CH23 Flashcards

1
Q

why must excess CO2 be eliminated efficiently and quickly?

A

an excessive amount of CO2 produces acidity that can be toxic to cells

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2
Q

how do the cardiovascular and respiratory systems cooperate to supply O2 and eliminate CO2?

A
  • respiratory system provides for gas exchange—intake of O2 and elimination of CO2
  • cardiovascular system transports blood containing the gases between the lungs and body cells
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3
Q

what happens if either the respiratory and cardiovascular system fail?

A

homeostasis is disrupted by causing rapid death of cells from oxygen starvation and buildup of waste products

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4
Q

what are the functions of the respiratory system?

A
  • gas exchange
  • regulating blood pH
  • receptors for the sense of smell
  • filters inspired air
  • produces sounds
  • rids the body of some water and heat in exhaled air
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5
Q

what is respiration?

A

Overall exchange of gases between the atmosphere, blood, and body cells

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6
Q

what are the basic steps of respiration?

A
  1. pulmonary ventilation
  2. external respiration
  3. internal respiration
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7
Q

what is pulmonary respiration?

A

breathing

  • inhalation (inflow) and exhalation (outflow) of air
  • exchange of air between the atmosphere and the pulmonary alveoli
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8
Q

what is external respiration?

A

exchange of gases between the pulmonary alveoli and the blood in pulmonary capillaries across the respiratory membrane

  • pulmonary capillary blood gains O2 and loses CO2
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9
Q

what is internal respiration?

A

exchange of gases between blood in systemic capillaries and tissue cells

  • blood loses O2 and gains CO2
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10
Q

what organs are in the respiratory system?

A
  • nose
  • pharynx (throat)
  • larynx (voice box)
  • trachea (windpipe)
  • bronchi
  • lungs
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11
Q

what are the two structural parts of the respiratory system?

A
  • upper respiratory: nose, nasal cavity, pharynx
  • lower respiratory: larynx, trachea, bronchi, lungs
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12
Q

what are the two functional parts of the respiratory system?

A
  • conducting zone: nose, nasal cavity, pharynx, larynx, trachea, bronchi, bronchioles, terminal bronchioles
  • respiratory zone: respiratory bronchioles, alveolar ducts, alveolar saccules (sacs), and pulmonary alveoli
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13
Q

what is the conducting zone?

A
  • series of interconnecting cavities and tubes both outside and within the lungs
  • filter, warm, and moisten air and conduct it into the lungs
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14
Q

what is the respiratory zone?

A
  • tubes and tissues within the lungs where gas exchange occurs
  • main sites of gas exchange between air and blood
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15
Q

what is otorhinolaryngology?

A

The branch of medicine that deals with the diagnosis and treatment of diseases of the ears, nose, and throat

oto- ear
rhino-nose
laryngo- throat

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16
Q

what is the nose?

A

specialized organ at the entrance of the respiratory system that consists of a visible external portion (external nose) and an internal nasal cavity (internal nose)

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17
Q

what is the external nose?

A

portion of the nose visible on the face and consists of a supporting framework of bone and hyaline cartilage covered with muscle and skin and lined by a mucous membrane

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18
Q

what bones form the bony framework of the external nose?

A
  • frontal
  • nasal
  • maxillae
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19
Q

what forms the cartilaginous framework of the external nose?

A
  • nasal septal cartilage: anterior portion
  • lateral nasal cartilages: inferior to nasal bones
  • alar cartilages: forms portion of nostril walls
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20
Q

why is cartilaginous framework of the nose flexible?

A

Because it consists of pliable hyaline cartilage
- the cartilage is connected to each other and certain skull bones by fibrous connective tissue

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21
Q

what are the external nares?

A

nostrils

The opening into the nasal cavity on the exterior of the body

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22
Q

what are nasal vestibules?

A

cavities that the nostrils lead into

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23
Q

what are the functions of the interior structures of the external nose?

A

(1) warming, moistening, and filtering incoming air

(2) detecting olfactory stimuli

(3) modifying speech vibrations as they pass through the large, hollow resonating chambers

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24
Q

what is resonance?

A

prolonging, amplifying, or modifying a sound by vibration

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25
Q

what is rhinoplasty?

A

surgical procedure in which the shape of the external nose is altered

  • cosmetic reasons
  • repair a fractured nose or a deviated nasal septum
  • nasal cartilage is reshaped, and the nasal bones are fractured and repositioned to achieve desired shape
  • An internal packing and splint are inserted to keep the nose in the desired position as it heals
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26
Q

what is the nasal cavity?

