Innervation of the Lungs
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Questions and Answers

Which of the following describes the organization of conducting and respiratory bronchioles?

  • Both conducting and respiratory bronchioles have alveoli and participate in gas exchange
  • Conducting bronchioles participate in gas exchange, while respiratory bronchioles lack alveoli
  • Both conducting and respiratory bronchioles lack alveoli and do not participate in gas exchange
  • Conducting bronchioles lack alveoli, while respiratory bronchioles have alveoli and participate in gas exchange (correct)
  • What is the function of the pulmonary plexuses in the lungs?

  • Facilitate gas exchange in the alveoli
  • Regulate the diameter of the bronchioles
  • Produce mucus to humidify the air in the airways
  • Provide motor and sensory innervation of the lungs (correct)
  • Which cells and mediators affect respiratory airways, including club and mast cells?

  • Macrophages and cytokines
  • Fibroblasts and histamine
  • Endothelial cells and leukotrienes
  • Club and mast cells and chemical mediators (correct)
  • What is the significance of the tracheobronchial tree's differences in diameter, glands, and cartilage?

    <p>It influences the conductance and resistance of air within the respiratory system</p> Signup and view all the answers

    What is the main source of the phospholipid surface film (SF) in the alveoli?

    <p>Lamellar bodies (LB)</p> Signup and view all the answers

    What is the average distance from the teeth to the vocal cords?

    <p>13 cm</p> Signup and view all the answers

    Which of the following is the largest subdivision of a lung lobe?

    <p>Bronchopulmonary segment</p> Signup and view all the answers

    What is most likely to produce bronchodilation?

    <p>Humoral release of epinephrine/norepinephrine</p> Signup and view all the answers

    What is a possible response to attempting laryngoscopy in a fully awake patient?

    <p>Laryngospasm</p> Signup and view all the answers

    What is the angle of the right main bronchus (away from the midline of the trachea) in an infant?

    <p>45</p> Signup and view all the answers

    What type of cells form and secrete lamellar bodies in the alveoli?

    <p>Type II alveolar epithelial cells</p> Signup and view all the answers

    Which part of the tracheobronchial tree lacks cartilage and glands?

    <p>Bronchioles</p> Signup and view all the answers

    How many main bronchi are present in the tracheobronchial tree?

    <p>2</p> Signup and view all the answers

    Which part of the tracheobronchial tree contains scattered cartilage plates?

    <p>Lobar bronchi</p> Signup and view all the answers

    What is the arterial supply of the lung stroma?

    <p>Bronchial arteries</p> Signup and view all the answers

    Which structure is surgically resectable and named according to the bronchi supplying them?

    <p>Bronchopulmonary segments</p> Signup and view all the answers

    Where do the bronchial veins drain in the lung stroma?

    <p>Superior vena cava (SVC)</p> Signup and view all the answers

    Which part of the tracheobronchial tree is located after the trachea bifurcates?

    <p>Main bronchi</p> Signup and view all the answers

    Which part of the tracheobronchial tree supplies lung lobes?

    <p>Lobar bronchi</p> Signup and view all the answers

    Which part of the tracheobronchial tree contains pyramidal-shaped subdivisions of a lobe?

    <p>Lobar bronchi</p> Signup and view all the answers

    Which part of the tracheobronchial tree occurs after tertiary bronchi and lacks cartilage and glands?

    <p>Bronchioles</p> Signup and view all the answers

    Which type of cells in the alveoli are specialized for gas exchange?

    <p>Type I epithelial cells</p> Signup and view all the answers

    What is the main function of Type II alveolar cells?

    <p>Secretion of surfactant</p> Signup and view all the answers

    What is the predominant balance to the excitatory cholinergic system for bronchodilation?

    <p>Non-adrenergic/non-cholinergic (NANC) system</p> Signup and view all the answers

    Which fibers inhibit secretion from bronchial glands and vasoconstrict pulmonary vessels?

    <p>Sympathetic fibers</p> Signup and view all the answers

    Which cells in the airways contain secretory granules filled with inflammatory mediators and can induce bronchoconstriction?

    <p>Club cells</p> Signup and view all the answers

    Which cells secrete proteins, surfactants, and act as progenitors for club cells and ciliated epithelial cells?

    <p>Club cells</p> Signup and view all the answers

    Which segment of the airways is completely lined with alveoli, alveolar ducts, and sacs?

    <p>Respiratory zone</p> Signup and view all the answers

    What is the main function of capillaries in the alveoli?

    <p>Gas exchange</p> Signup and view all the answers

    What do nonciliated bronchiolar exocrine cells (club cells) destroy when they reach bronchioles?

    <p>Airborne toxins</p> Signup and view all the answers

    What is the primary function of free-ranging phagocytic alveolar macrophages in the alveoli?

