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Flashcards in Pharmacology Deck (162)
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1

what is the dominant neuronal control of bronchial smooth muscle tone?

parasympathetic cholinergic innervation

2

what nerve carries the preganglionic fibres that will eventually supply the bronchial smooth muscle?

vagus nerve

3

where are the parasympathetic ganglia that will go onto supply the bronchial smooth muscle?

embedded in the walls of bronchi and bronchioles

4

post ganglionic parasympathetic fibres innervate what within the airways?

smooth muscle
submucosal glands

5

what 2 things does stimulation of parasympathetic division cause within the airways?
(and what is the combined result?)

1. bronchial smooth muscle contraction
2. increased mucous secretion
(collectively increases airway resistance)

6

what types of receptors are the parasympathetic division acting upon in the airways?

M3 muscarinic ACh receptors

7

how does the sympathetic system achieve its effects on the airways if its has no real innervation of bronchial smooth muscle?

causes release of adrenaline into circulation which acts on B2-adrenoceptors on bronchial smooth muscle

8

what 3 things does the sympathetic division cause within the airways?
(and what is the combined result?)

bronchial smooth muscle relaxation
decreased mucus secretion
increased mucociliary clearance
(collectively reduces airway resistance)

9

what type of receptors is the adrenaline (stimulated by the sympathetic system) acting on in the airways?

B2-adenoceptors

10

what is mucociliary clearance mediated by?

ciliated epithelium layer of the airways which remove particles and bacteria from airways by propelling upwards

11

what is asthma?

a recurrent and reversible obstruction to the airflow (caused by bronchoconstriction due to bronchiole spasms) in response to certain stimuli

12

what are 4 main causes (stimuli) of an asthma attack?

allergens (in atopic individuals)
exercise (cold, dry air)
respiratory infections
smoke, dust, environmental pollutants

13

what is the name for the acute severe type of asthma which is a medical emergency and can be fatal?

status asthmaticus

14

what do intermittent asthma attacks cause?

cough
wheeze
difficulty in breathing

15

what is chronic asthma?

long standing inflammation causing pathological changes to the bronchioles

16

what 4 pathological changes can be caused by chronic asthma?

1. increased mass of smooth muscle (hyperplasia + hypertrophy)
2. accumulation of intestitial fluid
3. increased secretion of mucus
4. epithelial damage

17

why in chronic asthma is there the accumulation of interstitial fluid?

due to increased secretions

18

what is exposed in epithelial damage and what does this result in?

epithelial damage exposes sensory nerve endings and cause them to become more sensitive- hyper-responsiveness

19

what causes a decreased FEV1 and PEFR in asthma?

increased airway resistance
due to inflammation and bronchoconstriction which causes airway narrowing

20

what are the sensory nerve endings that can be exposed if there is epithelial damage in asthma?

C-fibres
a class of irritant receptors

21

what type of substance works on C-fibre endings?
(so will have an increased effect if there is epithelial damage- hyperesponsiveness)

bronchoconstrictors (spasmogens)

22

what 2 phases make up an asthms attack usually?

immediate phase- bronchospasm
delayed phase- inflammatory reaction

23

what is the delayed inflammatory response triggered by?

acute bronchospasm

24

what type of Th cells are part of the antibody-mediate response involving IgE in response to an allergen? (atopic)

Strong Th2 response

25

what type of Th cells are part of the cell-mediated immune response involving IgG and macrophages in response to an allergen? (non-atopic)

low-level Th1 response

26

what do interleukins signal between?

white blood cells

27

what type of environment fo Th2 cells produce?

cytokine environment

28

what is the induction phase in the development of allergic asthma?

antigen presentation
cloncal expansion and maturation

29

what cell type differentiates and activates in response to IL 5 released from Th2 cells?

eosinophils

30

what type of cells express IgE receptors in response to IL 4 and IL 13 released from Th2 cells?

mast cells (in airway tissues)