Normal lung histology and pathophys of COPD

Question 1

3 components of the upper resp tract

Answer 1

nasal cavity
pharynx
larynx

Question 2

3 components of the lower resp tract

Answer 2

trachea
bronchi and bronchioles
alveoli

Question 3

3 roles of the nasal cavity and pharynx

Answer 3

cleans
humidifies
warms air

Question 4

2 roles of larynx

Answer 4

phonation

protection

Question 5

what cells line the nasal cavity and nasopharynx

Answer 5

columnar ciliated (respiratory) epithelium

Question 6

5 cell types found in the respiratory epithelium and function

Answer 6

Goblet cells- secrete mucus which traps particulate matter

Ciliated cells- moves mucus towards the oropharynx to be swallowed

submucosal seromucinous glands- Produce mucus and secrete watery fluid which helps to humidify air

blood vessels- warm air

lymphoid tissue- protect against inhaled pathogens

Question 7

type of epithelium in the oro and hypopharynx

Answer 7

stratified squamous epithelium

Question 8

how do the bronchioles differ from the trachea and bronchi

Answer 8

no cartilage in walls and no mucinous glands

Question 9

what lines the trachea and bronchus?

Answer 9

ciliated columnar (respiratory) epithelium

Question 10

2 component cells in the mucociliary escalator

Answer 10

goblet cells

ciliated cells

Question 11

What cells line the alveoli?

Answer 11

pneumocytes

Question 12

describe type 1 and type 2 pneumocytes

Answer 12

T1: large flattened cells- thin diffusion barrier

T2: secrete surfactant

Question 13

define COPD

Answer 13

airflow obstruction that is usually progressive, not reversible, and does not change markedly over several months. Characterised by an abnormal inflammatory response in the lungs

Question 14

what is emphysema

Answer 14

enlargement of the airspaces distal to the terminal bronchiole and destruction of alveolar walls.

Question 15

3 pathophysiological features of chronic bronchitis

Answer 15

mucous gland hyperplasia- hypersecretion of
mucus

squamous metaplasia of lining of airway

defective mucociliary clearance

Question 16

what 3 things contribute to the development of small airway disease/bronchiolitis and what does this lead to

Answer 16

mucus plugging
impaction of particles
inflammation

leads to…

scarring and fibrosis
narrowing and loss of small airways
impaired gas exchange

Question 17

how does smoking cause emphysema?

Answer 17

particles in small airways increase inflammatory cells (macrophages and neutrophils)

release of damaging substances e.g. elastases

release of oxygen free radicals which reduce the effectiveness of protective enzymes e.g. alpha 1 antitrypsin

both lead to destruction of normal elastic in the lung

Question 18

5 complications of COPD

Answer 18

resp failure
pneumonia
pulm HT and cor pulmonale
pneumothorax
polycythaemia (2y)

Question 19

Describe type 1 resp failure

Answer 19

“pink puffers”

good alveolar ventilation,
PaO2<8kPa
N or low PaCO2
breathless not cyanosed

Question 20

describe type 2 resp failure

Answer 20

“blue bloaters”

poor alveolar ventilation
Pa02 <8kPa
PaCO2 >6.5kPa
cyanosed
require hypoxic drive to stimulate breathing

Question 21

3 ways smoking increases risk of infection

Answer 21

affects normal ciliary action
damages epithelium
damages normal inflam cells

Question 22

5 complications of pneumonia

Answer 22

pleural effusion
empyema
abscess
bronchiectasis
dissemination of infection to adjacent organs and/or other parts of the body