Q

c-shaped rings of trachea

A

hyaline cartilage that’s incomplete dorsally

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35
Q

tracheal is and longitudinal

A

smooth muscles of trachea

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36
Q

submucosa

A

mucous and serous glands of trachea

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37
Q

mucosa of trachea

A

made of epithelium and lamina propria

38
Q

epithelium of trachea

A

pseudo stratified ciliated columnar & goblet cells (produce mucus)

39
Q

lamina propria of trachea

A

connective tissue, elastic fibers

40
Q

how many layers of respiratory epithelium in trachea?

A

1! just appears to be more because pseudo stratified

41
Q

cilia function in trachea

A

bring fluid from lungs to trachea, so can get rid of bacteria/other particles not desired in the lungs

42
Q

2 other cell types of respiratory epithelium

A

endocrine (kulchisky) cells- secrete serotonin, regulate airway reflexes; basal cells (not columnar)- will give rise to epithelia

43
Q

orientations of mainstem bronchi

A

right is more vertical than left; inhaled objects thus tend to lodge in right mainstem bronchus

44
Q

intrapulmonary bronchus

A

usually next to branch of pulmonary artery, irregular cartilage plates, smooth muscle, goblet cells, ciliated pseudo stratified columnar epithelium, transitions to ciliated simple columnar as bronchi get smaller

45
Q

broncho-pulmonary segment

A

area of lung supplied by a segmental bronchus and its accompanying pulmonary artery branch

smallest functionally independent region of a lung and smallest area of lung that can be isolated/removed without affect adjacent regions

secondary/tertiary bronchi travel alongside, and branch in parallel with, pulmonary arteries/arterioles

10 in each lung

46
Q

bronchiole

A

really thin epithelium so can have gas exchange with alveoli

characterized by no cartilage, smooth muscle, very few/no goblet cells, and epithelium transfers from ciliated simple columnar to ciliated simple cuboidal

47
Q

4 F’s of sympathetic innervation

A

fright, flight, fight, fornicate

48
Q

autonomic innervation of bronchial glands

A

sympathetic: inhibitory - make lumens BIG

parasympathetic (vagus): secretomotor

49
Q

autonomic innervation of bronchial smooth muscle

A

sympathetic: bronchodilation

parasympathetic (vagus): bronchoconstriction

50
Q

autonomic innervation of bronchial vasculature

A

sympathetic: vasoconstriction
parasympathetic: vasodialation

51
Q

why is it good to have a large diameter lumen in the bronchi/bronchioles?

A

no gas exchange

52
Q

autonomic innervation to alveolar vasculature

A

none! they are capillaries, controlled by locally circulating factors like histamine, not by nervous system

53
Q

sympathetics control in lungs

A

secretory inhibition, bronchodilation, vasoconstriction

54
Q

parasympathetics control in lungs

A

secretomotor, bronchoconstriction, vasodilation

55
Q

COPD and asthma

A

chronic obstructive pulmonary disease and asthma

may have abnormally high parasympathetic discharge and flow of air through bronchi, and inflammation

56
Q

L/R vagus orientations re: esophagus

A

left: anterior
right: posterior

57
Q

posterior pulmonary plexus

A

come off of vagus; sit on top of esophagus; eventually provide PARASYMPATHETIC innervation to lungs

58
Q

where does parasympathetic innervation to the lungs come from?

A

pulmonary plexus

59
Q

where does sympathetic innervation to the lungs come from?

A

sympathetic chain

60
Q

terminal bronchiole characteristics

A

biggest of microstructures

surrounded by layer of smooth muscle, no goblet cells, ciliated simple cuboidal epithelium, clara cells

61
Q

clara cells

A

precursors of bronchiolar epithelial cells

detoxify carcinogens, synthesize a surfactant-like protein, secrete alpha-1-antitrypsin which inhibits digestion of elastin

have secretory vesicles, no cilia

62
Q

emphysema

A

caused by elastic tissue breakdown

can be caused by breakdown of clara cells

63
Q

what does alveolar wall contain?

