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physiotherapy MSc term 1 > Cardiovascular/respiratory system Clinical skills > Flashcards

Cardiovascular/respiratory system Clinical skills Flashcards

1
Q

what is the structure of the upper respiratory tract

A

nasal and oral cavities
pharynx
larynx
trachea

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2
Q

what is the structure of the lower respiratory tract

A

lower part of trachea
2 primary bronchi
lungs
alveoli - terminal branches of lungs

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3
Q

what are the nose hairs used for

A

removing bacteria

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4
Q

why is the nasal cavity vascularized

A

heats the air and humidifies it to make it easier to travel through airways and prevents the trachea from having spasms

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5
Q

where does mucus come from

A

goblet cells in the epithelium

unnatural production of goblet cells with asthma - results in excess mucus

mucus traps debris and prevents infection

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6
Q

where do the lympatic vessels drain into

A

submandibular node and then into deep cervical nodes

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7
Q

what are the 3 parts of the pharynx

A

nasopharynx - above soft palate and opens anteriorly into nasal cavities
cut off from oropharynx by soft palate during swallowing and contains eustachian tube opening

oropharynx
laryngopharynx - separates esophagus and trachea , innervated by vagus
(descending order)

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8
Q

what muscles surround the fascial tube of the pharynx

A

superior, middle, and inferior constrictor muscles

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9
Q

what is the larynx

A

attached to trachea and hyoid bone, mainly cartilaginous

innervated by vagus nerve

acts as an open valve to allow air to pass when breathing and protects trachea and bronchi during swallowing

also responsible for speech production and coughing

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10
Q

what is the trachea

A

membranous tube that is supported by c-shaped rings of hyaline cartilage

thyroid gland straddles the trachea while the common carotid arteries are lateral to the trachea

the oesophagus lies directly behind the trachea

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11
Q

what are the divisions of the bronchial tree

A

Conducting Zone
trachea into bronchi, which break into bronchiles and then terminal bronchioles

Transitional and respiratory zones
terminal bronchioles turn into respiratory bronchioles and then into alveolar ducts, then finally into alveolar sacs

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12
Q

what are thhe 4 parts of a lung

A

apex - top peak (into root of neck)

Base - concave surface that touches diaphragm

root - attachment for lung and point where hilum enters the lung

hilum - where the root attaches to the lung , contains main bronchus, vessels, nerves

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13
Q

what attaches the lungs to the pericardium

A

pulmonary ligaments

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14
Q

how many fissures and lobes do the lungs have

A

right lung - superior, middle, and inferior lobes
horizontal and oblique fissures

Left lung - superior and inferior lobes
only oblique fissure. also contains cardiac notch

Cause heart sits on left side

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15
Q

what are bronchopulmonary segments

A

further division of the lobes of the lungs

each segment gets a gaseous mixture from a single segment bronchus

important to identify tumours or lesions

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16
Q

what supplies blood to the lungs

A

pulmonary arteries - bring in deoxygenated blood and then oxygenated blood leaves thru pulmonary veins back to heart

bronchial arteries - supply blood to connective bronchial tissue, while brhonchial veins drain the blood from them

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17
Q

what is the pleura of the lungs

A

inner/outer pleura lying next to organs (inner) and against chest wall (outer)

separated by liquid which allows the two to slip over each other w no friction

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18
Q

what is ventilation

A

act of moving gas in or out of the lungs

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19
Q

what is respiration

A

exchange of gasses between environment and tissue cells

regulation of acid/base, metabolic, and defence functions of the respiratory system

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20
Q

what is anatomical deadspace

A

volume of air that does not participate in any gas exchange

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21
Q

what is alveolar dead space

A

air that reaches alveoli, but not the blood

mainly seen in forms of lung disease

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22
Q

what is physiological dead space

A

anatomical plus alveolar

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23
Q

what is tidal volume

A

regular breaths (volume of air displaced with regular breathing)

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24
Q

what is IRV

A

inspiratory reserve volume

max u can inhale

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25
Q

what is VC

A

vital capacity, max u can inhale after max expiration

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26
Q

what is RV

A

residual volume, deadspace air

27
Q

what is ERV

A

expiratory reserve volume
max air u can expire after normal breathing

28
Q

what is TLC

A

total lung capacity

29
Q

how does transfer of gas occur

A

diffusion across the blood gas barrier

rate of diffusion dependant on gas and tissue properties (CO2 diffuses 20x faster than O2 cause it has much higher solubility

30
Q

describe the stucture and function of alveoli

A

provide a large surface area for the diffusion of gas (50 to 100 square metres)

minimize the distance for diffusion

match ventilation and blood flow

capillary only wide enough for one RBC at a time, and they come into contact with many alveoli making em saturated with O2 quick

have capillaries wrapped around alveoli to maximize diffusion

31
Q

what is the gas exchange ratio

A

v/q

ventilation/perfusion

perfusion will occur at the lowest part of the lung

important for maintaining partial pressure of O2 and CO2 levels in blood

32
Q

what are the 3 elements in the control of breathing

A

sensors - gather info

central controller (brainstem, dorsal respiratory group in medulla is inspiration and ventral respiratory group in medulla is expiration) - coordinate info and send impulses

effectors (respiratory muscles) - cause ventilation

33
Q

what is the apneustic centre

A

in lower pons, plays a role in abnormal ventilation in brain injury

34
Q

what is the pneumotaxic centre

A

upper pons

can switch off or inhibit inspiration and regulate inspired volume and rate

35
Q

how is voluntary breathing controlled

A

motor cortex can override brainstem and breathe on its own

pCO2 can be halved by hyperventilation

voluntary hypoventilation is hard to do

36
Q

what muscles are responsible for breathing

A

external intercostals - fibres running forwards and downwards (inhalation)

internal intercostals - fibres running backwards and downwards (exhalation)

diaphragm - main muscle of respiration
connected via central tendon attaching to the xiphisternum (innervated by phrenic nerve from roots C3,C4,C5)

