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a & p II exam 3 > chapter 23: respiratory system > Flashcards

chapter 23: respiratory system Flashcards

1
Q

what is the areolar CT of respiratory mucosa?

A

lamina propria

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2
Q

explain how mucus & cilia work together as a protective feature of the respiratory system?

A

mucus escalator: particulates from the inspired air get stuck in the mucus which is then swept out of the respiratory tract by the beating cilia

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3
Q

why do smokers tend to cough a lot?

A

cilia is destroyed by the chemicals in smoke, person is chronically drowning in their own mucus, cough is a mechanism to attempt to clear respiratory passages

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4
Q

the nasal cavity has three pairs of what in it to cause air to swirl as it passes through?

A

nasal conchea

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5
Q

the internal nares exit into what which is lined with pseudostratified columnar epithelium & contains the pharyngeal tonsils?

A

nasopharynx

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6
Q

why do neither the oropharynx or the laryngopharynx have cilia?

A

shared space with digestive system, has epithelium that resists abrasion from potentially sharp food

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7
Q

what is the elastic cartilage flap that cover the glottis during swallowing?

A

epiglottis

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8
Q

to produce wine-glass-shattering soprano sounds, vocal folds would need to be very what?

A

narrow and tight

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9
Q

what muscle is attached to the ends of hyaline cartilage, provides for constriction of the trachea in response to parasympathetic stimulation?

A

trachealis

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10
Q

the last branches of the conducting portion of the respiratory tree are what?

A

terminal bronchioles

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11
Q

all the alveoli serviced by one respiratory bronchiole is a what?

A

alveolar sac

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12
Q

what are the cells of the alveolar cells that produce surfactant?

A

type II

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13
Q

what happens when there’s a block occurs in a branch of the pulmonary artery which reduces blood flow & causes alveolar collapse?

A

pulmonary embolism

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14
Q

how many lobes does the right lung have?

A

3

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15
Q

what’s the serous membrane that covers the surface of the lung?

A

visceral pleura

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16
Q

what describes a lung that has elastic recoiled because it loss the surface tension that had been keeping it attached to the thoracic cavity wall and what’s the common cause of this?

A

atelectasis; pneumothorax

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17
Q

when the diaphragm contracts, the thoracic cavity what in size & air moves in or out?

A

increases, in

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18
Q

what occurs when there’s patient fails to produce enough surfactant to prevent alveoli from collapsing?

A

respiratory distress syndrome

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19
Q

what is the quiet breathing which only involves the diaphragm & external intercostal muscles?

A

eupnea

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20
Q

the amount of air you can force in behind the tidal volume (TV) is what?

A

inspiratory reserve volume (IRV)

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21
Q

what is the amount of air that actually reaches the alveoli for gas exchange per minute at rest?

A

alveolar ventilation

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22
Q

the earth’s atmosphere is 20% oxygen; at sea level or high at a mountain, still 20%, so what causes high altitude sickness then?

A

fewer overall molecules as elevation increases (20% of 1000 is 200 but 20% of 10 is only 2) resulting in lower partial pressure & thus less diffusion into the blood (above 25,000ft of elevation there are not enough oxygen molecules diffusing into the blood sustain cellular respiration)

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23
Q

in the tissues, the partial pressure (PP) of carbon dioxide is higher in the tissues than in the blood so the carbon dioxide diffuses from what to what? but at the lungs the partial pressure (PP) are reversed so the carbon dioxide diffuses from what?

A

tissues to blood; blood to alveoli

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24
Q

why does carbon monoxide poisoning occur even when oxygen is available?

A

CO binds to hemoglobin more strongly than O2

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25
Q

the Bohr effect is the observation that hemoglobin will what?

A

release O2 in acidic pH

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26
Q

what is the element essential to ability of hemoglobin to bind to oxygen?

A

iron

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27
Q

most of the carbon dioxide is carried in the blood as what?

A

carbonic acid

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28
Q

autoregulation of lung perfusion redirects blood flow to the alveoli with a higher what?

