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HHP > Respiratory > Flashcards

Respiratory Flashcards

1
Q

What does conducting portion contain?

A

Nasal cavities, pharynx, larynx, trachea, primary bronchi, bronchiole tree

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2
Q

What does respiratory portion contain?

A

Respiratory bronchioles, alveolar ducts, sacs, alveoli

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3
Q

What is the nasal vestibule lined with?

A

Stratified squamous keratinized, posteriorly pseudostratified columnar ciliated

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4
Q

What is respiratory region lined with?

A

Pseudostratified columnar ciliated with goblet cells

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5
Q

Define mucoperiosteum?

A

Lamina propria firmly attached to periosteum of bone

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6
Q

What is olfactory region lined with?

A

Pseudostratified columnar non motile cilia and no goblet cells

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7
Q

What does lamina propria of respiratory region contain?

A

CT, cells, capillary plexuses at right angles to airflow (warms air), mucus glands with serous demilunes

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8
Q

What do mucus serous demilunes do in respiratory region?

A

Trap particulate matter in air, matter is swept into pharynx by ciliary action

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9
Q

What gives olfactory epithelium yellow color?

A

Pigmentation and bowmans glands, lipofuscin granules are predominant in bowmans glands

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10
Q

Describe structure of olfactory receptor cells?

A

Bipolar neurons, single dendritic process that leads to olfactory vesicle, long thin non motile cilia extend from vesicle, axonal process leave from base of cell

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11
Q

What is lifespan of olfactory receptor cells?

A

1 month

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12
Q

What cells replenish olfactory receptor cells and supporting cells?

A

Basal stem cells

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13
Q

Is loss of olfactory sensation permanent?

A

No, cells replenish on monthly basis

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14
Q

Receptors on non motile cilia of olfactory vesicle bind with?

A

OBP, odorant binding protein

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15
Q

What do supporting cells of olfactory region secrete?

A

OBP, odorant binding protein

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16
Q

What is OBP?

A

Molecular carrier for already dissolved odorants and deliver them to olfactory receptors

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17
Q

Supporting cells makes what kind of junctions with olfactory cells?

A

Adherent junctions

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18
Q

What do supporting cells of olfactory region provide?

A

Physical and metabolic support to olfactory cells

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19
Q

Describe process of OBP binding

A

OBP bind with G protein couple receptors on olfactory vesicles, stimulus takes place. Adenyl cyclase gets activated and produces cAMP. cAMP binds with sodium and calcium channels, this influx starts depolarization.

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20
Q

What do brush cells function as in olfactory region?

A

Function as general sensory of olfactory mucosa, via afferent of trigeminal nerve

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21
Q

What does lamina propria of olfactory region contain?

A

Olfactory glands=bowmans glands, unmyelinated nerves and blood vessels

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22
Q

What are the oropharynx and laryngopharynx lined with?

A

Stratified squamous non keratinized

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23
Q

What is nasopharynx lined with?

A

Pseudostratified columnar ciliated

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24
Q

What is nasopharynx connected to in the ear?

A

Connected to middle ear by the auditory tube

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25
Q

What level does trachea divide into two main primary bronchi?

A

T4/T5

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26
Q

How does trachea lumen stay open?

A

Due to arrangement of C shaped hyaline cartilaginous rings

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27
Q

What bridges the gap between free ends of hyaline cartilage in the trachea?

A

Fibroelastic tissue and smooth muscle (trachealis muscle)

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28
Q

What is the trachea mucosa lined with?

A

Pseudostratified columnar ciliated with goblet cells

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29
Q

What does the submucosa of trachea contain?

A

CT, mucus glands with serous demilunes

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30
Q

What does the adventitia of trachea contain?

A

Dense CT that binds trachea to adjacent structures

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31
Q

What do ciliated columnar cells of trachea mucosa do?

A

Help remove small inhaled particles towards the pharynx

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32
Q

What is the dark line immediately below cilia in trachea mucosa?

A

Basal bodies

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33
Q

What is the mucouscilliary function?

A

Function to beat and remove particles trapped in cilia mucus

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34
Q

What is primary ciliary dyskinesia/ICS?

A

Autosomal recessive disease, abnormal ciliary motion and impaired mucocilliary clearance

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35
Q

What can ICS lead to ?

A

Recurrent respiratory infections, sinusitis, otitis media, male infertility

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36
Q

What complication is 50% of ICS patients associated with?

A

Situs inversus

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37
Q

What is Kartagener syndrome?

A

Dyenin arms are absent in the cilia and leads to abnormal ciliary function, Characterized by triad of situs inversus, chronic sinusitis, and bronchiectasis

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38
Q

What are brush cells in the trachea mucosa?