37
Q

what passes through the diaphragm and where

A

i ate 10 eggs at 12

inferior vena cava at t8

esophagaus at t10

aorta at t12

38
Q

what are the sensors that detect breathing rate changes

A

central chemoreceptors - respond to a change in the chemical composition of the blood or fluid around it, they sit near ventral surface of medulla and respond to changes in H+ (more h+, ventilation stimulated, less inhibits it)

peripheral chemoreceptors - in the carotid bodies at the bifurcation of common carotid arteries and the aortic arch, respond to decreases of pO2 and ph, and respond to increases of pCO2. less important than central

39
Q

how do we achieve airflow in lungs

A

pressure inside the lungs has to be lower to force air in (diaphragm contracts)

pressure inside lungs has to be higher to force air out (diaphragm relaxes)

40
Q

what encases the heart

A

mediastinum - space between the two pleural sacs

41
Q

what is the pericardium

A

tough fibrous sac that surrounds the heart and protects it from sudden overfilling, with the apex of it having the aorta coming out alongside the SVC and the pulmonary trunk

base is fused with central tendon

42
Q

what is the function of the heart

A

pump blood through vessels of the body, right heart gets and sends deoxygenated blood to lungs, left heart gets the oxygenated blood from lungs and sends to the body

43
Q

what is the structure of the heart

A

4 chambers (2 atria and 2 ventricles)

each chamber wall has an endocardium (inner layer)
myocardium (middle layer w muscle)
epicardium (external layer)

44
Q

what is the function of the right atrium

A

connects w IVC and SVC, receives blood from the body and pumps it down into Rventricle

45
Q

what is the function of the right ventricle

A

pumps deoxy blood thru pulmonary trunk to send to lungs

wall is made up of papillary muscles which have chordae tendinae arrising from them, attaching to the AV valve

46
Q

what is teh function of the left ventricle

A

the apex of the heart, the strongest area of the heart as it pumps blood to the entire body through the aorta

47
Q

what is the function of the left atrium

A

recieve oxy blood from pulmonary veins

48
Q

what are the AV valves called

A

right - tricuspid
left - mitral

both prevent backflow of blood and are controlled by the chordae tendinae/papillary muscles

49
Q

what is the semilunar valve

A

in right its pulmonary valve, preventing backflow into Rventricle, sealed when blood flows backwards

in left its aortic valve, same properties

50
Q

what supplies blood to the heart muscles

A

right/left coronary arteries (branches off the ascending aorta, and run in the coronary groove)

coronary sinus (opens into right atria to the left of IVC) and great cardiac vein drain the heart (mainly on the right side of heart.)

51
Q

what are the two branches of the right coronary artery

A

right marginal branch - towards apex of heart

posterior interventricular branch - left side of heart

52
Q

what are the two branches of the left coronary artery

A

anterior interventricular branch (apex)

circumflex branch (LV, LA, and left surface of heart

53
Q

what are the 3 parts to the circulatory system

A

systemic circulation - supplies body as a whole

pulmonary system - supplies the lungs

coronary system - supplying the heart

54
Q

trace the path of blood from IVC

A

IVC
RA
tricuspid valve
RV
pulmonary valve
pulmonary trunk/arteries
pulmonary veins
LA
mitral valve
LV
Aortic valve
Aorta
region of body (main artery)
arterioles
capillaries
venioles
veins
IVC or SVC

55
Q

what is the function of capillaries

A

permit rapid exchange of substances between the blood and interstitial fluid

transport O2 to the muscles and transport nutrients/waste

56
Q

what are the 3 components that regulate the CV system

A

control centre
effectors (heart, smooth muscles of vessels, and kidneys)
sensors

organized into a feedback loop

57
Q

where is the control centre for the CV system

A

thru cardiovascular centre in the medulla oblongata (contains cardiac centre and vasomotor centre)

58
Q

What is the cardiac centre

A

causes changes in heart rate and strength of contraction

causes increases by activating the cardiostimulatory pathways and decreases by activating the cardioinhibitory pathways (vagal nerve)

59
Q

what is the vasomotor centre

A

causes change in blood vessel tone

causes vasoconstriction by activating the vasoconstrictor areas

causes vasodilation by activating the vasodilator areas

60
Q

what are baroreceptors

A

pressure sensitive cells in the walls of carotid arteries and aortic arch, when they are stretched by force of BP they produce potentials to send to cardiovasular centre - carotid sinus receptors are more sensitive.

they exist in other vessels like VC and the chambers of the heart, and these are more sensitive to low-pressure changes caused by the effects of blood volume. they cause inhibition of the cardio-stim centre and lower BV and BP

61
Q

whaat are central chemoreceptors for CV system

A

stimulated by an assortment of chemicals

when stimulated they send signals to CNS to activate local smooth muscle

central chemoreceptors are located on anterior surface of oblongata and are sensitive to H+ changes from CSF. they control the ventilation depending on if theres increased H+ (acidosis - increased vasoconstriction) or lower H+ (alkalosis - decreased vasoconstriction)

62
Q

what are peripheral chemoreceptors for CV system

A

located in carotid bodies and aortic arch, respond to reductions in blood O2, or increases in blood CO2 and H+, and they stimmulate the vasopressor area and inhibit cardiostim centre

63
Q
A

physiotherapy MSc term 1 (8 decks)

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