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CP Exam 2 > Respiratory System and Gas Exchange part 1 (slides 1-50) > Flashcards

Respiratory System and Gas Exchange part 1 (slides 1-50) Flashcards

1
Q

Respiratory system structure

-The respiratory system consists of three portions:

A
  • An air-conducting portion (also conditions inspired air)
  • A respiratory portion for gas exchange between blood and air
  • A mechanism of ventilation controlled by the inspiratory and expiratory movements of the thoracic cage
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1
Q

Respiratory system functions

A
  • Olfaction

- Phonation

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2
Q

Conducting versus respiratory portions

- Conducting
     - A series of tubes cavities-function?
A

-Carry air to and from site of gas exchange

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3
Q

Conducting versus respiratory portions

- Conducting portion
    - comprised of?
A

-Comprised of nasal cavity, nasopharynx, larynx, trachea, bronchi, bronchioles, and terminal bronchioles

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4
Q

Conducting versus respiratory portions

- Conducting portion
    - Located in?
A

Located in head and neck

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5
Q

Conducting versus respiratory portions

- Respiratory portion
     - Function?
     - Extends from what to what?
A
  • Where gas exchange (O2 and CO2) occurs

- Extends from respiratory bronchioles to alveoli

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6
Q

Nasal cavity and paranasal sinuses

-Functions?

A
  • Warming and moistening of air

- Filtering of dust particles present in inspired air

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7
Q

Nasal cavity and paranasal sinuses

- Respiratory portion histology?
    - Supported by?
A
  • Respiratory portion is lined by pseudostratified ciliated epithelium with goblet cells
  • Supported by a lamina propria with seromucous glands, and rich superficial venous plexus
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8
Q

Nasal cavity and paranasal sinuses

-What happens to incoming air?

A

Incoming air is warmed by blood in the venous plexus and moistened by secretions of the seromucous glands and goblet cells

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9
Q

Nasal cavity and paranasal sinuses

-Function of conchae (sup, mid, inf)?

A

Create turbulence to help warm and moisten air

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10
Q

Histology of paranasal sinuses?

A

Lined by a thin pseudostratified columnar ciliated epithelium with few goblet cells

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11
Q

Respiratory system: wall structure

- "Respiratory epithelium"- lines most of the tract
      - histology?
A
  • Respiratory epithelium lines most of the tract

- Histology-ciliated pseudostratified columnar epithelium with goblet cells

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12
Q

Respiratory system: wall structure

- Lamina propria
     - description?
     - Composition relative to length?
A
  • Loose C.T. containing (sero)mucous glands, elastic fibers, bone/cartilage, and smooth muscle
  • COMPOSITION CHANGES THROUGHOUT LENGTH
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13
Q

Respiratory system: wall structure

-Advenitia-2 types of fibers?

A

Collagen and elastic fibers

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14
Q

Respiratory epithelium

-Type of cell that predominates?

A

Ciliated columnar cells

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15
Q

Respiratory epithelium

-Function of coordinated cilia movement?

A

-Coordinated cilia movement moves mucus and/or particulate matter towards the pharynx

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16
Q

Describe the granules in goblet cells

A

Large and light-staining

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17
Q

Respiratory epithelium

-Mucins-what are they and what do they do?

A
  • Hydrophilic glycoproteins

- Form mucus

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18
Q

Respiratory epithelium

-Where are mucins hydrated?

A

Extracellularly

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19
Q

Respiratory epithelium

-Where does the cell population taper off?

A

-Cell population tapers off in terminal bronchioles

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20
Q

Respiratory epithelium-mucus secretion?

A
  • Airway mucus traps inhaled particles and transports them out of the lungs by ciliary beating and cough
  • Excessive mucus or deficient clearance are characteristics of all common airway diseases
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21
Q

Respiratory epithelium-mucus secretion?

-Airway mucus is produced by what three secretory cell types?

A
  • Goblet cells
  • Clara cells of the terminal bronchioles
  • Serous cells of the submucosal glands
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22
Q

Respiratory epithelium-Mucus secretion

-Mucus contains what 4 components?

