Pulmonary Histology Week 1 Flashcards
German physician _________ first describes and named the ________ and was published in lung diseases and angina pectoris
Hans Kohn, Pore of Kohn
The respiratory stem is a combination of _______, _________, _______, and _______
cartilage, elastic fibers, collagen fibers, smooth muscle fibers
The concentration of ______ in the respiratory system is inversely proportional to the _____
elastic fiber, diameter
Elastic fibers found in lamina propria of the respiratory system run _______
longitudinally
The _____ of the respiratory system is mostly circular
smooth muscle
The _________ of the respiratory system provides conduit to transfer air
conducting portion
How does the conducting portion condition the air?
cleans, moistens, and warms air
What are the six cell types in the generic respiratory epithelium?
1) ciliated columnar cells, columnar cells, 2) mucous goblet cells, 3) brush cells, 4) diffuse endocrine or small granule cells, 5) basal cells or immature cells
The ______ produce serous secretion
columnar cells
The ______ have no cilia yet many microvilli. There are two kinds.
Brush cells
Describe the two types of brush cells.
One kind acts like goblet cells releasing mucinogen. Other kind has nerve ending on basal surface.
Name the two proposed functions of the nerve endings on the basal surface of some brush cells
sensory receptor for gas volume and o2/co2 conentration; intraepithelial receptor for trigeminal N/sneeze reflex
The mucous goblet cells continue until the _________. Describe the two functions.
terminal bronchiole. 1) synthesize mucinogen which when hydrated turns into mucous; 2) trap and remove bacteria/particles; 3)
The _________ are the most common types of cells and continue until the respiratory portion.
Ciliated columnar cells
In what direction do the cilia of ciliated columnar cells beat?
towards the mouth
The ________ are thought to control mucous and seromucous secretion and possibly vessel diameter
Diffuse endocrine or small granule cells
The __________ rest on the basement membrane and do not reach lumen and are therefore “psuedostratified.” They appear to be stem cells.
Basal cells or immature cells
_________ is the abnormal transformation of a tissue to a form which is not normal in response to a disease process, a physical or chemical event
Metaplasia
Describe metaplasia in smoker’s lungs
Increase in goblet cells in resp epithelium due to pollutants and decrease in cilia due to carbon monoxide
In the nasal cavity, the air is filtered, warmed and humidified by the ______
nasal mucosa
The ______ is the anterior portion of the nasal cavity
vestibule
The nasal fossa contains _____, ______, and _____ conchae AKA _____
inferior, middle, and superior; turbinates
The nasal cavity also contains vibrissae and ______ and ______ mucosa
olfactory, respiratory
In the lamina propria of the nasal cavity, ______ release IgA and IgE. Describe the action of IgE.
plasma cells. IgE binds to receptors on mast cells and basophils –> inflammatory mediators released
Drainage from maxillary sinus infections can be seen below the _________
middle concha
Why is the nasal cavity a great site for drug delivery?
There is convenient access to a superficial venous plexus beneath the nasal cavity mucosa
_______ are venous plexi located in the lamina propria that enlarge alternately on two sides of nasal cavity.
Swell bodies
How often do swell bodies enlarge and why?
about every 30 minutes. The mucosa on occluded side has time to recover from desiccation and help to direct air to olfactory epithelium.
The olfactory epithelium is located on the roof of the _______ and on the superior ______
nasal cavity, superior nasal conchae
What are the four cell types in the olfactory epithelium?
olfactory cell, substentacular cell, basal cell, and brush cells
The olfactory cell has _______ whose _____ surfaces are modified to form olfactory _____ and olfactory _____
bipolar neurons; apical; olfactory vesicle; olfactory cilia
The dendrite of the olfactory cell terminates as a _____ olfactory vesicle with _____ cilia
bulbous, non-motile
Which respiratory epithelial cell is the stem cell for all olfactory epithelium?
