Lecture 5 - Physiology of the airway Flashcards

(33 cards)

1
Q

What nerve is afferent in pharyngeal dilator refleves

A

Trigeminal nerve - 5th cranial nerve

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2
Q

Efferent nerve in pharyngeal dilator reflexes

A

vagus nerve - 10th cranial nerve

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3
Q

What occurs during pharyngeal dilation in the upper airway

A

pressure receptors in the brain stem respond to afferent fibres and cause efferent fibres to cause pharyngeal muscle contraction

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4
Q

Sleep disordered breathing causes

A

snoring - 25%

sleep apnoea - 10% (pauses in breathing during sleep due to an obstruction)

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5
Q

Clinical features of sleep disordered breathing

A
snoring sleep 
daytime somnolence ( sleepiness)
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6
Q

What is sleep disordered breathing associated with

A

obesity and hypertension

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7
Q

Treatment for sleep disordered breathing

A

weight loss
CPAP (continuous positive airway pressure) - sleep apnoea
used during sleep to avoid obstruction

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8
Q

What keeps the airway open

A

continuous muscle activity

reflex control of the muscles

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9
Q

When is control of the muscles poor

A

during sleep or with sedative drugs

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10
Q

Airway lining the fluid histology

A

Ciliated epithelial cells and goblet cells

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11
Q

Nose and pharynx has

A

pesudostratified cells

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12
Q

Trachea and bronchi have

A

columnar cells

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13
Q

Bronchioles have

A

cuboidal cells

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14
Q

What is airway lining fluid produced by?

A

ciliated epithelial cell and goblet cells

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15
Q

What do the ciliated epithelial and goblet cells produce?

A

mucin granules

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16
Q

when is mucin produced

A

in response to airway irritation
tobacco smoke
infection

17
Q

Lining of the airways

A

columnar cells, periciliar layer (salt and water) and mucous layer

18
Q

what does the periciliar layer do

A

removes particles we dont want captured by the mucus up the airway away from the lungs

19
Q

What motion does the cilia use to move the mucus?

A

periciliar layer allows them to move it.

20
Q

What effects the strokes of the cilia

A

tobacco smoke
inhaled anaesthetics
air pollution
infections

21
Q

what function does the airway lining fluid perform

A

humidification
- nose breathing better than mouth breathing
- affected by breathing pattern (at rest and at exercise)
- heat and moisture exchanger
active control of pericilary layer to move mucus .
low humidity - less mucus
high humidity - more mucus

22
Q

how does lining help in airway defence?

A

Muco-ciliary escalator
mucus and cilia moving things out
expectoration - coughing

23
Q

What is cystic fibrosis

A

Autosomal recessive inheritance
1 in 2500 births
Abnormal cystic fibrosis transmembrane regulator protein (sodium chloride channel)
Progressive lung infection and destruction
affects all systems with epithelial surfaces (GI, Genital, urinary)

24
Q

What happens when very large particles are inhaled

A

Deposited in the nose and pharynx. has an inertial impact (resistance of any physical object)
examples pollen and sawdust

25
What happens to large particles
deposited in the large airways inertial impaction fungal spores
26
What happens to small particles in the airway
deposited in the bronchioles through sedimentation particulate pollution, stone dust, asbestos
27
what happens to very small particles in the airway
it is exhaled through diffusion | eg. smoke
28
What affects the fate of inhaled particles apart from size
humidity in the inspired gas
29
how do inhaler particle size relate to drug delivery system? in the future
size related to site of action in the airway Large - hay fever medium - ashtma, COPD small - absorption in the blood
30
What are non-immunological defences
2. physical barrier and removal 2. chemical inactivation -lysosome protease enzyme eg. elastase and anti-protease -antimicrobial peptides eg. human B defensins 3. Alveolar macrophages (ingest them)
31
What are immunological defences?
2 types: Humoral and cell mediated
32
How does humoral immunity work?
IgA - nose and large airways IgG - small airways IgE - allergic disease Actions: inhibits binding of pathogens to epithelial cells complement activation recruitement of immune cells
33
What is cell mediated immunity?
epithelial cells macrophages Pathology: neutrophils - infection eosinophils - allergy