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HSF > Compendium 4 > Flashcards

Compendium 4 Flashcards

1
Q

For complete exchange of oxygen (O2)
and carbon dioxide (CO2) in respiration, four steps occur
simultaneously:

A
  1. Ventilation
    - This is what most of us think of as breathing. It is the movements of the thorax and certain muscles that cause air to go into and out of our lungs.
    - Movement of air in and out of lung
  2. External respiration
    - Oxygen enters the blood in the lungs and CO2 exits the blood in the lungs.
    - Gas exchange between lungs and blood
  3. Gas transport
    - Carbon dioxide and O2 are circulated in the blood to and from tissues.
  4. Internal respiration
    - Gas exchange with the tissues involves the exit of O2 from blood to move into the tissues, while CO2 exits the tissues to enter the blood.
    - Gas exchange between blood and tissues
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2
Q

Functions of the respiratory system

A
  1. Respiration
    - Ventilation
    - External respiration
    - Transport of respiratory gases
    - Internal respiration
  2. Regulation of blood pH- can be altered by changing levels of blood CO2
  3. Voice production- air moving past the vocal folds makes sounds and speech possible
  4. Smell/ olfaction
  5. Protection- preventing microorganisms entering and removing it
  6. Production of chemical mediators- lungs produce ACE enzyme important for blood pressure regulation
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3
Q

7 structures make up respiratory system

A
  • The external nose
  • Nasal cavity
  • Pharynx
  • Larynx
  • Trachea
  • Bronchi
  • Lungs
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4
Q

Classified in 2 ways

A
  1. Structurally
    - Upper respiratory tract
     External nose, nasal cavity, pharynx, larynx
    - Lower respiratory tract
     Trachea, bronchi, bronchioles, lungs
  2. Functionally
    - Conducting zone
     Exclusively air movement
     Nose to bronchioles
    - Respiratory zone
     Lungs, where gas exchange between air and blood takes place
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5
Q

The Nose

A

Consists of the external nose and nasal cavity

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6
Q

External nose:

A
  • Visible structure

- Largest part is composed of hyaline cartilage plates

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7
Q

Nasal cavity

A
  • The open chamber where air first enters
  • Extends from anterior structures called nares (nostrils) to posterior structures, choana
    Nares
  • External opening of the nasal cavity
  • Just inside each naris, in the anterior part of the nasal cavity is the region called vestibule
    Vestibule
  • Lined with stratified squamous epithelium
    The choanae are the in the posterior part of the nasal cavity are the openings into the pharynx
    Hard palate
  • Anterior portion of the roof of the mouth
  • It is formed by the palatine process of the maxillae and the palatine bone
  • Covered by a highly vascular mucous membrane that forms floor of nasal cavity
  • Separates nasal cavity from oral cavity
    Nasal septum
  • Divides nasal cavity into left and right portions
  • Anterior part = cartilage
  • Posterior part = vomer bone and the perpendicular plate of the ethmoid bone
    Conchae
  • 3 lateral bony ridges on each side of the nasal cavity
  • Used to be named turbinate bones – ‘wind turbine’ helping air churn through tunnels
  • These tunnels are called meatus
  • Superior, middle and inferior concha
  • Superior, middles and inferior meatus
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8
Q

Functions of the nose

A
  1. Passageway for air
  2. Cleans the air
    - Vestibule is lined with hairs which trap some of the large particles of dust
    - Nasal septum and nasal conchae increase the surface area of the nasal cavity and make airflow more turbulent, increasing the likelihood that air will come into contact with mucus membranes (pseudostratified ciliated epithelium with goblet cells)
    - Goblet cells secrete mucus which traps debris in the air
    - Cilia on the surfaces of mucus membranes sweep the mucus posteriorly to the pharynx, where it is swallowed and eliminated by stomach acid
  3. Humidifies and warms air
    - Via warm blood flow through cavity
    - Via moisture from mucus epithelium and excess tears which drain into nasal cavity
  4. Smell
    - Olfactory epithelium, the sensory organ for smell located in superior part of nasal cavity
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9
Q