A

elastic tissue (elastin)

64
Q

acinus (pl=acini)

A

functional subunit of the lung supplied by a single respiratory bronchiole

65
Q

subdivisions from bronchus to alveolus

A 
bronchus, 
respiratory bronchiole, 
alveolar duct,
alveolar sac, 
alveolus
66
Q

respiratory bronchiole characteristics

A

simple cuboidal epithelium, wall punctuated by alveoli and smooth muscle; isn’t smooth anymore, has potholes in it with lumps of smooth muscle

67
Q

alveolar duct characteristics

A

wall punctuated by alveolar sacs and alveoli

68
Q

alveolar sac characteristics

A

terminal part of alveolar duct, alveolar clusters = alveolar sac

69
Q

alveolar capillaries

A

seen inside of alveolar sac

can fit 1 RBC through

70
Q

cell types in capillary walls / function

A

function: more surface area for gas exchange

cells:
type I alveolar cell, capillary endothelial cell

71
Q

blood-air barrier for gas exchange made of

A

simple squamous epithelium

direct exchange from endothelial cell to alveolar cell

72
Q

cell types in alveolar wall cells

A

endothelial cells,
type I pneumocytes,
type II pneumocytes

73
Q

characteristics of endothelial cells in alveolar wall cells

A

thin, flat

do gas exchange

74
Q

characteristics of type I pneumocyte cells in alveolar wall cells

A

thin, flat
do gas exchange
only 40% of alveolar cells
cover 90% surface of alveoli

75
Q

characteristics of type II pneumocyte cells in alveolar wall cells

A 
thick, protruding, "foamy" 
no gas exchange 
60% alveolar cells
replace damaged type I cells 
secrete surfactant
76
Q

what type of cell secretes surfactant?

A

type II pneumocyte

77
Q

what is alveolar surface area equal to?

A

tennis court!

78
Q

lamellar bodies

A

secretory vesicles that produce surfactant in type II pneumocytes

produce it in form of tubular myelin weaves

look like little jupiters

79
Q

surfactant characteristics

A

phospholipids, cholesterol, carbs, proteins

decreases alveolar surface tension

keeps cell surface water layer thin, so increases gas exchange

increases stretchability (compliance)

prevents alveolar collapse

reduces fluid flow from capillaries into airways

80
Q

what does low surfactant levels cause?

A

respiratory distress syndrome

ie in premature babies

81
Q

pore of kohn

A

alveolar pores

allow equalization of pressure between alveoli, facilitate flow between acini when bronchioles are blocked

82
Q

is it good to have surfactant in alveolar pores?

A

no; blocks communication between alveoli

83
Q

alveolar macrophages

A

phagocytyze extra surfactant

aka “dust cells” because ingest inhaled particulate matter

84
Q

what is rate that lungs can recruit alveolar macrophages?

A

1 million macrophages/hr!

85
Q

characteristics of smoker’s lungs

A

excess carbon particles (trapped in macrophages)

chronic bronchitis (excess mucus from goblet cells)

increased pneumonia risk

loss of elasticity (emphysema, fibrosis)

metaplasia (bronchi epithelium changes to stratified squamous), interstitial disease (thickened alveolar walls)

cancer

86
Q

cell type of trachea and mainstem bronchus

A

ciliated pseudo stratified columnar

87
Q

cell type of intrapulmonary bronchus

A

transitions

88
Q

cell type of broncho-pulmonary segment

A

ciliated simple columnar

89
Q

cell type of bronchiole

A

transitions

90
Q

cell type of terminal bronchiole

A

ciliated simple cuboidal

91
Q

cell type of respiratory bronchiole

A

simple cuboidal

92
Q

cell type of alveolus

A

simple squamous

Structures (ASV) (30 decks)

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