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Z YEAR 1 BRS cardiology > Structure and function of the airways > Flashcards

Structure and function of the airways Flashcards

1
Q

What is the branching the airways?

A

dichotomous branching

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2
Q

Where does the mechanical stability come from?

A

cartilage

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3
Q

What are type 1 cells in the alveolar regions?

A
  • incredibly thin (like fried eggs) -cover ~95% of alveolar surface
  • delicate barrier
  • Facilitate gas exchange
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4
Q

What are type II cells?

A
  • Replicate to replace type 1 ells
  • release surfactant (reduces surface tension), antiproteases
  • Xenobiotic metabolism
  • Type II cells – greater numbers than Type I cells, but only cover ~5% of surface
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5
Q

What is the basic function of the respiratory airways?

A

Getting air efficiently to the gas exchange region. Keeping the pipework clear

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6
Q

What are the airways conduit to?

A

Conduit (‘pipes’) to:

  1. conduct O2 to the alveoli
  2. conduct CO2 out of the lung
    - gas exchange
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7
Q

What are the airways facilitated by?

A

Facilitated by:

  • mechanical stability (cartilage)
  • control of calibre (smooth muscle)
  • protection and ‘cleansing’
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8
Q

What does the pharynx do?

A

a common passageway for food, liquids and air.

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9
Q

What do the conchae do?

A

highly vascular – contribute to warming and ‘humidification’ of intra-nasally-inhaled air

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10
Q

What do the nasal hairs do?

A

Nasal hairs filter out large particles

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11
Q

What cell type are lining cells in the airway?

A
  • Ciliated
  • Intermediate
  • Brush
  • Basal
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12
Q

What cell type are contractile cells in the airway?

A

-Smooth muscle (airway, vasculature)

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13
Q

What cell type are secretory cells in the airway?

A
  • Goblet (epithelium)
  • mucous
  • serous (glands)
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14
Q

What cell type are connective tissue in the airway?

A

-Fibroblast
-interstitial cell
(elastin, collagen, cartilage)

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15
Q

What cell type are neuroendocrine cells in the airway?

A
  • Nerves
  • Ganglia
  • Neuroendocrine cells
  • Neuroepithelial bodies
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16
Q

What cell type are vascular cells in the airway?

A
  • Endothelial
  • Pericyte
  • Plasma cell (+smooth muscle)
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17
Q

What cell type are immune cells in the airway?

A
  • Mast cell
  • Dentritic cell
  • Lymphocyte
  • Eosinphil
  • Macrophage
  • Neutrophil
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18
Q

How is mucin secreted?

A

Mucin secretion by guinea pig tracheal goblet cell

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

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19
Q

What are the airway submucosal glands?

A
  1. Mucous cells secrete mucus
  2. Serous cells secrete anti-bacterial enzymes (e.g. lysozyme)
  3. Glands also secrete water and salts (e.g. Na+ and Cl-)
20
Q

What is the function of airway epithelium?

A
  • Secretion of mucins, water and electrolytes
  • components of ‘mucus’ (+ plasma, mediators etc)
  • Movement of mucus by cilia – mucociliary clearance
  • Physical barrier
21
Q

What is produced by airway epithelium?

A

-Production of regulatory and inflammatory mediators:
1. Nitric oxide (NO - via nitric oxide synthase, NOS)
2. Carbon monoxide (CO - via hemeoxygenase, HO)
3. Arachidonic acid metabolites (e.g. prostaglandins – via COX)
Chemokines (e.g. interleukin (IL)-8)
4. Cytokines (e.g. GM-CSF)
5. Proteases

22
Q

How is NOS in airways?

A
  • NOS expression in human airway epithelium

- Brown staining = nitric pride synthase (NOS) - produces nitric oxide (NO)

23
Q

How does airway smooth muscle function in inflammation?

A
  1. Structure:
    - Hypertrophy
    - Proliferation
  2. Tone: airway caliber (with or without inflammation)
    - Contraction
    - Relaxation
  3. Secretion: (with or without inflammation but increase if inflammation)
    - Mediators
    - Cytokines
    - Chemokines
24
Q

What are the secretory functions in airway smooth muscle with Inflammation or exposure to bacterial products or cytokines?

A

-Activates NOS -> NO
-Activates COX -> Prostaglandins
-Increase prod Cytokines
-Increase prod Chemokines
-Increase prod adhesion molecules
>Last three used in inflammatory cell recruitment

25
Q

What is the airway vasculature like?