A
  • Mucins
  • Antimicrobial molecules
  • Immunomodulatory molecules
  • Protective molecules
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23
Q

Respiratory epithelium-Mucus secretion

- Mucus contains 4 components
       - Antimicrobial molecules such as?
A

Defensins, lysozyme, IgA

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24
Q

Respiratory epithelium-Mucus secretion

- Mucus contains 4 components
       - Immunomodulatory molecules such as?
A

Secretoglobin and cytokines

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25
Q

Respiratory epithelium-Mucus secretion

- Mucus contains 4 components
       - Protective molecules such as?
A

Trefoil proteins and heregulin

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26
Q

Goblet cells produce what specific type of mucin?

A

MUC 5AC

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27
Q

Ciliated cells produce what specific types of mucins?

A

MUC 1, MUC 4, and MUC 16 (possibly)

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28
Q

Mucus glands produce what specific types of mucin?

A

MUC 5B and MUC 16

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29
Q

MUC 1, MUC 4, and MUC 16 are know as what type of mucin?

-Found in 2 different forms?

A
  • Tethered mucins

- Found in a cell associated form and a secreted form

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30
Q

Mucin molecules are designed for?

A

Optimum binding and trapping of inhaled bacteria and particles for clearance from the lung, this is because of the diverse carbohydrate side chains
-It has been suggested that mucins bind most bacteria, viruses, and inhaled particles

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31
Q

2 specific types of mucins that are the main components of the mucin raft?

A

MUC 5AC and MUC 5B

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33
Q

Respiratory epithelium-Mucus secretion

- normal airway mucus composition?
- The hydration of the mucus determines its?
A
  • Normal airway mucus is 97% water and 3% solids (mucins, non-mucin proteins, salts, lipids, and cellular debris)
  • The hydration of the mucus determines its viscosity and elastic properties, two essential characteristics for normal clearance of mucus by ciliary action and cough
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34
Q

Respiratory epithelium-Mucus secretion

  • Airway mucus consists of two layers?
  • What is the position of the layers relative to each other?
A
  • Periciliary layer

- Mucus gel layer atop the periciliary layer

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35
Q

Which mucins are continuously synthesized and secreted to replenish gel layer cleared by ciliary beating to eliminate inhaled particles, pathogens, and dissolved chemicals that might damage the lungs?

A

Polymeric MUC5AC and MUC5B

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36
Q

Basal cells and neuroendocrine cells (NE, cells of Kulchitsky)
-Where are they located?

A

They rest on the basal lamina but do not extend into the lumen

37
Q

Bronchial carcinoid tumors (including small cell lung carcinoma) arise from what type of cell?
-Where do these tumors to metastasize to?

A
  • Neuroendocrine cells (of Kulchitsky)

- Metastasize to regional lymph nodes

38
Q

What substances are secreted by neuroendocrine cells?

A

Peptide hormones-serotonin, somatostatin, calcitonin, ADH, and adrenocorticotropic hormone (ACTH)

39
Q

Trachea-What lines most of the tract?

A
  • “Respiratory epithelium”-lines most of the tract = ciliated pseudostratified columnar with goblet cells
  • Lamina propria-loose C.T. containing (sero)mucous glands, elastic fibers, bone/cartilage, and smooth muscle
40
Q

Trachea-type of cartilage?

A

15-20 C-shaped rings of hyaline cartilage

41
Q

Trachea

  • Fibroelastic ligament
    - types of fibers?
    - function?
A
  • Collagen and elastic fibers

- Prevents overdistension of the lumen

42
Q

Trachea

  • Trachealis muscle
    • type of muscle?
    • Function
A

Smooth muscle that results in narrowing during cough reflex

43
Q

When coughing-smaller diameter of trachea causes?

A

Smaller diameter of trachea increases the velocity of expired air
-Helps to clear the air passage

44
Q

Bronchi

A
  • As bronchi divide into intrapulmonary bronchi, the tracheal C-shaped rings break down into cartilage plates (distributed around the lumen) and smooth muscle bundles shift between the mucosa and the cartilage plates
  • Aggregates of lymphoid tissue are in the wall of intrapulmonary bronchi (known collectively as BALT, bronchial associated lymphoid tissue)
45
Q

Bronchi

-Secondary (lobar) bronchi

A

Wall structure similar to main bronchi except:

-Supporting cartilages form irregular plates or islands rather than rings

46
Q

Bronchi

-Tertiary (segmental) bronchi

A
  • Smaller diameter than mainstream bronchi

- Multiple branchings leading to smaller bronchi and eventually bronchioles

47
Q

Bronchioles

-Respiratory epithelium?

