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SF3- EXAM 2 > Non- Respiratory Functions of the Lungs > Flashcards

Non- Respiratory Functions of the Lungs Flashcards

1
Q

What is the three tier defense system of the lungs?

A
  • Mucociliary clearance that moves inhaled and trapped particles cephalad toward the mouth
  • Phagocytic and inflammatory cells that destory inhaled substances
  • Specialized mucosal immune system
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2
Q

What are the three major components of the mucociliary clearance system?

A
  • Sol- Periciliary fluid
  • Gel Phase- Viscoelastic muscus layer
  • Cilia- Surface of the epithelial cells and embedded in the periciliary fluid
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3
Q

Why is periciliary fluid produced?

A

Due to active ion transport by the pseudostratified ciliated columnar epithelial cells (type II cells).

NOTE: If not removed we will drown in a matter of minutes.

*Periciliary fluid is a nonviscous fluid

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4
Q

What is the importance of periciliary fluid?

A

Maintaining normal fluid depth and ionic composition in the periciliary fluid is critical for rhythmic beatings of the cilia and normal mucociliary clearance.

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5
Q

How is the fluid ion composition and volume maintained, in periciliary fluid?

A

Several mediators, under basal conditions and in response to inflammation, stimulate Cl− secretion by airway epithelial cells. The balance between Cl− secretion and Na+ absorption determines the volume and ionic composition of the periciliary fluid and maintains the depth of this fluid at about 5 to 6 μm.

NOTE: When net NaCl transport into periciliary fluid is stimulated, diffusive entry of water into the periciliary fluid is enhanced because of the osmotic gradient that occurs transiently as a result of NaCl transport.

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6
Q

How much mucus is made by healthy individuals per day?

A

100 mL

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7
Q

Where is the mucus layer located in relation to the periciliary layer?

A

On top

NOTE: The mucus layer is low viscosity and high elasticity

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8
Q

What are the components of mucus?

A
  • Water
  • Macromolecules
  • Electrolytes
  • Glycoproteins
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9
Q

Which 4 cell tyoes contribute to the production of mucus?

A
  • Goblet cells
  • Mucous Cells
  • Serous cells
  • Clara cells
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10
Q

Where are the mucous producing serous cells located?

A

In the submucosal tracheobronchial glands

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11
Q

Injury to goblet cells and infection increases __________ of mucus secreted by goblet cells

A

viscosity

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12
Q

Goblet cells are found in tracheobronchial division but disappear after the _____ division.

A

12th

NOTE: Smoking and chronic bronchitis leads to increased proliferation of goblet cells and they begin to appear lower in the tracheobronchial tree. This leads to increases mucous production

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13
Q

Submucosal tracheobronchial glands are present wherever there is _______ in the upper regions of the conducting airways.

A

Cartilage

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14
Q

Goblet cells secrete _________

A

Neutral and acidic glycoproteins rich in sialic acid

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15
Q

Submucosal tracheobrochial glands secrete ________

A

Water, ions, and mucous

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16
Q

Which cell types are found in submucosal tracheobronchial glands?

A

Mucous cells and serous cells

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17
Q

Serous cells secrete___________

A

Neutral glycoproteins and bacterial compounds (lysozyme, lactoferrin, and antileukoprotease)

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18
Q

What provides innervation to submucosal tracheobronchial glands?

A

Parasympathetic

Sympathetic

Peptidergic (vasoactive interstinal polypeptide)

NOTE: Histamine and arachidonic acid also increase mucus production

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19
Q

Compare and contrast serous cells and mucous cells with the terms below.

Granules

Glycoproteins

Hormones

Receptors

Degranulation

A

Granules

  • Serous: Small, electron dense
  • Mucous: Large, electron lucent

Glycoproteins

  • Serous: Neutral; Lysozyme, lactoferrin
  • Mucous: Acidic

Hormones

  • Serous: alpha- adrenergic > Beta- adrenergic
  • Mucous: Beta adrenergic > alpha adrenergic

Receptors

  • Serous : Muscarinic
  • Mucous: Muscurinic

Degranulation

  • Serous: a-adrenergic, cholinergic, substance P
  • Mucous: B-adrenergic, cholinergic
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20
Q

Where are clara cells located?