A

A mucosa‐lined cavity on either side of the nasal septum that opens onto the face at the nostrils and into the nasopharynx at the choanae

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27
Q

what is the nasal septum?

A

vertical partition that divides the nasal cavity into right and left sides

anterior portion is made of hyaline cartilage

posterior portion is vomer and ethmoid’s perpendicular plate, maxillae, palatine bones

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28
Q

what are the choanae (internal nares)?

A

One of the two openings posterior to the nasal cavity opening into the nasopharynx

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29
Q

where do the paranasal sinuses and nasolacrimal ducts empty into?

A

into the nasal cavity

  • mucous membrane that lines the sinuses are continuous with the lining of nasal cavity
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30
Q

what are the different paranasal sinuses?

A
  • frontal sinus
  • sphenoidal sinus
  • ethmoid sinuses
  • maxillary sinuses
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31
Q

what is the function of the paranasal sinuses?

A
  • produce mucus
  • resonating chambers for sound
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32
Q

What is the path taken by air molecules into and through the nose?

A

nostrils → vestibule → nasal cavity → choanae

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33
Q

Which part of the nose is attached to the frontal bone?

A

the root of the nose

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34
Q

what is the root of the nose?

A

superior attachment of nose to the frontal bone

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35
Q

what is the apex of the nose?

A

the tip of the nose

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36
Q

what is the bridge of the nose?

A

bony framework of nose formed by nasal bones

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37
Q

what are the different regions of the nasal cavity?

A

respiratory region: larger, inferior

olfactory region: smaller, superior

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38
Q

what is the respiratory region?

A

region of nasal cavity lined with **ciliated pseudostratified columnar epithelium ** and goblet cells (respiratory epithelium) that serves conducting respiratory function of the nasal cavity

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39
Q

what is the nasal vestibule?

A

anterior portion of the nasal cavity just inside the nostrils surrounded by cartilage and lined by skin containing coarse hairs that filter out large dust particles

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40
Q

what is the function of the three conchae?

A
  • form projections in nasal cavity that subdivide each side of the nasal cavity into meatuses lined with mucous membrane
  • arrangement of conchae and meatuses increases surface area in the internal nose and prevents dehydration by trapping water droplets during exhalation
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41
Q

what is a tonsillectomy?

A
  • surgical removal of the tonsils
  • performed in individuals who have frequent tonsillitis-inflammation of the tonsils; tonsils that develop an abscess or tumor; or tonsils that obstruct breathing during sleep
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42
Q

what warms the inhaled air in the conchae and meatuses?

A

blood in capillaries transfer heat to the air

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43
Q

what moistens inhaled air in the conchae and meatuses?

A
  • mucus secreted by goblet cells moistens air and traps dust particles
  • drainage from the nasolacrimal ducts also helps moisten the air, and is sometimes assisted by secretions from the paranasal sinuses
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44
Q

what is the function of cilia in the nasal cavity?

A

move the mucus and trapped dust particles toward the pharynx, at which point they can be swallowed or spit out, thus removing the particles from the respiratory tract

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45
Q

what is the olfactory region?

A

region of the nasal cavity with olfactory sensory neurons, supporting epithelial cells, basal epithelial cells, and cilia that serve olfactory (smelling) function of the nasal cavity

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46
Q

what is the pharynx?

A

throat

a 13cm tube that starts at the choanae and runs partway down the neck, where it opens into the esophagus posteriorly and the larynx anteriorly

  • wall is composed of skeletal muscles and is lined with a mucous membrane
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47
Q

what is the function of the pharynx?

A
  • passageway for air and food
  • provides a resonating chamber for speech sounds
  • houses the tonsils, which participate in immunological reactions against foreign invaders
48
Q

what are the anatomical regions of the pharynx?

A
  • nasopharynx
  • oropharynx
  • laryngopharynx
49
Q

how are the muscles of the pharynx arranged?

A
  • outer circular layer
  • inner longitudinal layer
50
Q

what is the nasopharynx?

A

The superior portion of the pharynx, lying posterior to the nose and extending inferiorly to the soft palate

51
Q

what is the soft palate?

A

arch-shaped muscular partition between the nasopharynx and oropharynx that is lined by mucous membrane

52
Q

what are the five openings in the wall of the soft palate?