A
  • Gradually reduces in thickness
  • The number of goblet cells is reduced
  • Epithelium becomes simple ciliated columnar without goblet cells in the terminal bronchioles
48
Q

Bronchioles

-Goblet cells are replaced by?

A

Goblet cells are replaced by clara cells in the bronchioles

49
Q

Bronchioles

-Clara cells compared to goblet cells?

A

-Clara cells produce a less viscous secretion

50
Q

Bronchioles

-Lamina propria becomes dominated by?

A

The lamina propria of the bronchioles becomes dominated by a spiraling layer of muscularis mucosa in the terminal bronchioles

51
Q

At what level do glands and cartilage disappear?

-What remains?

A
  • At the level of the bronchioles

- Only a thin layer of adventitia remains in the terminal bronchioles

52
Q

Bronchioles

-With further divisions and reduction in the diameter of the bronchioles the conducting airways end with?

A

terminal bronchioles

53
Q

Asthma

-Characterized by?

A

-Characterized by reversible bronchoconstriction of the smooth muscle bundles encircling the bronchiolar lumen and mucus hypersecretion by goblet cells

54
Q

Asthma

  • Can be triggered by?
  • This leads to?
  • Classic symptoms?
A
  • Can be triggered by allergens or autonomic neural factors leading to a reduction in the lumen of the airways
  • Classic symptoms-wheezing, cough and dyspnea (shortness of breath)
55
Q

Terminal bronchiole

  • Pulmonary lobule?
  • Pulmonary acinus (on slide 24 but doesn’t say what it is)???
A

A terminal bronchiole and the associated regions of pulmonary tissues that it supplies

56
Q

Clara (club) cells

A
  • Clara cells are epithelial cells with a dome-shaped apical domain lacking cilia
  • They represent 80% of the epithelial cell population of the terminal bronchiole
  • Clara cells secrete surfactant that differs from that produced by type II alveolar cells
57
Q

Clara (club) cells

-After airway injury-Alveolar bronchialization

A

-After airway injury, clara cells can proliferate and migrate to replenish alveolar epithelial cells

58
Q

Clara (club) cells

-What happens to airborne toxins?

A
  • Clara cells engulf airborne toxins and break them down via their cytochrome P-450 enzymes (particularly CYP4B1, which is only present in the clara cells)
  • Cytochrome P-450 is present in the smooth ER of the clara cells
59
Q

Cystic fibrosis

-Pathology?

A

-Cystic fibrosis results in the production of abnormally thick mucus by glands lining the respiratory and GI tracts

60
Q

Cystic Fibrosis

-Mutation?

A

-Inherited mutations of cystic fibrosis transmembrane conductance regulator (CFTR) result in defective Cl- transport and increased Na absorption

61
Q

Cystic Fibrosis

-Bacterial infections are associated with?

A

Bacterial infections are associated with the thick mucus plugs consisting of entangled MUC5AC and MUC5B polymers and dehydrated mucus

62
Q

Cystic Fibrosis

-Typical symptoms?

A

Cough, purulent secretions, and dyspnea

63
Q

So, what’s happening physiologically in the conducting portion?

A
  • Control of bronchiole diameter (airway resistance)

- When air flows through a tube, the airway resistance makes airflow more difficult

64
Q

If airway resistance is high, what happens to airflow and the muscle effort it take to produce the airflow?

A
  • If airway resistance is high, the airflow decreases and it takes more muscle effort to produce this airflow
  • Opposite if resistance is low
65
Q

So, what controls the airway resistance?

-Equation?

A

radius is the main factor

Resistance = (8 x viscosity x L)/r ^4

66
Q

Why do we want to change the airway resistance?

