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14-16 - The Respiratory System Flashcards

1
Q

Outline the 4 functions of the respiratory system…

A
  1. Gas exchange
  2. pH regulation (via retention or removal of CO2)
  3. Protection from inhaled irritants and pathogens
  4. Vocalisation
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2
Q

Gas exchange can be divided into 3 phases…

A
  • External ventilation
    • atmosphere to the lung
  • Internal transport
    • transport of gases via blood
  • Internal respiration
    • blood to cells
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3
Q

“Respiratory and circulatory systems coordinate the tranfer of ___ and ___ between ____ and the atmosphere.”

A

“Respiratory and circulatory systems coordinate the tranfer of O2 and CO2 between cells and the atmosphere.”

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4
Q

The anatomy of the respiratory system can be divided into the upper and lower respiratory tracts. Where does one end and the other begin?

A

The upper respiratory tract is the area between the nasal cavity and the start of the trachea. The lower respiratory tract is from the trachea down.

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5
Q

In terms of functional anatomy, the conducting systems connect the _________________ to the ___________. They _____, _______ & humidify the air.

A

In terms of functional anatomy, the conducting systems connect the external environment to the exchange surfaces. They warm, filter & humidify the air.

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6
Q

The left lung has __ lobes.

A

The left lung has 2 lobes.

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7
Q

The right lung has __ lobes.

A

The right lung has 3 lobes.

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8
Q

In terms of functional anatomy, the respiratory zone comprises the _____ and their __________ supply. It is the ___________ surface.

A

In terms of functional anatomy, the respiratory zone comprises the alveoli and their capillary supply. It is the gas exchange surface.

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9
Q

The nose and nasal cavity serve which 4 functions?

A
  • Filter debris
  • Secrete antibacterial substances
  • Olfactory receptors
  • Enhances vocal resonance
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10
Q

The soft palate of the pharynx prevents entry of…

A

Food into the nasopharynx and nasal cavity

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11
Q

The larynx prevents foods and liquids from entering…

A

The respiratory tract (wih the epiglottis)

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12
Q

The structure of the lower respiratory tract conducting system (i.e. from larynx to alveoli) is often described as the…

A

Bronchial tree (due to its progressively branching structure)

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13
Q

The trachea splits into two branches, the left and right _______ ______

A

The trachea splits into two branches, the left and right primary bronchi

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14
Q

Divisions 2-11 are…

A

Progressively smaller bronchi

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15
Q

Divisions 12-23 are the…

A

Bronchioles

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16
Q

The terminal division of the bronchioles (24) feeds into…

A

A cluster of alveoli

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17
Q

Epithelial cells in the lower conducting system…

A ciliated epithelial layer lines the ______, ______ and primary _______ .

A

Epithelial cells in the lower conducting system…

A ciliated epithelial layer lines the larynx, trachea and primary bronchi.

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18
Q

The ciliated epitheal layer lining the lower conducting system is made up of which two cell types?

A

Goblet cells (secrete mucus) and cilliated cells (sweep mucus up to pharynx, secrete saline)

Together their action creates the mucocillary escalator which removes noxious particles from the lungs.

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19
Q

The saline secretion pathway in the ciliated cells of the airway epithelium is essential for the proper function of the…

A

Mucocillary escalator

(In cystic fibrosis this pathway is disfunctional)

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20
Q

Outline the 4 steps of the saline secretion pathway

A
  1. NKCC brings Cl- from ECF
  2. Anion channels, such as CFTR, allow Cl- to enter lumen
  3. Na+ follows from ECF to lumen by paracellular pathway (pulled by electrochemical gradient)
  4. Overall ion movement creates a concentration gradient which pulls water into the lumen (NaCl + H2O = saline)
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21
Q

C-shaped rings of cartillage help keep trachea open while remaining…

A

Flexible enough to allow for the change in diameter occuring during breathing

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22
Q

The posterior (back) surface of the trachea is covered with…

A

Elastic connective tissue and smooth muscle (trachealis muscle)

