A&P2 Respiratory Flashcards
What are the extra duties of the respiratory system?
Regulate blood pH Smell receptors Filter air Produce sounds Expel heat/water
What are the components of the respiratory system?
Nose Pharynx Larynx Trachea Bronchi Lungs
Respiratory system can be categorized into what two categories?
Structural
Functional
What does the structural category contain?
URT; nose, nasal cavity, pharynx, associate structures
LRT; larynx, trachea, bronchi, lungs
What does the functional category contain?
Conducting zone- filtration, warming and moistening of air
Respiratory zone: tube/tissue in lung that exchanges gas
What structures does the Conducting Zone contain?
Nose Nasal cavity Pharynx Larynx Trachea Bronchi Bronchioles Terminal bronchioles
What structures does the Respiratory zone contain?
Respiratory bronchioles
Alveolar ducts
Alveolar sacs
Alveoli
What are the three components that make up the nasal cartilaginous and framework?
What do they provide?
Septal nasal
Lateral nasal
Alar cartilage
External nose flexibility
Where is the nasal cavity located?
Inferior to nasal bone
Superior to maxilla
What does the nasal cavity merge with anteriorly/posteriorly?
Ant- External nose
Post- internal nares->pharynx
What two areas drain into the nasal cavity?
Paranasal sinuses
Nasolacrimal ducts
What makes up the roof, floor and lateral walls of the nasal cavity?
Roof: ethmoid
Floor: Palatine/maxillae processes
Lateral: ethmoid, maxillae, lacrimal, palatine, inferior nasal concha
Where/what is the nasal vestibule?
Anterior portion of nasal cavity in side of nostrils
What makes the nasal septum?
Hyaline cartilage
Ethmoid perpendicular plate, vomer
What are the purposes of the sinus cavities?
Produce/drain mucus
Voice resonation
Facial structure
Which way do turbinates face?
Lateral to medial
What are the spaces between the turbinates called?
Meatuses
What structures of the nose help catch water on exhalation to help prevent dehydration?
Mucus membranes lining conchae
3 functions of the turnbinates?
Warm incoming air
Moisten air
Trap dust
Where does the pharynx start and end?
Internal nares
Level of cricoid cartilage
What type of muscle make sup the wall of the pharynx?
Skeletal
Inner- longitudinal
Outer- circular
Relaxation of pharynx muscles aid with ____ while contraction aids with _____
Relax= patentcy Contract= deglutition
What are the 3 anatomical regions of the pharynx?
Nasopharynx
Oropharynx
Laryngo/Hypopharynx
What are the 5 openings in the nasopharynx?
Two internal nares
Two eustacian tubes
One oropharynx
Where are the adenoids located?
Nasopharynx
What part of the respiratory tract exchanges air with the eustacian tubes to equalize pressure?
Nasopharynx
Where does the oropharynx start/end?
Soft palate
Upper border of epiglottis
Level of inferior hyoid bone
Define Fauces and it’s location
Opening of the mouth
Oropharynx
What tonsils are found in the Oropharynx?
Palatine
Lingual
3 total
Where does the Laryngo/hypopharynx start and end?
Inferior hyoid
Esophagus (posterior)
Larynx (anterior)
What connects the laryngopharynx with the trachea?
Larynx
Where does the larynx begin and end?
Begin- hyoid/base of tongue
Ends- just after vocal cords
Larynx is anteriorly located to which cervical vertebrae?
4-6
What are the 3 functions of the larynx?
When open- breath
Partial open- phonation
Closed- protection from deglutition
How many pieces of cartilage are in the larynx?
9
What are the 3 singular and 3 paired pieces of cartilage in the larynx?
Three singular:
Thyroid
Epiglottis
Cricoid
Paired: Arytenoid
Corniculate
Cuneiform
What gives the larynx a triangular shape?
What give the point to this area?
Thyroid cartilage (Adam's apple) Laryngeal prominence
Why is the thyroid cartilage in males larger?
Why are vocal cords in females smaller?
Testosterone
Androgen
How is the epiglottis attached to the trachea?
Base of epiglottis connects to posterior surface of thyroid cartilage by thyroepiglottic ligament
Which way (anterior/posterior) does the epiglottis close?
Folds posteriorly to cover trachea
What reflex occurs when debris/liquid/food enters the trachea?
Cough
What is the only “true” ring of cartilage in the respiratory tract?
Cricoid cartilage- hyaline cartilage forming inferior wall of larynx
Where/how is the cricoid cartilage attached to the body?
