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Respiratory phase 1 > Respiratory editing > Flashcards

Respiratory editing Flashcards

1
Q

What is hypersensitivity?

A

Undesirable reaction produced by the immune system.

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2
Q

Hypersensitivity: What is the mechanism of a type 1 reaction?

A

Antigens interact with IgE bound to mast cells. Histamine is released. This can cause hayfever, asthma, acute anaphylaxis etc. (Antihistamines are often given as treatment).

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3
Q

What is the parasympathetic neurotransmitter in the lungs?

A

Acetylcholine.

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4
Q

What is the sympathetic neurotransmitter in the lungs?

A

Noradrenaline.

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5
Q

What is the effect of Ach on the pulmonary vessels?

A

Bronchoconstriction and vasodilation.

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6
Q

What is the effect of noradrenaline on the pulmonary vessels?

A

Bronchodilation and vasoconstriction.

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7
Q

Name 2 receptors for Ach.

A

Muscarinic (G protein coupled) and Nicotinic (ligand gated ion channels).

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8
Q

Host defense: What is innate immunity?

A

Immunity that doesn’t require prior exposure. It usually involves phagocytosis and inflammation.

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9
Q

Briefly describe the mechanism of inflammation.

A

Vasodilation results in exudation of plasma. Neutrophils and monocytes migrate into tissues.

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10
Q

What are alveolar macrophages derived from?

A

Monocytes. They are the resident phagocyte in the lungs and they coordinate inflammatory response.

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11
Q

What is the function of the epithelial barrier in host defense?

A

Moistens and protects airways.

Functions as a barrier to pathogens and foreign matter.

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12
Q

What is the muco-ciliary escalator?

A

Mucosal secretions from goblet cells and submucosal glands trap particulate matter. The beating cilia transport the mucus up the respiratory tract. This acts to prevent infection.

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13
Q

What is coughing?

A

An explosive expiration that acts to clear foreign matter from the airways. It is an important defense mechanism.

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14
Q

What does the lung bud form from?

A

The respiratory diverticulum - an out-pouching of the fore gut.

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15
Q

What is the septum called that seperates the lung bud from the oesophagus in the embryo?

A

Tracheoesophageal septum.

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16
Q

What are the 5 stages of respiratory tract development called? What happens in these stages?

A
  1. Embryonic (0-5 weeks): lungs and trachea develop.
  2. Pseudoglandular (5-16 weeks): branching of trachea.
  3. Canalicular (16-26 weeks): Respiratory bronchioles form.
  4. Saccular (26w-birth): Terminal sacs form.
  5. Alveolar (8 months to childhood): Alveoli mature.
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17
Q

Describe the first breath.

A
  1. Fluid is removed from the lungs.
  2. Adrenaline increases surfactant release.
  3. Air is inhaled.
  4. O2 VASODILATES pulmonary vessels.
  5. Umbilical arteries and ductus arteriosus constricts. Foramen ovale closes.
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18
Q

Define anatomical dead space.

A

The volume of air taken in during a breath that does not enter the alveoli.

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19
Q

Define physiological dead space.

A

The volume of air that is taken in during a breath that does not take part in gas exchange.

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20
Q

What is the main cell involved in acute inflammation?

A

Neutrophils.

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21
Q

Name 4 non-immune host defense mechanisms.

A
  1. Mucus.
  2. Muco-cilliary escalator.
  3. Epithelium.
  4. Cough.
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22
Q

What layer of the tri-laminar disc is the respiratory tract derived from?

A

The endoderm.

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23
Q

What is the respiratory diverticulum an out-pouching of?

A

The foregut.

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24
Q

What does the respiratory diverticulum go on to form?

A

The lung buds.

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25
Q

Give 2 ways that oxygen is carried around the body?

A
  1. Bound to Hb.

2. Dissolved in blood.

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26
Q

Does the umbilical vein carry oxygenated blood or deoxygenated?

A

Oxygenated (umbilical artery carries deoxygenated).

