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Flashcards in L1 Intro Deck (42):
1

Trachea Anatomy

10cm long
Larynx --> T4/5
C-shaped cartilage ring- keeps airway open as is only entry point for air
Trachealis- a) cough reflex, narrow airway to change pressures b) flexibility for bolus of food in posterior oesophagus

2

Trachea Histological appearance

Lumen: Respiratory epithelium (pseudo. col. epi. + goblet cells + basal cells)
Glands
Smooth muscle (not that much as not much effect on control of flow in that airway)
Cartilage

3

Trachea Function

Large open tube
-Conducting zone

4

Bronchus Anatomy

15 Generations of branching
Cartilage plates: keep airway from collapsing
Glands
Non-continuous Smooth muscle
Respiratory EPtihelium

5

Bronchus Histological appearance

Large Bronchi: Respiratory epi
Smaller Bronchi: Transition to columnar ciliated + goblet

6

Bronchus Function

-need to keep airways open in segmental + lobar bronchi
1) Conditioning
2) Branching
3) Transition (towards blood air barrier in alveoli)

7

Bronchiole Anatomy

1mm diameter (narrower + simpler)
Last Bronchiole of C.Z.= Terminal Bronchiole

8

Bronchiole Histological Appearance

cuboidal ciliated epithelium
club cells
Smooth Muscle
-No Glands, cartilage or Goblet cells (not needed, airways so small that can control lumen size via smooth muscle only)

9

Bronchiole function

Smooth Muscle (contraction/relaxation) Controls flow into alveoli

10

Journey that air takes

Nasal cavity --> Pharynx --> Larynx --> trachea --> Bronchi --> Bronchioles --> Alveoli
-Protected by thorax/thoracic cage
-Left lung smaller due to heart
-massive surface area/very compact

11

Bronchial Tree

Trachea
--> Primary/Main Left and Right Bronchus
--> Lobar Bronchus
--> Segmental Bronchus
--> Terminal Bronchiole
--> Respiratory Bronchioles
--> Alveolar duct
--> Alveolar sacs
--> Alveoli

12

Functions of Respiratory System

1. Protection against unsterile air
2. Sound production (as air goes through larynx)
3. Partial role in Blood Volume and pH control

13

Upper Respiratory Tract

Nasal Vestibule
Nasal Cavity
Pharynx

14

Lower Respiraotry Tract

Larynx
--->
Alveoli

15

Upper and Lower Respiratory Tract division

Anatomical divisions
clinical relevance re treatment
1) Upper R.T. Infection: infection isnt too dangerous. cold/pharyngitis. dont need aggressive antibiotics. fast resolving.
2) Lower R. T. I.
-less ability to defend against pathogens
- pneumonia/bronchitis
-dont resolve/fever/wheeze

16

Ear infection

eustachian tube
-excessive fluid draining into ears
-common in children

17

Functional divisions

1. Conducting zone (Nasal cavity --> terminal bronchioles)
-NO gas exchange
-More complex: preparation for gas exchange
2. Respiratory Zone (Resp. Bronchiole --> Alveoli)
-Gas exchange
-greater SA
-rich capillary network
-last defense

18

Pseudostratified columnar ciliated epithelium

Location: Nasal cavity --> Bronchi
Function:
1) Ciliated: Mucociliary escalatory. motile cilia, beating and catching particles in carpet of mucus. move to back of throat to spit out
2) Protective: Tall cell for thick layer

19

Goblet cells

Location: Nasal cavity --> Bronchi
Function:
1) Mucus production: Acute (for infection/noxious substance/hayfever/smoking)
-stimulate quite response

20

Basal cells

Location: Base of BM basement Membrane
Function:
1) Stem cell population
-differentiate into Goblet cells and Pseudostratified Columnar Ciliated Epi.
-sit on bottom

21

Brush cells

Location:
Function:
1) Sensory cells (produce nervous response upon insult)

22

Small Granule Cells

Location:
Function:
1) Endocrine cells (release e.g histamine. in response to toxin)

23

Club cells

a.k.a. Clara cells
Location: Bronchioles
Function:
-Cuboidal. Non ciliated
1) secrete watery substance
a) hydration
b) antimicrobial secretions

24

Type 1 Pneumocytes

Location: Alveoli
Function:
-squamous (super skinny) - Flat and Thin Blood-Air Barrier/membrane
1) Increase SA in alveoli

25

Type II Pneumocytes

Location: Alveoli
Function:
1) secrete surfactant - reduce surface tension in alveoli

26

Macrophages

Location: Alveoli
Function:
a) Defence - wandering (in airspace) (anything that hasnt been filtered in conducting zone)
-impaired mucociliary clearance (chronic infection/smoker/condition)= greater chance of getting pathogens into resp zone = increased macrophage number

27

Four CT/Parenchyma

1. Cartilage
2. Elastic Fibres
3. Collaged
4. Smooth Muscle

28

Cartilage

Location: Trachea & Bronchi
-larger areas, keep open for tubes with great tendency to collapse
Function:
1) keep airways open/patent
Disease:
-not really effected with age
-only a lil calcification (arthritis)