A

ppO2 (partial pressure O2)

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29
Q

what is the respiratory rhythmicity center serves as the pacesetting respiratory center by being active for 2 seconds & inactive for 3?

A

dorsal respiratory group/ DRG

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30
Q

when will you have more breaths per minute: when there’s more or when there’s less signaling from the pneumotaxic center?

A

more

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31
Q

respiratory system functions:

A
  1. external respiration
  2. pulmonary ventilation
  3. protection of respiratory surfaces (dehydration, temp. change, pathogens)
  4. produce sound
  5. produce olfactory sensation
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32
Q

upper respiratory system (anatomy of respiratory system)

A

-functions to warm & humidify air
-nose, nasal cavity, sinuses, pharynx

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33
Q

conducting portion (lower respiratory system -> anatomy of respiratory system)

A

-bring air to respiratory surfaces
-larynx, trachea, bronchi, bronchioles

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34
Q

respiratory portion (lower respiratory system -> anatomy of respiratory system)

A

-gas exchange
-alveoli

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35
Q

respiratory mucosa

A

-lines conducting portions
-pseudostratified columnar epithelium
lamina propria contains mucus glands & serous glands (lysozyme)
-usually ciliated
-scattered goblet cells (mucin production)
-cilia move mucus to pharynx to be swallowed

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36
Q

mucus (respiratory defense system)

A

from goblet cells & glands in lamina propria, traps foreign objects

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37
Q

cilia (respiratory defense system)

A

-“mucus escalator”
move carpet of mucus with trapped debris out of respiratory tract

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38
Q

alveolar macrophages (respiratory defense system)

A

phagocytes particles that reach alveoli

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39
Q

cystic fibrosis

A

-failure of cilia
produce thick mucus which blocks airways & encourages bacteria growth

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40
Q

what does smoking & inhaling of irritants result in?

A

-destroys cilia
-chronic inflammation -> cancer (squamous cell carcinoma)

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41
Q

nose functions (upper respiratory system)

A

-external feature
1. opening to airway for respiration
2. moisten & warm entering air
3. resonating chamber for speech
4. house olfactory receptors

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42
Q

nose features (upper respiratory system)

A

-external nares conduct air into vestibule
-vestibule leads to nasal cavity

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43
Q

vestibule (nose feature -> upper respiratiry system)

A

space in flexible part, lined with hairs to filter particles, leads to nasal cavity

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44
Q

nasal cavity (upper respiratory system

A

-divided into right & left by nasal septum
-superior portion has olfactory epithelium
-nasal conchae
-hard & soft palate form floor
-internal nares open to nasopharynx
-mucosa has large blood supply
-paranasal sinuses

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45
Q

nasal conchae (nasal cavity
-> upper respiratory system)

A

-superior, inferior, middle project into cavity on both sides
-cause air to swirl
1. increase likelihood of trapping foreign material in mucus
2. provide time for smell detection
3. provide time & contact to warm & humidify air

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46
Q

epistaxis

A

nosebleed

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47
Q

paranasal sinuses (nasal cavity -> upper respiratory system)

A

-in frontal, sphenoid, ethmoid & maxillary bones
-lined with respiratory mucosa, connected to nasal cavity, aids in warming/ moistening air

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48
Q

rhinitis

A

inflammation of nasal mucosa -> ↑ mucus production

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49
Q

what happens when there’s an infection in the nasal cavity?