basal cell
The __________ of the respiratory epithelium allows for olfactory adaptation
spatio-temporal patterning
Olfactory epithelium allows direct access to the central nervous system via _____
cranial nerve I
Axons of the bipolar neuron (olfactory cell) are surrounded by a cytoplasmic extension of olfactory _______ which pierce the _____ plate of the _____ bone into the olfactory bulb
myelin-producing cells, cribriform, ethmoid bone
In the nose, the _____ secretes IgA that is transported into the lumen of the ______.
plasma cell, olfactory gland
IgA causes the olfactory gland of Bowman to release secretory product containing ______
odorant-binding protein
The supporting cells of the olfactory epithelium have a ____ located, ____ nucleus and a microvilli border
apically, ovoid
The __________ binds to the modified cilia of the bipolar neurons
odorant-OBP complex
The ______ are airspaces within cranial bone lined with respiratory epithelium
paranasal sinuses
What are three clinical correlations involving the paranasal sinuses?
endoscopic sinus surgery, radiofrequency ablation, sinus stents
The larynx contains larger ____ plates and smaller _______ plates
hyaline, elastic cartilage
The larynx connects what two structures?
trachea and pharynx
The _____ has a tracheal and lingual side and contains two types of epithelium along with _______.
epiglottis, elastic cartilage
Describe what occurs to the epiglottis when swallowing food.
The backward motion of the tongue forces the epiglottis over the larygneal opening and closes the larynx –> directs food into esophagus
The ____ vocal cords contain an upper pair of folds that are covered with _________.
false, respiratory epithelium
The ____ vocal cords are covered with ______ due to air movement
true, stratified squamous epithelium
____ vocal cords contain muscle while ____ vocal cords contain glands. Neither contain both.
True, False
The true vocal cords contain the ______ muscle and _______ composed of elastic fibers
vocalis skeletal, vocal ligament
The ______ contains 16-20 rings and bifurcates to form the ______, the one on the ____ side being more vertical. this structure is involved with coughing and swallowing.
tracheae, primary bronchi, right
The trachea contains what four structures?
respiratory epithelium, lamina propria, submucosa, and adventitia
The respiratory epithelium of the trachea contains a thick _____
basement membrane
The lamina propria of the trachea contains ______ and _____ fibers with a well defined _____
collagen and elastic, elastic lamina
The submucosa contains _____ glands that can extend in thto the ______
seromucous, lamina propria
The adventitia of the trachea contains C-shaped _____ cartilage rings that are closed off posteriorly by ______. The perichondrium fuses with the submucosa and adventitia.
hyaline, trachealis muscle
What are the four types of cells that make up the epithelial lining of the trachea?
Columnar ciliated cell, goblet cell, basal cell, and endocrine cell
The apical portion of the ______ contains mucus secretion that is released by ______, forming part of a protective mucus blanket
goblet cell, exocytosis into lumen
Which cell in the epithelial lining of the trachea does not extend to the free surface?
BASAL CELL
The _____ contain small granules and can be observed in the basal region of the epithelium. They are members of the ________ (APUD or ________)
endocrine cell, diffuse endocrine system, amine precursor uptake and decarboxylation
The bronchial tree is divided into the _______ which divide into the _______ after entering the lung parenchyma
extrapulmonary bronchi, intrapulmonary bronchi
The ______ resemble than the trachae in that the right side is straighter. The right side _____ while the left side bifurcates.
extrapulmonary bronchi, trifurcates
The extrapulmonary bronchi are more _____ than intrapulmonary and their ______ rings become irregular. Smooth muscle spirals between the _____ and ____
rigid, cartilaginous, submucosa and cartilage
The intrapulmonary bronchi divide into secondary and tertiary levels. The secondary are ____ whereas the _____ and enter the ______
lobar, segmental, bronchopulmonary segments
There are ___ secondary intrapulmonary bronchi on the right side and __ on the left side. In terms of tertiary, there are ___ on left side and ___ on right side
3 on right, 2 on left, 8 on left, 10 on right
A ________ supplies a pulmonary lobule.
