Chapter 22: Respiratory System Flashcards

1
Q

respiratory system

A

organ system that takes in air and expels it from the body

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2
Q

respiration refers to

A

ventilation of the lungs (breathing)

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3
Q

functions of the respiratory system

A
  • gas exchange
  • communication (speech)
  • olfaction
  • acid base balance
  • blood pressure regulation
  • blood and lymph flow
  • platelet production
  • expulsion of abdominal contents
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4
Q

blood pressure regulation

A

assists with synthesis of angiotensin II, a hormone that regulates blood pressure

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5
Q

blood and lymph flow

A

breathing creates pressure gradients between thorax and abdomen that promote flow of lymph and blood

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6
Q

platelet production

A

more than half of platelets are made by megakaryocytes in lungs (not in bone marrow)

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7
Q

expulsion of abdominal contents

A

breath-holding assists in urination, defecation, and childbirth

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8
Q

principal organs of respiratory system

A

nose, pharynx, larynx, trachea, bronchi, and lungs

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9
Q

conducting zone

A

-passages that serve only for airflow (no gas exchange)
-Nostrils through major bronchioles

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10
Q

upper respiratory tract

A

airway from nose through larynx

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11
Q

lower respiratory tract

A

regions from trachea through alveoli

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12
Q

respiratory zone

A

-regions that participate in gas exchange
-Alveoli and nearby structures

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13
Q

nose

A

-warms, cleanses, and humidifies inhaled air; detects odors; and serves as a resonating chamber that amplifies voice
-Extends from nostrils (nares) to posterior nasal apertures (choanae)—posterior openings
-Facial part is shaped by bone and hyaline cartilage

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14
Q

superior half of nose

A

nasal bones and maxillae

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15
Q

inferior half of nose

A

lateral and alar cartilages

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16
Q

ala nasi

A

flared portion at lower end of nose shaped by alar cartilages and dense connective tissue

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17
Q

what divides nasal cavity into right and left nasal fossae?

A

nasal septum

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18
Q

structure of nasal septum

A

-Vomer forms inferior part
-perpendicular plate of ethmoid forms superior part
-septal cartilage forms anterior part
-Paranasal sinuses and nasolacrimal duct drain into nasal cavity

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19
Q

Superior, middle, and inferior nasal conchae (turbinates) project from

A

lateral walls toward septum

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20
Q

nose epithelium

A

-Ciliated pseudostratified columnar epithelium
-Olfactory epithelium is involved in the sense of smell

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21
Q

goblet cells (ciliated cells)

A

have motile cilia that propel the mucus posteriorly toward pharynx to be swallowed

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22
Q

epithelia of pharynx

A

-Nasopharynx passes only air and is lined by pseudostratified columnar epithelium
-Oropharynx and laryngopharynx pass air, food, and drink and are lined by stratified squamous epithelium

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23
Q

muscles of the pharynx assist in

A

swallowing and speech

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24
Q

larynx

A

-Cartilaginous chamber about 4 cm (1.5 in.) long
-Primary function is to keep food and drink out of airway
-involved in production of sound, so commonly called the “voice box”

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25
Q

epiglottis

A

flap of tissue that guards superior opening of larynx

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26
Q

3 big solitary cartilages

A

-Epiglottic cartilage
-Thyroid cartilage
-Cricoid cartilage

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27
Q

3 smaller paired cartilages

A

-Arytenoid cartilages
-Corniculate cartilages
-Cuneiform cartilages

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28
Q

vocal cords (vocal folds)

A

-produce sound when air passes between them
-Contain vocal ligaments covered with stratified squamous epithelium, suited to endure vibration and contact

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29
Q

glottis

A

the vocal cords and the opening between them

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30
Q

trachea

A

-Lined by ciliated pseudostratified columnar epithelium
-Contains mucus-secreting cells, ciliated cells, and stem cells

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31
Q

mucocillary escalator

A

-mechanism for debris removal
-Mucus traps inhaled particles, upward beating cilia moves mucus to pharynx to be swallowed

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32
Q

trachealis

A

muscle spans opening in rings; contracts or relaxes to adjust airflow *internal median ridge—the carina

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33
Q

tracheotomy

A

-to make a temporary opening in the trachea and insert a tube to allow airflow
-Prevents asphyxiation due to upper airway obstruction

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34
Q

intubation

A

-when a patient is on a ventilator, air is introduced directly into trachea
-Air must be filtered and humidified

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35
Q

base

A

broad concave portion resting on diaphragm

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36
Q

apex

A

tip that projects just above the clavicle

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37
Q

costal surface

A

pressed against the ribcage

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38
Q

mediastinal surface

A

faces medially toward the heart

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39
Q

hilum

A

-slit through which the lung receives the main bronchus, blood vessels, lymphatics, and nerves
-Structures near hilum constitute root of lung