A

Considered a receptor cell, in contact with afferent nerve endings for general sensation for mucosa

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39
Q

What are small granule cells/Kulchitsky cells?

A

Part of DNES, diffuse neuroendocrine system, secrete paracrine hormones that act locally

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40
Q

What are Kulchitsky cells sensitive to?

A

Nicotine, known to be involved in small cell lung cancer

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41
Q

What are DNES cells in contact with in trachea mucosa?

A

Nerve fibers, known as pulmonary neuroepithelial bodies

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42
Q

What do DNES pulmonary neuroepithelial bodies do?

A

Monitor local tissue hypoxia, alert respiratory center of brain to increase respiration

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43
Q

What do basal cells do in trachea mucosa?

A

Maintain individual cell replacement in the epithelium

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44
Q

Is basal lamina in trachea prominent?

A

Yes very, more prominent in smokers and asthmatics

45
Q

What does lamina propria of trachea consist of?

A

Loose CT, diffused lymphocytes that infiltrate epithelium, BALT

46
Q

What is BALT?

A

Bronchus associated lymphatic tissue

47
Q

What separates lamina propria from underlying submucosa in trachea mucosa?

A

Band of elastic fibers (elastic membrane)

48
Q

What does trachea submucosa consist of?

A

Loose CT, diffuse lymphatic tissue and nodules, large vessels and lymphatics, seromucous submucosal glands

49
Q

What are seromucous submucosal glands?

A

Mucus secreting acini with serous demilunes, ducts with simple cuboidal

50
Q

What does trachea adventitia consist of?

A

CT, largest blood vessels, nerves, and lymphatics, some adipose tissue

51
Q

Trachea divides into two main primary bronchi with two parts?

A

Extrapulmonary bronchi, same structure as trachea
Intrapulmonary bronchi, cartilage plates with circumferential smooth muscle layer

52
Q

Intrapulmonary bronchi divide into?

A

Secondary and tertiary bronchi

53
Q

What is mucosa of intrapulmonary bronchi lined with?

A

Pseudostratified columnar ciliated with goblet cells

54
Q

What does lamina propria consist of in intrapulmonary bronchi?

A

CT, cells, BALT

55
Q

Is basal lamina prominent in secondary or tertiary bronchi?

A

Not visible, discrete

56
Q

What does muscularis of intrapulmonary bronchi consist of?

A

Continuous layer of smooth muscle, contraction regulates diameter of airway

57
Q

What function does muscularis of intrapulmonary bronchi perform?

A

Contraction regulates diameter of airway

58
Q

What does submucosa of intrapulmonary bronchi consist of?

A

Loose CT, serous glands, adipose tissue

59
Q

What does adventitia of intrapulmonary bronchi consist of?

A

Dense CT

60
Q

Terminal bronchioles are?

A

Smallest conducting bronchioles

61
Q

What are terminal bronchioles lined with?

A

Simple cuboidal ciliated and non ciliated club cells

62
Q

Function of respiratory bronchioles?

A

Air conduction and gas exchange

63
Q

Are goblet cells present in terminal or respiratory bronchioles?

A

No, they are present in smokers and asthmatics

64
Q

When do club cells increase in number?

A

Along the length of the bronchiole

65
Q

What do secretory vesicles of club cells have?

A

Surface active agent, a lipoprotein that prevents luminal adhesion if airway collapsed

66
Q

What does the club cell secrete?

A

Protein CC16, protects against oxidative stress and inflammation
Decreases in asthma and COPD patients

67
Q

What type of mucus does club cells secrete?

A

Mucus 5B, gene is called MUC5B

68
Q

What happens to club cells during asthma?

A

They transform to goblet cells and produce mucus 5C

69
Q

Cytoplasm of club cells contain?

A

Numerous cisternae of sER that contain cytochrome P450 enzyme system
Lysosomes active against bacteria

70
Q

What does P450 enzyme system do?

A

Detoxifies harmful compounds in air

71
Q

Where can P450 enzyme system be found?

A

Club cells and liver cells

72
Q

What are respiratory bronchioles line with?

A

Simple cuboidal with ciliated cells and club cells

73
Q

What does thick region of respiratory bronchiole have?

A

Large amount of club cells and smooth muscle bundles

74
Q

What does thin region of respiratory bronchioles have?

A

Few club cells and thin smooth muscle

75
Q

What controls diameter of alveoli in respiratory bronchioles?

A

Elastic fibers, help expand during inspiration and recoil during expiration

76
Q

Alveoli septal wall is vascularized with what?