Pharynx

A
  • Receives air from the nasal cavity
  • From superior to inferior, there are 3 regions of the pharynx = nasopharynx, oropharynx, laryngopharynx
    Nasopharynx
  • Immediately posterior to nasal cavity
     Specifically - posterior to choanae and superior to soft palate
  • Soft palate
     Incomplete partition composed of muscle and cartilage – separates nasopharynx and oropharynx
     Posterior extension of soft palate = uvula
     Blocks swallowed materials away from the nasopharynx and nasal cavity
  • Nasopharynx is lined with mucus membrane which traps debris
  • Pseudostratified ciliated columnar epithelium
  • Houses openings of Eustachian tubes
  • Posterior surface has pharyngeal tonsils
    Oropharynx
  • Middle portion of the pharynx
  • Immediately posterior to the mouth and begins at soft plate
  • Region called fauces joins mouth and oropharynx
  • Moist stratified squamous epithelium
  • Palatine tonsils and lingual tonsils located near fauces
    Laryngopharynx
  • Stratified squamous epithelium
  • Posterior to epiglottis
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10
Q

Larynx

A
  • Also know as voice box
  • Passageway for air only
  • Located in the anterior part of the laryngopharynx and extends from the base of the tongue to end of trachea
  • Held in place by membranes and or muscles superior to hyoid bone
  • Its rigidity is due to being made up of 9 cartilage pieces which are connected to each other by muscles and ligaments
  • 6 paired (present on left and right side of larynx)
     Arytenoid – seen by posterior aspect and medial not anterior
     Corniculate – seen by posterior and medial
     Cuneiform
  • 3 unpaired (single cartilage)
     Thyroid – largest, also known as Adams apples
     Cricoid
     Epiglottis – prevents food going into trachea
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11
Q

Functions of the larynx

A
  1. Maintains an open passageway for air movement
    - Thyroid and cricoid cartilage maintain this open passageway
  2. Directs food into the oesophagus away from respiratory tract
    - Epiglottis and vocal folds
  3. Sound production via vocal folds
    - Expired air moves passed vocal folds causing them to vibrate and produce sound
  4. Trap debris from entering lungs
    - Cilia on the pseudostratified ciliated columnar cells which line the larynx below the vocal folds
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12
Q

Trachea (windpipe)

A
  • Descends from the larynx and sits anterior to oesophagus
  • Has 15-20 ‘C-shaped’ hyaline cartilage rings -> support
  • C-shape provides structural support to maintain open
  • Dense connective tissue and smooth muscle in between cartilage rings
  • Tracheal lumen (empty space) lined with pseudostratified ciliated columnar epithelium with goblet cells (mucous producing)
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13
Q

Tracheobronchial tree

A
  • Carina is the last piece of cartilage of the trachea and is where it splits into 2 bronchi and is very sensitive so if any debris gets there you’ll have coughing fit
    Moving from trachea to terminal bronchioles:
  • Increase in smooth muscle
  • Decrease in cartilage
  • Change in epithelium in lumen from pseudostratified ciliated columnar -> simple ciliated columnar -> simple ciliated cuboidal
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14
Q

Alveolus side

A

Simple squamous epithelium and the special name for this is called type 1 pneumocytes
- Type 1 pneumocyte
 Gas exchange occurs here ->simple diffusion
- Type 2 pneumocytes (scattered in type 1 pneumocytes)
 Cuboidal cell
 Secretes a surfactant to reduce surface tension in the lungs and prevent collapse of the alveoli – so walls won’t stick together upon breathing out
Macrophages in the alveoli
Basement membrane

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15
Q

Capillary side

A
  • Basement membrane
  • Capillary endothelium
  • Simple squamous epithelium
  • Red blood cells
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16
Q

Lungs

A
  • Cone shaped with a base and apex (top)
  • Left lung has 2 lobes + cardiac notch where heart sits
  • Right lung has 3 lobes
  • Lobes separated by fissures- indentations of tissue
  • Hilum on medial surface – entry point for blood and nervous supply, lymphatic vessels and bronchi
  • Hilum – entry point for blood vessels, nerves and tracheal tree
  • Bronchopulmonary segments
     Theres 10 segments
     Segment seprated by connective tissue septum and each segment receives own artery and vein from an individual tissue or segmental bronchus
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17
Q

Classify the structures into whether they fall within the ‘conducting zone’ or ‘respiratory zone’

A

Conducting zone: nasal cavity, pharynx, larynx, trachea, primary bronchus, secondary bronchus, tertiary bronchus, bronchiole, terminal bronchiole,

Respiratory zone: respiratory bronchiole, alveolar duct, alveolar sac, alveoli

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18
Q

Match the structure with its correct epithelium: vestibule, nasal cavity, nasopharynx, oropharynx, laryngopharynx, trachea, alveoli

A

Vestibule – stratified squamous epithelium
Nasal cavity – pseudostratified ciliated columnar epithelium
Nasopharynx - pseudostratified ciliated columnar epithelium
Oropharynx - stratified squamous epithelium
Laryngopharynx - stratified squamous epithelium
Trachea – pseudostratified ciliated columnar epithelium (with goblet cells)
Alveoli – simple squamous epithelium

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19
Q

Why do we breathe oxygen?

