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Cardiology > Structure and Function of the airways > Flashcards

Structure and Function of the airways Flashcards

1
Q

What does the trachea split into?

A

Bronchi

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2
Q

What is the name given to the type of branching that splits into two?

A

Dichotomous branching

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3
Q

Why is the cartilage ‘C’ shaped?

A

Mechanical Stability

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4
Q

What is the alveolar region made of?

A

Alveoli

Alevolar duct

Alveolar sac

Repiratory bronchioles

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5
Q

What is the function of the alveolar region?

A

Gas Exchange

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6
Q

What is the structure of an alveolar unit?

A

Alveolar macrophages = phagocytosis (ingest particles) = clean

Type I cell = v. thin, facillitates gas exchange between the alveoli and blood

Type II = replicate to produce more type I cells when the Type I cells get damaged, secrete surfactant (reduced surface tension), antiproteases and nullify toxins

Xenobiotic metabolism

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7
Q

Describe the image, spot where the Type I and Type II cells are?

(Two fried eggs)

A

Type I cells- incredibly thin like fried eggs

Cover 95% of alveolar surfaces

Type II cells: Greater number than type I but only cover 5% of surface

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8
Q

What are the basic functions of the respiratory airways?

A

Getting air efficently to the gas exchange region.

Keeping the pipework clear

Conduct O2 to the alveoli, allow for CO2 to exit

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9
Q

What are the basic functions of the airways faciliatated by?

A

Mechanical stability (cartilage)

Control of calibre (smooth muscle)

Protection and ‘cleansing’

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10
Q

What structure prevents air being taken into the stomach and food into the lungs?

A

Epiglottis

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11
Q

What are conchae? Where are they found?

A

Thin, scroll-shaped bony elements forming the upper chambers of the nasal cavities

Lots of vasculature = warming of air before it goes down

Nasal hairs = filter out the hair (first line of defence in protecting the lower airways

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12
Q

How are the airway structures organised?

A

Not a full circle of cartilage (C-shaped) = improve mechanical stability

When the smooth muscle contractes, it squeezes some of the mucus out

Many vasculature - fill tracheal tissue with oxygen

Goblet cells = produces mucus

Cilia

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13
Q

What are the different airway cell types?

A

Lining Cells

Contractile Cells

Secretory Cells

Connective tissue

Neuroendocrine

Vascular cells

Immune cells

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14
Q

What cells are Lining cells?

A

Ciliated

Intermediate

Brush

Basal

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15
Q

What are the three layers of the airway wall?

A

Mucus Layer

Cilia

Epithelial cells

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16
Q

Why are there many mitochondria in the ciliated cells?

A

Mitochondria = provide ATP to power sweeping motion of cilia

17
Q

What is mucin secretion? Where is it from? How is it stimulated?

A

from goblet cells

Size expansion = intragranules release their contents

Enormous capacity

18
Q

What is the role of the submucosal glands?

A

Washes mucus secretion to the collecting duct

Secrete mucus

19
Q

What is the role of serous cells?

A

Secrete anti-bacterial enzymes

e.g. lysozyme

20
Q

What do ciliated cells do?

What rhythm do the cilia follow for sweeping?

A

Waft molecules up and out of the airway

Some cilia go one way, and some go the other way - works like a mexican wave

Metachronal rhythm - movement controlled by calcium

21
Q

What is the function of the epithelium?

A

Secretion of mucins, water and electrolytes

  • components of ‘mucus’ (+ plasma, mediators etc)

Movement of mucus by cilia – mucociliary clearance

Physical barrier

Production of regulatory and inflammatory mediators

22
Q

Give examples of regulatory and inflammatory mediators

A

Nitric oxide (NO - via nitric oxide synthase, NOS)

Carbon monoxide (CO - via hemeoxygenase, HO)

Arachidonic acid metabolites (e.g. prostaglandins – via COX)

Chemokines (e.g. interleukin (IL)-8)

Cytokines (e.g. GM-CSF)

Proteases

23
Q

What is the function of the smooth muscles of the airway?

A

Structure = hypertrophy and proliferation

Function = contraction and relaxation to constrict and open up the airways

Constriction to stop something going too far down - gives better chance of coughing it up

24
Q

What happens when there is inflammation in the smooth muscle of the airways?

A

Structure = hyper proliferated

Tone = more contracted

Secretion = excess

25
Q

What is the airway vasculature?

A

Trachio-bronchial circulation system

26
Q

What are the main features of tracheo-bronchial circulation?

A

1-5% of cardiac output

Blood flow to airway mucosa = 100-150 mL/min/100g tissue (amongst the highest to any tissue)

Bronchial arteries arise from many sites on

aorta, intercostal arteries and others

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 vasculature is found under the epithelium?

Why is it structured this way?

A

Plexus of arteries, capillaries and veins found just under the epithelium

Direct exchange, contributes to warming, clear away inhaled drugs, supplies airway tissue with inflammatory cells and proteinaceous plasma

28
Q

What are the functions of tracheo-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 drug)
  • Supplies airway tissue and lumen with inflammatory cells
  • Supplies airway tissue and lumen with proteinaceous plasma (termed ‘plasma exudation’)
29
Q

What are the nerves found in the airways that control airway function?

A

parasympathetic (cholinergic)

(sympathetic – adrenergic?)

sensory

30
Q

What are the regulatory and inflammatory mediators involved in the control of airway function?

A

histamine

arachidonic acid metabolites (e.g. prostaglandins, leukotrienes)

cytokines

chemokines

Proteinases/proteases (e.g. neutrophil elastase)

Reactive gas species (e.g. O2-, NO)

31
Q

What are some respiratory diseases that result in the loss of airway?

A

Asthma

COPD

Cystic Fibrosis

32
Q

What is the risk factor for COPD?

A

Smoking

33
Q

What is asthma? What are its characteristics?

A

A clinical syndrome characterised by increased airway ‘responsiveness’ to a variety of stimuli (® airways obstruction)

Airflow obstruction varies over short periods of time and is reversible (spontaneously or with drugs)

Dyspnoea, wheezing and cough (varying degrees - mild to severe)

Airway inflammation –> re-modelling

34
Q

What are the pathological signs of asthma?

A

Eosinophils

bronchoconstriction

35
Q

What is the current understanding of asthma?

A

‘simple’ schematic

excess mucus

Cholinergic reflex set off = bronchoconstriction + mucus secretion

Cardiology (16 decks)

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