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CPR > Pulmonary Defense Mechanisms > Flashcards

Pulmonary Defense Mechanisms Flashcards

1
Q

Removal mechanisms in the airways are aimed at?

A

MINIMIZING inflammation

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2
Q

What are the main defense mechanisms in the upper airways and bronchi?

A

Anatomic barriers - epithelium
Cough reflex
Mucociliary apparatus
IgA

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3
Q

What are the main defense mechanisms in the alveoli?

A

Alveolar macrophages
Type 1/2 Alveolar cells, Club cells
Surfactants and opsonins
Neutrophils

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4
Q

What can trigger the cough reflex?

A

Chemicals, mechanical stimulation, inflammation and voluntary

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5
Q

Describe the events of the cough reflex

A
  1. Deep inspiration
  2. Closure of the glottis to trap the air
  3. Build up of intrathoracic pressure
  4. Initiation of expiratory effort
  5. Sudden release of trapped air at a higher pressure
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6
Q

List 3 airway epithelium functions

A
  1. Barrier function
  2. Defense function - produce cytokines
  3. Translocate IgA into the mucus at the lumen surface
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7
Q

What size particles can be deposited in the mucus of the upper airways?

A

Greater than 2-3 micrometers and less than 10 micrometers

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8
Q

What are some things that the mucus contains?

A

IgA, lysozyme, lactoferrin, peroxidases

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9
Q

What are the 2 layers that the cilia on the airway epithelial cells traverse through to reach the foreign particles?

A

Sol (aqueous) layer

Mucus (gel) layer

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10
Q

For the mucociliary apparratus, what do the cilia do?

A

They extend through the sol layer and the mucus layer to propel the foreign particles forward to attempt to expel them

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11
Q

The upper airways also have a LARGE population of TRegs. What do they produce to minimize inflammation?

A

IL-10 and TGFbeta

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12
Q

What is the alveoli’s first line of defense?

A

Alveolar macrophages

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13
Q

What type of macrophages are alveolar macrophages and what is their job?

A

M2 - maintain tolerance

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14
Q

What are the types of surfactant proteins found in the alveoli?

A

A and D

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15
Q

List some of the jobs that SP-A and SP-D have in the alveolar spaces

A
  1. Bind pathogens
  2. Damage bacterial membranes
  3. Modulate macrophage phagocytosis
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16
Q

What do alveolar macrophages release to minimize inflammation?

A

IL-10 and TGFbeta

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17
Q

If/when the acute inflammatory response begins, what cytokines are responsible for increasing the expression of adhesion molecules?

A

IL-1 and TNF

18
Q

With the acute inflammatory response, IL-1 and TNF increase adhesion molecules. What cell type slows down, binds to endothelium and enters?

A

Neutrophils

19
Q

What chemokine to neutrophils follow?

A

IL-8

20
Q

Neutrophils then deploy their ____ to catch bacteria

A

NETs

21
Q

If the acute inflammatory response turns to chronic, what cells will infiltrate?

A

Activated T cells

M1 macrophages

22
Q

The chronic inflammatory state brings T cells and M1s to the site. It also causes what 2 things?

A
  1. Mucus HYPERsecretion

2. Remodeling of tissue – fibrosis

23
Q

What are the main molecular events that occur during the early phase of a Type 1 Hypersensitivity?

A
  1. Cross-link mIgE

2. Degranulation of Mast cells

24
Q

What are the early phase symptoms of a Type 1 Hypersensitivity?

A

Sneezing
Pruritis
Rhinorrhea (runny nose)
Congestion

25
Q

What are the main cells that infiltrate the area during the late phase of a Type 1 Hypersensitivity?

A 
Eosinophils
Neutrophils
Basophils
Th2 lymphocytes
MORE mast cells
26
Q

What are the 2 jobs of the eosinophils in the late phase of the Type 1 Hypersensitivity reaction?

A
  1. Pro-inflammation

2. Local tissue damage

27
Q

What are the late phase symptoms of a Type 1 Hypersensitivity?

A

Fatigue
Myalgia
Asthma

28
Q

What 2 things are responsible for chronic asthma remodeling?

A

Leukotrienes (C4, D4, E4)

Prostaglandins (D2, E2, F2)

29
Q

With chronic asthma remodeling, leukotrienes cause?

A

Bronchospasm
Increased permeability
Mucus production

30
Q

With chronic asthma remodeling, prostaglandins cause?

A

Bronchospasm

Vasodilation

31
Q

With chronic asthma remodeling what is deposited in the submucosa?

A

Collagen - by smooth m. cells and fibroblasts

32
Q

With COPD, what cytokine causes secretion of more cytokines?

A

Th17

33
Q

With COPD, Th17 causes secretion of?

A

IL-8, IL-17, IL-22

34
Q

With COPD, Th17 causes secretion of more cytokines that results in infiltration of what cells?

A

Neutrophils and inflammatory macrophages

35
Q

Ventilator Associated Lung Injury physical damage?

A

Over inflation

Mechanical stress

36
Q

Ventilator Associated Lung Injury biodamage?

A

Hyper-oxygenation
Free radicals
Increased Neutrophils

37
Q

With a Ventilator Associated Lung Injury, what do Neutrophil NETs lead to?

A

Platelet activation and clot formation

38
Q

Vaping Associated Lung Injury shows ______ on chest X-ray

A

Bilateral infiltrates

39
Q

Is there an infection with a Vaping Associated Lung Injury (VALI)?

A

NO

40
Q

What can a Vaping Associated Lung Injury turn into?

A

Lipoid Pneumonia

41
Q

With is Lipoid Pneumonia?

A

Pneumonia caused by inhaling lipids

42
Q

Besides a Vaping Associated Lung Injury, what else can cause Lipoid Pneumonia?

A

Chronic essential oil use

CPR (48 decks)

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