A

Richest capillary network

77
Q

Alveoli septal wall contains what?

A

Fibroblasts and ECM

78
Q

What does alveoli septal wall ECM consist of?

A

Elastic fibers-help control diameter of the alveoli
Reticular fibers-protection from over-expansion, prevents collapsing, provides support

79
Q

What are alveolar pores of Kohn?

A

Pores that connect neighboring alveoli, equalize air pressure and permit collateral circulation when a bronchiole is obstructed

80
Q

Alveoli septal wall is the site of what?

A

Air blood barrier

81
Q

What happens in thin segment of air blood barrier?

A

Gas exchange, thin layer of surfactant here

82
Q

What happens in thick segment of air blood barrier?

A

Site of tissue fluid accumulation, contains CT cells and fibers between basal laminae, macrophages are present here

83
Q

Gas diffusion sequence for thin segment?

A

Type I pneumocyte-fused basal lamina of pneumocyte and capillary-endothelial capillary

84
Q

Gas diffusion sequence for thick segment?

A

Type I pneumocyte-basal lamina of pneumocyte- connective tissue- basal lamina of capillary-endothelial capillary

85
Q

Type I pneumocyte/Type I alveolar cell

A

Main function is gas exchange, joined by occluding junctions to prevent leakage of fluid into air space, no cell division

86
Q

Type II pneumocyte/Type II alveolar cell

A

Progenitors for type I pneumocyte, contains lamellar body granules in cytoplasm

87
Q

Lamellar bodies granules contain?

A

phospholipids, neutral lipids, proteins

88
Q

What do lamellar bodies secrete?

A

Surfactant layer

89
Q

What do type II pneumocytes use to synthesize surfactant?

A

Choline

90
Q

What does pulmonary surfactant provide?

A

Reduces surface tension in alveoli, helps prevent collapsing, eases breathing, modulates alveolar immune responses due to bacterial properties

91
Q

What is RDS?

A

Respiratory distress syndrome

92
Q

When is RDS common?

A

Premature babies, humans that have a gene mutation of surfactant gene

93
Q

What is surfactant removed by?

A

Alveolar macrophages and type I pneumocytes

94
Q

Where are alveolar macrophages derived from?

A

Monocytes

95
Q

What are dust cells?

A

Macrophages that scavenge surface to remove inhaled particles like dust

96
Q

Where do alveolar macrophages function?

A

CT of the alveolar septum and in air space of alveolus

97
Q

What are heart failure cells?

A

Macrophages that phagocytize red blood cells and have hemosidrin that may enter the alveoli in heart failure

98
Q

Why do smokers have large dust cells?

A

Nicotine particles

99
Q

What are receptors called on type II pneumocytes?

A

ACE2 receptors

100
Q

What do ACE2 receptors control?

A

Blood pressure

101
Q

Explain high blood pressure and ACE2 receptors

A

Renin is produced in kidneys, sent into circulation which converts angiotensin to angiotensin I, endothelial cells of the capillaries convert angiotensin I to angiotensin II which increases blood pressure, ACE2 receptors bind with angiotensin II and modify effects of high blood pressure.

102
Q

Explain COVID 19 and ACE2 receptors

A

COVID spike proteins fit perfectly in ACE2 receptors, the virus is internalized and replicates its mRNA. Alveoli collapse, gas exchange is reduced, fluid accumulation in alveoli and bronchioles, type II cell does not produce surfactant, blood pressure increases.

103
Q

What is emphysema?

A

Enlargement of air spaces and destruction of alveolar wall, leads to reduced gas exchange

104
Q

What cells are effected in emphysema?

A

Type II pneumocytes

105
Q

What does alveolar cell death lead to in emphysema cases?

A

Destruction of alveolar wall, reduced surface area for gas exchange

106
Q

What are causes of emphysema?

A

Chronic smoking, air pollutants, genetic factors like Alpha I Antitrypsin

107
Q

What is process of Alpha I Antitrypsin?

A

Protein is created in rER but transport to golgi fails. Since it is the “off switch” to producing neutrophil elastase, excess of the neutrophil elastase takes place, excess destroys normal tissue, air space is destroyed and large air spaces occur with permanent damage. (Leads to emphysema)

108
Q

What happens to asthmatic bronchioles?

A

Inflammation of bronchioles and smooth muscle constricts, contains large amounts of goblet cells and mucus is produced

109
Q

Where does mucus from asthmatics get coughed up from?

A

Deep bronchioles, whereas mucus from bronchitis is coughed up from upper respiratory passages

HHP (17 decks)

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