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23
Q

As the airways divide into progressively narrower passages the cartilage changes from…

a) Complete rings to C-shaped with more plates
b) C-shaped to complete rings with fewer plates
c) Columnar to square with more plates
d) Cartilage to bone with fewer plates

A

As the airways divide into progressively narrower passages the cartilage changes from…

a) Complete rings to C-shaped with more plates

b) C-shaped to complete rings with fewer plates

c) Columnar to square with more plates
d) Cartilage to bone with fewer plates

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24
Q

In addition to the change in cartilage, moving from bronchi to bronchioles there are also changes in (2). The overall effect of these changes is…

A

The amount of smooth muscle (it increases) and the epithelial cells become more columnar

The overall effect of these changes is to allow the tiny airways to change diameter thus controlling airflow through the bronchioles and alveoli.

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25
True or false... Bronchioles lack ciliated epithelium
**TRUE**
26
True or false... Bronchioles lack cartilage and a smooth muscle layer
**FALSE!** ## Footnote Bronchioles lack cartilage, however they do have a smooth muscle layer
27
For each terminal/respiratory bronchiole there... a) is one alveolar duct b) are 3+ alveolar ducts c) are 2+ alveolar ducts d) is one alveoli
For each terminal/respiratory bronchiole there... a) is one alveolar duct b) are 3+ alveolar ducts **c) are 2+ alveolar ducts** d) is one alveoli
28
Name the 3 types of alveoli cell... (Hint: one of them is an immune cell)
* **Type I** * Thin for *gas exchange* (90% of cells) * **Type II** * Smaller, thicker, produce *surfactant* * **Macrophages** * *Protect* alveoli from small particles
29
Which is the most abundant type of alveoli cell?
**Type I (thin gas exchange cells)**
30
*"External intercostal muscles and scalenes raise the rib cage up and out. Internal intercostal and accessory muscles are not recruited."* This is a description of: a) forced inhalation b) normal inhalation c) pressure changes d) forced breathing
*"External intercostal muscles and scalenes raise the rib cage up and out. Internal intercostal and accessory muscles are not recruited."* This is a description of: a) forced inhalation **b) normal inhalation** c) pressure changes d) forced breathing
31
In terms of muscles recruited, describe the difference between quiet breathing and active breathing expiration...
In quiet breathign expiration results from the **passive elastic recoil** of the lings, rib cage and diaphragm. In active breathing **internal intercostals, abdominals and accessory muscles** are involved (pulling ribs down and diaphragm up)
32
33
The **basal laminae** of type I alveolar cells are...
**Fused** with the endothelial cells of the capillary to **decrease the distance for gas exchange**
34
**Boyle's law** describes the relationship between pressure and...
Volume
35
Pressure gradients influence ventilation. Name 3 pressures relevant to ventilation...
* **Patmos** - **atmospheric pressure** (760mmHg @ sea level) * **Palv** - **intrapulmonary pressure** (within alveoli), rises and falls w/ ventilation, equilibrates w/ Patmos * **PIP** - pressure in **pleural cavity**, rises and falls w/ ventialtion
36
Describe the process of **inspiration**...
1. Contraction of inspiratory muscles 2. Thoracic volume increase and intrapleural pressure drops 3. Lung volume increases 4. Alveolar pressure drops 5. Air is pulled into lungs
37
Describe the process of **expiration**...
* Relaxation of inspiratory muscles (and contraction of expiratory muscles\*) * Thoracic volume decreases and intrapleural pressure rises * Lung volume decreases * Alveolar pressure increases * Air is pushed out of lungs to functional residual capacity (or below functional residual capacity\*) \*in the case of **forced expiration**
38
PIP (intraplural pressure) is typically: a) 760mmHg b) -4mmHg c) 12mmHg d) -12mmHg
PIP (intraplural pressure) is typically: a) 760mmHg **b) -4mmHg** c) 12mmHg d) -12mmHg (negative as the two sides of the intraplural cavity pull away from one another)
