Innervation of the Airways and Obstructive and Restrictive Disease

Question 1

what does the parasympathetic nervous system provide innervation to?

Answer 1

all of tracheobronchial tree

Question 2

what does the parasympathetic nervous system specifically innervate in the lungs?

Answer 2

airway smooth muscle
submucosal glands

Question 3

what does the sympathetic nervous system innervate in the lungs?

Answer 3

larger airways, not smaller airways
B2 receptors respond to circulating epinephrine

Question 4

what does the eNANC (nonadrenergic noncholinergic) system lead to?

Answer 4

smooth muscle contraction
increased mucous
vasodilation, microvascular leakage, inflammatory cell activity

Question 5

what does the iNANC (nonadrenergic noncholinergic) system lead to?

Answer 5

smooth muscle relaxation
decreased smooth muscle proliferation
decreased platelet aggregation and adhesion

Question 6

what do eNANC nerves innervate?

Answer 6

airway smooth muscle
submucosal glands
blood vessels
form diffuse network immediately below the epithelium

Question 7

what are the major neurotransmitters of the eNANC system?

Answer 7

tachykinins, including neurokinin and substance P

Question 8

what fibers contain the major neurotransmitters of the eNANC system?

Answer 8

C fiber afferents mainly

Question 9

what is the iNANC system probably critical for?

Answer 9

proper function of the lower airways

Question 10

what are the major neurotransmitters of the iNANC system?

Answer 10

nitric oxide
VIP also involved

Question 11

why is nitric oxide an ideal local transcellular messenger?

Answer 11

small
lipophilic
very short duration of action

Question 12

what does nitric oxide do?

Answer 12

antagonizes actions of acetylcholine: smooth muscle relaxation, decreases airway smooth muscle proliferation, and decreases platelet aggregation and adhesion

Question 13

what are some inflammatory mediators?

Answer 13

histamine
serotonin
prostaglandins
leukotrienes
platelet activating factor
reactive oxygen species
cytokines

Question 14

what does histamine on the H1 receptor cause?

Answer 14

smooth muscle contraction, microvascular leakage and edema

Question 15

what does histamine on the H2 receptor cause?

Answer 15

bronchodilation, negative feedback of histamine release
minor

Question 16

what does serotonin cause?

Answer 16

mast cell degranulation
vasoconstriction
bronchoconstriction
microvascular leakage

Question 17

what do prostaglandins mediate?

Answer 17

bronchoconstriction
airway hyperreactivity
bronchodilation
chemoattraction

Question 18

what do leukotrienes cause?

Answer 18

slow reactive substance (anaphylaxis)
contraction
increased microvascular permeability
mucous production
eosinophil and neutrophil chemoattraction

Question 19

what is platelet activating factor formed secondarily to?

Answer 19

membrane phospholipase A2 activation

Question 20

what does platelet activating factor do?

Answer 20

airway constriction
microvascular leakage
eosinophil, platelet chemotactant
sustained bronchial hyper-responsiveness

Question 21

what do reactive oxygen species do?

Answer 21

destruction of microorganisms and neoplastic cells
inflammatory mediator release

Question 22

what happens in restrictive disease?

Answer 22

lungs cannot expand fully because of disease of the lung itself, the pleura, or the chest wall
compliance reduced

Question 23

what are common causes of restrictive disease?

Answer 23

pleuropneumonia
pneumonia
pulmonary edema
obesity

Question 24

what happens in obstructive disease?

Answer 24

lungs cannot fully empty

Question 25

what are common causes of obstructive disease?

Answer 25

canine bronchitis feline asthma equine inflammatory lung disease equine recurrent airway obstruction

Question 26

in restrictive diseases, ______________, which is the inverse of ______________, is increased

Answer 26

elastance compliance

Question 27

what affects the neuromuscular system that can cause restrictive disease?

Answer 27

myasthenia gravis botulism

Question 28

do animals with restrictive diseases have a hard time breathing in or breathing out?

Answer 28

in

Question 29

why do patients with restrictive disease tend to breathe rapidly and shallowly?

Answer 29

elastic work is increased, will be even more increased if breathe deeper non-elastic work component is higher when breathing faster

Question 30

what characterizes an obstructive lung disease?

Answer 30

increase in resistance

Question 31

what affects airway resistance?

Answer 31

parasympathetic stimulation sympathetic stimulation nonadrenergic noncholinergic obstruction compression of airways

Question 32

what does loss of tethering result in?

Answer 32

airway obstruction: not held open

Question 33

what are some common histopathologic features of chronic bronchitic diseases?

Answer 33

goblet cell hypertrophy and hyperplasia mononuclear cell infiltration increased connective tissue within the lamina propria epithelial hyperplasia

Question 34

what causes asthma-type diseases?

Answer 34

allergen-mediated mechanisms

Question 35

what are some common histopathologic features of airway hyperreactivity?

Answer 35

increased mucus production mucosal edema thickening of the epithelial basement membrane infiltration of the airway walls by inflammatory cells

Question 36

do eosinophils predominate in equine inflammatory airway disease?

Answer 36

very rarely

Question 37

what is the predominant cell type in recurrent airway obstruction?

Answer 37

neutrophils

Question 38

postganglionic parasympathetics: ganglionic transmission is mediated via _____________________, whereas actual smooth muscle contraction is mediated via _____________________

Answer 38

acetylcholine through nicotinic receptors acetylcholine via muscarinic receptors

Question 39

how does an M3 receptor in airway smooth muscle lead to contraction?

Answer 39

phospholipase C activated, which forms IP3, which causes release of calcium ions

Question 40

what do M2 receptors mediate?

Answer 40

inhibit release of acetylcholine downregulate its own response

Question 41

norepinephrine is the principle neurotransmitter for ____________, whereas epinephrine is for the ________________

Answer 41

nerves adrenal medulla

Question 42

what does activation of B2 receptors in the sympathetic nervous system lead to?

Answer 42

improved mucus clearance adenylate cyclase leads to accumulation of intracellular cAMP: decreased levels of calcium through protein kinase A

Question 43

when are eNANC nerves particularly important?

Answer 43

viral-induced airway hyperresponsiveness injured respiratory epithelium exposes nerves

Question 44

what is serotonin thought to be important in?

Answer 44

feline asthma

Question 45

what prostaglandins mediate bronchoconstriction?

Answer 45

PGD2 PGF2alpha TXA2

Question 46

what prostaglandins mediate airway hyperreactivity?

Answer 46

TXA TGD

Question 47

what prostaglandin mediates bronchodilation?

Answer 47

PGE2

Question 48

in obstructive disease, the animal must generate a __________________ for a given amount of _______

Answer 48

higher driving pressure flow

Question 49

what is resistance like in restrictive diseases?

Answer 49

normal or lower than normal hard to take in, but easy to get rid of

Question 50

why do patients with restrictive disease tend to breathe rapidly and shallowly?

Answer 50

with increases breathing rates, the non-elastic work component is higher with deeper breaths, the elastic work is greater they already have a higher elastic work due to the disease

Question 51

what does beta-2 sympathetic activation lead to?

Answer 51

bronchodilation circulating beta-2 stimulation is what causes it (not innervation)

Question 52

why is airway resistance lower at high lung volumes?

Answer 52

airways are tethered open to greater extent

Question 53

is there usually a primary infectious component to chronic bronchitis?

Answer 53

no