Nonrespiratory Functions of the Lungs: Khundmiri

Question 1

what are the other functions of the lungs besides gas exchange?

Answer 1

to maintain low fluid volume: lungs has its own mucosal associated tissues

Mucosa Associated Lymphoid Tissue (MALT)
?????

Question 2

What are the Three tier defense mechanisms of the lung

Answer 2

Mucociliary clearance that moves inhales and trapped particles cephalad toward the mouth

Phagocytic and inflammatory cells that destroy inhaled substances

Specialized mucosal immune system

Question 3

What is the function of the mucocialry and what are the three components?

Answer 3

to protect the lower respiratory system

Three major components (two fluid layers)
Sol – Periciliary Fluid
Gel Phase – Viscoelastic Mucus Layer
Cilia – Surface of the epithelial cells and embedded in the periciliary fluid

Question 4

Describe the Periciliary Fluid

Answer 4

very important for the rhythmic beating of cilia

• epithelial sodium channels ENaC
• cystic fibrosis transmembrane receptors (cholride channel) - CFTR
• aquaporin (ADP) which are conducting water

Question 5

sodium concentration allows what to occur

Answer 5

osmosis taking water from one portion of the cell to the other

Question 6

If you add an inhibitor of sodium channel amiloride, what happens?

Answer 6

you are not transporting sodium inside the cells
given to HTN pts to inhibit sodium reabsorption in kidneys, thus lung volume should increase but that doesn’t happen because your system probably??????

you are building up osmolarity in the ???
increase ???

Question 7

If you inhibit aquaporins

Answer 7

stops movement of water under physiological conditions because you don’t want to fill up the lungs with water

Question 8

What is on top of the periciliary fluid?

Answer 8

-mucus layer

Functions to:
-to entrap inhaled substances
-Low viscosity and highly elastic
because of the glycoproteins that are present

make about 100 mL and are recyled out??

Question 9

What are the four types of cells that make mucus?

Answer 9

?????

Question 10

Goblet cells

Answer 10

secrete neutral or acidic glycoproteins

in pts who smoke or with chronic bronchitis produce large amount of mucus due to increased proliferation of goblet cells

Question 11

Submucosal tracheobronchial glands

Answer 11

secrete acidic glycoproteins
they also contain enzyme with the function of killing bacteria
size and number increase in bronchitis

Question 12

What are the differences between properties of submucosal glands serous and mucous cells?

Answer 12

granules are end close particles that contain digestive enzymes

mucus has no substance P
both are muscarinic

Question 13

Clara cells

Answer 13

• Located in the epithelium if bronchioles
• Contribute to mucus secretion
• Secrete non-mucinous material containing carbohydrates and proteins
• Play important role in bronchial regeneration after injury: these cells can act as stem cells causing regeneration of the bronchial cells after injury; injury due to infection or trauma

Question 14

What is the sputum clincally?

Answer 14

-Expectorated mucus
Serum proteins, lipids, electrolytes, Ca, DNA from degenerated white cells
Also contains extrabronchial secretions – nasal, oral, lingual, pharyngeal, and salivary secretions
Color of sputum correlates with presence of infection and how long it has remained in the lower respiratory tract

Question 15

What causes the movement of mucus and clearing of??

Answer 15

cilia

Question 16

What are cilia?

Answer 16

• originate from the basal body of epithelial cells
• are covered by an outcropping of the plasma membrane
• Ciliary movement is dependent upon ATP and also require Calcium and Magnesium

Question 17

Describe cilia movement

Answer 17

• the cilia go into the mucus layer during forward movement
• present in the preciliar fluid during reverse beat
• nasopharynx beat in the direction to move mucus into the pharynx
• trachea propel mucus upward toward pharynx where it is swallowed

Question 18

genetic disorders caused by changes in ciliary function

Answer 18

cycstic fibrosis

Kartagner syndrome

Question 19

cycstic fibrosis

Answer 19

wrong cilia due to chloride channel CFTR

preci fluid maintained but inward movement of sodium and outward movement of Chloride

there is a decrease in the ACTIVITY of CFTR because the proteins are not going to the membrane —-NOT the number

there are NO changes in the transcription and translation of CFTR just sits inside cells and eventually gets degraded

and thus sodium is just moving inside the cells increasing osmolarity and thus water precilary fluid is decreased (it will not move)

if ENaC was disrupted there would be increased preciliry fluid

pts have recurrent pulmonary infections

Question 20

Kartagner syndrome

Answer 20

genetic disorder due to mutations in a protein called kinesin structural proteins which keep the dynein arms together

there is disruption in the dynein arms

in this case the pt would have Bronchiectasis, Chronic Sinusitis, Situs Inversus Totalis

males are infertile because ciliar are important for locomotion of sperm

Question 21

being bombarded with different particles causing particle deposition which is dependent on the

Answer 21

size of particle

if larger than 10 um they will impact nasal passages and will not penetrate the lower respirtaory tract

