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Flipped Class Respiratory System Flashcards

1
Q

What are the functions of the respiratory system?

A
  1. Olfaction
    • Olfactory mucosa in nasal cavity
  2. Phonation
    • Vocal folds
  3. Conduction and conditioning of air
    • transport of air to respiratory portion
    • Warmth
    • Air clearance
  4. Gaseous exchange :
    • Respiratiry portion—> blood-gas barrier
  5. Endocrine—> hormones
    • Neuroendicrine cells
  6. Immune functions
    • Bronchial associated lymphoid tissue
    • Alveolar macrophages
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2
Q

Describe the vestibule of the nasal cavity

A 
Cartilage framework
Stratified squamous epithelium (skin)
   -short firm hairs(“vibrissae”)
   -sweat and sebaceous glands 
       -Glands and vibrissae trap large particles
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3
Q

Describe the respiratory region of the nasal cavity

A

-Respiratory epithelium (pseudostratified, columnar, ciliated, with Goblet cells)

-Lamina propria
-Vessels (capillaries) lined up perpendicular to the airflow—>warms the air.
Clinical correlate: nasal congestion
-Turbinates—> increase the surface area covered by respiratory mucosa

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4
Q

Summarize the olfactory region

A

Found at the roof of nasal cavity and the superior nasal conchae

Lined by psuedostratified columnar epithelium with four cell types

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5
Q

What are the effects of rhinitis?

A

Allergic reactions or viral infections (e.g. common cold)—> Rhinitis/coryza( inflammation of the nasal mucous membrane)

Capillaries that reside near the surface of the Lamina propria become engorged —> Lamina propria becomes distended with fluid—> marked swelling of the mucous membrane —> restriction of the air passage—> breathing difficult

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6
Q

What are the features of olfactory receptor cells?

A

Histolog8cql features:
-longboard thin nonmotile cilia with odor receptors

Axons from the olfactory nerve

Function: bipolar neurons

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7
Q

What are the features of Brush cells?

A

Histological features:
-Columnar and extend to the Apical surface (basal surface synapses with nerve fibers)) Short microvilli

Function- Sensory receptors

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8
Q

What are the features of supporting cells?

A

Histological features:

  • Apical microvilli
  • Mitochondria ++++, sER and rER
  • Secretory vesicles—> contain odorant binding protein OBP

Function: mechanical and metabolic support

Helps in odor perception

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9
Q

What are the histologicak features of the basal cell?

A

Histological features:
-nuclei form a row in close proximity to the basal lamina

Function: regenerate supporting and olfactory receptor cells

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10
Q

What are the structures of the olfactory regions?

A

Serous olfactory glands/ Bowman’s glands have their secretory units in the Lamina propria

  • Acinar cells have lipofuscin granules
  • Serous secretion—> lysozyme and IgA
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11
Q

What is the larynx ?

A

Skeleton of hyaline and elastic cartilages

Function: air condition and phonation

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12
Q

What are the layers of the trachea?

A
  1. Mucosa:
    - RE- respiratory epithelium
    - Lamina propria- loose connective tissue
    - Longitudinal elastic fibers in deep LP
  2. Submucosa:
    - loose connective tissue
    - seromucous glands
  3. Cartillaginous layer
    - C-shaped hyaline - open posteriorly “Gap” between free cartilage ends is completed by a fibroelastic membrane and Trachealis muscle (smooth)
  4. Adventitia
    - Connective tissue-binds trachea to adjacent structures
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13
Q

Describe respiratory epithelium

A

Pseudostratified

Lines most of the conducting part of the respiratory system and has five cell types: ciliated columnar, mucus, brush, small granule and basal

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14
Q

What are the features of ciliated columnar Cells?

A

Histological features:
Columnar and extend to surface about 250 cilia each

Function: sweeping motion helps expel particles trapped in mucus

Clin8cal notes: primary ciliary dyskenesis in Kartegener’s syndrome

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15
Q

What are the features of mucus?

A

Histological features: short blunt microvilli

Function: secretes mucin granules which forms a protective barrier

Clinical notes: increased in smokers and chronic inflammation

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16
Q

What are the features of small granule or Kulchitsky?

A

Most numerous at bifurcation of primary bronchi

Basal granules

Function: enteroendocrine cells

Secrete Catecholamines, ADH, ACTH, serotonin and bombesin

Clinical notes: primary cells affected in small cell carcinoma of the lung

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17
Q

What are the features of Basal cells?

A

Histological features: near basement membrane

Function: stem cells that regenerate all other cell types

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18
Q

What are the features of brush cells in respiratory epithelium?

A

Histological features:

Columnar and extend to the Apical surface short microvilli

Function: synapse with afferent nerves—> Sensiry function

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19
Q

What is the mucociliary escalator?