Attached to 1st ring of trachea by cricotracheal ligament
How do the Cricoid and Thyroid cartilage attach?
Cricothyroid ligament and inferior thyroid cartilage horns
What is the Cricoid cartilage’s role in a cricothyroidotomy?
Incision made above cartilage (below thyroid cartilage) into cricothyroid membrane
Where is the Arytenoid Cartilage located?
Posterior and superior border of cricoid cartilage
What is the function of the Arytenoid Cartilage?
Gives us vocal ligaments
What are the “true” vocal cords?
Arytenoid cartilage
What type of joint with the cricoid cartilage gives the area it’s mobility?
What does this mobility offer?
Synovial
Position/tension to change vocal cords
Where is the Corniculate cartilage located?
What is it’s function?
Sits above arytenoid cartilage
Vestibular/ventricular ligaments (false vocal cords)
Where is the Cuneiform Cartilage?
What is it’s function?
Non-articulating cartilage located anteriolaterally/superior to corniculate cartilage
Supports corniculate and arytenoid during movement
Where is there ciliated tissue within the respiratory tract?
What types of cells are located here?
Inferior to larynx
Ciliated columnar- trap/move particles for expulsion
Goblet- mucus
Basal- structure/strength
What are the two folds/pairs of vocal cords?
Vestibular/ventricular- superior/false
Vocal- inferior/true
What fold are used for normal speech and what pairs are used for growling?
Normal- vocal (inferior/true)
Growl- vestibular/ventricular (superior/false)
What pairs/folds are used for holding pressure against the thoracic cavity?
Vestibular/ventricular (superior/false)
For voice production, the elastic ligaments are stretched between which two cartilages?
Thyroid and arytenoid
Laryngeal muscles contract, pull elastic ligaments which stretch vocal cords (adduct) narrowing the rima glottidis
Greater the air pressure passing over the cords causes what type of changes to voice/noise?
Greater pressure=louder the sound
Cords pulled tight = ? noise
Cords are relaxed = ? noise
Tight= rapid vibration, higher pitch Relax= less rapid vibration, lower pitch
What happens during whispering?
All but posterior portion of rima glottidis is closed
No vibration occurs, no pitch is present
How is intelligible speech formed?
Changing shape of oral cavity as we enunciate
As size of oral cavity changes, resonance quality changes
What parts of the respiratory system whelp with voice production by acting as resonating chambers?
Pharynx
Mouth
Nasal cavity
Paranasal sinuses
How are vowel sounds made?
How are consonant sounds made?
What structure help with forming both?
Vowel- constricting/relaxing muscles in wall of pharynx
Consonant- movement of mouth
Both- face, lips, tongue
Male vocal cords are ___ and __ when compared to females vocal cord
What do these characteristics cause?
Males- thicker and longer which cause slower vibration and lower pitch
Where does the trachea start and end?
Larynx->T5
What are the 4 layers of the trachea?
External to interior Adventitia Hyaline cartilage Submucosa Mucosa
How many cartilage rings are within the trachea?
16-20
Which direction do the hyaline cartilage rings open?
Posterior, facing esophagus
What tissue spans the opening of the hyaline cartilages in the trachea?
Fibromuscular membrane
Define Trachealis Muscle
Transverse smooth muscle inside of the fibromusclar membrane at the opening of the trachea cartilage rings
What layer of the trachea contains the sermucous glands and ducts?
Submucosa
What layer of the trachea provides protection from inhaled foreign particles?
Mucosa
Trachea branches at T5 within what area of the chest?
Mediastinum
Right bronchus characteristics
Shorter
More vertical
Wider
What is the most sensitive area of the cough reflex?
Carina
What areas of the respiratory tract contain pseudostratified ciliated columnar epitherlium?
Trachea
Nasal cavity
Bronchi
How many primary/main bronchus?
How many secondary/lobar bronchus?
How many tertiary/segmental bronchus?
Primary- two
Secondary- five
Tertiary- twenty
What marks the transition from the bronchi to bronchioles?
Lumen is less than 1mm thick
No cartilage in airway walls
What is the last part of the conducting zone AND last macroscopic airway?
Terminal bronchioles
What is the first part of the respiratory zone AND first microscopic airway?
Respiratory bronchioles
As bronchi transition into smaller branches, the rings of cartilage are replaced with what?
Plates of cartilage
What characteristics/lack of characteristics identifies a bronchiole?