2-10 um – deposited in the lower respiratory tract by initial impaction and turbulent flow in the nasopharynx, trachea, and bronchi due to inertia

0.2-2 um – deposited by sedimentation secondary to gravity – depends on airway diameter

Less than 0.2 um particles are deposited by Brownian motion – depends on particle’s diffusion coefficient – come in contact with epithelium where there are no cilia and mucociliary transport

Elongated shaped particles like asbestos and silica are deposited by interception – particle’s center of gravity:

Question 22

Deposition of silica

Answer 22

especially people who used silica in mining and photography industries the silica in these individuals would get phagocytosed by macrophages

because the silica cannot be metabolize it punctures the macrophages and damages the alveoli

(terminal ends of the bronchial tree is the achilles heel region)

eventually going into the lung interstitium

Question 23

what are the metabolic functions of lungs?

Answer 23

they metabolism based on active needs

the most important ones are : angiotensin I

angiotensin made in liver is converted to angiotensin I in the lungs by an enzyme made in kidney, renin

Question 24

what are other substances metabolized in the lungs?

Answer 24

• serotonin

- endothelial cells

Question 25

The lungs DO NOT metabolize

Answer 25

``` Epinephrine Dopamine Histamine Isoproterenol Angiotensin II Substance P ```

Question 26

The lungs has its own immune system

Answer 26

for the lung to know which substances are or are not harmful for it inflammation causes removal of particles but also causes disruption in normal physiological activity

Question 27

What are the two types of immune cells

Answer 27

innate and adaptive?

Question 28

CHART

Answer 28

????

Question 29

MALT

Answer 29

The respiratory system together with gastrointestinal system and the urinary system has mucosal immune system This system is unique – adaptive immune response is initiated only after the insulting agent has bypassed the innate immune response

Question 30

The most important function of MALT or BALT in lungs

Answer 30

limits sensitization only to the mucosal tissue ???He said something about macrophages BALT help make antibodies IgA

Question 31

IgA

Answer 31

plasma cells in the lungs secrete IgA once formed binds to receptors on epithelial cells gets endocytosed ?????? all these things require movement from ER tubular structures and move along the dynein fibers inside the cells; all dependent on calcium concentration DO NOT bind to the complement system -limits pro-inflammatory properties ?????

Question 32

Allergic Lung Diseases - Asthma

Answer 32

normally your lungs are producing IgA to combat infect in cases of allergy your lungs will switch over to IgE - in the IgE case, your immune response will take about 4-6 hours

Question 33

two disease responbile for pulmonary responsible ????

Answer 33

Goodpasture’s syndrome is an autoimmune response to the lung basement membrane that results in hemorrhagic disease; abs are produce against your own lung IgA deficiency is the most common inherited immunoglobulin deficiency and is frequently associated with chronic lung disease.

Question 34

What are the types of adative and innate immune cells?

Answer 34

TCR - preferentially localize to mucosal sites : first line of defense against

Question 35

What are the function of the natrual killer cells

Answer 35

engulf and kill target release enzymes that poke holes in the plasma membrane of viruses or bacteria due to activty of cytokines: IL-4, IL-5, IL-3, IFN, and TNF NK cell number and activity increases in asthma

Question 36

first nonepithelial cells to respond to foreign substances

Answer 36

Dendritic and Alveolar Macrophages

Question 37

Dendritic and Alveolar Macrophages????

Answer 37

when it pass through?? bind to dendrites which get primed ?? naive T cells to get activated move into pulmonary ?? once released bind to effector T cells to ????

Question 38

Alveolar Macrophages

Answer 38

common in immune disorders or inflammatory diseases of the lungs chemotaxis: engulf bacteria because of high oxygen radials they will kill the pathogen Suppress T cell activity – secretion of NO, PGE2, IL-10, TGF-beta????

Question 39

Toll-Like Receptors (TLRs)

Answer 39

response to nonpathogenic substances they are single chain polypeptides present in the PM when they are bound to the nonpatho sub activating a huge signaling cascade that will activate Nkappa B???? this will go to induce transcription of proteins that will go to destroy the pathogens???

Question 40

Are age related diseases

Answer 40

emhysema and bronchitis

Question 41

What are features of emphysema?

Answer 41

caused mostly by smoking casuing inflammatory cells to ??????? elastase cause not only damage to bacteria or inflammatory cells but digest elastin fibers which are normal in your lungs thus alpha 1-antitripsin is inhibitor of elastase smoking decreases alpha 1-antitripsin some people are resistant to smoking as they have higher than normal activity of alpha 1-antitripsin people with lower alpha 1-antitripsin are more susceptible to emphysema

Question 42

What are features of bronchitis ?

Answer 42

????

Question 43

Pulmonary embolism

Answer 43

hypoxic vasoconstriction causes pulm HTN, V/Q imbalances, increases dead air space, chest pain,