39
**Elasticity** is the ability of tissue to...
Return to its original state after being stretched
40
Elastic recoil is important for _______ expiration.
Elastic recoil is important for **normal** expiration.
41
Elastic fibres support the...
**Alveolia**
42
List 3 factors affecting **gas exchange** in the alveoli...
1. **Surface area** 2. **Diffusion distance** (barrier thickness + amount of fluid) 3. **Perfusion** of the alveoli
43
There are three main physical factors which influence pulmonary ventilation. They are...
* **Airway resistance** * **Alveolar surface tension** (liquid film gas water boundary) * **Lung compliance** (strech of the lung and chest wall)
44
**1. Airway resistance** is determined by (4)...
* Length of system\* * Airway diameter * Flow (laminar or turbulent) * Viscocity of gas\* \*can assume as constant
45
Bronchi have the highest resistance. Factors that can further increase the resistance are...
* Inflammation * ↑ Mucus secretion * Tumours
46
**Bronchial tone** is controlled by the _______ nervous system...
**Bronchial tone** is controlled by the **autonomic** nervous system...
47
**Bronchoconstriction** occurs via innervation by the ___________ NS
**Bronchoconstriction** occurs via innervation by the **parasympathetic** NS
48
**Bronchodilation** occurs when...
Circulating **adrenalin** binds to **sympathetic β2 receptors**
49
**2. Alveolar surface tension** occurs at the liquid-gas boundary because the gases are...
**Non-polar**
50
**2. Alveolar surface tension** is ( higher / lower / the same ) in smaller alveoli...
**2. Alveolar surface tension** is **higher** in smaller alveoli... This creates a higher resistance to inflation
51
**Surfactant** reduces surface tension and is necessarily present in ( smaller / greater ) quantities in small alveoli to prevent their collapse (bonus: which is known as _____________ )
**Surfactant** reduces surface tension and is necessarily present in **greater** quantities in small alveoli to prevent their collapse (bonus: which is known as **atelectasis** )
52
**Surfactant** is produced by which type of alveolar cell (type I or type II)?
**Type II**
53
**Surfactant** contains both **protein** and **phospholipid**. Molecules have both a **polar** and **non-polar** end allowing them to...
Disrupt hydrogen bonding between water molecules (like detergent, soap or pancreatic bile)
54
**Infant Respiratory Distress Syndrome (RDS)**
**Lack of surfactant** (often in premature births as it is not produced until the last 10-12wks of gestation)
55
**3. Lung compliance** is defined as the change in volume produced by a given change in...
Pressure (it is the reciprocal of elasticity)
56
The 3 factors affecting **compliance** are...
* 2. Alveolar surface tension * Distensibility\* of lung elastic tissue during inflation * Movement or stretchability of chest wall during inspiration \*ability to swell due to pressure from the inside, e.g. like a balloon
57
**Compliance** decreases as pressure...
**Increases** (as the limit of stretch is approached)
58
**Emphysema...** a) decreases compliance as scar tissue replaces elastic tissue b) increases compliance due to loss of alveoli c) increase compliance as scar tissue replaces elastic tissue d) decreases compliance due to loss of alveoli
**Emphysema...** a) decreases compliance as scar tissue replaces elastic tissue *(this is fibrosis)* **b) increases compliance due to loss of alveoli** c) increase compliance as scar tissue replaces elastic tissue d) decreases compliance due to loss of alveoli
59
List the 4 key **pulmonary volumes** and state which can be measured by **spirometry**...
* **Tidal volume (TV or VT)** * Normal breath **(~500ml)** * **Expiratory Reserve Volume (ERV)** * Forced expiration **(~1200ml)** * **Insipiratory Reserve Volume (IRV)** * Exercise inspiration **(~3100ml)** * **Residual volume (RV)\* (~1200ml)** * Remaining volume after max expiration \* cannot be measured by spirometry
60
**Pulmonary capacities** can be calculated from the sum of...
2 or more **pulmonary volumes**
61
List the 4 main **pulmonary capacities** and how they are calculated from the relevant pulmonary volumes...