A
  • 2 choanae
  • 2 openings to the auditory tubes
  • 1 into the oropharynx
53
Q

what tonsil is found in the soft palate?

A

pharyngeal tonsil/adenoid

54
Q

what is the function of the nasopharynx?

A
  • receives air from the nasal cavity along with dust-laden mucus
  • lined with ciliated pseudostratified columnar epithelium: cilia move the mucus down toward the most inferior part of the nasopharynx
  • exchanges small amounts of air with the auditory tubes to equalize air pressure between the tympanic cavity and the atmosphere
55
Q

what is the oropharynx?

A

intermediate portion of the pharynx, lying posterior to the mouth and extending from the soft palate to the hyoid bone

56
Q

what is the fauces?

A

The opening from the mouth into the pharynx

57
Q

what is the function of the oropharynx?

A
  • common passageway for air, food, and drink
  • subject to abrasion by food particles, it is lined with nonkeratinized stratified squamous epithelium
58
Q

what are the tonsils that can be found in the oropharynx?

A
  • palatine
  • lingual
58
Q

what is the function of the laryngopharynx?

A
  • common passageway for air, food, and drink
  • subject to abrasion by food particles, it is lined with nonkeratinized stratified squamous epithelium
58
Q

what is the laryngopharynx?

A

inferior portion of the pharynx, extending downward from the level of the hyoid bone that divides posteriorly into the esophagus and anteriorly into the larynx

58
Q

What is the larynx?

A

voice box

  • short passageway that connects the laryngopharynx with the trachea
  • lies in the midline of the neck anterior to the esophagus and the fourth through sixth cervical vertebrae (C4–C6)
59
Q

what are the pieces of cartilage that compose the larynx wall

A

1 thyroid cartilage
1 epiglottic cartilage
1 cricoid cartilage

2 arytenoid
2 cuneiform
2 corniculate

59
Q

what is the function of the larynx’s intrinsic muscles?

A

connect the cartilages to one another

59
Q

why are the arytenoid cartilages the most important cartilages of the larynx?

A

they influence changes in position and tension of the vocal folds (true vocal cords for speech)

59
Q

what is the laryngeal cavity?

A

space that extends from the entrance into the larynx down to the inferior border of the cricoid cartilage

59
Q

what is the function of the larynx’s extrinsic muscles?

A

connect the cartilages to other structures in the throat

60
Q

what is the laryngeal vestibule?

A

portion of the laryngeal cavity above the vestibular folds (false vocal cords) is called the laryngeal vestibule

61
Q

what is the infraglottic cavity?

A

portion of the cavity of the larynx below the vocal folds

62
Q

How does the epiglottis prevent aspiration of foods and liquids?

A

During swallowing, the epiglottis closes over the rima glottidis, the entrance to the trachea, to prevent aspiration of food and liquids into the lungs

63
Q

what is the thyroid cartilage?

A

laryngeal prominence or Adam’s apple

  • two fused plates of hyaline cartilage that form the anterior wall of the larynx and give it a triangular shape
  • present in both males and females but is usually larger in males due to the influence of male sex hormones on its growth during puberty
64
Q

what is the thyrohyoid membrane?

A

ligament that connects the thyroid cartilage to the hyoid bone

65
Q

what is the epiglottic cartilage?

A

large, leaf-shaped piece of elastic cartilage

66
Q

what is the epiglottis?

A

A large, leaf-shaped piece of cartilage covered by a mucous membrane and lying on top of the larynx, attached to the thyroid cartilage; its unattached portion is free to move up and down to cover the glottis (vocal folds and rima glottidis) during swallowing

67
Q

what happens during swallowing to the larynx and pharynx?

A
  • pharynx and larynx rise
  • Elevation of the pharynx widens it to receive food or drink; elevation of the larynx causes the epiglottis to move down and form a lid over the glottis, closing it off
  • closing of the larynx in this way during swallowing routes liquids and foods into the esophagus and keeps them out of the larynx and airways
68
Q

what is the glottis?

A

The vocal folds (true vocal cords) in the larynx plus the space between them (rima glottidis)

69
Q

what happens when something other than air pass into the larynx?

A

cough reflex occurs, usually expelling the material

70
Q

what is the cricoid cartilage?

A

ring of hyaline cartilage that forms the inferior wall of the larynx

71
Q

how is the cricoid cartilage important?

