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Pulmonary interstitium
The document discusses the pulmonary interstitium, which is the connective tissue within the lungs. It has three main functions: supporting the lung, fluid balance, and repair/remodeling. The interstitium is made up of a thin portion forming barriers between alveoli and capillaries, and a thick portion where fluid can accumulate. The thick portion contains extracellular matrix, macrophages, and fibroblasts. There are three zones of interstitial tissue: peripheral, axial, and parenchymal. Fluid balance in the interstitium is regulated by Starling forces and leakage can occur if pressures are too high. Remodeling of the matrix is also important for lung biology and chronic inflammation. The document then provides examples of
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Pulmonary interstitium
- 1. Topic chest: Interstitium Anatomy& Physiology Chaiyapongse-Thorsang R1 Aj. Wiwatana
- 4. Board exam(2008) About interstitialedema, which is false? A. Near drowning is pure hydrostatic edema. B. Post-obstructive edema is pure hydrostatic. C. At High altitude can find increased permeability with diffuse airspace damage. D. Pressure > 25 mmHg. E. Early drowning?
- 5. Interstitium • Connective tissueswithin the lung – Basement membrane of alveoli and capillaries – Perivascular and perilymphatic tissues • Functions – Supporting lung – Fluid balance – Repair and remodelling
- 6. Interstitium • Thin portions(tightjunction) of interalveolar septa: – Basal lamina + adjacent capillary endothelium – Strict diffusion barrier between alveolar surface and underlying tissues • Thick portion: – Tissue fluid can accumulate or cross into the alveoli – Lymphatic vessels in the connective tissue of the terminal bronchioles drain fluid that accumulates in the thick portion of the septum
- 7. Interstitium: thick portion •Component: extracellular matrix – Collagen: tensile strength – Elastin: flexibility – Proteoglycans: • Maintain hydration • Adhesive activity • Component of growth factors
- 8. Interstitium: thick portion •Component: interstitial cell – Macrophage: wander about on the epithelial surfaces (septum and air space) • Clear the respiratory spaces of inhaled particles • Migrate to the bronchioles or the lymphatics/lymphoid tissue (interstitium) – Fibroblast
- 10. Interstitium • 3 zones –Peripheral connective tissue(pleural) – Axial connective tissue(central, bronchovascular) – Parenchymal connective tissue(intralobular)
- 11. Axial connective tissue •Originate at the hilum • Surrounds the bronchovascular structures • Extend peripherally • Terminate at centre of the acini
- 12. Peripheral connective tissue •Subpleural space and interlobular lung septa
- 13. Parenchymal connective tissue •Penetrate into secondary pulmonary lobule and lie along intralobular venule
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- 25. • Peripheral lung(cortex): – Thicker and better defined interlobular septa – Esp. apical, anterior, and lateral aspects of the upper lobes, the anterior and lateral aspects of the middle lobe and lingula, the anterior and diaphragmatic surfaces of the lower lobes, and along the mediastinal pleural surfaces • Central lung zone (medulla): – Thinner and less well defined interlobular septa • In healthy patients, a few septa are often visible in the lung periphery
- 26. Cortex Medulla Rich interlobularseptum Poor interlobular septum Low blood flow High blood flow Low air flow High air flow High lymphatic flow Low lymphatic flow
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- 31. Function of interstitium •Supporting lung • Fluid balance • Repair and remodelling
- 32. Fluid balance • Starlingforce • Net fluid movement between compartments ( Jv ) • Capillary hydrostatic pressure ( Pc ) • Interstitial hydrostatic pressure ( Pi ) • Capillary oncotic pressure ( πc ) • Interstitial oncotic pressure ( πi ) • Filtration coefficient ( Kf ) • Reflection coefficient ( σ )
- 33. Fluid balance Circ J2010; 74: 2507 - 2516
- 34. Fluid balance: leakage ColorAtlas of Pathophysiology © 2000 Thieme
- 35. Fluid balance: leakage CircJ 2010; 74: 2507 - 2516
- 36. Fluid balance: leakage CircJ 2010; 74: 2507 - 2516
- 37. Repair, remodelling andmatrix turnover • Critical element of lung biology • Lung remodelling: chronic inflammation • Matrix turnover: dynamic balance between accumulation and distribution of matrix component – Synthesis – Degradation
- 38. Am J PhysiolLung Cell Mol Physiol 298: L715–L731, 2010
- 40. Board exam(2008) About interstitialedema, which is false? A. Near drowning is pure hydrostatic edema. B. Post-obstructive edema is pure hydrostatic. C. At High altitude can find increased permeability with diffuse airspace damage. D. Pressure > 25 mmHg E. Early drowning?
- 42. Board exam Which typeof the pulmonary interstitium produces a peribronchial cuffing picture? A. Axial B. Peripheral C. Parenchymal D. Peripheral and parenchymal E. Axial and peripheral
- 43. Board exam Which typeof the pulmonary interstitium is visible in HRCT of the normal lung? A. Axial B. Peripheral C. Axial and parenchymal D. Axial and peripheral E. Peripheral and parenchymal
- 44. Board exam Which interstitialcomponent is damaged in emphysema? A. Collagen B. Proteoglycans C. Elastin D. Basement membrane E. Fibroblast
- 45. Pathogenesis of Emphysema:From the Bench to the Bedside. Amir Sharafkhaneh, Nicola A. Hanania, Victor Kim. Proc Am Thorac Soc. 2008 May 1; 5(4): 475–477.
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