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40
Q

right lung

A

-Has three lobes—superior, middle, and inferior lobes
-Horizontal fissure separates superior and middle lobes, and oblique fissure separates middle and inferior lobes

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41
Q

left lung

A

-Has indentation to accommodate heart—cardiac impression
-Has two lobes—superior and inferior lobes, separated by a single oblique fissure

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42
Q

bronchial tree

A

-a branching system of air tubes in each lung
-Extends from main bronchus to 65,000 terminal bronchioles

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43
Q

main (primary) bronchi

A

-divide into lobar (secondary) bronchi
-A Lobar bronchi branch into segmental (tertiary) bronchi

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44
Q

bronchioles

A

continuations of airway that lack supportive cartilage and are 1 mm or less in diameter

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45
Q

pulmonary lobule

A

-portion of lung ventilated by one bronchiole
-terminal bronchioles
-respiratory bronchioles
-alveolar ducts
-End in alveolar sacs—clusters of alveoli around a central space (atrium)

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46
Q

alveoli

A

-microscopic air pouches in the lungs
-for gas exchange

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47
Q

cells of the alveoli

A

-Squamous (type 1) alveolar cells
-Great (type 2) alveolar cells
-Alveolar macrophages (dust cells)

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48
Q

Squamous (type 1) alveolar cells

A

-Thin cells allow rapid gas diffusion between air and blood
-Cover 95% of alveolus surface area

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49
Q

Great (type 2) alveolar cells

A

-Repair the alveolar epithelium when the squamous (type 1) cells are damaged
-Secrete pulmonary surfactant

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50
Q

pulmonary surfactant

A

mixture of phospholipids and proteins that coats the alveoli and prevents them from collapsing during exhalation

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51
Q

respiratory membrane

A

-thin barrier between the alveolar air and blood
-Gases exchanged across respiratory membrane, which consists of three layers:
Squamous alveolar cells
Endothelial cells of blood capillary
Their shared basement membrane

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52
Q

pleura

A

serous membrane that lines thoracic wall and forms surface of lung

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53
Q

visceral pleura

A

forms surface of lung

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54
Q

parietal pleura

A

Adheres to mediastinum, inner surface of the rib cage, and superior surface of the diaphragm

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55
Q

pleural cavity

A

potential space between pleurae-Fluid layer

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56
Q

pleural effusion

A

pathological seepage of fluid into the pleural cavity

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57
Q

functions of pleurae and plural fluid

A

-reduction of friction (allow lungs to move with minimal friction)
-creation of a pressure gradient (assist with lung inflation)
-compartmentalizatin (prevents spread of infection)

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58
Q

Boyles law

A

-governs air flow into and out of the lungs:
-At a constant temperature, the pressure of a given quantity of gas is inversely proportional to its volume

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59
Q

if lung volume decreases then intrapulmonary pressure

A

rises

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60
Q

if the pressure rises above atmospheric pressure then air

A

moves out of the lungs

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61
Q

if the pressure falls below atmospheric pressure then air

A

moves into the lungs

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62
Q

atmospheric (barometric) pressure

A

-the weight of the air above us
-lower at higher elevations

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63
Q

intrapulmonary pressure

A

-air pressure within lungs
-changes with lung volume according to Boyles law

64
Q

pulmonary compliance

A

-ease with which the lungs can expand; change in lung volume relative to a given pressure change
-reduced with degenerative lung diseases

65
Q

Infant respiratory distress syndrome (IRDS)

A

premature babies lacking surfactant are treated with artificial surfactant until they can make their own

66
Q

principal muscles of respiration

A

diaphragm and intercostal muscles

67
Q

diaphragm

A

prime mover of respiration

68
Q

internal and external intercostal muscles

A

assist diaphragm

69
Q

Valsalva maneuver

A

breathing technique used to help expel contents of certain abdominal organs

70
Q

Ventral respiratory group (VRG)

A

-In medulla
-Primary generator of the respiratory rhythm

71
Q

Dorsal respiratory group (DRG)

A

-In medulla
-Modifies the rate and depth of breathing

72
Q

Pontine respiratory group (PRG)

A

-In pons
-Modifies rhythm of VRG by outputs to both VRG and DRG

73
Q

Automatic, unconscious breathing is controlled by

A

respiratory centers

74
Q

Central chemoreceptors

A

-Brainstem neurons that respond to changes in pH of cerebrospinal fluid
-Ensures stable C O2 level in blood