    <p>Debris and microorganism removal</p> Signup and view all the answers

    What is the main function of visceral afferent fibers from CNX and thoracic nerves in the pulmonary plexus?

    <p>Sensory and motor innervation to smooth muscle and glands</p> Signup and view all the answers

    During 'flight or fight' circumstances, what hormonal release results in relaxation of airway smooth muscle?

    <p>Epinephrine and norepinephrine</p> Signup and view all the answers

    Study Notes

    • The innervation of the lungs includes right and left plexuses that follow the trachea and bronchial tree.
    • The pulmonary plexuses provide sensory and motor innervation to the smooth muscle and glands.
    • Parasympathetic (cholinergic) and sympathetic (adrenergic) fibers provide weak motor effect on airway diameter, causing vasoconstriction and inhibition of gland secretion.
    • Visceral afferents travel with CNX fibers and the non-adrenergic/non-cholinergic (NANC) system provides inhibition, including bronchodilation, which is the predominant balance to the excitatory cholinergic system.
    • The pulmonary plexus includes autonomic and visceral afferent fibers from CNX and thoracic nerves.
    • Vagal parasympathetic fibers are secretomotor, glands, and bronchoconstrictive – smooth muscle with postganglionic parasympathetic innervation being a major source of unitary smooth muscle contraction.
    • Sympathetic innervation from fibers of T1 to T4 inhibit secretion from bronchial glands, vasoconstrict of pulmonary vessels, and inhibit bronchoconstriction of smooth muscle, while weakly bronchodilating.
    • Visceral afferent fibers transmit sensory information, which are sparse compared to somatic structures, and are nociceptive and reflexive.
    • Hormonal release of epinephrine and norepinephrine during "flight or fight" circumstances results in relaxation of airway smooth muscle, with β2 adrenergic receptors widely distributed in smooth muscle and combining with GPCRs in the plasma membrane of myocytes to cause smooth muscle relaxation and bronchiole dilation.
    • Mast cells, which are heavily granulated and reside in the connective tissues of airways, contain secretory granules filled with inflammatory mediators, including histamine, proteoglycans, lysosomal enzymes, and metabolites of arachidonic acid, which can induce bronchoconstriction, stimulate mucus secretion, and increase permeability of bronchial vessels when degranulation occurs.
    • Smooth muscle in airways contains significant amounts of collagen and elastic connective tissue fibers, with walls of bronchi and bronchioles having a thicker layer of smooth muscle relative to the diameter of the bronchiole lumen.
    • The respiratory epithelium descending the tracheobronchial tree has varying heights and complexities, with the trachea and bronchus having ciliated pseudostratified columnar epithelium, conducting bronchioles having ciliated simple columnar epithelium, and terminal bronchioles having ciliated simple cuboidal epithelium, which is replaced by club cells.
    • Club cells, also known as nonciliated bronchiolar exocrine cells, secrete proteins, including surfactant apoproteins A,B, and D, lipids, glycoproteins, and modulators of inflammation, act as progenitors for club cells and ciliated epithelial cells, and destroy airborne toxins that reach bronchioles.
    • An acinus is a part of the lung supplied by a single 1st order respiratory bronchiole, with all structures to and including the alveolar sac, and all parts of an acinus are involved in gas exchange.
    • Alveoli are composed mainly of a thin layer of squamous Type I epithelial cells, which are specialized for gas exchange, and Type II alveolar cells, which are cuboidal epithelium and produce surfactant, with surfactant reducing surface tension and produced in lamellar bodies derived from the Golgi.
    • The respiratory zone is the segment of airways completely lined with alveoli, alveolar ducts, and sacs, and each respiratory bronchiole gives rise to 2-11 alveolar ducts, with alveolar ducts being elongated airways with walls completely lined with alveoli and having very small amounts of smooth muscle and elastic tissue.
    • An acinus is part of the lung supplied by a single 1st order respiratory bronchiole and all structures to and including the alveolar sac, and all parts of an acinus are involved in gas exchange.
    • Alveoli are composed mainly of a thin layer of squamous Type I epithelial cells and large, thin, flattened Type II alveolar cells, with Type II cells producing surfactant.
    • Alveoli have a coverage of 10% alveolar surface by Type II alveolar cells, which function as stem cells, and free-ranging phagocytic alveolar macrophages monitor and remove debris and microorganisms.
    • The adult human alveolus contains prominent cells, including capillaries, the interstitium, and the alveolar epithelium, with intimately related capillaries, the interstitium, and the alveolar epithelium.

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    Test your knowledge on the innervation of the lungs, including the role of pulmonary plexuses, parasympathetic and sympathetic fibers, and non-adrenergic/non-cholinergic (NANC) system in airway regulation.

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