A
  1. Tracheo-bronchial circulation (systemic)
  2. 1-5% of cardiac output
    -Blood flow to airway mucosa = 100-150 mL/min/100g tissue (amongst the highest to any tissue)
  3. Bronchial arteries arise from many sites on
    aorta, intercostal arteries and others
26
Q

How does blood return from trachea circulation?

A

Blood returns from tracheal circulation via systemic veins

27
Q

How does blood return from bronchial circulation?

A

Blood returns from bronchial circulation to both sides of heart via bronchial and pulmonary veins

28
Q

What is the function of the 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 in the control of airway function?

A

-Nerves:
parasympathetic (cholinergic)
-LACK of sympathetic
-sensory

30
Q

What are the regulatory and inflammatory mediators in the airway?

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 disease with loss if airway ‘control’?

A
  1. Asthma, chronic obstructive pulmonary disease (COPD) and cystic fibrosis (CF)
  2. All are common conditions:
    Asthma – ~5% of population (industrialised countries)
    COPD – 4th cause of death in UK and USA
    CF – lethal autosomal recessive gene defect (~1:20 gene frequency; affects ~1:2000 Caucasians): CFTR
32
Q

What is asthma?

A

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

33
Q

What are the characteristics of asthma?

A 
1. Airflow obstruction varies over short periods of time and
is reversible (spontaneously or with drugs)
2. Dyspnoea, wheezing and cough (varying degrees - mild to severe)
3.. -Airway inflammation -> re-modelling
34
Q

How is airway controlled?

A
  1. Parasympathetic Cholinergic nerves induce contraction airway smooth muscle (airway constriction) and mucus secretion (glands) - ACh neurotransmitter
  2. Airway relaxation (humans) via NOS-containing nerves and adrenaline (adrenal glands)
    - Different inflammatory cells and mediators in airways
    - Cells produce more than one mediator; mediators do more than one thing
  3. Use Nitric oxide producing nerves for relaxation airway smooth muscle
35
Q

What do submucosal glands secrete?

A

mucus, water, salts and anti-bacterials

36
Q

What do cilia do?

A

Cilia (ciliated cells) beat metachronally for effective mucociliary clearance

37
Q

What do airway epithelium produce?

A

Airway epithelium produces nitric oxide (NO) – control of ciliary beat?

38
Q

What do airway smooth muscles have?

A

Airway smooth muscle cells have contractile and secretory functions

39
Q

When do respiratory diseases occur?

A

Loss of homeostatic ‘control’ leads to respiratory disease

40
Q

What is involved in the airway pathophysiology of asthma?

A

The airway pathophysiology of asthma involves the lumen, epithelium, basement membrane, submucosal structures (e.g. submucosal glands), vasculature and smooth muscle

41
Q

What does NOS and COX do for inflammation?

A
  1. NOS causes release of NO for vasodilation
  2. COX causes prostaglandin release that is pro-inflammatory
  3. Cytokine//chemokine//adhesion molecule release all help to chemoattract other cells (cell recruitment) to the site of inflammation
42
Q

What is the tracheo bronchial circulation?

A
  • 1-5% CO
  • Tracheal circulation return via systemic veins
  • Bronchial circulation returns via bronchial and pulmonary veins to both sides of the heart
43
Q

What is the function of the tracheo bronchial circulation?

A 
Good gas-exchange
Warming
Humidifying 
Clearing mediators of inflammation 
Clear drugs 
Supply tissues with cells 
Supply tissue with plasma
44
Q

What is the PNS control of the airway?

A
  • PNS – ACh on muscarinic receptors
    1. Mucus secretion
    2. Bronchoconstriction
    3. BV dilation
45
Q

What is the SNS control of the airway?

A
  • SNS – NA/A on adrenergic receptors via cervical thoracic ganglion
    1. Bronchodilation
    2. Adrenaline release from adrenals relaxes
46
Q

What are inflammatory mediators?

A

Histamine
PG and LT
Cytokines
Chemokines

47
Q

What is the asthma pathology?

A
  • Epithelial fragility
  • Basement membrane thickening
  • Mucus plug in lumen
  • Vasodialtion
  • Cellular infiltration

Z YEAR 1 BRS cardiology (10 decks)

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