75
Q

Peripheral chemoreceptors

A

-Carotid and aortic bodies
-Respond to the O2 and C O2 content and the pH of blood

76
Q

Stretch receptors

A

Inflation (Hering–Breuer) reflex—triggered by excessive inflation; protective reflex that inhibits inspiratory neurons and stops inspiration

77
Q

Irritant receptors

A

-Respond to smoke, dust, pollen, chemical fumes, cold air, and excess mucus
-Trigger protective reflexes such as bronchoconstriction, shallower breathing, breath-holding (apnea), or coughing

78
Q

Pneumothorax

A

presence of air in pleural cavity

79
Q

Bronchodilation

A

-increase in diameter of bronchus or bronchiole
-Epinephrine and sympathetic stimulation
-Increase airflow

79
Q

what 2 factors influence airway resistance

A

bronchiole diameter and pulmonary compliance

80
Q

Bronchoconstriction

A

-decrease in diameter of bronchus or bronchiole
-Histamine, parasympathetic nerves, cold air, and chemical irritants
-Decrease airflow

81
Q

how many mL fills the conducting zone of the airway?

A

about 150

82
Q

anatomical dead space

A

where there is no gas exchange

83
Q

Physiological (total) dead space

A

sum of anatomical dead space and any pathological dead space

84
Q

Alveolar ventilation rate (AVR)

A

-amount of air ventilating alveoli per minute
-crucially relevant to the body’s ability to get oxygen to the tissues and dispose of carbon dioxide

85
Q

residual volume

A

leftover air that cannot be exhaled, even with maximum effort

86
Q

Spirometry

A

-measuring pulmonary ventilation
-Assess severity of a disease, monitor improvement or deterioration

87
Q

Spirometer

A

device used to make measurements; recaptures expired breath and records rate and depth of breathing, speed of expiration, and rate of oxygen consumption

88
Q

Tidal volume (TV)

A

volume of air inhaled and exhaled in one cycle of breathing (500 mL)

89
Q

Inspiratory reserve volume (IRV)

A

air in excess of tidal volume that can be inhaled with maximum effort (3,000 mL)

90
Q

Expiratory reserve volume (ERV)

A

air in excess of tidal volume that can be exhaled with maximum effort (1,200 mL)

91
Q

Residual volume (RV)

A

-air remaining in lungs after maximum expiration (1,300 mL)
-Allows some gas exchange with blood before next breath of fresh air arrives

92
Q

Vital capacity (VC)

A

-total amount of air that can be inhaled and then exhaled with maximum effort
-VC = E R V + TV + IRV (4,700 mL)

93
Q

Inspiratory capacity

A

-maximum amount of air that can be inhaled after a normal tidal expiration
-IC = TV + IRV (3,500 mL)

94
Q

Functional residual capacity

A

-amount of air remaining in lungs after a normal tidal expiration
-F R C = RV + E R V (2,500 mL)

95
Q

total lung capacity

A

-maximum amount of air the lungs can contain
-TLC = RV + VC (6,000 mL)

96
Q

what aids in diagnosis and assessment of restrictive and obstructive lung disorders?

A

spirometry

97
Q

restrictive disorders

A

-Reduction in pulmonary compliance, limit how much lungs can inflate
-Any disease that produces pulmonary fibrosis
-black lung disease, tuberculosis

98
Q

Obstructive disorders

A

-Interfere with airflow by narrowing or blocking the airway
-Make it harder to inhale or exhale a given amount of air
-asthma, chronic bronchitis

99
Q

what combines elements of restrictive and obstructive disorders?

A

emphysema

100
Q

Forced expiratory volume (FEV)

A
  • percent of vital capacity that can be exhaled in a given time interval
  • Healthy adult reading is 75% to 85% in 1 second
101
Q

peak flow

A

-maximum speed of expiration
- measure with spirometer

102
Q

Minute respiratory volume (MRV)

A

amount of air inhaled per minute

103
Q

Maximum voluntary ventilation (MVV)

A

-MRV during heavy exercise
-May be as high as 125 to 170 L/min

104
Q

Eupnea

A

relaxed, quiet breathing

105
Q

apnea

A

temporary cessation of breathing

106
Q

Dyspnea

A

labored, gasping breathing; shortness of breath

107
Q

Hyperpnea

A

increased rate and depth of breathing in response to exercise, pain, or other conditions

108
Q

Hyperventilation

A

increased pulmonary ventilation in excess of metabolic demand

109
Q

Hypoventilation

A

reduced pulmonary ventilation leading to an increase in blood C O2

110
Q

Kussmaul respiration

A

deep, rapid breathing often induced by acidosis

111
Q

Orthopnea

A

dyspnea that occurs when person is lying down

112
Q

Respiratory arrest

A

permanent cessation of breathing

113
Q

Tachypnea

A

accelerated respiration

114
Q

Henry’s law

A

the amount of gas that dissolves in the water is determined by its solubility in water and its partial pressure in air

115
Q

pressure gradient of PO2

A

104 mm Hg in alveolar air versus 40 mm Hg in blood

116
Q

pressure gradient of PCO2

A

46 mm Hg in blood arriving versus 40 mm Hg in alveolar air

117
Q

Hyperbaric oxygen therapy

A

treatment with oxygen at greater than 1 atm of pressure

118
Q

how is partial pressure affected at high elevations?

