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Cardiovascular and Respiratory > Structure and function of airways > Flashcards

Structure and function of airways Flashcards

1
Q

What is the branching like in the airways?

A

dichotomous, everything divides into 2

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2
Q

What provides mechanical stability?

A

Cartilage specifically C-shaped rings
c shaped rings formed by Hyaline cartilage connected by tracheal muscle and elastic connective tissue, forming a fibroelastic membrane, encloses the posterior surface

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3
Q

Gap at the back of trachea?

A

Oesophagus for food

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4
Q

Order of airways

A

trachea -> left and right bronichi -> bronchioles -> terminal bronchioles = non cartolaginous -> respiratory brochioles -> alveolar ducts -> alveolar sacs -> alveoli

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5
Q

Where does gas exchange take place?

A

Alveolar region

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6
Q

What cells can make up the alveolar region?

A

Type I
Type II
macrophages
fibroblasts

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7
Q

What are type I epithelial cells?

A

Very thin-walled epithelial cells with a delicate barrier that facilitates gas exchange

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8
Q

What are type II epithelial cells?

A

Can replicate to replace type I cells

Secrete Surfactant - detergent - keeps alveoli open: reduces surface tension, antiprotease. prevents inner walls from sticking together. prevents collapse of alveolus

Xenobiotic metabolism (metabolise noxious chemicals and particles that may get down to alveoli)

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9
Q

What are the alveolar walls in contact with that allow gas exchange?

A

Capillary endothelium

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10
Q

Function of fibroblasts in alveolar region?

A

Produce the matrix that holds everything together

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11
Q

The function of fibroblasts in the alveolar region?

A

Produce the matrix that holds everything together

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12
Q

What cell covers ~ 95% of alveolar surface?

A

Type I cell but greater numbers of type II but bc they are smaller only = ~ 5%

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13
Q

Basic function of respiratory airways?

A

conduit (pipes) to: carry out gas exchange-
conduct O2 to alveoli and CO2 outof lung
(12,000l of air)

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14
Q

What are the respiratory airways facilitated by?

A

Mechanical stability (cartilage)
Control of calibre (smooth muscle)
protection & ‘cleansing’

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15
Q

What is the pharynx?

A 
common passageway for foods, liquids and air
split into 3 regions:
nasopharynx
oropharynx
laryngopharynx
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16
Q

What are the conchae?

A

Curved shelves of bone projecting out from the lateral walls of the nasal passage.

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17
Q

The function of the conchae?

A

Highly vascular - contribute to warming and ‘humidification’ of intra-nasally inhaled air
also produce moisture

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18
Q

What do nasal hairs do?

A

filter out large particles

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19
Q

submucosal glands?

A

secrete mucus. can help to cough out if something accidentally goes through

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20
Q

Structure of airway wall

A

Mucus layer
Cilia
Epithelial cells

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21
Q

What does the airway epithelium contain?

A

Goblet cells which produce mucus

Ciliated cells which waft the mucus and then we swallow it

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22
Q

Which cells make up the lining cell

A

ciliated, intermediate, brush, basal

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23
Q

Which cells make up the contractile cells?

A

smooth muscle (airway, vascular)

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24
Q

Which cells make up the secretory cells?

A

Goblet (epithelium), mucus, serous (glands)

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25
Q

What is the opening of the airway?

A

Lumen

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26
Q

Goblet cells have a lot of (x) granules

A

x = MUCIN

contain mucin in a highly condensed form

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27
Q

Ciliated cells have lots of (a) because they are highly (b)

A

a = mitochondria
b=energetic

to keep cilia beating

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28
Q

What happens if we require mucus?

A

Mucin granules come to the apical surfaceof the cell (goblet) and fuse with it.
A double pore opens, airway liquid comes in and mucin takes up water and expands.

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29
Q

What happens if we require mucus?

A

Mucin granules come to the apical surface of the cell (goblet) and fuse with it.
A double pore opens, airway liquid comes in and mucin takes up water and expands.

