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Respiratory BS > Respiratory lecture 5-Physiology of the airways > Flashcards

Respiratory lecture 5-Physiology of the airways Flashcards

1
Q

What is obstructive pulmonary disease?

A

When overall volume of the lungs available for gas exchange is unchanged but there is obstruction to the flow of gases along the airways. (NARROWING OF AIRWAYS THAT CONDUCT AIR INTO AND OUT OF LUNGS)

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2
Q

What is restrictive pulmonary disease?

A

The available lung volume for gaseous exchange is reduced, or restricted, but there is no obstruction to airflow. (TLC REDUCED BUT AIRFLOW AND AIRWAY RESISTANCE IS NORMAL)

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3
Q

What is the genioglossus?

A

Bulk of muscle in tounge

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4
Q

What is the tensor palati

A

Muscles running across the back of the soft palette

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5
Q

What is an afferent signal?

A

Nerve impulse going towards the brain bringing information into the brain

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6
Q

What is an efferent signal?

A

Signal going away from brain sending information out to the body

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7
Q

What is the snoring noise?

A

When the soft palette flaps backwards and forwards whenever they breathe in

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8
Q

What happens to pharyngeal muscle reflex when you go to sleep?

A

Your brain relaxes and is slower which slows the reflex down (less powerful and effective). Pharynx doesn’t act quickly enough and you start to snore.

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9
Q

How do you detect sleep apnoea?

A

When tidal volume slowly decreases and stops and starts again

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10
Q

What are the clinical features of sleep apnoea?

A

snoring, daytime somnolence and associated with obesity and hypertension.

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11
Q

Why is obesity associated with more active airway reflexes?

A

Fat around pharynx narrows the airway which means you have to have extra airway muscle activity to overcome the fact your airway is narrowed by obesity.

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12
Q

What is CPAP?

A

Machine that applies positive pressure to the nose which stops pharynx from collapsing at the back as it is kept open by the pressure

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13
Q

what is required to keep airway patent?

A

continuous muscle activity

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14
Q

how are muscles controlled in the airway?

A

via a reflex arc (pharyngeal reflex arc)

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15
Q

what happens when you slow reflex down?

A

Airway control worsens and

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16
Q

What slows reflex down?

A

Sleep and sedative drugs

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17
Q

What is epithelium?

A

lining of body cavity

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18
Q

What is airway epithelium?

A

epithelial cells with cilia on top

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19
Q

what happens to epithelial cells as you go down airway?

A

cells get smaller and thinner

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20
Q

What type of epithelial cells do you have in nose and pharynx?

A

Pseudostratified (nuclei at different levels)

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21
Q

What type of epithelial cells do you have in trachea and bronchi?

A

columnar

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22
Q

What type of epithelial cells do you have in bronchioles?

A

cuboidal

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23
Q

why can’t you have cilia in alveoli?

A

make them too thick for gas exchange

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24
Q

What cell type secreted fluid in airway epithelial cells?

A

goblet cells

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25
Q

what makes up sticky part of airway fluid?

A

Mucin

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26
Q

What causes more mucin to be released than normal?

A

Airway irritation, tobacco smoke, infection

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27
Q

What makes smokers lungs different?

A

They have more goblet cells and therefore more mucin

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28
Q

Why do smokers have more goblet cells?

A

Goblet cells are permanently stimulated

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29
Q

What are the two layers of airway fluid?

A
  1. Mucous layer (gel layer)

2. Periciliary layer (Salt layer)

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30
Q

Consistency of mucous layer?

A

sticky

31
Q

Consistency of periciliary layer?

A

watery

32
Q

what is cilia inhibited by?

A

tobacco smoke, inhale anaesthetics, air pollution and infection

33
Q

what does cigarette smoke do to cilia?

A

paralyze them due to cyanide in it which stops cilia working properly

34
Q

What are the functions of airway lining fluid?

A

Humidification and airway defence

35
Q

What is humidification

A

when water evaporates from airway lining and is added to gas

36
Q

why does nose breathing achieve better humidification?