Complete smooth muscle with NO cartilage
Terminal bronchioles have an ____ function
How do the complete this function
Exocrine
Club cells- formerly Clara cells
What are the functions of Club Cells?
Non-ciliated cells along epitherlial cells
Protects from toxins/carcinogens
Produces/secretes surfactant
Function as stem cells
Surfactant within bronchioles is used for what function?
Prevents bronchiole lumen from collapsing/remaining closed after exhalation
What impact does the ANS have on bronchioles?
Norepi binds to beta-adrenergic receptors in airway causing brachodilation and increased cilia beat frequency
What impact does the PNS have on bronchioles?
Ach binds to muscarinic receptors causing slight constriction and increased mucus production
Are there more cholinergic or adrenergic receptors in pulmonary smooth muscles?
Cholinergic
What is the membrane that encloses and protects the lungs?
Pleural membrane
Parietal pleura- thoracic wall
Visceral pleura- covers lungs
Where is pleural fluid made/secreted?
100mL/hour made at parietal layer and drains to visceral/lymphatics
Presence of pleural fluid keeping pleural layers adhere together is called what?
Surface tension
Fluid is on luminal surface
Air trapped where causes tension pneumo?
Pleural cavity
What are the lobes/segments of each lung?
Right- 3 lobes
superior- 3 segments
middle- 2 segments
inferior- 5 segments
Left- 2 lobes
superior- 5 segments
inferior- 5 segments
Where do lungs extend from superior/inferior?
Supraclavicular->diaphragm
What/where is the only place you can palpate lungs?
Supraclavicular space
R lung is ___ and ___ but shorter than left
Thicker
Broader
Why is the L lung usually 10% smaller than the right lung?
Cardiac notch, apex of the heart
Define lingula
Medial projection of inferior aspect of superior L lobe
Inferior aspect of cardiac notch
Define costal surface
Define Mediastinal surface
Define diaphragmatic surface
Costal- anterior surface
Media- medial of both lungs
Diaphragm- inferior aspect/base fitting convexity of diaphragm
Define Hilus
Bronchi, vessel, nerve and lymph entrance/exit to lungs
What structure separates the two lobes of the left lung?
Oblique/major fissure
What structure separates the three lobes of the right lung?
Oblique/major- separates inferior/middle, lateral aspect of superior/inferior lobes
Horizontal/minor- separates superior and middle lobes
Define bronchopulmonary segments
Lung tissue segment supplied by one tertiary bronchus
Bronchopulmonary segments are further broken down into what?
Lobules
What does each lobule of a lung contain?
Lymph vessel
Arteriole
Venule
Branch of terminal bronchiole
Terminal bronchioles branch inside ____ into respiratory bronchioles
Lobules
Where do alveoli begin appearing?
Respiratory bronchioles
What structure/feature connects alveoli together and helps equalize pressure throught an alveolar sac?
Pores
What are the two types of cells found in the walls of alveoli?
Type 1- alveolar; main site for gas exchange
Type 2- septal; in between Type 1 cells, secrete alveolar fluids
What are the functions of the alveolar fluid?
Keeps cell/air moist
Contains surfactant
What cells are found in alveoli but are not embedded within the walls?
Alveolar macrophages (dust cells) Monocytes (fibroblast-like cells)
What doe the monocytes in alveolar tissue produce?
Reticular and elastic fibers
What molecules make up alveolar fluid?
Phospholipids
Lipoproteins
Surfactant- lowers surface tension of alveolar fluid, reduces alveoli from collapsing and maintain patency
Where is high or low surface tension wanted/needed?
High- pleural cavity to keep parietal and visceral layers together
Low- alveoli, keep layers apart during exhalation
What forms the respiratory membrane?
How do gases cross this membrane?
Alveolar and capillary walls
Diffusion
How do the muscular walls of the bronchi receive oxygenated blood?
Bronchial arteries
What are the 3 steps of respiration?
Pulmonary ventilation- breathing, inhalation/exhalation of air and exchange between atmosphere and alveoli
External respiration- external respiration, exchanges gases between alveoli and blood in pulmonary capillaries (gain O2, lose CO2)
Internal Respiration- gas exchange between systemic capillaries and tissue cells (blood loses O2 and gains CO2)
Define Cellular Respiration and what phase of respiration does it occur?
Metabolic reaction consuming O2 and releasing CO2
Internal Respiration
3 things that influence rate of airflow?
Alveolar surface tension (surfactant)
Compliance of lungs (fibrosis)
Airway resistance (asthma)
When/how does air enter the lungs?