A

blockage of sinuses: headache from negative pressure

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50
Q

pharynx (upper respiratory system)

A

-chamber between internal nares & entrances to larynx and esophagus
-three parts: nasopharynx, oropharynx, laryngopharynx

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51
Q

nasopharynx (pharynx -> upper respiratory system)

A

air only
-posterior to nasal cavity
-pseudostratified columnar epithelium
-closed off by soft palate & uvula during swallowing
-pharyngeal tonsil located on posterior wall (inflammation can block airway)
-auditory tubes open here

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52
Q

oropharynx (pharynx -> upper respiratory system)

A

food & air
-posterior to oral cavity
-stratified squamous epithelium
-palatine & lingual tonils in mucosa

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53
Q

laryngopharynx (pharynx -> upper respiratory system)

A

food & air
-lower portion
-stratified squamous epithelium
-continuous with esophagus

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54
Q

larynx (lower respiratory system)

A

-hyaline cartilage around glottis
-contains epiglottis
-folds epithelium over ligaments of elastic fibers create vocal fold/cords
-vocal cords project into glottis
-air passing through glottis vibrates folds producing sound

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55
Q

glottis

A

opening from laryngopharynx to trachea

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56
Q

epiglottis

A

elastic cartilage flap, cover glottis during swallowing

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57
Q

high pitch

A

pitch controlled by tensing/ relaxing cords: tense & narrow
-controlled by amount fo air

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58
Q

sound production (larynx)

A

phonation

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59
Q

speech

A

formation of sound using mouth & tongue with resonance in pharynx, mouth sinuses & nose

60
Q

laryngitis

A

inflammation of vocal folds due to infection or overuse can inhibit phonation

61
Q

trachea (lower respiratory system)

A

-attached inferior to larynx
-walls composed of 3 layers: mucosa, submucosa & adventitia
-branches into right & left primary bronchi

62
Q

mucosa of trachea

A

pseudostratified columnar epithelium, goblet cell, lamina propria with smooth muscle & glands

63
Q

submucosa of trachea

A

CT with additional mucus glands

64
Q

adventitia of trachea

A

CT with hyaline cartilage rings (keeps airway open)
-15-20 C-shaped, has opening toward esophagus (allow expansion), ends connected by trachealis muscle

65
Q

primary bronchi (lower respiratory system)

A

-similar structure as trachea (no trachealis muscle)
-right: steeper angle
-enter lungs at hilum (along with blood & lymphatic)

66
Q

inside lungs bronchi branch, get smaller in diameter:

A

branch ~23 times creating the bronchial tree

67
Q

as bronchi get smaller, structure changes:

A
  1. less cartilage in adventitia
  2. more smooth muscle in lamina propria
  3. epithelium thinner, less cilia, less mucus
68
Q

terminal bronchi (lower respiratory system)

A

-smallest bronchi of respiratory tree
-no cartilage
-last part of conducting
-each delivers air to one pulmonary lobule (separated by CT)
-inside lobule, terminal bronchiole branches into respiratory bronchiols
-connect to alveolar sac

69
Q

trachea, bronchi & bronchioles innervated by ANS to control airflow to lungs:

A

-sympathetic = bronchodilation
-parasympathetic = bronchoconstriction

70
Q

asthma

A

strong bronchoconstriction activated by inflammatory chemicals (histamine) reduces airflow
-epinephrine inhaler mimics sympathetic (bronchodilation)

71
Q

alveoli (lower respiratory system)

A

-wrapped in capillaries
-held in place by elastic fiber
-3 cell types: type I, II & alveolar macrophages
-connected to neighbors by alveolar pores (equalize pressure)

72
Q

type I cells (alveoli -> lower respiratory system)

A

simple squamous epithelium, lines inside, gas exchange

73
Q

type II cells (alveoli -> lower respiratory system)

A

cuboidal epithelial cells produce surfactant

74
Q

surfactant (alveoli -> lower respiratory system)

A

phospholipids + proteins, prevent alveolar collapse

75
Q

alveolar macrophages (alveoli -> lower respiratory system)

A

phagocytosis of particles

76
Q

gas exchange occurs in the respiratory membrane (0.5μm thick):

A
  1. type I cells of alveolus
  2. thin basal lamina (fusion)
  3. endothelial cells of capillary
77
Q

pneumonia

A

inflammation of lungs from infection or injury, fluid in alveoli prevents gas exchange