A

it is the landmark for making an emergency airway called a tracheotomy

72
Q

what are the arytenoid cartilages?

A

triangular pieces of mostly hyaline cartilage located at the posterior, superior border of the cricoid cartilage. They form synovial joints with the cricoid cartilage and have a wide range of mobility.

73
Q

what are the corniculate cartilages?

A

horn-shaped pieces of elastic cartilage, are located at the apex of each arytenoid cartilage

74
Q

what are the cuneiform cartilages?

A

club-shaped elastic cartilages anterior to the corniculate cartilages, support the vocal folds and lateral aspects of the epiglottis

75
Q

what lines the larynx superior to the vocal folds?

A

nonkeratinized stratified squamous epithelium

76
Q

what lines the larynx inferior to the vocal folds?

A

ciliated pseudostratified columnar epithelium consisting of ciliated columnar cells, goblet cells, and basal cells

  • The mucus produced by the goblet cells helps trap dust not removed in the upper passages.
  • The cilia in the upper respiratory tract move mucus and trapped particles down toward the oropharynx; the cilia in the lower respiratory tract move them up toward the laryngopharynx.
77
Q

what happens when vocal folds are pulled taut by muscles?

A

they vibrate more rapidly, and a higher pitch results

78
Q

what happens when you decrease muscular tension on the vocal folds?

A

they vibrate more slowly and produce lower-pitched sounds

79
Q

why does a man’s voice generally sound lower than a woman’s

A

Due to the influence of androgens (male sex hormones), vocal folds are usually thicker and longer in males than in females, and therefore they vibrate more slowly

80
Q

what allows us to enunciate words?

A

Muscles of the face, tongue, and lips

81
Q

what allows us to produce vowel sounds?

A

constricting and relaxing the muscles in the wall of the pharynx

82
Q

what is laryngitis?

A
  • inflammation of the larynx that is most often caused by a respiratory infection or irritants such as cigarette smoke
  • hoarseness/loss of voice by interfering with the contraction of the folds or by causing them to swell to the point where they cannot vibrate freely
83
Q

what is the trachea?

A

windpipe

  • Tubular air passageway extending from the larynx to the fifth thoracic vertebra
84
Q

where does the trachea bifurcate?

A

superior border of the fifth thoracic vertebra (T5)

85
Q

What is the benefit of not having complete rings of tracheal cartilage between the trachea and the esophagus?

A

Because the tissues between the esophagus and trachea are soft, the esophagus can bulge and press against the trachea during swallowing

86
Q

How many lobes and corresponding lobar bronchi are present in each lung?

A

The left lung has two lobes and two lobar bronchi; the right lung has three of each

87
Q

what are the layers of the tracheal wall?

A

(1) respiratory mucosa (deep)

(2) submucosa,

(3) hyaline cartilage,

(4) adventitial layer (composed of areolar connective tissue)

88
Q

what is found in the respiratory mucosa?

A
  • epithelial layer of ciliated pseudostratified columnar epithelium and an underlying layer of lamina propria that contains elastic and reticular fibers
  • provides the same protection against dust as the membrane lining the nasal cavity and larynx
89
Q

what does the submucosa consist of?

A

areolar connective tissue that contains seromucous glands and their ducts

90
Q

how many rings of hyaline cartilage are found in the trachea?

A

16-20 rings, connected by dense connective tissue

  • provides a semirigid support to maintain patency so that the tracheal wall does not collapse inward (especially during inhalation) and obstruct the air passageway
91
Q

what spans the open part of the trachea (the one that touches esophagus)?

A

membranous wall of the trachea with transverse smooth muscle fibers, called the trachealis muscle

  • allow the diameter of the trachea to change subtly during inhalation and exhalation, which is important in maintaining efficient airflow.
92
Q

what is a tracheostomoy?

A

provide an airway when the usual route for breathing is obstructed or impaired and to remove secretions from the lungs

  • Indications for a tracheostomy include medical conditions that require use of a mechanical ventilator (breathing machine), vocal cord paralysis, throat cancer, severe neck or mouth injuries, airway burns, foreign body obstructions, and conditions that make it difficult for a person to cough up secretions.
93
Q

what is an endotracheal intubation?

