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PHAR2200 > lung structure and airway diseases > Flashcards

lung structure and airway diseases Flashcards

1
Q

What does the respiratory tract consist of?

A

nasal cavity and sinuses
larynx
trachea
bronchi
bronchioles
alveolar duct
alveoli

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2
Q

What does the conducting airways consist of?

A

trachea
primary bronchus
secondary bronchus

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3
Q

What does the resistance airways consist of?

A

bronchiole
terminal bronchiole
respiratory bronchiole

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4
Q

What does the respiratory airways consist of?

A

alveolar duct
alveolar sac

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5
Q

The bronchus is covered in…?

A

smooth muscle and elastic fibres

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6
Q

What lines the bronchus and bronchiole?

A

epithelium

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7
Q

What is the role of the pulmonary arteries and veins?

A

carry blood to (arteries) and from (veins) the lungs

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8
Q

Does the pulmonary veins carry O2?

A

yes

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9
Q

Does the pulmonary arteries carry CO2?

A

yes

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10
Q

What is the role of the bronchial arteries and veins?

A

supply blood to and drain from the airways

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11
Q

Do bronchial arteries carry O2?

A

yes

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12
Q

Do bronchial veins carry CO2?

A

yes

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13
Q

What type of epithelium lines the airway?

A

pseudostratified columnar

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14
Q

What is the role of the epithelium?

A

physical barrier (inhibits and prevents)
housekeeping role (ciliate cells)
catabolic metabolism (via cytochrome P450)
anabolic metabolism (synthesis of inhibitory mediators - PGE2)

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15
Q

What are the main nerve types?

A

cholinergic (excitatory)
noradrenergic (inhibitory)
inhibitory nonadrenergic noncholinergic (iNANC)
excitatory nonadrenergic noncholinergic (eNANC)

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16
Q

What role does the cholinergic nerves play?

A

major role in regulating airway smooth muscle tone and mucus production

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17
Q

What is the major role of iNANC?

A

release nitric oxide
innervates smooth muscle directly
relaxation

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18
Q

What is the role of eNANC?

A

release neuropeptides
increase airway tone, secretion of mucus and microvascular leakage

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19
Q

What is asthma?

A

chronic inflammatory disease of the airways characterised by bronchial obstruction and airflow limitation

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20
Q

Can bronchial obstruction and airflow limitation be reversible?

A

yes, either spontaneously or with treatment

21
Q

What are the characteristics of asthma?

A

shortness of breath
wheeze
tight chest
cough

22
Q

What are the two phases of the allergic response?

A

early phase response
late phase response

23
Q

What happens during the early phase of an allergic response?

A

decrease in FEV1, peak at 30-40 minutes, resolved in 2-3 hours
mast cell-derived histamine and leukotrienes

24
Q

What happens in the late phase of an allergic response?

A

release of inflammatory mediators cause submucosal oedema, airway wall swelling, secretion of mucus
epithelium remodelling, airway muscle hypertrophy/hyperplasia, subepithelial fibrosis

25
Q

What is FEV1?

A

the amount of air forced from lungs in 1 second

26
Q

What are the major characteristic features of asthma?

A

reversible bronchial obstruction
airway hyperresponsiveness
airway wall remodelling

27
Q

What is bronchial obstruction in asthma caused by?

A

a range of endogenous mediators

28
Q

What happens during bronchial obstruction?

A

increase airway smooth muscle tone; secretion of mucus
shedding of epithelium and accumulation of debris
oedema and selling of submucosa
airway smooth muscle hypertrophy + hyperplasia
sub-epithelial fibrosis

29
Q

What causes airway hyperresponsiveness?

A

a range of unrelated stimuli - methacholine, histamine, cold air

30
Q

What is the rule for airway resistance?

A

resistance to airflow is inversely proportional to the radius of the lumen raised to the fourth power

31
Q

What happens during airway hyperresponsiveness?

A

airway resistance
airway narrowing

32
Q

What happens during airway remodelling?

A
  1. dilated blood vessels
  2. infiltration of inflammatory cells - eosinophil; mast cell; mononuclear
  3. destroyed epithelium cells
  4. thickened basement membrane
  5. mucus plug with eosinophil and desquamated epithelial cells
  6. hypertrophied smooth muscle
33
Q

Where is histamine stored?

A

in mast cells and basophils

34
Q

When is histamine released?

A

in early phase response

35
Q

What can histamine cause?

A

bronchoconstriction, airway wall oedema

36
Q

What are the major histamine receptor antagonists?

A

H1 and H4

37
Q

What is H1 receptor?

A

seasonal allergies
not useful in asthma

38
Q

What is H4 receptor?

A

asthma, atopic dermatitis, psoriasis

39
Q

When is leukotrienes released?

A

early and late phase response

40
Q

What is LTB4?

A

chemoattractant for inflammatory cells

41
Q

What is LTC4, LTD4, LTE4?

A

potent bronchoconstrictors
cause secretion of mucus
induce release of chemical mediators from inflammatory cells

42
Q

What is COPD?

A

chronic obstructive pulmonary disease

43
Q

What makes up COPD?

A

chronic bronchitis + emphysema

44
Q

What are some primary causes of COPD?

A

tobacco smoking
air pollution

45
Q

What is a treatment of COPD?

A

ipratropium bromide (muscarinic antagonist) + salbutamol (β2-adrenoceptor agonist)

46
Q

What are the features of chronic bronchitis?

A

inflammatory disease with irreversible airflow limitation
hypersecretion of bronchial mucus
secondary respiratory infections

47
Q

What types of drugs provide symptom relief for chronic bronchitis?

A

β2-adrenoceptor agonists
muscarinic antagonist
glucocorticoids
mucokinetic drugs
antibiotics

48
Q

What is another way to treat chronic bronchitis?

A

selective phosphodiesterase IV inhibitors (roflumilast)

49
Q

How does selective phosphodiesterase IV inhibitors help?

A

improves lung functions
decrease freq. of exacerbations
targets underlying inflammation

PHAR2200 (9 decks)

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