A

gases are lower; pressure gradient for oxygen is lower so less diffuses into blood

119
Q

Ventilation–perfusion coupling

A
  • Air flow and blood flow are matched to each other
  • Pulmonary blood vessels change diameter depending on air flow to an area of the lungs
    -Bronchi change diameter depending on blood flow to an area of the lungs
120
Q

gas transport

A

the process of carrying gases from the alveoli to the systemic tissues and vice versa

121
Q

what is specialized for oxygen transport?

A

hemoglobin

122
Q

Arterial blood carries about

A

20 mL of O2 per deciliter

123
Q

Oxyhemoglobin (HbO2)

A

O2 bound to hemoglobin

124
Q

Deoxyhemoglobin (HHb)

A

hemoglobin with no O2

125
Q

Oxyhemoglobin dissociation curve

A

-illustrates relationship between hemoglobin saturation and ambient P O2
-Not a linear relationship

126
Q

90% of the C O2 is hydrated (reacts with water) to form

A

carbonic acid

127
Q

Carbon monoxide (C O)

A

colorless, odorless gas in cigarette smoke, engine exhaust, fumes from gas furnaces

128
Q

Systemic gas exchange

A

unloading of O2 and loading of C O2 at systemic capillaries

129
Q

Chloride shift

A

bicarbonate pumped out of RBC in exchange for chloride ion from plasma

130
Q

Venous reserve

A

amount of O2 remaining in the blood after it passes through the systemic capillary beds

131
Q

Ambient PO2

A

-active tissue has decreased PO2
-O2 is released from Hb

132
Q

temperature

A

active tissue has high temp, promotes O2 unloading

133
Q

ambient pH

A

-active tissue has high CO2
- lowers pH of blood
-promotes O2 unloading called the Bohr effect

134
Q

BPG

A

when RBCs produce a metabolic intermediate of anerobic metabolism

135
Q

Haldane effect

A

Deoxyhemoglobin binds more hydrogen ions than oxyhemoglobin

136
Q

acidosis

A

blood pH lower than 7.35

137
Q

alkalosis

A

blood pH higher than 7.45

138
Q

hypocapnia

A

PCO2 less than 37 mm Hg, most common cause of alkalosis

139
Q

hypercapnia

A

PCO2 greater than 43 mm Hg; most common cause of acidosis

140
Q

Respiratory acidosis and respiratory alkalosis

A

pH imbalances resulting from a mismatch between the rate of pulmonary ventilation and the rate of CO2 production

141
Q

what can be a corrective homeostatic response to acidosis?

A

hyperventilation

142
Q

what can be a corrective homeostatic response to alkalosis?

A

hypoventilation

143
Q

Chronic hypoxemia

A

-PO2 less than 60 mm Hg
-Can significantly stimulate ventilation

144
Q

hypoxic drive

A

-Caused by long-term hypoxemia
-Respiration driven more by low P O2 than by C O2 or pH

145
Q

hypoxia

A

-deficiency of oxygen or the inability to use oxygen
-marked by cyanosis

146
Q

cyanosis

A

blueness of the skin

147
Q

Hypoxemic hypoxia

A

High altitude, drowning, hypoventilation

148
Q

Ischemic hypoxia

A

-Inadequate circulation of blood
-Congestive heart failure

149
Q

anemic hypoxia

A

Due to inability of the blood to carry adequate oxygen

150
Q

Histotoxic hypoxia

A

Metabolic poisons (for example, cyanide) prevents O2 use in tissue

151
Q

Chronic obstructive pulmonary diseases (COPDs)

A

-long-term obstruction of airflow and substantial reduction in pulmonary ventilation
-usually associated with smoking

152
Q

major COPDs are

A

chronic bronchitis and emphysema

153
Q

emphysema

A

-alveolar walls break down
-lungs fibrotic and less elastic
-air passages collapse
-weaken thoracic muscles

154
Q

3 major forms of lung cancers

A

squamous cell carcinoma, adenocarcinoma, and small cell (oat cell) carcinoma