Libro blanco de las ACES Pediátricas 2024

Neumología Pediátrica. Anexos ❚ 707 c. Know the histologic changes in the airways associated with chronic states of hypersecretion, eg, bronchitis, cystic fibrosis d. Know the effect of beta-agonists on the secretion of periciliary fluid from airway epithelial cells 3. Mucociliary transport a. Know that mucociliary mechanisms and alveolar macrophages both clear inhaled microorganisms b. Understand the alterations in mucus that reduce mucociliary function c. Know that mucociliary clearance is an important host defense in the nose, ears, and sinuses, as well as in the lower respiratory tract d. Know the pharmacologic agents that alter mucociliary transport e. Understand the factors that increase or decrease mucociliary transport E. Cough 1. Normal physiology a. Know that the highest densities of cough receptors are found in the larynx, trachea and bronchi b. Know that chemical, mechanical, or pharmacologic stimulation of cough receptors causes afferent fibers in vagus nerve to transmit impulses to the medulla c. Know the neural pathways important in cough d. Understand the role of glottic closure in the production of effective cough e. Understand the role of tracheal compression in the production of effective cough 2. Pathophysiology a. Know the extrapulmonary afferent pathways that may produce cough b. Recognize that muscular and efferent neural abnormalities may render cough ineffective F. Respiratory reflexes and defense of the lung 1. Know the stimuli that can cause reflex laryngospasm and/or apnea in infants G. Pulmonary lymphatics 1. Know that pulmonary lymphatics are an important component of the lung defense system 2. Know that efferent lymph vessels course through the connective tissue of the bronchovascular bundle and terminate in regional lymph nodes 3. Know the factors responsible for lung lymph fluid balance between secretion and absorption 4. Know the constituents of lung lymph fluid, including lymphocytes, protein, and lipids 5. Know the ontology of pulmonary lymph nodes H. Air-blood barrier 1. Know that bronchoalveolar lavage cells constitute representative samples of cells present within alveoli and peripheral bronchioles 2. Know that tight junctions are a key defense in guarding alveoli against flooding I. Pulmonary macrophage 1. Origin and distribution a. Know that alveolar macrophages are derived from blood monocytes that replicate within the pulmonary interstitium and mature into macrophages 2. Function a. Know that alveolar macrophages ingest and degrade foreign material