Carbon monoxide ka ba?

Kasi
ang lakas ng affinity mo sa
utak at puso ko MC,
Mr.
[PHYSIOLOGY
LECTURE DR. REVILLA]
Respiratory function of the lung

bronchitis thickening and increase in amount of

sputum

The collection of oxygen and excretion of CO2

Smokers cough abnormal;

inflammation in the airways

Non respiratory functions of the lung

The exchange of different metabolites

Aids in the balancing of the fluids
The immune system present in the lungs

4.

it

already

indicates

Clara cells
a. Important in remodelling of destroyed
tissues (regeneration process)

Sol layer- periciliary layer 97-98%(water); less viscous

Mucociliary clearance system

from submucosal bronchial area

Very low chloride secretion can cause higher
viscosity (occurs in Cystic fibrosis (gene
mutation of CF)) damage in CFTR (Cystic
Fibrosis
Transmembrane
Conductance
Receptors) recurrent infection higher risk in
caucaseans

Cilia central microtubule doublet contain ATPase that

is responsible for the contractile beat of the cilium
-

1.
2.
3.

They have microtubules that have dynein arms

(contracts together)
They beat in a coordinated oscillation in a
biphasic,
and
wavelike
rhythm
called
Metachronism

They move fast and have a strong forward stroke

manner. (they go up to the gel layer). But they have a
slow return or recovery stroke.
Cilia in the nasopharynx beat in the direction
that propels the mucus into the pharynx
- Cilia in the trachea propel mucus upward
toward the pharynx
The mucus is then swallowed
1. Move up
2. Forward stroke
3. Retract
4. Goes back to resting location

2 fluid layers and the cilia

Gel layer (mucus layer high viscosity from
goblet cells
Sol layer periciliary fluid
Cilia positioned on the surface of the airway
epithelial cells

Cells that produce Mucus in Gel layer

The kartageners syndrome general absence of ciliary

protection
-

1.

2.

3.

Goblet cells ( interspersed in the ciliary

epithelium)
a. More secretion from goblet cells, the
more the viscosity of the secretion
Mucus cells (submucosal glands)
a. The mucus and goblet cells are
different, because one secretes acidic
contents while the other is a neutral
substance
Serous cells (submucosal glands)
a. Increase secretion of serous cells
increases the volume of the sputum

They have recurrent infection destroys the

terminal bronchioles; no propulsion for sperm
(sterile); chronic sinusitis and bronchiectasis
They have situs inversus the organs do not go
to their target location; thus the organs are
misplaced and at the reversed position
(DEXTROCARDIA) right heart; left liver

Mucociliary blanket increased goblet cell secretion =

increased sputum viscosity
Increased submucosal gland secretion = decreased
sputum viscosity
Sputum Normal value: 100 mL
Terminal bronchioles to alveoli Achilles heel of the
lung the mucociliary blanket is absent. The
macrophages are the only defensive mechanism in this
region.

These 3 types undergo hypertrophy and

hyperplasia in COPD especially in chronic

Carbon monoxide ka ba? Kasi

ang lakas ng affinity mo sa
utak at puso ko MC,
Mr.
[PHYSIOLOGY
LECTURE DR. REVILLA]

No more goblet cells any mucus formation in

this area can cause mucus plugging and later
on, atelectasis (lung collapse

Carbon monoxide ka ba? Kasi

ang lakas ng affinity mo sa
utak at puso ko MC,
Mr.
[PHYSIOLOGY
LECTURE DR. REVILLA]
Particle deposition and clearance

later

Impaction - If you inhale more than 10 microns

they are impacted in your nose (form as
booger)
o Inertial impaction -(2-10 microns;
impacted by inertia; it will lodge to the
bronchi and carina (most likely)
caused by turbulent flow in the
airway formation of mucus )
o In bronchodilators it is significant
that particles are <2 microns so that it
will not have inertial impaction
Sedimentation .2 2 microns they are
suspended in the air and goes to the terminal
bronchioles
o Asthma medications holding of
breath for 10 seconds after inhalation
of medication allow sedimentation of
the particles topical nature
deposited in the bronchioles
bronchodilation
Interception
o Silica elongated particle imbed in
mucus area (cannot be eliminated
through mucus excretion) silicosis
/lung asbestosis/black lung of coal
miners/pneumoconiosis

cause

cough

Immune Defense System composed of innate and

adaptive immune cells

Metabolic functions of the lung

on

MALT (mucosa associated lymphoid system) / BALT

(bronchus)

Angiotensin I renal hormone which goes to

the lung most potent vasoconstrictor
Serotonin
Bradykinin,TNF, Complements
o Bradykinin causes cough
o Renin produces bradykinin and ACE I;
thus when you are using ACE inhibitor,
more substrates are directed to the
production of bradykinin and would

Function independently to the systemic immune

system

Innate immune cells (1st line of defense of lung

(mucosal tissues))
-

The adaptive immune response is initiated only

after the insulting agent bypasses the innate
immune response

Contains the natural killer cells, NK T cells

o In the alveoli; destroy particles thru
lysosomes
Dendritic cells and alveolar macrophages
o In the interstitium
o Sends the particles into the lymph node
via phagocytosis

(last line of defense inflammation ( it may lead to

scarring and fibrosis)
Adapative immune cells this is the primary defense
mechanism of Non-mucosal tissues (example:
spleen, kidney and liver)

TCRs (T-cell receptors)- (1st line of defense in

ADAPTIVE)
o T cells
Immunoglobulin A (IgA) antigen antibody
complex binding and transports particles

Carbon monoxide ka ba? Kasi

ang lakas ng affinity mo sa
utak at puso ko MC,
Mr.
[PHYSIOLOGY
LECTURE DR. REVILLA]
In asthma and other allergic processes
IgA are replaced by IgE (allergic
antibody) ; attaches to mast cells
mast cells degranulates and releases
leukotrienes
which
cause
bronchoconstriction
o
antileukoid medications in the pediatric
cases inhibit degranulation of mast cells
prevents release of leukotrienes
Pathogen associated molecular pattern PAMP
and TLRs (toll like receptors) toll talaga iyon,
hindi tall
o Last line of defense
o

TR4 gram (-) microorganisms

TR2 gram (+)

o SHOULD IDENTIFY FIRST if the particle
is pathological or just foreign particles.
Talc granulomatosis tablet form of
medication
are
pulverized
and
inhaled
(example: hydromorphone) particles goes to
the terminal bronchioles induce inflammation

Notetakers:
Elijah Quinto
Kat Balberan