A

In the epithelium of bronchioles

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21
Q

_________ cells play an important role in bronchial regeneration after injury.

A

Clara cells

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22
Q

Clara cells secrete _______

A

Non-mucinous material containing carbohydrates and proteins

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23
Q

What are the components of sputum?

A
  • Serum proteins
  • Lipids
  • Electrolytes
  • Ca
  • DNA from degenerated white cells

NOTE: Sputum can also contain extrabronchial secretions (nasal, oral, lingual, pharyngeal, and salivary secretions

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24
Q

What info can be extrapolated based off of the color of sputum?

A
  • Presence of infection
  • How long it has remained in the lower respiratory tract
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25
Q

What molecules are required for cilia movement?

A

ATP

Ca++

Mg ++

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26
Q

Cilia are an outgrowth of the _________ and are covered by an outcropping of the plasma membrane (tip).

A

Basal body

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27
Q

Cilia beat about ________ beats/min, with a power forward stroke and a slow return or recovery period.

A

1000

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28
Q

During forward movement, the tips of the cilia extend upward into the _____ layer to move the mucus and entrapped substances. During the reverse beat the cilia release the mucus and withdraw completely in the ________ layer.

A

Viscous mucus; Periciliary fluid

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29
Q

Cilia in the nasopharynx beat in the direction to move mucus into the ________.

A

Pharynx

30
Q

Cystic fibrosis results from a mutation in _____.

A

CTFR

Note : This genetic disorder is characterized by thick, tenacious, and dehydrated airway secretions.

31
Q

Which component of the mucociliary clearance system is affected by cystic fibrosis?

A

Periciliary fluid layer

NOTE: In CF, there is a decrease in ability to secrete Cl- and therefore increases Na+ absorbtion. This causes a reduction in periciliary fluid, which results in thick mucus that cannot be cleared by the mucociliary clearance system.

32
Q

True or false. Kartagener’s syndrome is a sex-linked recessive tract.

A

False

Kartagener’s syndrome is an autosomal recessive trait

33
Q

Kartagener’s syndrome

A

A rare genetic syndrome associated with immotile cilia due to a mutation in dynein fibers

34
Q

What secondary conditions is Kartagener’s syndrome characterized by?

A
  • Bronchiectasis
  • Chronic Sinusitis
  • Situs inversus totalis

NOTE: Males with this condition are infertile

35
Q

Kartagener’s syndrome results in _______ respiratory failure.

A

Type I Respiratory failure which is characterized by chronic Sinus Infection and frequent lung infections – pneumonia, bronchitis.

36
Q

Particle deposition depends on the size, density over which the particle travels, and the relative humidity of air. Where are particles larger than 10 µm deposited?

A

In the nasal passages, as they do not penetrate the lower respiratory tract

37
Q

Particle deposition depends on the size, density over which the particle travels, and the relative humidity of air. Where are particles between 2-10 µm deposited?

A

In the lower respiratory tract by initial impaction and turbelent flow in the nasopharynx, trachea, and bronchi due to inertia

38
Q

Particle deposition depends on the size, density over which the particle travels, and the relative humidity of air. How are particles between 0.2-2 µm deposited?

A

By sedimentation secondary to gravity. This depends on airway diameter

39
Q

Particle deposition depends on the size, density over which the particle travels, and the relative humidity of air. How are particles less than 0.2 µm deposited?

A

By Brownian motion. This depends on particle’s diffusion coefficient. These particles come into contact with epithelium where there are no cilia or mucociliary transport.

40
Q

Particle deposition depends on the size, density over which the particle travels, and the relative humidity of air. How are elongated shaped molecules deposited?

A

By interception (the particles center of gravity)

41
Q

What are the three main patterns influencing the deposition of particles in the lung?

A
  • Impaction
    • ​The tendency of particles to collect on the posterior nasopharynx where transitional airflow occurs
  • Sedimentation
    • ​Occurs in distal airways
  • Diffusion
    • ​Random Brownnian motion of particles
42
Q

Turbulent airflow influences ___________; bifurcation of the airway affects the_________preventing particles from changing direction quickly and as a result you have inertial impaction.

A

deposition; inertia

43
Q

______________ is the gradual settling of particles based on weight.

A

Sedimentation

44
Q

Terminal region of the bronchiole that lacks ciliated cells

A

Achilles heel

45
Q

Smaller particles are cleared by ________ or ______.