* **Inspiratory capacity** **(IC)** = VT + IRV * (max insp.) * **Functional Residual Capacity** **(FRC)** = ERV + RV\* * (remaining total vol. after normal insp.) * **Vital Capacity (VC)** = (VT + IRV) + ERV * (max insp. and exp.) * **Total Lung Capacity** **(TLC)** = VT + IRV + ERV + RV\* * (lung vol. after max insp.)
62
Name four types of **non-respiratory ventilation**...
* **Sigh** * **Yawn** * **Sneeze** * **Cough**
63
Name the 3 *types* of **dead space** (areas that don't contribute to gas exchange)...
1. **Anatomical dead space** (*conducting airways*) 2. **Alveolar dead space** (*disfunctional alveoli*) 3. **Physiologic dead space** (*total* dead space including *anatomical* and *alveolar*)
64
_Measuring forced volumes and capacities_ FEV1 is the \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ FVC stands for \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ FEV1 is \_\_\_% of FVC
_Measuring forced volumes and capacities_ FEV1 is the **forced expiratory volume in 1 second** FVC stands for **forced vital capacity** FEV1 is **80**% of FVC
65
_Measuring forced volumes and capacities_ Describe how **obstructive** lung disease affects FEV1 and FVC values...
* **FEV1 will be decrease** as the obstruction **reduces the rate of expiraiton** * FVC will be largely the same (example: asthma)
66
_Measuring forced volumes and capacities_ Describe how **restrictive** lung disease affects FEV1 and FVC values...
* FEV1 is similar * **FVC is reduced** as total lung capacity is reduced (example: pulmonary fibrosis)
67
After breathing out, the dead space will be filled with \_\_\_\_\_\_\_\_\_\_. After breathing in, the dead space will be filled with \_\_\_\_\_\_\_\_\_.
After breathing out, the dead space will be filled with **stale air**. After breathing in, the dead space will be filled with **fresh air**.
68
**Pulmonary ventilation =**
**Pulmonary ventilation = ventilation \* tidal volume** (this includes the dead space so \> alveolar ventilation)
69
**Alveolar ventilation =**
**Alveolar ventilation = ventialtion rate \* (tidal volume - dead space volume)**
70
**Dalton's Law**
Partial pressures *"The pressure exerted by an individual gas is determined only by its relative abundance in the mixture"* PA = Ptotal x %A
71
**Henry's Law**
**Solubility of gas** solubility of a gas in liquid (at constant temperature) depends on the **solubility of gas** & **partial pressure** of gas Solubility = Henry's law constant \* partial pressure Sgas = Kgas\* Pgas
72
**Fick's Law**
**Diffusion** Flux = (P x ΔC) / X where... P = permeability of barrier x surface area ΔC = concentration gradient across membrane x = diffusion distance
73
The typical composition of air is...
* 21% O2 * 79% N2 * 0.46% H2O * 0.04% CO2
74
PO2 in the dead space is ( lower / the same / higher ) compared with the surrounding atmosphere.
PO2 in the dead space is **lower** compared with the surrounding atmosphere.
75
**Hyperbaric oxygen therapy** uses high PO2 to treat...
* **Severe blood loss** * **Crush injuries** * **Anemia** * **Decompression sickness** (the bends) * pressure redissolves gas bubbles
76
Concentration gradients drive...
Gas exchange
77
Alveolar ventilation is affected by...
Posture, rate of inspiration and the amount of air inspired
78
Lung perfusion (Q) varies due to...
Gravity (as the pulmonary circulation is at relatively low pressure)
79
What is the V/Q ratio for optimal gas exchange...
0.9-1
80
Problems with diffusion in... * **Emphysema** * **Fibrotic lung disease** * **Pulmonary edema** * **Asthma**
Problems with diffusion in... * **Emphysema** -\> destruction of alveoli reduces SA for gas exchange * **Fibrotic** **lung** **disease** -\> thickened wall slows gas exchange * **Pulmonary** **edema** -\> increased diffusion distance * **Asthma** -\> reduced ventilation of alveoli
81
**Local control** to ensure **V/Q matching** in the lungs (2)...
* **Hypoxic pulmonary vasoconstriction** * Mediated by O2 levels * redirects flow to ventilated alveoli * **Bronchiole diameter** * Mediated by CO2 levels * ↑CO2 levels bronchiole dilation
82

Physiology (17 decks)

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