A

Ciliary beating moves particles trapped in mucus towards the pharynx

Clinical correlate: kartegeners syndrome

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20
Q

Give an overview of the bronchi

A

Primary or main bronchi are structurally like trachea

Primary bronchi—> 2-3 secondary/lobar bronchi—> total 8- 10 tertiary/segmental bronchi per lung

Segmental bronchi supply a bronchopulmonary segment

Bronchi can also be classified as:
A. Extrapulmonary

B. Intrapulmonary: surrounded by lung tissue

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21
Q

Summarize the structure of bronchi

A

Mucosa: respiratory epithelium

Muscular layer: Spirally oriented smooth muscles in—> regulates the airway diameter

Submucosa: loose connective tissue with sero-mucus glands (GI) in larger bronchi

Cartilage layer:

  • Extrapulmonary bronchi: cartilage rings
  • Intrapulmonary bronchi-cartilage plates

Adventitia: connective tissue in the extrapulmonary part then surrounded by lung tissue in intrapulmonary broncho

22
Q

What is chronic bronchitis?

A

-Associated with smoking, inhalation of toxic fumes and exposure to heavy air pollution

Clinical: chronic productive cough and positive history

On examination wheezing, cyanosis—> blue bloater

Chronic irritation—> inflammatory changes—> metaplasia

Shows thickened basement membrane

Hypertrophy of smooth muscle

Increased glands >50% of the wall

23
Q

Explain the squamous metaplasia of respiratory epithelium

A

Columnar to squamous metaplasia of the respiratory epithelium
-Basal cells generate squamous cell

  • Smoking: loss of ciliated cell activity—> cough —> metaplasia
  • Bronchitis, bronchiectasis—> chronic cough—> metaplasia
  • Metaplasia—> squamous cell carcinoma
24
Q

Give an overview of bronchioles

A

Diameter is 1 mm or less

Larger (regular) bronchioles—> terminal bronchioles —> respiratory bronchioles

Epithelium
-Large bronchioles: Ciliated, psuedostratified columnar that transition into simple ciliated columnar (Goblet cells present)

-Smaller bronchioles (terminal and respiratory ): simple cuboidal with secretory club cells interspersed among ciliated cells (No goblet cells)

No subepithelial cells

-Smooth muscle replaces cartilage plates (branching points may contain small elements of cartilage)

Widespread construction in the bronchioles, decrease diameter and increases resistance to airflow

