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05 > Alterations to Respiration > Flashcards

Alterations to Respiration Flashcards

1
Q

What is the role of the Respiratory System?

A
  • sense of smell
  • speech
  • acid-base balance
  • fluid balance
  • gas exchange
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2
Q

What is Ventilation?

A

Movement of gases between the lungs and the environment

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3
Q

What is Perfusion?

A

Movement of blood through the lungs

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4
Q

What is Diffusion in the respiratory system?

A

Movement of gases between the lungs and the blood

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5
Q

What is the purpose of the lower airway?

A

ventilation and gas exchange

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6
Q

What is the purpose of the upper airway?

A

filter, warm and moisten incoming air

- allows better gas exchange and diffusion through the alveoli

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7
Q

What does the upper airway compose of?

A
  • nose
  • sinuses
  • pharynx (throat)
  • larynx (voice box)
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8
Q

What are Anterior Nares?

A

Are lined with hair follicles which trap foreign particles and stops them from entering the lungs

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9
Q

What are Turbinates?

A

Tree bony projections which protrude into the nasal cavity

  • they increase SA = more trapping of pathogens
  • covered in mucous and trap pathogens that have not filtered by the vibrissae
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10
Q

What are Cilia?

A
  • Lines the bronchus and bronchioles
  • Hair-like projections that push pathogens/debris in the mucous up the airways - where it is cough out
  • If respiratory secretions thicken, the cilia may be prevented from moving freely thus impairing the protective function of the mucociliary defence system
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11
Q

What is the Pharynx?

A

Tube or cavity that connects mouth and nasal passages with the oesophagus

  • It is divided into three parts

Nasopharynx

Oropharynx

  • both air and food through
  • extends posteriorly from the soft palate to the epiglottis
  • any obstruction leads to immediate cessation of ventilation

Laryngopharynx

  • connects the oropharynx to the trachea
  • when air contains foreign substances, the laryngeal muscle close the airway and a cough reflex is initiated
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12
Q

What is the Epiglottis?

A

Leaf shaped structure
- during swallowing the edges of the epiglottis moves down to cover the larynx thus routing food and drink to the oesophagus

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13
Q

What does the lower airway consist of?

A
  • Trachea
  • Two main stem bronchi
  • lobar segmental, and subsegmental bronchi
  • Bronchioles
  • Alveolar ducts
  • Alveoli
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14
Q

What is the tracheobranchial tree?

A

consists of trachea bronchi & bronchioles

  • branching network of tubes
  • approx. 23 levels of branching, increasingly narrower tubes
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15
Q

What is the Trachea?

A
  • Windpipe
  • connects larynx with major bronchi of the lungs
  • carina has sensitive mucous and will initiate coughing if irritated
  • walls supported by C-shaped rings of hyaline cartilage - this prevents the trachea from collapsing when the pressure of the thorax becomes negative
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16
Q

What is the Bronchi?

A
  • primary bronchi has similar to the trachea
  • smallest of the conducting airways
  • no cartilage present and there is an increase in smooth muscle and elastic fibres
  • bronchospasm can cause contraction of the smooth muscle which narrow the bronchioles and impairs airflow
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17
Q

What is the function of the lungs?

A
  • gas exchange
  • inactivate vasoactive substances e.g. Bradykinin
  • convert angiotensin 1 to angiotensin 2
  • reservoir for blood storage
  • heparin producing cells are in abundance in the capillaries of the lungs to prevent small clots
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18
Q

What are respiratory lobules?

A
  • where gas exchange takes place
  • each loluble is the smallest functional unit of the lung
  • supplied by a terminal bronchiole, arteriole, pulmonary capillary and a venule
  • gas exchange takes place in the terminal respiratory bronchiole, alveolar ducts and alveoli
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19
Q

What are alveolar ducts and alveoli?

A
  • alveolar ducts are lined with simple epthelium
  • alveoli are cup shaped, thin wall structures
  • 300 million in adult lung

2 types of alveolar cells

  • type 1 - allows gas exchange to occur
  • type 2 - produce surfactant to prevent alveoli from collapsing
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20
Q

Describe the gas exchange process

A

oxygen moves from alveoli to pulmonary capillaries as dissolved gas
- moves down partial pressure gradient

Oxygen
- Alveoli PO2 is 100mmHg – venous end of pulmonary capillary PO2 is 40mmHg

Carbon dioxide

  • pulmonary capillary PCO2 is 45mmHg
  • alveoli PCO2 is 40mmHg
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21
Q

Describe lung circulation

A
  • has a dual supply
    pulmonary and bronchial circulation
  • distributes blood to the conducting airways and supporting structure of the lungs
  • warms and humidifies air in conducting airways
  • bronchial blood vessels are the only ones to undergo angiogenesis when vessels in the pulmonary circulation are obstructed
  • Pulmonary circulation brings deoxygenated blood from the right of the heart via the pulmonary artery
  • Oxygenated blood returns via the pulmonary veins into the left artium
22
Q

What is the Pleura?

A

Thin and double layered serous membrane
- space between is the pleural cavity contains small amount of fluid

  • surface tension of the pleural fluid also brings the lungs surfaces with the chest wall close together –> allows greater inflation of the alveoli during respiration
23
Q

What happens during inspiration?

A
  • chest cavity increases due to the movement of the respiratory muscles expanding the chest cage
  • intrathoracic pressure become negative
  • air is drawn into the lungs
24
Q

What happens during expiration?