A

Lymphatic drainage or phagocytosis

NOTE: This is usually rapid and occurs in less than 24 hrs

46
Q

______________ clears particles that are coughed up, expectorated or swallowed.

A

Mucociliary system

NOTE: Particles removed by this system are removed within minutes to hours

47
Q

In “pneumoconiosis” or the black lung disease of coal miners, coal dust particles damage the ___________where the particles are deposited

A

Achilles heel

48
Q

Silicosis

A

A form of occupational lung disease caused by inhalation of crystalline silica dust, and is marked by inflammation and scarring in the form of nodular lesions in the upper lobes of the lungs.

49
Q

_____________ cells metabolize substances and modify venous blood before it enters the systemic circulation.

A

Endothelial

50
Q

Endothelial cells are receptors for ____________.

A
  • Bradykinin
  • Tumor Necrosis Factor
  • Components of complement
  • Ig Fc fragments
  • Adhesion molecules
51
Q

What molecules are synthesized and secreted by endothelial cells?

A
  • Prostacyclin
  • Endothelin
  • Clotting factors
  • Nitric Oxide
  • Prostaglandins
  • Cytokines

​NOTE: Does not synthesize leukotrienes, due to a lack of 5-lipoxygenase

52
Q

What molecules are NOT metabolized by enothelial cells?

A

Epinephrine

Dopamine

Histamine

53
Q

What is unique about mucosal immune system?

A

Adaptive immune response is initiated only after the insulting agent has bypassed the innate immune response

54
Q

What role do immune cells play in the lungs to limit the immunological and inflammatory response to foreign substances?

A
  • T lymphocytes- limited antigen recognition
  • Plasma cells- synthesize non-complement binding antibody IgA
  • Innate immune cells- Alveolar macrophages, natural killer cells and dendritic cells
55
Q

True or false. In MALT, lymph nodes are encapsulated.

A

False

In MALT, lymph nodes are not encapsulated and has only afferent lymph drainage.

NOTE: Lymph nodes are encapsulated in the systemic immune system and have both afferent and efferent lymphatic drainage. MALT is independent of systemic immune system.

56
Q

Plasma cells sysnthesize and secrete _________.

A

IgA

NOTE: IgA binds to a surface receptor of epithelial cells

57
Q

IgA binds to _______ receptor of epithelial cells.

A

poly-Ig

NOTE: The receptor helps in pinocytosis in the epithelial cells and helps in exocytosis into the airway lumen.

58
Q

Poly-Ig is enzymatically cleaved and the secretory piece remains attached to the IgA. What is the reason for this?

A

Protects from digestion of IgA

59
Q

True or false. IgA does not bind to the complement.

A

True

60
Q

IgE binds to ____ cells in the presence of allergen.

A

Mast

61
Q

Goodpasture’s syndrome

A

An autoimmune response to the lung basement membrane that results in hemorrhagic disease

62
Q

__________ deficiency is the most common inherited immunoglobulin deficiency and is frequently associated with chronic lung disease.

A

IgA

63
Q

____________ provide bridge between innate and adaptive immunity

A

CR gamma delta

NOTE: CR gamma delta suppress IgE respone to inhaled antigen

64
Q

Function of Natural Killer Cells

A
  • Kill target cells without previous sensitization
  • Kill target cells by release of granular enzymes, perforins, and serine esterases

NOTE: NK cell activity increases in asthma

65
Q

What are the first nonepithelial cells to respond to a foreign substance?

A

Dendritic and Alveolar macrophages

66
Q

Role of alveolar macrophages

A
  • Phagocytize the foreign substance and clear through the lymphatic system
  • Suppress T- Cell Activity

NOTE: If substance escapes and reaches interstitial areas, it comes in contact with dendritic cells

67
Q

Function of dendritic cells

A
  • Dendritic cells capture, process, and present to T cells.
  • Activate T Cells
68
Q

Where are toll-like receptors expressed?

A

Expressed on Bronchial epithelial cells, Type II cells, Macrophages, and Dendritic cells

69
Q

What type of changes occur in the pulmonary system with agin?

A
  • Loss of elastic recoil
  • Stiffening of the chest wall
  • Alterations in gas exhange
  • Increases in flow resistence
70
Q

Causes of emphysema

A
  • Smoking
  • Air pollution
  • Childhood respiratory infections
  • Deficiency in alpha 1-antitrypsin

SF3- EXAM 2 (11 decks)

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