terminal bronchioe
The _______ is derived from the terminal bronchiole and organizes a pulmonary ____
respiratory bronchiole, acinus
The lamina propria of the mucosa of the bronchi are rich in ______ while the muscularis consists of ______
elastic fibers, spiral smooth muscle
The submucosa of bronchi are rich in _____ fibers and contain seromucous glands between _______ and ______ that extend into the lamina propria
elastic, cartilage plates, smooth muscle
The bronchus contains a ________ layer and adventitia as well
hyaline cartilage
As bronchi become smaller, irregular ______ are observed. Each one consists of ______ surrounded by a bundle of connective tissue fibers blending with the perichondrium.
cartilage plates, hyaline cartilage
Bundles of _______ fibers are found between cartilage plates and bronchial mucosa. The mucosa is lined by typical respiratory epithelium
smooth muscle fibers
Seromucous glands are found in the lamina propria of bronchi with the ____ projecting beyond the layer of smooth muscle cell bundles. The excretory ducts open up into the _______
secretory acini, bronchial lumen
______ lack seromucous glands and have no cartilage. They are by definition 1mm or less long.
Bronchioles
Describe the type of epithelium found in bronchioles.
ciliated columnar with goblet cells to a ciliated columnar/cuboidal with Clara cells
True/False: Clara cells contain cilia
FALSE, contain short microvilli
Clara cells secrete _____ that help protect the mucosa and degrade airborne toxins via ________
glycoprotein, sER p450 cytochromes
Clara cells divide to ______ the bronchiole epithelium.
regenerate
True/False: As goblet cells decrease, clara cells increase
TRUE
Describe the lamina propria of bronchioles
predominantly smooth muscle and elastic fibers. no cartilage or seromucous glands.
In a _______ response, the bronchioles constrict, whereas in a ______ response the bronchioles dilate
parasympathetic, sympathetic
Describe what occurs in asthma in terms of bronchioles
Asthma leads to widespread constriction of smooth muscle in the bronchioles causing a decrease in diameter
Asthma is the most common chronic illness in children, affecting ____. It also affects ___ of adults in North America. In addition, there are _____ deaths annually from asthma in the US
1 in 15, 5%, 5K
The respiratory bronchiole contains _______ [type of epithelium] and the lamina propria is very thin smooth muscle and elastic fibers at _______
simple ciliated cuboidal with Clara cells; alveolar openings
The alveolar ducts are lined with ________ and contain smooth muscle and a lot of _______ in the lamina propria
squamous epithelium, elastic fibers
The squamous epithelium in the alveolar ducts is primarily what kind of cell?
type I pneumocyte
The _____ are pouch like evaginations. 85% of these structures develop after birth until age 10
alveoli
What are the alveoli lined by?
type I and type II pneumocytes
The _______ connects adjacent alveoli and are responsible for _____ when blockage of a small bronchiole occurs
pores of Kohn, collateral respiration
The _______ is a type of simple squamous epithelium that is very attentuated and involved in the exchange of gases
type I pneumocyte
True/False: Type I pneumocytes cover 95% of alveolar surface and can regenerated when needed
FALSE - can not regenerate
The _______ is a type of cuboidal epithelium that covers 5% of the alveolar surface and can regenerate an entire surface
type II pneumocyte
Type II pneumocytes produce surfactant. What does surfactant do?
reduces surface tension, stored in lamellar bodies (TEM), present at 26-28 weeks in amniotic fluid
______ are found between type I and type II pneumocytes
occluding junctions
Describe the pathology of respiratory distress syndrome
Premature infants lack sufficient surfactant and the alveoli collapse. Mom is given glucocorticoids to induce synthesis of surfactant by baby.
The interalveolar septum consists of thin and thick portions. Describe the function of the thin portion.