25
Explain the structure-function 9f club cells in bronchiol3s
Club cells (Cc) are bronchioles exocrine cells 1. Secretes: - surfactant active agent - club cell protein - CC16–> marker for the disgn9sjs of chronic lung diseases - leaks across blood gas barrier in lung injury—> elevated in serum - decreases in bronchi-alveolar lavage 2. Detoxification 3. Stem cells
26
Explain the pathophysiology of bronchial asthma
Inflammatory airway disease -Main symptoms are short breath, wheezing and coughing ``` Pathophysiology- Airway obstruction -increased mucus -increased smooth muscle contraction -Bronchiolar wall inflammation ```
27
How is bronchial asthma?
Albuterol (B2 agonist), anti cholinergic medications which relax the smooth muscles Corticosteroids—> anti-inflamnatory
28
Explain cystic fibrosis (Mucoviscidosis)
Autosomal dominant disorder recessive disorder Mutation in CFTR gene- encodes for epithelial Cl- ion channel protein (causing defective/absent Cl ion transport and abnormal exocrine gland secretion - typically increased viscosity of secretions with obstruction of excretory ducts) In lungs leads to ‘mucociliary escalator’ dysfunction -accumulation of unusually thick, viscous mucus - bronchiolar obstruction (with subsequent bronchiolar wall thickening and alveolar degeneration) - frequent respiratory tract infections
29
What is the significance of respiratory bronchioles ?
Forest sites where gaseous exchange take place Transitional zone (involved in BOTH ‘air comfuction’ and ‘gas exchange’)** - Supported by a small amount of smooth muscle and elastic fibers - Walls are interrupted by alveoli - Simple cuboidal epithelium with ciliated and Club cells proximal to TB but predominantly Club cells distally Simple cuboidal epithelium with ciliated and club cells Smooth muscle plates
30
What is the significance of alveolar ducts?
Respiratiry bronchioles transition into alveolar ducts as the number of alveolar out-pouching’s increase. Alveolar ducts are lined by numerous alveoli Bundles of smooth muscle cells found between alveolar out-pocketing (interalveolar septum)
31
What is the significance of alveolar sacs ?
Alveolar ducts terminate into alveolar sacs Several alveoli will open into a single alveolar sac Alveoli are thin-walled polyhedral terminal sacs where gaseous exchange takes place -Alveoli are separated from each other by an interalveolar septum -Cell types: Macrophages, type 1, and Type 2 pneumocytes
32
What is the function of dust cells?
Alveolar macrophages or dust cells move freely between the interstitial tissue and alveolar surface - Phagocytosis of inhaled particles as well as degrade surfactant - In septum dust cells are frequently observed loaded phagocytizes material: - RBCs in heart failure-heart failure cells - asbestos particles in asbestos
33
What is the function of type 1 pneumocytes?
- Squamous cells which line 95% of alveolar surface - Terminal cells not capable of mitosis - Surface is covered by surfactant - Form tight junctions with adjacent type II and type 1 cells- firm part of the blood-air barrier
34
What is the function of type 2 pneumocytes ?
- Cuboidal cells which secrete surfactant - Found at the septal junctions—> AKA septal cells. - Most numerous but cover only 5% of alveolar surface - Apical lamellar bodies—> foamy appearance - Stem cells for both type 1 and type 2 cells
35
What is the function of alveolar surfactant?
Reduces the alveolar surface tension at the air-epithelium interface (pr3vents alveolar collapse during exhalation)
36
What is the composition of alveolar surfactant?
1. Phospholipid- Dipalmitoyl phosphatidylcholine (DPPC)—> principal agent responsible for reducing surface tension 2. Surfactant proteins (SP) SP-A: most abundant, regulates synthesis and secretion of surfactant and modulates immune response to microorganisms SP-A and SP-D: regulates the allergic response to airborne antigens SP-B and SP-C: regulates spreading of surfactant Adequate amount of surfactant is produced after 35th week of gestation Regulated by cortisol, insulin, thyroxin, and prolactin
37
What is the clinical correlate of alveolar surfactant ?
Premature infants especially <28 weeks old Management: exogenous surfactant at birth Glucocorticoids to the mother with possible preterm delivery a few days prior
38
Describe the interventricular septum
Contains Collagen fibers Elastic fibers—> pulmonary recoil Continuous capillaries Permanent and transient cells Site of the air-blood barrier Adjacent alveoli communicate through alveolar pores (of Kohn) which allows collateral airflow
39
What is pneumonia?
Air spaces filled with exudate containing white blood cells (mainly neutrophils), red blood cells, fibrin Capillaries in the interalveolar septum are enlarged and congested with red blood cells
40
What are the parts of the thin portion of blood gas barrier?
Most. Effective blood-air barrier 1. Surfactant 2. Type 1 pneumocytes 3. Fused basal lamina of P1 and capillary endothelium 4. Endothelial cells
41
What are the composition of the thick blood gas barrier?
1. Surfactant 2. Type 1 pneumocytes 3. Basal lamina of P1 4. Connective tissue elements 5. Basal lamina capillary endothelium 6. Endothelial cells
42
Explain emphysema
Characterized by a permanent enlargement of respiratory spaces affecting airways distal to the term8nal bronchioles -Neutrophils release proteases including elastance—> breaks down elastic fibers Serum. Alpha 1 antitrypsin (AAT) counteracts elastase activity Smoking elevates neutrophils activity—> elevated elastase—> destruction of elastic fibers—> permanent dilation of airways
43
Give the pathophysiology of different lung cancer types?
Small cell lung cancer- associated with smoking Non small cell lung cancer -small cell carcinoma- associated with smoking Adenocarcinoma-most common in non smoking women
44
Give the origins of lung cancer types
Small cell lung cancer (oat cell carcinoma)-Neuroendocrine cells. Cushing syndrome due to ACTH secretion Non small cell lung cancer (SCC)- squamous metaplasia of respiratory epithelia. Eosinophilic keratin pearl lesions—> see SCC of larynx Adenocarcinoma- bronchial, bronchiolar and alveolar epithelium—> bronchoalveolar carcinoma or bronchigenic. Glandular tumor
45
What are the characteristic features of different types of lung cancers?
Small cell lung cancer (oat cell carcinoma)-central mass, aggressive often metastasized when diagnosed Non small cell lung cancer- SCC-central mass Adenicarcinoma-peripheral mass
46
As conduction system becom3s respiratory zone…
Decrease in goblet cells Support carried out by cartilage—> smooth muscle—> elastic and reticular fibers
47
Where is respiratory epithelium found?
Nasal cavity, trachea, bronchi,
48
Where are simple squamous epithelia (pneumocytes) found?
Anyth8ng that has alveolar in it, including capillaries
49
What is the respiratory zone ?
Respiratory bronchioles Alveolar ducts Alveolar sacs Alveoli
50
What is the conducting zone?
Nasal cavity Larynx Trachea Bronchi Bronchioles Term8nal bronchioles

CPR 2 (32 decks)

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