A
  • “I want to send the air in my lungs to the ‘right’ places

- For right now, that means the air goes to the alveoli that have a good blood supply

67
Q

Describe how the resistance of the airways is controlled and the consequences of changes in airway resistance

A
  • Contraction of smooth muscle produces changes in radius
  • Since resistance is inversely proportional to the radius to the fourth power, a small change in radius –> BIG change in resistance
68
Q

Decrease radius–>?

A

Increased resistance to airflow (opposite for increased radius)

69
Q

We use the changes in resistance to?

A

We use the changes in resistance to direct the air to the ‘right’ part of the lung-the part with the blood!

70
Q

Physiology: Dead space

-When you inhale air travels into?

A

When you inhale, air travels into:

-Trachea–>bronchi–>bronchioles–>eventually to alveoli (gas exchange)

71
Q

When you inhale, air travels into trachea, bronchi, and bronchioles, however?

A

The trachea, bronchi, and bronchioles are not designed for gas exchange (wasted)

72
Q

Physiology: dead space

A
  • The conducting airways dead space because no gas exchange occurs there
  • In a normal person, anatomical dead space holds about 150 ml of air
73
Q

Alveolar dead space

A
  • Occasionally we have alveoli that do not participate in gas exchange
  • This alveolar dead space occurs when either there is no blood flow to the alveolus getting air
74
Q

Physiologic dead space =?

A

Physiologic dead space = anatomic dead space + alveolar dead space

75
Q

How does physiologic dead space compare to anatomic dead space in normal, healthy individuals?

A

In normal healthy individuals physiologic dead space is not that much greater than anatomic dead spaces

76
Q

Anatomic Dead Space

  • Definition?
  • Examples?
A
  • Areas of the respiratory system that do not participate in gas exchange by design
  • Examples-trachea, bronchi
  • Air must travel through them to get to the gas exchange surface in the alveoli
77
Q

Alveolar Dead Space

-Definition?

A
  • Alveoli that do not participate in gas exchange (despite the fact that they should be)
  • Results when an alveoli GETS AIR BUT NO BLOOD
  • We all have some, but shouldn’t have too much
78
Q

Respiratory portion-Characteristics of the wall of a respiratory bronchiole?

A

-Discontinuous-interrupted by the saccular outpocketing of alveoli

79
Q

Respiratory portion-the wall of terminal bronchioles is not associated with?

A

Alveoli

80
Q

Respiratory portion

  • Contains?
  • Lining?
A
  • Bundles of smooth muscle fibers that form knobs bulging into the lumen
  • Lining epithelium is cuboidal-to-simple squamous
  • Elastic fibers
81
Q

Respiratory portion-Elastic fibers are important components of?

A

Elastic fibers are important components of the bronchioles and alveolar walls

82
Q

Pores of Kohn

-Function?

A
  • Connect adjacent alveoli

- Responsible for collateral respiration when blockage of a small bronchiole occurs

83
Q

Alveolar ventilation

  • definition?
  • What is it called if it is per minute?
  • average value?
A
  • Volume of air reaching the alveoli
  • If per minute: VA(dot)
  • Average value is 4 L/min
84
Q

Perfusion (Q)

  • Blood that comes from?
  • Average value?
A
  • The right ventricle

- Avg value= 5 L/min

85
Q

Alveolar ventilation

  • Definition?
  • Calculation?
A
  • How much air actually gets to alveoli
  • Alveolar ventilation = (tidal volume-dead space) x resp. rate
  • units: ml air/min
86
Q

Perfusion (Q)

  • Definition?
  • How should the values of the left and right ventricles compare?
A
  • How much blood to the lungs
  • Cardiac output (SV x HR)
  • Left and right ventricles should match
87
Q

The points of the lungs is to?

A

bring perfusion and ventilation together

88
Q

Smoker’s respiratory epithelium

-Changes in cell populations characteristic to this?

A
  • Metaplasia
  • Change to stratified squamous for better protection
  • Decrease in ciliated columnar cells-decrease in movement of mucus
  • Increase in goblet cells to protect against pollutants
  • Congestion of smaller airways
89
Q

Smoker’s respiratory epithelium

-Smoker’s melanosis

A
  • Benign focal pigmentations of oral mucosa

- Tends to increase significantly with tobacco consumption

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