When/how does air exit the lungs?
Pressure is greater in atmosphere/environment
Pressure is less in atmosphere/environment
Define pulmonary ventilation
Breathing
Define External (pulmonary) Breathing
Gas exchange between alveoli and blood
Define Internal (tissue) Respiration
Gas exchange between systemic capillaries and tissue cells
Define Atmospheric Pressure
Pressure of air outside of body’s airway
Define Intrapleural (intrathoracic) pressure
Fluid pressure between visceral and parietal layers of pleura
Define Alveolar (intraplumonic) Pressure
Pressure inside of lungs, specifically inside alveoli
When is the pressure in lungs equal to atmospheric pressure?
Just before start of inhalation
What must first occur within the lungs for airflow to occur?
How does this happen?
Pressure in alveoli must be lower than atmosphere
Increasing lung size and thoracic cavity
Define Boyles Law
Pressure of a gas in a closed container is inversely proportional to volume of the container
Volume inc- press dec
Volume dec- press inc
What are the main muscles of inhalation?
Diaphragm
External Intercostals
How does the diaphragm move during inhalation and what is the effect of this movement?
Contracts, flattens
Increases vertical diameter of thoracic cavity
What movement is responsible for drawing 3/4s of the air into the lungs?
Diaphragm contraction
External Intercostal- 25%, increase anteroposterior and lateral diameters
During normal respiration, intrapleural pressure is always ___ than atmospheric pressure
Lower
Intrapleural pressure decreases with thoracic cavity size increase
Normally, parietal and visceral pleurae adhere tightly together because of what 2 things?
Subatmospheric pressure
Surface tension
Thoracic cavity expansion pulls on what membrane which pulls on lungs too to increase size?
Parietal pleura pulled outward taking visceral pleura and lungs with it
As lung volume increases, alveolar/intrapulmonic pressure ___
Reduces
This is the difference between internal and atmospheric pressure
What are the accessory muscles for respiration?
Sternocleidomastoid- elevate sternum
Scalene- elevate ribs 1-2
Pectoralis- elecates ribs 3-5
Inhalation is a ____ process
Exhalation is a ___ process
Active
Passive
What 3 motions allow exhalation to be passive?
Elastic recoil of lungs
Smooth muscle recoil of airways
Surface tension pull in alveoli due to alveolar fluid
When does exhalation begin?
Inspiratory muscles start to relax
What are the muscles of exhalation used during forceful breathing?
Abdominals
Internal intercostals
What 3 factors contribute to the rate of airflow and ease of pulmonary ventilation?
Alveolar fluid surface tension
Lung compliance
Airway resistance
When liquid surrounds a gas circumferentialy, what kind of force is produced?
Inward direction
Surface tension in the lungs causes alveoli to do what?
What does this phenomenon cause?
Assume smallest possible diameter
Accounts for 2/3 of elastic recoil during exhalation
What is Surfactant’s role?
Reduces amount of constant inward pressure that pulls on walls of alveoli together
Prevents alveoli collapse and open w/ less air pressure
Define Law of Laplace
What does this law explain?
Pressure inside a spherical surface is inversely proportional to radius
Why smaller alveoli have higher pressure
Define lung compliance
How much effort is required to stretch lungs and chest wall
High- easy expansion
Low- expansion resistance
How is compliance determined?
Elasticity and surface tension
Why do lungs normally have high compliance?
Elastic fibers
Surfactant
What structure offers resistance to airflow in/out of lungs?
Walls of airways, especially bronchioles
Define Eupnea
Normal pattern for quiet breathing
Can consist of shallow, deep or combined breathing
Define Costal Breathing
Shallow/chest breathing
Up/Out movement of chest from external intercostal contraction
Define Diaphragmatic breathing
Deep breathing
Abdomen outward movement caused by diaphragm
What device is used to measure volume of air exchanged during breathing and respiratory rate?
Spirometer
Respirometer
What does in/exhalation look like on a spirogram?
In- up
Ex- down
Male- primary
Female- parentheses
Define Tidal Volume
Volume of one breath
Define Minute Volume
Total volume of air inhaled and exhaled each minute
RR x TV
How much of tidal volume actually reaches the respiratory zone?