Exchange of gases and blood-gas barrier (4 parts)
Describe the 4 parts of the blood-gas barrier
surfactant layer; cytoplasm of type I pneumocyte; fused basal lamina between type I and cap epithelium; cytoplasm of capillary epithelium
The interalveolar septum consists of thin and thick portions. Describe the components of the thick portion.
there are continuous capillaries; elastic, collagen and reticular fibers; fibroblasts, macrophages, and mast cells
Describe the function of the interalveolar septum
removes fluid from essentially a closed space through a wicking action
Describe lymphatic flow in the interalveolar septum
there are no lymphatics from about the alveolar air sacs distally - fluid then diffuses proximally in the interstitium at about level of resp bronchioles - lymphatics then follow the bronchial tree
What are the two types of macrophage (dust cell) populations found in the interalveolar septum?
those associated with alveolar wall (fixed population) and those that roam free
Dust cells produce _____
elastase
Why do alveolar macrophages in heart failure pts stain positive for Fe?
they have digested RBC’s
The Pores of Kohn develop at 3-4 years of age. Describe their 2 functions other than collateral ventilation in the case of bronchiole obstruction.
equilibrate the pressure from alveoli to alveoli, allow passage of roaming macrophages
The capillary component of the pulmonary vasculature is the site of gaseous exchange and has systolic pressure between _____
15-25mmHg
The bronchial arteries have a systemic systolic pressure of _______. They are branches off the _____ and follow the bronchial tree to the level of the _______.
110-135mmHg, thoracic aorta, respiratory bronchioles
The bronchial arteries anastomose with branches of the _______
pulmonary vein
The pulmonary vein arises from _____ and travels in the connective tissue septa
venules draining the alveolar capillary plexuses
What does the connective tissue septum limit?
a pulmonary lobule
_______ drain the alveolar capillaries
pulmonary vein plexuses
The visceral pleura of the lung is composed of what two components?
fibroelastic connective tissue, simple squamous mesothelial cells
The pulmonary vein transports _____ and the pulmonary artery transports ______
oxygenated blood, deoxygenated blood
The pulmonary artery enters lung with main bronchi, branches following the bronchial tree, and terminates at the _____ where it gives rise to the _________
respiratory bronchiole, alveolar capillary plexuses
Bronchial arteries carry _____ and also follow the bronchial tree. They supply branches to the walls of the bronchi, arteries, veins and connective tissue septa
oxygenated blood
The ________ links the superficial (pleural) lymphatic plexus and also drains in the hilum into main lymphatic vessels
deep (pulmonary) lymphatic plexus
The most common preventable cause of death is:
a) overweight and obesity
b) alcohol
c) tobacco smoking
d) infectious diseases
e) MVC’s
c
_______ is a protein that protects the lung from the action of elastase
alpha-1-antitrypsin
Destruction of the _______ causes emphysema.
interalveolar wall
In emphysema, the fourth leading cause of death in the U.S., there is decreased ______ in the lungs and they are unable to _______
elasticity, recoil
True/False: The main issue in emphysema is that you cannot get enough air
FALSE, you can get enough air, you just can’t move it
Emphysema is associated with exposure to cigarettes and other substances that inhibit ______ - 2 to 3% of cases are hereditary.
alpha-1-antitrypsin
____ after you smoke your last cigarette, your blood pressure and pulse go back to normal
20 minutes
_____ after you smoke your last cigarette, your hands and feet feel warmer because you circulation has improved
1 hour
_____ after smoking your last cigarette, your nicotine and carbon monoxide levels fall and oxygen in your blood returns to normal
8 hours
______ after smoking your last cigarette, CO is removed from your body
1 day
____ after smoking your last cigarette, nicotine is removed from your body
2 days
_____ after smoking your last cigarette, withdrawal symptoms begin to ease
2 weeks
_____ after smoking your last cigarette, withdrawal symptoms stop
1 month
______ after smoking your last cigarette, your risk of heart attack, cancer and other smoking diseases begins to fall
6 months