77
Q

pulmonary embolism

A

block in branch of pulmonary artery, reduced blood flow causes alveolar collapse

78
Q

gross anatomy of lungs

A

-concave base, rest on diaphragm
-right: 3 lobes
-left: 2 lobes & cardiac notch
-cavity lined with parietal pleura
-lungs covered by visceral pleura
-both pleura produce serous pleural fluid to reduce friction during expansion

79
Q

pleurisy

A

inflammation of pleura, can restrict movement of lungs, causing breathing difficulty

80
Q

pulmonary ventilation (step 1 of respiratory physiology)

A

-movement of air into/out of alveoli
-visceral pleura adheres to parietal pleura via surface tension: altering size of pleural cavity will alter size of lungs

81
Q

pneumothorax

A

injury to thoracic cavity, air breaks surface tension, lungs recoil = atelectasis

82
Q

atelectasis

A

collapsed lung

83
Q

mechanics of breathing

A

-boyle’s law: gas pressure is inversely proportional to volume
-air flows from area of high pressure to low pressure

84
Q

contraction of diaphragm pulls it toward abdomen:

A
  • lung volume↑
    -air pressure ↓
    -air flows in
85
Q

relaxation causes diaphragm to rise in dome shape:

A
  • lung volume ↓
  • air pressure ↑
    -air flows out
86
Q

air way resistance (factor influencing pulmonary ventilation)

A
  • diameter of bronchi
    -obstructions
87
Q

alveolar surface tension (factor influencing pulmonary ventilation)

A

-surfactant (type II cells) reduces alveoli surface tension to allow inflation
-respiratory distress syndrome

88
Q

respiratory distress syndrome

A

too little surfactant requires great force to open alveoli to inhale
-premature babies

89
Q

compliance (factor influencing pulmonary ventilation)

A

effort required to expand lung & chest
-high compliance = expand easily
-low compliance = resist expanison

90
Q

how is compliance affected by CT structure? (factor influencing pulmonary ventilation)

A

loss of elastin/ replacement by fibrous tissue =↓ compliance

91
Q

emphysema

A

respiratory surface replaced by scars, ↓ elasticity ↓ compliance & have loss of surface for gas exchange

92
Q

how is compliance affected by alveolar expandability vs collapse? (factor influencing pulmonary ventilation)

A

-↑ surface tension (↓ surfactant) = ↓ compliance
-fluid (edema) =↓ compliance

93
Q

how is compliance affected by mobility of the thoracic cavity? (factor influencing pulmonary ventilation)

A

less mobility =↓ compliance

94
Q

inspiration

A

inhalation involves contraction of muscles to increase thoracic volume
-eupnea & hypernea

95
Q

eupnea (inspiration)

A

-quiet breathing
-diaphragm: moves 75% of air
-external intercostal: elevate ribs, 25% of air

96
Q

hypernea (inspiration)

A

-forced breathing
-maximum rib elevation increases respiratory volume 6x: serrates anterior, pectoralis minor, scalenes & sternocleidomastoid

97
Q

eupnea (expiration)

A

passive, muscle relax, thoracic volume decrease

98
Q

hypernea (expiration)

A

abdominal muscles (obliques, transverses, rectus) contract, forcing diaphragm up, thoracic volume further decreases

99
Q

a breath

A

one respiratory cycle

100
Q

tidal volume (TV)

A

amount of air inhaled or exhaled with each breath under resting conditions
-500ml in males & females

101
Q

inspiratory reserve volume (IRV)

A

amount of air that can be forcefully exhaled after a normal tidal volume inhalation
-3100ml in males & 1900ml in females

102
Q

expiratory reserve volume (ERV)

A

amount of air that can be forcefully exhaled after a normal tidal volume exhalation
-1200ml in males & 700ml in females

103
Q

residual volume (RV)

A

amount of air remaining in the lungs after a forced exhalation
-1200ml in males & 1100ml in females

104
Q

total lung capacity (TLC)

A

maximum of air contained in lungs after a maximum inspiratory effort
-TV + IRV + ERV + RV
-6000ml in males & 4200ml in females