A
  • largely a passive process

- chest wall and lung structures recoil decreasing the size of the chest cage

25
Q

Describe the concept of “Lung Compliance”

A

ability for the lungs to be inflated

  • measure the change in lung volume that occurs with the change in intrapulmonary pressure
  • determined by elastin and collagen fibres, water content, surface tension and compliance of the thoracic cage
26
Q

Pulmonary Oedema

A

Fluid accumulation in the tissue and air spaces of the lungs

Leads to impaired gas exchange and may cause respiratory failure.

27
Q

Hypoxaemia

A

Reduced concentration of oxygen in the blood

28
Q

Hypercapnia

A

Increased concentration of CO2 in the blood

29
Q

Dyspnoea

A

Feeling of breathlessness

  • V/Q mismatches
  • lung diseases
  • may relate to stretch receptors
30
Q

Hypoventilation

A

Decreased alveolar ventilation (leads to respiratory acidosis)

  • inadequate ventilation to perform gas exchange
31
Q

Hyperventilation

A

Increased alveolar ventilation (leads to respiratory alkalosis)

32
Q

Haemoptysis

A

Coughing up bloodly mucous

33
Q

Cyanosis

A

Bluish discolouration of the skin by desaturation of haemoglobin or peripheral vasoconstriction

34
Q

What is lung consolidation?

A

region of lung tissue which usually contains gas is filled with fluid

it can be

  • pulmonary oedema
  • exudate
  • pus
  • inhaled fluids
  • blood
35
Q

What is pleural effusion?

A
  • excess fluid in the pleural cavity
  • compresses the lungs and restricts lung expansion during inhalation

fluid may be from

  • pus
  • blood
  • serous fluid
  • larger effusion may require an intercostal drain
36
Q

Pneumothorax

A

condition where air enters the pleural cavity separating the visceral and parietal pleura destroying the negative pressure
- can be classified as primary and secondary
(fractured ribs and COPD)

37
Q

What is a Shunt?

A

Perfusion without ventilation

  • occurs when alveoli of the lungs are perfused with blood but there is not supply of air to the region of perfusion
  • often from alveoli filled with fluid
  • blood leaving area with low levels of oxygen and increased amounts of carbon dioxide
38
Q

Dead air space

A

volume of inhaled air which does not take place in gas exchange either because:

  • it is in the conducting zone
  • it is in alveoli that are poorly perfused

poor perfusion can be caused by blood clot - pulmonary embolism

39
Q

Coughing

A
  • protective and neurally mediated reflex
  • protects lungs from accumulation of secretions and foreign particles
  • initiated by receptors in the tracheobronchial wall
  • cough reflex may be impaired by diseases that impaired by diseases that impair or weaken the abdominal and respiratory muscles
40
Q

Tissue hypoxia

A
  • blood vessels in the pulmonary circulation undergo significant vasconstriction when exposed to hypoxia
  • enables blood to redirected from areas with poor ventilation to areas with good ventilation to enable maximum oxygen delivery
  • if alveolar oxygen falls below 60mmHg, marked vasoconstriction will occur and blood flow to the area may eventually cease
41
Q

Chronic Obstructive Pulmonary Disease

A

Group of progressive respiratory disease that increase resistance to airflow

  • cause of hypoxaemic and hypercapnic cases
  • co-exist with emphysema, asthma, chronic bronchitis

e.g. bronchial asthma prevents airflow via constriction of the smooth muscle in the airways and mucous production

42
Q

Chronic Bronchitis

A

Chronic inflammation of the bronchi

  • Persistent cough which is productive (produces sputum & mucus)
  • Chest x rays shows prominent vessels

Smoking is the most common cause

43
Q

Emphysema

A

Alveoli are destroyed

  • reduces SA for gas exchange and makes them unable to hold shape on exhalation
  • Chest x ray shows hyperinflation

smoking is the most common cause

44
Q

Asthma

A

chronic inflammatory disease characterised by reversible airway obstruction and bronchospasm

  • mucous production blocks inflamed airway
  • shortness of breath
  • linked to genetic and environmental factors
45
Q

Atelectasis

A

Incomplete expansion of the lung or a portion of the lung

  • lung compression e.g. pneumothorax
  • caused by pleural effusion
  • increased lung recoil due to decreased surfactant
46
Q

Acute Respiratory Distress Syndrome

A

severe lung syndrome caused by direct and indirect factors

  • inflammation of the lungs leading to impaired gas exchange
  • release of inflammatory mediators, hypoxaemia and multiple organ failures

often fatal and need intensive care

47
Q

List some infections of the pulmonary system

A

influenza

Tuberculosis is caused by a bacterial infection causing scar tissue in the lungs

Bronchiolitis is an inflammation and obstruction of the small airways due to infection and most common in children

48
Q

Pneumonia

A

Inflammation of the lung structures e.g. alveoli and bronchioles
- can be caused by bacteria, virus and gastric secretions

49
Q

Obstructive Sleep Apnoea

A

Partial or complete airway obstruction during sleep
- disrupting sleep patterns and decreasing ventilation

it is developed from smoking, increased age, obesity and being male

50
Q

What is Croup?

A

Acute inflammation of the upper respiratory tract

  • occurs usually in children aged between 6 months to 5 years as they have smaller airways
  • airway obstruction occurs (subglottic region) due to mucosal oedema and secretions related to the viral infection
  • patient initially has a sore throat that develops into a barking cough
  • usually resolves with 1 to 2 days

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