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27
Q

What is the importance of the ductus venosus in foetal circulation?

A

It is used to bypass the liver. Oxygenated blood from the umbilical vein can go straight to the IVC and not through the liver.

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28
Q

What is the epithelium of the vocal cords?

A

Stratified squamous non-keratinising.

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29
Q

What is the base, apex and roof of the maxillary sinus formed from?

A

Base - lateral wall of the nose.
Apex - zygomatic process of the maxilla.
Roof - floor of the orbit.

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30
Q

Which sinus is a labyrinth of air cells?

A

The ethmoid.

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31
Q

What vertebral level does the larynx extend to?

A

T5.

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32
Q

True or False: alveolar macrophages release interleukins.

A

True - this is important in the coordination of an immune response.

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33
Q

Why does constriction of bronchioles cause significant increase in airway resistance and can cause an expiratory wheeze such as seen in asthma?

A

Bronchioles have no cartilage, only smooth muscle. This means they are more likely to constrict and increase airway resistance.

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34
Q

Which respiratory tract structures are lined with smooth muscle and contain no cartilage?

A

Bronchioles.

35
Q

Anaphylaxis is caused by the cross-linking of an immunoglobulin on the surface of an inflammatory cell, resulting in the release of a potent chemical mediator. State the class of the immunoglobulin, the name of the cell and the name of the chemical mediator.

A
  • Immunoglobulin: IgE.
  • Cell: Mast cell.
  • Chemical mediator: Histamine.
36
Q

What are broncho-pulmonary segments?

A

Discrete functional and anatomical units of the lung. Each segment is supplied by a specific segmental/tertiary bronchus.

37
Q

How many broncho-pulmonary segments are there in the right lung?

A

10.

38
Q

How many broncho-pulmonary segments are there in the left lung?

A

8.

39
Q

How do we recognise pathogens we have nerve seen before?

A

Pattern recognition receptors - PRRs.

40
Q

What are the causative agents of acute inflammation?

A

Pathogens, damaged tissue.

41
Q

What are the causative agents of chronic inflammation?

A

Persistent acute inflammation, persistent foreign bodies, autoimmune reactions.

42
Q

What are main cells involved in acute inflammation?

A

Neutrophils! Also eosinophils and basophils.

43
Q

What are main cells involved in chronic inflammation?

A

Mononuclear cells e.g. monocytes, macrophages, lymphocytes, plasma cells.

44
Q

What are the primary mediators in acute inflammation?

A

Vasoactive amines.

45
Q

What are the primary mediators in chronic inflammation?

A

Cytokines, growth factors, ROS etc.

46
Q

What are the outcomes of chronic inflammation?

A

Tissue destruction, fibrosis, necrosis, chronic inflammation.

47
Q

What are the outcomes of acute inflammation?

A

Resolution.

48
Q

What suppresses alveolar macrophage activation in a healthy lung?

A

Respiratory epithelium.

49
Q

Which results in inflammation, necrosis or apoptosis?

A

Necrosis.

50
Q

Why is the lung at increased risk of inflammation?

A
  1. Huge area in contact with the external environment.

2. The lung contains the majority of our WBC’s at any one time.

51
Q

What is the function of mucus?

A

It protects the epithelium from foreign material and from fluid loss.

52
Q

What mechanism moves airway mucus up into the throat?

A

Muco-ciliary escalator.

53
Q

What is mucus composed of?

A

Water, carbohydrates, lipids and proteins.

54
Q

Name 4 non-immune host defence mechanisms.

A
  1. Epithelial barrier.
  2. Mucus.
  3. Muco-ciliary escalator.
  4. Coughing.
55
Q

What nerves does the efferent limb of the cough reflex include?

A

Recurrent laryngeal and spinal nerves.

56
Q

What nerves does the afferent limb of the cough reflex include?

A

Receptors within the sensory distributions of Cn 5, 9 and 10.

57
Q

What is adaptive immunity?

A

An antigen-specific immune response.

58
Q

What is the function of B cells?