105
Q

vital capacity (VC)

A

maximum amount of air that can expire after a maximum inspiratory effort
-TV + IRV + ERV (80% of TLC)
-4800ml in males & 3100ml in females

106
Q

respiratory rate

A

breath/min
~18-20 at rest

107
Q

respiratory minute volume (RMV/MRV)

A

respiratory rate multiplied by tidal volume
~6L

108
Q

anatomic dead space

A

not all reaches alveoli, some remains in conducting portions
~1ml/Ib body weight

109
Q

alveolar ventilation

A

air reaching alveoli/min at reast
~4.2L

110
Q

air compoments (gas exchange -> step 2 of respiratory physiology)

A

79% N2, 21% O2, 0.5% H2O, 0.04% COs, trace inert gasses

111
Q

partial pressure (PP) of gas (gas exchange -> step 2 of respiratory physiology)

A

concentration in air

112
Q

gasses follow diffusion gradients to diffuse into liquid (gas exchange -> step 2 of respiratory physiology):

A

rate depends on partial pressure (PP) & temp.

113
Q

high altitude sickness

A

↓ PP O2 at high altitude causes ↓ diffusion into blood

114
Q

decompression sickness

A

PP of air gasses high underwater, hight amount of N2 diffuse into blood
-if pressure suddenly ↓ N2 leaves blood as gas causes bubbles (damage, pain)

115
Q

what treats decompression sickness?

A

hyperbaric chambers

116
Q

diffusion at respiratory membrane efficient (gas exchange -> step 2 of respiratory physiology):

A
  1. substantial differences in PP across membrane
  2. distance is small
  3. gases are lipid soluble
  4. large surface area for diffusion
  5. coordination of blood & airflow:↑ blood to alveoli with ↑ O2
117
Q

diffusion at respiratory membrane in lungs (gas exchange -> step 2 of respiratory physiology):

A

-PP O2 ↑ in alveoli, ↓ capillary: diffuse into capillary
-PP CO2 ↓ in alveoli ↑ in capillary: diffuse into alveoli

118
Q

diffusion at respiratory membrane in tissues (gas exchange -> step 2 of respiratory physiology):

A

-pressure & flow reserved
-O2 into tissues
-CO2 into capillary

119
Q

transport of oxygen (gas transport -> step 3 of respiratory physiology)

A

-1.5% dissolved in plasma
-most bound to iron ions no heme of hemoglobin in erythrocytes: 4 O2/Hb
~280 million Hb/RBC = 1 billion O2/RBC

120
Q

hemoglobin saturation (transport of oxygen -> gas transport -> step 3 of respiratory physiology)

A

% of hemes bound to O2
~97.5% at alveoli
@ ↑PP O2 hemoglobin binds O2
@ ↓ PP O2 hemoglobin drops O2

121
Q

carbon monoxide poisoning

A

Co out-competes O2 for binding to Hb, even at low PP CO, causes suffocation (no O2)

122
Q

Bohr effect (factor that affects Hb saturation -> transport of oxygen -> gas transport -> step 3 of respiratory physiology)

A

Hb releases O2 in acidic pH (high CO2 creates carbonic acid)

123
Q

temperature (factor that affects Hb saturation -> transport of oxygen -> gas transport -> step 3 of respiratory physiology)

A

Hb releases O2 in ↑ temp.

