Lecture 21: Lung Macro & Micro Flashcards Preview

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Flashcards in Lecture 21: Lung Macro & Micro Deck (47):
1

lung lymphatics

white lines under visceral surface, channel lymph towards hilum and mediastinal lymph nodes

2

pleura composition and components

pleura is made of one layer of mesothelial cells, visceral (inner, intimate with lung) and parietal (outer)

3

pneumothorax

shrunken lung, associated with air in the pleural cavity

4

hemothorax

blood in the pleural cavity

5

sensory innervation of the lung and pleura

vagus nerve, vagus and sympathetic fibers for the visceral pleura, phrenic and intercostal for parietal pleura

6

vagus nerve in relation to lung position

vagus runs posterior to hilum of lung

7

phrenic nerve in relation to lung position

phrenic runs anterior to hilum

8

phrenic nerve diaphragm

provides motor (GSE) fibers to diaphragm

9

orientation of hilum components on right and left side

On left side artery, bronchi, vein (Are Brides Vain?)
On right side bronchi, artery, vein (You're Right, Brides Are Vain!)
This is only true at point of exit from the lung, things can cross if the cross section is taken at a different point

10

Impressions on two lungs

Right lung impressions --> cardiac, azygos vein/arch, S. vena cava, I. vena cava, esophagus, brachiocephalic trunk
Left lung impressions --> cardiac, aortic arch, left subclavian, left brachiocephalic vein

11

The lungs have a dual blood supply

De-ox. from the pulmonary arteries, ox. from the bronchial arteries that come directly off of the aorta

12

bronchopulmonary segments

segments corresponding to bronchial tree, there are many of them

13

tracheobronchial tree components, switch from macro to micro

trachea --> intrapulmonary bronchus (primary/main, secondary/lobar, tertiary/segmental) -->bronchiole --> SHIFT TO MICRO STRUCTURES --> terminal bronchiole, respiratory bronchiole --> alveolar duct --> alveolar sac --> alveolus

14

components of trachea, outer to inner

adventitia, c-shaped rings, trachealis and longitudinal smooth muscles, submucosa, mucosa

15

adventita

outer covering of trachea, made of connective tissue

16

c-shaped rings

hyaline cartilage, incomplete dorsally

17

trachealis and longitudinal

smooth muscles

18

submucosa

mucous and serous glands

19

mucosa

epithelium and lamina propria

20

Epithelium of the trachea

part of the mucosa, made up of pseudostratified columnar ciliated cells with goblet cells

21

lamina propria

made up of connective tissue and elastic fibers

22

purpose of cilia and trachea

move small debri out of respiratory pathway, active movement

23

other cell types present in trachea epithelium

endocrine (kulchisky) cells secrete seratonin to regulate airway breathing reflex, undifferentiated basal cells

24

which mainstream bronchii is more verticle

the right one, more likely to choke on the right side

25

Intrapulmonary bronchus

branches off of trachea, usually next to main branch of pulmonary artery at hilum, made up of smooth muscle, irregular cartilage plates, goblet cells, ciliated pseudostratified columnar cells. Transition to simple ciliated columnar as bronchii get smaller

26

broncho-pulmonary segment/secondary and tertiary bronchii

branches off intrapulmonary bronchus, travel along side pulmonary artery/arterioles, branch in same pattern, epithelium fully ciliated simple columnar

27

bronchiole

branches off broncho-pulmonary segment, no cartilage, smooth muscle, very few to no goblet cells, epithelium transitions from ciliated simple columnar to ciliated simple cuboidal

28

Autonomic innervation of bronchiole glands and smooth muscle

Glands: Sympathetic is inhibiting, Parasympathetic is secretomotor
Bronchiole smooth muscle: Sympathetic is bronchodilation (greater need for O2, fight or flight), parasympathetic is bronchoconstriction

29

Autonomic innervation of bronchiole and alveolur vasculature

Bronchioles: Sympathetic is vasoconstriction, parasympathetic is vasodilation (maybe, could have no affect)
Alveolar: no affect, capillaries not capable of constriction or dilation. Flow is hormonally regulated

30

Affects of sympathetics on the lungs

secretory inhibition, bronchiodilation, vasoconstriction

31

Affects of parasympathetics on lungs

increased secretomotor, bonchioconstriction, maybe vasodilation

32

pulmonary plexus

cluster of nerve trunks, contains sympathetic and parasympathetic axons, and parasympathetic ganglia

33

terminal bronchiole

branches off bronchiole, surrounded by layer of smooth muscle, no goblet cells, ciliated simple cuboidal epithelium, clara cells

34

What are clara cells

Found in terminal bronchiole, precursor to bronchiolar epithelial cells, synthesizes surfactant, inhibits elastin digestion (elastin digestion leads to emphysema), detoxes carcinogens. Contains many secretory vesicles seen on EM. Have a rounded top that bulges above ciliated cuboidal cells

35

alveolar wall

contains elastin, which stains black on resorcin-fuschin stain

36

acinus

functional subunit of the lung supplied by a single respiratory bronchiole

37

respiratory bronchiole

branches off of terminal bronchiole, simple cuboidal epithelium, wall encircled by smooth muscle that is punctured by alveolus, supplies single acinus

38

alveolar duct

branches off of respiratory bronchiole, a space whose wall is made up of alveolar sacs and alveoli, basically leads towards them from the bronchiole

39

alveolar sac

terminal part of alveolar duct, contains may alveoli

40

alveolar capillaries relationship to lumen

protrude into lumen of alveoli, provide more surface area

41

How wide is blood-air barrier?

.3 microns, alveoli epithelium, basement membrane, endothelium

42

Alveolar wall cells

Type I pneumocytes --> thin, gas exchange, 40% of cells but 90% of surface
Type II pneumocytes --> thick/bulging, no gas exchange, 60% of cells, replace damaged type I cells, produce surfactant

43

lamellar bodies

structure inside of type II pneumocytes that creates surfactant, made up of secretory vesicles made of tubular myelin weaves

44

functions of surfactant

keep alveoli inflated, reduces fluid from from capillaries into alveoli, increases compliance (Stretchability), decreases alveolar surface tension, keeps cell water surface layer thin

45

alveolar pores

holes in the epithelium surrounding alveoli connecting different alveoli together. equalizes pressure and facilitates flow between acini when a certain bronchiole might be blocked (kind of like collateral circulation)
also called alveolar pore of kohn

46

function of alveolar macrophages

ingest extra surfactant, also ingest inhaled particulate matter so they have the name "dust cells"

47

issues in smoker's lungs

excess carbon particles trapped in macrophages, chronic bronchitis caused by excess mucus production, increased risk for pneumonia, increased risk for emphysema (loss of elastin, fibrosis of tissue), metaplasia (bronchii epithelium changes to stratified squamous), interstitial disease (alveolar walls are thickened), cancer