70%
Rest remains in conducting airways (anatomical dead space)
Define Alveolar Vent Rate
Volume that actually reaches respiratory zone in one minute
70% resp zone x breath/min
Define Inspiratory and Expiratory Reserve Volume
Very deep in/forced exhale
ERV- amount over tidal volume exhaled
Define Residual Volume
Air that cannot be exhaled otherwise alveoli would collapse
Can not be determined by spirometry
Equation of inspiratory capacity
IC= tidal vol + insp reserve vol
Functional residual capacity equation
FRC= residual vol + expiratory reserve vol
Vital capacity equation
VC= insp reserve vol + tidal vol + expir reserve vol
Total lung capacity equation
TLC= vital capacity + residual vol
Alveolar air is dependent on what factors?
Air composition
Alveolar ventilation
Concentration of dissovled gases
What is the make up of atmospheric air?
79% N
21% O
1% other
When does the composition of air begin to change?
@ respiratory zone
What is Dalton’s Gas law?
Each gas in a mixture of gases exerts its own pressure as if no other gases were present
Pressure remains constant
The partial pressures og gases determine the movement of O and CO2 between what 3 areas?
Atmospherre and lungs
Lungs and blood
Blood and tissue cells
Dalton’s law says each gas moves from a ___ partial pressure to a ___ partial pressure
Higher to lower
Higher the pressure (larger the gradient) faster the gas moves
Define Henry’s law
Quantity of gas that will dissolve in a liquid ids proportional to the partial pressure of the gas and it’s solubility
CO2 is __x more soluble in blood plasma
Why doesn’t N bind w/ Hbg?
24x
Low solubility
Define Pulmonary Gas Exchange
External Respiration
O2 from air in alveoli to blood
CO2 from pulmonary to alveoli
Converts deoxygenated blood to oxygenated blood
Define Systematic gas exchange
O2 from blood to tissue
CO2 from tissue to blood
Converts oxygenated blood to deoxygenated blood
Define PaO2
Partial pressure of dissolved/free oxygen in arterial blood
Measured by arterial blood draw
Define SaO2
Measurement of O that is bound to Hbg in arterial blood
Saturation
Define Spo2
Measurement of O that is bound to Hbg peripherally
How does pulse oximeter measure SpO2?
Colorimetric measurement
What is the most important factor that determines how much O2 is bound to Hbg?
Partial pressure of O
Higher= more O combines w/ partially saturated Hgb
As Po2 gets higher, the affinity for O2 to bind to Hgb does ___?
Gets higher
What 4 factors affect the affinity of O2?
pH
PCO2
Temp
2,3 bisphosphoglycerate
As pH dec, the affinity for O2 ____ and causes the curve to shift to the _____
Dec
Right
With a decreased pH and at a higher Po2, the saturation of Hgb is ___ than if the pH were normal
Less
As pH inc, the affinity for O2 ____ and causes the curve to shift to the _____
Inc
Left
With a increased pH and at a higher Po2, the saturation of Hgb is ___ than if the pH were normal
Higher
As temperature increases O2s affinity for Hgb ____
Deccreases
Where is 2,3-bisphosphoglycerate found?
RBCs
Formed during break down of glucose to produce ATP
Inc BPG decreases affinity, more O2 is unloaded from Hgb to tissue
What are the 3 ways CO2 is transported in the blood?
Dissolved CO2- exhaled from lungs
Carbamino compounds- combined w/ AA/proteins
Bicarbonate ions- dissociates by carbonic anhydrase
What are the 3 areas of the Respiratory Center?
Medullary rhythmicity- basic rhythm, inspiration/exhalation
Pneumotaxic center- pons, transition between inhalation/exhalation; inhibits inspiratory area before lungs are too full
Apneustic center- pons, transition between inhalation/exhalation; prolongs inhalation/deep inhalation; inhibited by pulmonary stretch receptors and pneumotaxic center
What ions stimulate the respiratory center?
Inc levels of CO2 and H+
What 3 chemicals modulate how quickly and deeply we breath?
O2
H+
CO2
Where are the chemoreceptors located that monitor blood chemistry?
Central- medulla oblongata; respond to H and CO2 only
Peripheral- aortic/carotid bodies; respond to H, CO2 and O2 levels
Sudden/severe pain does what to respiration?
Visceral pain does what?
Brief apnea
Slow
Stretching anal sphincter does what to respiratory rate?
Physical/chemical irritation does what?
Inc
Cessation
Inc BP does what to respiratory rate?
Dec BP?
Inc- lowers
Dec- inc
What is the flow of structures as you descend down the bronchial tree?
Lobular bronchioles Terminal bronchioles Respiratory bronchioles Alveolar ducts Alveolar sacs Alveolus