124
Q

BPG (2,3-diphosphoglycerate) (factor that affects Hb saturation -> transport of oxygen -> gas transport -> step 3 of respiratory physiology)

A

produced by healthy RBC during glycolysis
-↑ BPG = ↑ O2 release

125
Q

pregnancy (factor that affects Hb saturation -> transport of oxygen -> gas transport -> step 3 of respiratory physiology

A

fetal Hb = ↑ O2 binding

126
Q

hypoxia

A

inadequate O2 delivery to tissues

127
Q

transport of carbon dioxide most common action (gas transport -> step 3 of respiratory physiology)

A

~70% as carbonic acid
-in RBCs & plasma
-carbonic anhydrase in RBCs catalyze reaction with water: CO2 + H2O <-> H2CO3 <-> H+ + HCO3-
-reaction reversed at lungs

128
Q

transport of carbon dioxide second common action (gas transport -> step 3 of respiratory physiology)

A

~23% as carbaminohemoglobin
-CO2 bound to amino groups of Hb

129
Q

transport of carbon dioxide least common action (gas transport -> step 3 of respiratory physiology)

A

~7% dissolved in plasma

130
Q

age-related changes (respiratory system)

A
  1. elastic tissue deteriorates: ↓ compliance & ↓ VC
  2. arthritic changes in rib cage: ↓ mobility & ↓ RMV
  3. emphysema, some degree: ↓ gas exchange
131
Q

regulation of respiration

A

respiratory homeostasis requires that diffusion rates at peripheral capillaries (O2 in CO2 out) & alveolar capillaries (CO2 out O2 in)
-if not respiration & cardiovascular functions will be altered

132
Q

lung perfusion (autoregulation -> regulation of respiration)

A

blood flow in lungs is constantly redirected to alveoli with high partial pressure of O2

133
Q

alveolar ventilation (autoregulation -> regulation of respiration)

A

alveoli with high partial pressure of CO2 receive increased airflow

134
Q

respiratory rhythmicity centers (neural regulation -> regulation of respiration)

A

-located in medulla oblongata
-control basic pace & depth of respirations
-DRG & VRG

135
Q

dorsal respiratory group (DRG) (respiratory rhythmicity centers -> neural regulation -> regulation of respiration)

A

-controls diaphragm & external intercostal muscles on every breath
-serves as pacesetting respiratory center (active 2 sec, inactive 3 sec)

136
Q

ventral respiratory group (VRG) (respiratory rhythmicity centers -> neural regulation -> regulation of respiration)

A

controls accessory muscles during forced breathing

137
Q

respiratory centers (neural regulation -> regulation of respiration)

A

-located in pons
-influence & modify activity of DRG & VRG to fine-tune breathing rhythm & prevent lung over inflation
-monitor input from sensory receptors to trigger appropriate reflexes to alter respiratory rate & depth of respiration to satisfy gas exchange needs

138
Q

apneustic center (respiratory center ->neural regulation -> regulation of respiration)

A

-smaller
-stimulates DRG for inhalation: helps ↑ intensity of inhalation
-responds to lung inflation signals from sensory receptors

139
Q

pneumotaxic center (respiratory center ->neural regulation -> regulation of respiration)

A

-bigger
-inhibits apneustic center to allow exhalation
-modifies pace set by DRG & VRG
- ↑ signaling will ↑ respiratory rate by ↓ duration of inhalation
- ↓ signaling will ↓ respiratory rate but ↑ depth by allowing apneustic center to signal DRG for greater inhalation

140
Q

respiratory reflexes (neural regulation -> regulation of respiration)

A

respiratory center modify activity based in input from receptors

141
Q

chemoreceptor (respiratory reflex ->neural regulation -> regulation of respiration)

A

monitor CO2, O2 & pH in blood & CSF (cerberal spinal fluid)

142
Q

baroreceptors (respiratory reflex ->neural regulation -> regulation of respiration)

A

monitor blood blood pressure in aorta & carotid artery

143
Q

stretch receptors (respiratory reflex ->neural regulation -> regulation of respiration)

A

monitor inhalation of the lungs (Hering-Breuer Reflex: don’t over inhale)

144
Q

pulmonary irritant receptors (respiratory reflex ->neural regulation -> regulation of respiration)

A

monitor particles in respiratory tracts & trigger cough or sneeze

145
Q

other receptors for respiratory reflexes (neural regulation -> regulation of respiration)

A

pain, temp. & other visceral sensations can trigger the reflexes

a & p II exam 3 (3 decks)

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