A

an endotracheal tube is advanced through the mouth (or sometimes the nose), pharynx, and larynx into the trachea. During the procedure, a laryngoscope, a lighted instrument that permits visualization of the larynx, is employed. Once the vocal folds are located, the tube is placed in the inferior portion of the trachea. The laryngoscope also holds the tongue aside while the tube is inserted into the trachea. Endotrachial intubation is used to permit air to freely pass into and out of the lungs. The tube can also be connected to a ventilator. In some cases, the tube can be used to introduce anesthesia, medications, and oxygen or to suction respiratory secretions.

94
Q

what is a mechanical ventilator?

A

a machine that is used to support ventilation (breathing). It is a form of life support.

  • oxygenating the lungs, removing carbon dioxide, helping people breathe more easily and ventilating for individuals who have lost the ability to breathe on their own. The mechanical ventilator blows humidified and warmed air and oxygen through a tube into the airways and then into the lungs. The rate at which this is done can be adjusted to deliver a certain amount of air per minute. The tube is then placed into the trachea via the tracheostomy or endotracheal intubation procedure
  • an invasive procedure
95
Q

what is a CPAP?

A
  • noninvasive
  • consists of a machine that contains a motorized fan that draws air in from a room, humidifies it, and gently pressurizes it. The air is then delivered through a hose that connects to a mask placed over the nose and/or mouth. The mildly pressurized air helps to keep the airways open
  • CPAP is indicated for sleep-related disorders, such as sleep apnea.
96
Q

why is an aspirated object is more likely to enter and lodge in the right main bronchus than the left?

A

The right main bronchus is more vertical, shorter, and wider than the left

97
Q

what are the main bronchi?

A

contain incomplete rings of cartilage and are lined by ciliated pseudostratified columnar epithelium

98
Q

what is the carina?

A

internal ridge at the point where the trachea divides into right and left main bronchi

99
Q

what is special about the mucous membrane of the carina?

A

one of the most sensitive areas of the entire larynx and trachea for triggering a cough reflex

100
Q

why is widening and distortion of the carina a serious sign?

A

usually indicates a carcinoma of the lymph nodes around the region where the trachea divides

101
Q

describe how trachea bifurcates into many generations until it turns into alveolar ducts

A

CONDUCTING ZONE:
1. trachea (Gen 0)

  1. main bronchi (Gen 1)
  2. lobar bronchi (Gen3 in R,2 in L)
  3. segmental bronchi (Gen 10)
  4. bronchioles (11-16)
  5. terminal bronchioles (11-16)

RESPIRATORY ZONE
7. respiratory bronchioles (17-19)

  1. alveolar ducts(20-22)
  2. alveolar saccules(23)
102
Q

what are in terminal bronchioles?

A

These bronchioles contain exocrine bronchiolar (Clara) cells, which are nonciliated columnar cells, interspersed among ciliated simple columnar cells
- may protect against harmful effects of inhaled toxins and carcinogens, produce surfactant (discussed shortly), and function as stem cells, which give rise to various cells of the epithelium

The terminal bronchioles represent the end of the conducting zone of the respiratory system

103
Q

what are some epithelial changes that occur as branching occurs in the bronchial tree

A

mucous membrane in the bronchial tree changes:

ciliated pseudostratified columnar epithelium
- main bronchi to segmental bronchi

ciliated simple columnar epithelium w/ goblet cells
- in larger bronchioles

ciliated simple cuboidal epithelium with no goblet cells
- in smaller bronchioles

nonciliated simple cuboidal epithelium
- terminal bronchioles

104
Q

what happens to inhaled particles in regions where no cilia is present?

A

inhaled particles are removed by macrophages

105
Q

what are some structural changes that occur as branching occurs in the bronchial tree

A
  • Plates of cartilage gradually replace the incomplete rings of cartilage in main bronchi and finally disappear in the distal bronchioles.
  • Amount of smooth muscle increases
106
Q

why can muscle spasms close off airways?

A

as the amount of cartilage decreases, the amount of smooth muscle increases

107
Q

what happens to the smooth muscle and airways during exercise?

A

activity in the sympathetic part of the autonomic nervous system (ANS) increases and the suprarenal medulla releases the hormones epinephrine and norepinephrine; both of these events cause relaxation of smooth muscle in the bronchioles, which dilates the airways

  • lung ventilation improves
108
Q

how does the parasympathetic nervous system affect the bronchi?

A

The parasympathetic part of the ANS and mediators of allergic reactions such as histamine cause contraction of bronchiolar smooth muscle, which results in constriction of distal bronchioles

109
Q
A