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30
Q

What do the submucosal glands have in common with goblet cells?

A

They both produce mucus

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31
Q

Where is the mucus produced in submucosal gland?

A

cells = acini = secrete mucin into airway duct.
have mucous acini - secrete mucus
and serous acini

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32
Q

What do the serous acini secrete?

A

secrete anti-bacterial enzymes (e.g. lysozyme)

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33
Q

Other than mucus and ab enzymes what else do submucosal glands secrete?

A

Water and salt (Na+, Cl-)

34
Q

How many cilia per ciliated cell?

A

~ 200

35
Q

What do the apical ‘hooks’ on cilia do?

A

engage with mucus

36
Q

What do the apical ‘hooks’ on cilia do?

A

engage with mucus

37
Q

How do acini secrete mucous?

A

Secretes mucous extracellularly into collecting duct, traversing to the ciliated duct, the cilia waft the mucous out of the gland

38
Q

What duct is mucous from submucosal glands secrete into?

A

Ciliated duct

39
Q

What type of mucous is secreted by serous cells?

A

More dilute mucous, contains lysozyme

40
Q

What is the purpose of more dilute mucous secretions from serous cells?

A

Flush over the vicious mucous secretions and washes it into the collecting duct

41
Q

What characteristic microtubule arrangement is presented by ciliated cell?

A

9+2

42
Q

What is the name of the cilia microtubule in ciliated cells?

A

Axoneme microtubule

43
Q

What is the function of ciliated cells?

A

Cilia beat to waft the mucous. Apical hooks engage with the mucous, assist with mucous removal, sliding movement of rods facilitate bidirectional movement

44
Q

What is the name of the cilia microtubule in ciliated cells?

A

Axoneme microtubule which slide over each other to move the cilia one way then the other

45
Q

What is the function of ciliated cells?

A

Cilia beat to waft the mucous. Apical hooks engage with the mucous, assist with mucous removal, sliding movement of rods facilitate bidirectional movement

46
Q

What type of rhythm is exhibited by cilia beating?

A

Metachronal rhythm

47
Q

What is metachronal cilia rhythm?

A

Time, mucous on superficial surface, mucous is transmitted by cilia.
Backwards cilia sequentially moves the mucous through alternating forward and backward movements.
Rafts of mucous are present in typical airways instead of a full layer.

48
Q

What are the four main functions of airway epithelium?

A

Secretion of water, mucin and electrolytes
Movement of mucous by cilia, mucociliary clearance
Physical barrier against inhaled stuff
Production of regulatory and inflammatory mediators

49
Q

Which enzyme complex secreted nitric oxide?

A

Nitric oxide synthase

50
Q

How does the addition of anti-NOS antibodies identify presence of nitric oxide synthase?

A

Brown staining which shows lots of NOS/NO in epithelium

51
Q

Name the regulatory and inflammatory mediators that the airway epithelium produces

A 
Nitric Oxide
Carbon monoxide
Arachidonic acid metabolites 
Chemokines e.g. IL-8
Cytokines e,g, GM-CSF
Proteases
52
Q

Which enzyme helps produce carbon monoxide?

A

Hemoxygenase, HO

53
Q

What is an example of an Arachidonic acid metabolite and which enzyme is required to produce it?

A

Prostaglandins via COX

54
Q

What happens when you put nitric oxide donors onto ciliated cells?

A

cilia speed up so the effect is that they influence ciliary beat

55
Q

What are the functions of airway smooth muscle cells?

A

Structure, Tine and Secretion of certain substances

56
Q

How is nitric oxide secretion controlled?

A

In response to cytokines, nitric oxide synthase is upregulated, enhancing secretions o NO, accentuating its effect on cilia and inflammation

57
Q

What is ariway tone?

A

= airway caliber:

contraction & relaxation so the tone would be how relaxed or contracted it is

58
Q

What does airway smooth muscle secrete?

A

Mediators
Cytokines
Chemokines
( not so much secreted normally but increased!!! in respiratory conditions due to inflammation )

59
Q

What happens to the structure of smooth muscle cells when someone has a respiratory disease?

