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Cardiovascular & Respiratory Medicine > Structure and function of the airways > Flashcards

Structure and function of the airways Flashcards

1
Q

What type of branching do the airways do?

A

-dichotomus

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2
Q

What provides the mechanical stability to the lungs?

A

-cartilage

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3
Q

What are the lobes of the lungs?

A

3 right lung lobes:

  • superior
  • middle
  • inferior

2 left lung lobes:

  • superior
  • inferior
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4
Q

What are the different parts of the bronchus?

A
  • primary
  • secondary (lobar)
  • tertiary (segmental)
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5
Q

Compare Type I and Type II cells in the alveolar unit.

A

Type I cells:

  • very thin, delicate barrier (facilitates gas exchange)
  • cover 95% of alveolar surfaces

Type II cells:

  • replicate to replace Type I cells
  • secrete surfactant (reduced surface tension), antiproteases
  • xenobiotic metabolism
  • greater in number but only cover 5% of surfaces
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6
Q

What are the basic functions of the respiratory airways and what is this facilitates by?

A
  • getting air efficiently to the gas exchange region
  • keeping the pipework clear
  • conduit to conduct O2 to alveoli
  • conduit to conduct CO2 out of the lung
  • gas exchange

Facilitated by:

  • mechanical stability (cartilage)
  • control of calibre (smooth muscle)
  • protection and ‘cleansing’
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7
Q

What is the pharynx?

A

-common passageway for food, liquids and air

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8
Q

What is the conchae?

A
  • highly vascular- contribute to warming and ‘humidification; of intra-nasally-inhaled air
  • nasal hairs filter out large particles
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9
Q

Give the cells types which are lining cells.

A
  • ciliated
  • intermediate
  • brush
  • basal
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10
Q

Give the cells types which are contractile cells.

A

-smooth muscle (airway, vasculature)

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11
Q

Give the cells types which are secretory cells.

A
  • goblet (epithelium)
  • mucous
  • serous (glands)
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12
Q

Give the cells types which are found in connective tissue.

A
  • fibroblast

- interstitial cell (elastin, collagen, cartilage)

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13
Q

Give the cells types which are neuroendocrine cells.

A
  • nerves
  • ganglia
  • neuroendocrine cells
  • neuroepithelial bodies
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14
Q

Give the cells types which are vascular cells.

A
  • endothelial
  • pericyte
  • plasma cell (+ smooth muscle)
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15
Q

Give the cells types which are immune cells.

A
  • mast cell
  • dendritic cell
  • lymphocyte
  • eosinophil
  • macrophage
  • neutrophil
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16
Q

Which cell secretes mucin?-

A

-by guinea pig tracheal goblet cell

expansion of intra-granular mucin upon secretion; to ATP, Real Time

17
Q

Which cell secretes mucin?

A

-by guinea pig tracheal goblet cell

expansion of intra-granular mucin upon secretion; to ATP, Real Time

18
Q

What do serous cells secrete?

A

-anti-bacterial enzymes (e.g lysozyme)

19
Q

What do the submucosal glands also secrete, other than mucus and enzymes?

A

-water and salts

20
Q

What is an axoneme?

A

-a strand of a cilium

21
Q

How many cilia are there roughly per ciliated cell?

A

-about 200 cilia

22
Q

What are the functions of the airway epithelium?

A
  • secretion of mucins, water and electrolytes, components of ‘mucus’
  • movement of mucus by cilia- mucociliary clearance
  • physical barrier
  • production of regulatory and inflammatory mediators:
  • NO via nitrous oxide synthase
  • CO
  • arachidonic acid metabolites (e.g prostaglandins)
  • chemokines
  • cytokines
  • proteases
23
Q

What are the functions of the airway epithelium?

A
  • secretion of mucins, water and electrolytes, components of ‘mucus’
  • movement of mucus by cilia- mucociliary clearance
  • physical barrier
  • production of regulatory and inflammatory mediators:
  • NO via nitrous oxide synthase NOS
  • CO via haemeoxygenase HO
  • arachidonic acid metabolites (e.g prostaglandins) via COX
  • chemokines
  • cytokines
  • proteases
24
Q

What happens to airway smooth muscle during inflammation?

A

Structure:

  • hypertrophy
  • proliferation

Tone (airway caliber):

  • contraction
  • relaxation

Secretion:

  • mediators
  • cytokines
  • chemokines
25
Q

What are the secretory functions of airway smooth muscle during inflammation?

A

inflammation

bacterial products
-cytokines stimulate NOS to release NO, COX to release prostaglandins, cytokines, chemokines and adhesion molecules

-the released cytokines, chemokines and adhesion molecules stimulate inflammatory cell recruitment

26
Q

Tell me about the trachea-bronchial circulation (systemic).

A
  • 1-5% of cardiac output
  • blood flow to airway mucosa = 100-150 ml/min/100g tissue
  • blood returns from tracheal circulation via systemic veins
  • blood returns from bronchial circulation to both sides of heart via bronchial and pulmonary veins
27
Q

What are the functions of the trachea-bronchial circulation?

A
  • good gas exchange directly between airway tissues and blood
  • contributes to warming of inspired air
  • contributes to humidification of inspired air
  • clears inflammatory mediators
  • clears inhaled drugs (good/bad, depending on drugs)
  • supplies airway tissue and lumen with inflammatory cells
  • supplies airway tissue and lumen with proteinaceous plasm (‘plasma exudation’)
28
Q

What is the parasympathetic innervation of the airways?

A

Parasympathetic (cholinergic) ‘motor’ pathway

  • ACh neurotransmitter
  • nodose ganglion
  • vagus nerve
  • causes restriction and increased mucous secretion (submucosal glands stimulated)
29
Q

What is the effect of the sympathetic innervation on the airways?

A
  • results in relaxation to increase amount of airflow
  • adrenaline from adrenal gland also has same effect.

-NO release (spinal cord- cervical thoracic ganglion) causes relaxation

30
Q

What is respiratory disease?

A
  • loss of homeostatic control leads to pathophysiology and clinical symptoms of respiratory disease
  • loss of ‘airway’ control
31
Q

Examples of respiratory diseases?

A
  • asthma (5% of population)
  • chronic obstructive pulmonary disease (COPD)
  • cystic fibrosis (CF)
32
Q

What is the 4th cause of death in the UK and USA?

A

-COPD

33
Q

What is asthma?

A

-a clinical syndrome characterised by increased airway ‘responsiveness’ to a variety of stimuli - airway obstruction

  • airflow obstruction varies over short periods to time and is reversible (spontaneously or with drugs)
  • dyspnoea, wheezing and cough
  • airway inflammation- re-modelling
34
Q

What is the pathology of airway inflammation?

A
  • basement membrane thickening
  • epithelial fragility
  • mucus plug in lumen
  • vasodilation- congested vessels
  • cellular infiltration
35
Q

What is the pathology of asthma?

A
  • excess mucous- goblet cell hyperplasia
  • sensory nerve activation, cholinergic reflex- mucus hyper secretion and bronchoconstriction
  • subepithelial fibrosis

Inflammatory mediators increase e.g cytokines and Bfs

  • mast cells
  • eosinophils
  • Th2 lymphocyte
  • fibroblasts

Cardiovascular & Respiratory Medicine (15 decks)

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