29

Elastic Fibres

Location: All way through Resp, Tract
Function:
1) provides elasticity "compliance"
-important with age
Disease:
- Emphysema
-COPD/smokers

30

Collagen

Location: Lamina Propria + Interalveolar septa (walls b/w alveoli)
-all way down in various components
Function:
1) Provide tension (stops over inflation/expansion)
Disease:
-Fibrosis (interstitial lung disease. increased collagen = increased stiffness= harder to breath)

31

Smooth Muscle

Location: Wall of Airways --> until alveolar ducts
Function:
1) bronchiole function. Controls Tone/Flow in airways
-control diameter via constricting/relaxing
Disease:
Asthma

32

Mucus

Function: keeps airways hyrdated
Sources:
1. Goblet cells (acute)
2. Seromucous glands (in submucosa/ under epithelial layer). Combination of a) sticky thick mucus (muco polysaccharides) b) watery hydration
Relationship:
-Biphasic to help cilia move
-Lower cilia beat upwards towards pharynx. Upper cilia beat down towards pahrynx. move re pressures.
Layers:
1) Top: Thick mucus capturing particles
2) Under: Watery Sol layer. Cilia able to move

33

Cystic fibrosis

Thick top mucus layer
-salt balance off
-cilia have difficulty beating as no watery sol layer

34

Cant clear mucus

- productive cough
-wheeze
-mucociliary escalatory impairment

35

Cilia beating

Synchronised
Not all beating at same time- Domino effect
-very fast
-Goblet cells are NON-ciliated

36

Primary Cilia Dyskinesia

3 Tertiary
--> evolves into Cartagenal syndrome
-Tiny hooks in health people, dianine motor proteins, which are important for beating
a) People with Primary Cilia Dyskinesia have congenital defects in dianine proteins production
-immotile/dysfunctional cilia
-beat a little bit/ but in a disorganised fashion/ not full whip-like motion/pattern
-imparied muco ciliary clearance = sinus and lung infections
Note: smoking paralyses cilia = impaired mucociliary clearance= chronic lung infection susceptibility
b) genetic defect so motile cilia in:
i) hearing loss
ii) fertility problems (sperm motile flagella)
iii) brain (swelling and headaches)
Syndrome: multiple pathologies
Heterotaxy/citi-invertus
=in developmental node when body pattern is being decided (asymetrical)
=cilia beating to move morphogen/growth chemical towards left (heart forms)
=Loss of left right symmetry in embryo with this genetic defect.
Perfectly healthy but organs disorganised/different sides.
=require careful monitoring

37

Nasal brushings

1) Get Cilia samplings
scrape epithelium off
-cant do to children
b) Sacarin tablet inside vestibule layer. Time how long it takes to taste sweet sacrin flavour
-healthy= 3min (mucociliary escalator beating)
-unhealthy= 10 min +
Course diagnosis b4 course diagnosis

38

Heterotaxy/citi-invertus

Heterotaxy/citi-invertus
=in developmental node when body pattern is being decided (asymetrical)
=cilia beating to move morphogen/growth chemical towards left (heart forms)
=Loss of left right symmetry in embryo with this genetic defect.
Perfectly healthy but organs disorganised/different sides.
=require careful monitoring

39

Sinisitus

Chronic inflammation of the nasal cavity
-Rhinosinisitis
-constant stream of mucus
-hard to know source when have this chronic infection which cannot be treated
-end up changing composition of epithelium
-hyper proliferation/plasia of airway
-50% goblet cells
=chronic facial pain and whole of sinuses fill up with mucus
-constantly blowing nose --> epithelium becomes squamous/inability to defend/reoccuring cycle of infection
-swallowing mucus to get sore tummy
Cure:
-snip chonci bones, reduce SA producing the mucus

40

Air Preparation for gas exchange

1. Filtration: remove pathogens
2. Warmed: 20->37 degrees
3. Humidify: saturated with water for efficient gas exchange

41

Nasal cavity

1. Nares/Nostrils have Vibrissae (course hairs)
-beginning of filtration
2. Lined with Respiratory epithelium (pseudostratified epi + goblet) - layer of mucus
3. Conchae = Turbanent bones (Superior, Middle + Inferior (largest)) boney projections) -covered in Resp Epi- Swirling
a) slow air down (swirled) (water hitting rocks)
b) throws big particles onto mucus layer
c) Humidity (watery serous secretions/ + goblet cell mucous layers)
d) increased SA (for all functions)
4) Rich capillary network
-underneath cell layer
-counter current -Heating start warming
5) Pharynx Laminar flow

42

Nasal Cycle

One side of nose choncae will engorge blood and narrow
-varies every 90 min in mammals
-helps to give one side a break, recover, regenerate, hydrate. patent
-Patent
-CPAP Continuous Positive Air Pressure (dont have good compliance, not good nasal cycle, pushing air at same rate through both sides