A

inflammation:

now contribute more to structure e.g. in asthma - enlargement due to proliferation = HYPERTROPHY

60
Q

How can the contractile force of smooth muscle within airways increase?

A

Inflammation and smooth muscle hypertrophy occurs through proliferation of smooth muscle in addition to hyperplasia. The increase in the mass of smooth muscle simultaneously increases the contractile force of that muscle.
Marked increase in secretion of mediators

61
Q

What is the airway circulation?

A

tracheo-bronchial circulation = systemic

62
Q

What % of cardiac output is represented by the tracheo-bronchial systemic circulation?

A

1-5% cardiac ouput

63
Q

What is the average blood flow to airway mucosa?

A

100-150 mL/min/100g tissue = among highest to any tissue

64
Q

Where do bronchial arteries arise from?

A

Arise from many junctions on the aorta and intercostal arteries

65
Q

How does blood return from the tracheal circulation?

A

Via Systemic veins

66
Q

How does blood return from bronchial circulation?

A

To both sides of the heart via bronchia and pulmonary veins

67
Q

What is the main function of sub epithelial microvasculature within the trachea bronchia circulation?

A

Direct gas exchange between systemic circulation and respiratory surface
highly vascular system facilitates direct gas exchange between tissues and blood

68
Q

What are the functions of the tracheo-bronchial circulation?

A

Direct gas exchange between airway tissues and blood
Contributes to warming inspired air
Contributes to humidification of inspired air
Clears inflammatory mediators
Clears inhaled drugs (good/bad depending on drugs)
Supplies airway tissue w lumen with inflammatory cells
Supplies airway tissue and lumen w proteinaceous plasma (plasma exudation - leaks out vessels to bathe tissues)

69
Q

What controls airway function

A

Nerves
Regulatory and inflammatory mediators
Proteinases/proteases
Reactive gas species

70
Q

Which nerves are involved in airway function?

A

Parasympathetic (cholinergic)
Sympathetic (adrenergic?)
Sensory

71
Q

Which regulatory and inflammatory mediators involved in airway control?

A

Histamine
Arachidonic acid metabolites (e.g. prostaglandins, leukotrienes)
cytokines
chemokines

72
Q

Examples of proteinases/proteases involved in airway control

A

Neutrophil elastase

73
Q

Example of gas species involved in airway control

A 
Nitric oxide (cillary beat)
O2
74
Q

Mechanism for parasympathetic pathway?

A

Sensory nerves detect need for contraction e.g. peanut in airway
impulse travels along vagus nerve to brain stem passing the nodose ganglion
Cholinergic reflex: paraymp/cholinergic nerves = motor pathway and neurotransmitter = ACh
ACh causes contraction of airways

75
Q

How do airways relax?

A

via Adrenaline (opens up airways - more O2 for fight/flight)

not noradrenaline - we have nerves w nitric oxide synthase which causes airways to relax

76
Q

How is sympathetic control exerted on the airways?

this is for animals?

A

Adrenergic reflex causes bronchodilation, smooth muscle relaxes dilating the airways.
Adrenaline is secreted by the adrenal gland and directly relaxes the airways

77
Q

What are some respiratory diseases?

A

Asthma, COPD, cystic fibrosis (CF) - lethal autosomal recessive gene defect

78
Q

What does COPD stand for?

A

Chronic Obstructive Pulmonary disease

4th cause of death in UK and USA

79
Q

What is asthma?

A

affects ~5% of population

A clinical syndrome characterised by increased airway responsiveness to a variety of stimuli (leads to airway obstruction).
Airway obstruction varies over short periods of time and is reversible (Adrenaline stimulates bronchodilation, airways reopen).

80
Q

What is airway remodelling?

A

Airway changes in structure over a long period of time.

Usually associated with inflammation

81
Q

Main proteases of airway control

A

Neutrophil elastase?

82
Q

What participates lung disease?

A

loss of homeostatic control

Cardiovascular and Respiratory (5 decks)

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