A

Antibody production.

59
Q

Name 3 types of T cells.

A
  1. Cytotoxic T cells.
  2. Helper T cells.
  3. Memory T cells.
60
Q

What is the function of cytotoxic T cells?

A

They track down infected cells.

61
Q

What is the function of helper T cells?

A

they secrete cytokines to attract macrophages and neutrophils etc.

62
Q

What can cause a type 1 hypersensitivity reaction?

A

Pollen, cat hair, peanuts (allergies).

63
Q

What can cause a type 2 hypersensitivity reaction?

A

Transplant rejection, transfusion mismatch.

64
Q

What can cause a type 3 hypersensitivity reaction?

A

Fungal.

65
Q

What can cause a type 4 hypersensitivity reaction?

A

TB.

66
Q

What are the functions of lymphocytes?

A

They make antibodies, decide what type of antibodies to make and kill diseased cells.

67
Q

What is the Gell and Coombs classification?

A

It describes 4 types of hypersensitivity reaction.

68
Q

Describe the mechanism and give examples of a type 1 hypersensitivity reaction.

A
  • Mechanism: immunological memory to something causing an allergic response. IgE antibodies bind to mast cells -> histamine release.
  • Anaphylaxis, hayfever etc. Can be caused by pollen, allergens.
69
Q

Describe the mechanism and give examples of a type 2 hypersensitivity reaction.

A
  • Mechanism: immunoglobulins bound to surface antigens.

- Transfusion mismatch or transplant rejection.

70
Q

Describe the mechanism and give examples of a type 3 hypersensitivity reaction.

A
  • Mechanism: immune complexes, activation of complement.

- Fungi and pigeon droppings etc. (pigeon fancier’s lung).

71
Q

Describe the mechanism and give examples of a type 4 hypersensitivity reaction.

A
  • Mechanism: T cell mediated.

- Reactions to TB.

72
Q

What comprises a respiratory acinus?

A

Respiratory bronchiole, alveolar duct and alveolus.

73
Q

What part of the respiratory tract lies behind the sternal angle?

A

The tracheal bifurcation.

74
Q

Give an example of a restrictive lung disease?

A

Pulmonary fibrosis.

75
Q

Give an example of an obstructive lung disease?

A

Chronic bronchitis and emphysema.

76
Q

What is the affect of pulmonary fibrosis on the following: FEV1, FVC, PEF, TLC and DLCO?

A
  • FEV1 = reduced significantly.
  • FVC = reduced significantly.
  • PEF = Typically not variable.
  • TLC = reduced.
  • DLCO = reduced.
77
Q

What is the affect of emphysema on the following: FEV1, FVC, PEF, TLC and DLCO?

A
  • FEV1 = reduced.
  • FVC = normal or slightly reduced.
  • PEF = typically not variable.
  • TLC = increased (hyperinflation).
  • DLCO = reduced.
78
Q

What is the affect of asthma on the following: FEV1, FVC, PEF, TLC and DLCO?

A
  • FEV1 = normal or slightly reduced.
  • FVC = normal.
  • PEF = variable, diurnal fluctuation.
  • TLC = increased.
  • DLCO = normal.
79
Q

What is DLCO?

A

Uptake of CO in ml at standard temperature and pressure.

80
Q

Define inspiratory capacity (IC).

A

The maximum volume of air that can be forcibly inspired - IC = TV + IRV.

81
Q

What are the 6 stages of neutrophil action?

A
  1. Identify threat.
  2. Activation.
  3. Adhesion.
  4. Migration.
  5. Phagocytosis.
  6. Bacterial killing.
82
Q

What is the consequence of mucus plugs in the lungs?

A

Airway obstruction which can ultimately lead to death.

83
Q

What is the equation for trans-pulmonary pressure?

A

Transpulmonary pressure = alveolar pressure - pleural pressure. (TPP is always positive).

84
Q

What layer of the trilaminar disc is pleura derived from?

A

Mesoderm.

Respiratory phase 1 (8 decks)

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