A

Air has got further to go

37
Q

how does rate of breathing affect humidification?

A

Air takes further and further down the airway before its fully humidified

38
Q

What happens when you breathe out?

A

The warm air coming back from lungs heats up epithelia and put water back into airway lining fluid (water condenses)

39
Q

Why do we have the heat and moisture exchange cycle?

A

we would loose too much water

40
Q

What do epithelial cells control?

A

The depth of the airway lining fluid

41
Q

Why is depth of lining fluid important?

A

Cilia can only work if the fluid depth is correct. if it gets too deep the cilia can’t reach mucus.

42
Q

How do epithelial cells change the fluid depth?

A

Change activity of chloride channel. Secrete chloride into water and sodium follows the chloride down the electrochemical gradient so salt amount is controlled. Via osmosis water will follow it.

43
Q

how do epithelial cells remove ‘mucus’?

A

Move fluid up the lungs (cough)

44
Q

what is the clinical feature of CF?

A

autosomal recessive inheritance

45
Q

whats wrong in CF?

A

abnormal CF transmembrane regulator protein.

46
Q

What happens as a result of CF?

A

Progressive lung infection and destruction. All systems with epithelial cells are affected.

47
Q

What are very large particles and where are they deposited?

A

greater than 8 micrometers (pollen,sawdust) and deposited in nose and pharynx.

48
Q

What mechanism are Very Large and Large particles deposited by ?

A

Inertial impaction?

49
Q

What are large particles and where are they deposited?

A

3-8 micrometers and in large airways

50
Q

What are small particles and where are they deposited?

A

0.5- 3 micrometers and in bronchioles

51
Q

What mechanism are small particles deposited by ?

A

sedimnetation

52
Q

What are very small particles and where are they deposited?

A

less than 0.5 micrometers and they are exhaled.

53
Q

how does gravity help?

A

we rely on sedimentation and gravity to cause smaller particles to fall and get stuck to mucus

54
Q

what determines where particles are deposited?

A

size

55
Q

where are large particles captured

A

upper airway mucous

56
Q

where are small particles deposited

A

alveoli

57
Q

How do lungs defend body?

A
  1. Acts as physical barrier and removal
  2. Chemical inactivation (lysozyme, protease enzyme and antimicrobial peptides)
  3. Alveolar macrophages
58
Q

Why are CF patients prone to disease

A

Defence system sensitive to salt levels and if sodium chroride conc is wrong , the defence systems dont work

59
Q

what chemicals do lung cells release?

A

lysozyme, protease enzyme (anti-protease system) and antimicrobial peptides

60
Q

What are lysozyme?

A

Protein enzyme that breaks apart cell wall.

61
Q

what are protease enzymes?

A

enzyme that will attack any protein which stops proteins in viruses or bacteria from being active

62
Q

why are protease enzymes in mucus?

A

So they aren’t in contact with epithelial cells so they don’t damage out own cells.

63
Q

what are anti-protease systems?

A

Defence mechanism against our protease enzymes if they try to damage our own cells.

64
Q

what are antimicrobial peptides?

A

Naturally occurring antibiotics e.g.human B defensin which are small peptides that the lung releases, they are non specific and they will inhibit the growth of any bacteria.

65
Q

what are alveolar macrophages?

A

final layer of defence which clean up around alveoli

66
Q

What is the humoral immunological response?

A

Immunoglobulins

67
Q

What do immunoglobulins do?

A

inhibit binding of pathogens to epithelial cells, complement activation and recruit other immune cells.

68
Q

what is involved in cell-medicated immunological response?

A

Epithelial cells and macrophages

69
Q

what happens when you get bacterial infection?

A

neutrophils will be present at site

70
Q

what happens when you have an allergy?

A

Eosinophils will be at the site

71
Q

What is 1st layer of defence?

A

physical removal of inhales pathogens

72
Q

What is 2nd layer of defence?

A

non-immunological processes destroy pathogens

73
Q

what is 3rd layer of defence?

A

immune cells are present in the airway

Respiratory BS (3 decks)

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