A

We breathe oxygen because it is a gas our bodies need to produce energy

20
Q

Describe the path air takes as it move into and out of the lungs

A

Nose – nasal cavity – the pharynx – larynx – trachea – trachea splits into left and right bronchus – air continues through primary/ main bronchus – moves into secondary/ lobar bronchus – then into tertiary/ segmental bronchus – bronchioles – terminal bronchiole – respiratory bronchiole – alveoli

And same on the way out but in reverse

21
Q

How does the respiratory tract protect the lungs from dust and pathogens?

A

Ciliated epithelium cam carry dust pathogens away from cells, out of body, away from lungs. Found in concha of nasal cavity, nasal pharynx, trachea, parts of the trachea bronchiole tree
Tonsils in nasopharynx and oropharynx which have immune protection
Mucus producing goblet cell scattered in epithelium that produce mucus, trap things cilia then move that mucus away from lungs
Hairs in vestibule of nasal cavity
Macrophages lining alveoli

22
Q

Factors affecting gas exchange through the respiratory membrane

A
  1. Thickness of the respiratory membrane
    - Thicker membrane reduces the rate of movement of gas
    - Normal thickness is 0.5 to 1 micrometre, if thicker rate of exchange across respiratory membrane will be reduced (thicker due to fluid, Tb)
  2. Surface area
    - Lower surface area reduces volume of gas exchange taking place
    - 300-500 million alveoli
    - Emphysema – walls of alveoli break down reducing SA
  3. Diffusion coefficient
    - Diffusion coefficient – how easily a gas can diffuse in and out of a liquid or tissue
    - A relative number
    - Higher the diffusion coefficient = faster
  4. Partial pressure - pressure exerted by each gas in a mixture of gases
    - When the partial pressure (Pp) of a gas is greater on one side of the respiratory membrane compared to the other side, the gas moves from the side with the higher Pp to the side with the lower Pp
23
Q

Gas transport

A 
Oxygen (O2 )
-	Transported via:
	Red blood cells (haemoglobin) (98.5%) most oxygen transported attached to a protein called haemoglobin
	Dissolved in blood plasma (1.5%) 
Carbon dioxide (CO2 )
-	Transported as:
	HCO3 – dissolved as bicarbonate ions in plasma (70%)
	CO2 dissolved in plasma (7%)
	Bound to haemoglobin (23%)
24
Q

How are O2 and CO2 exchanged in the alveoli

A

oxygen is breathed in by lungs, makes its way to alveoli and crosses the respiratory membrane, remembering most O2 travels attached to haemoglobin, so that oxygen moves from the alveoli across the respiratory membrane into the capillary and you’ve got your RBC here with haemoglobin protein, O2 binds to it, this blood then transported to different parts of the body through CS where O2 is transferred to various tissues for chemical reactions for energy production, and after reaction CO2 produced as by-product, leaves tissues and transported around body most dissolved in plasma as hydrogen carbonate, transferred from blood across respiratory membrane to be exhaled out of lungs

25
Q

pulmonary ventilation

A 
Process of moving air into and out of the lungs 
Some structures involved in ventilation:
-	Lungs
-	Diaphragm
-	Rib cage
-	Sternum
-	Intercostal muscles
26
Q

inspiration

A

LUNGS: volume increases as it fill with air
DIAPHRAGM: moves inferiorly and flattens, contract
RIB CAGE: elevated moves upward
STERNUM: elevated moves upward with rib cage
INTERCOSTAL MUSCLES: contract

27
Q

Expiration

A 
LUNGS: volume decreases as air leaves
DIAPHRAGM: moves superiorly as it relaxes into its dome-shape
RIB CAGE: depresses move down
STERNUM: depresses move down
INTERCOSTAL MUSCLES: relax
28
Q

Boyle’s law

A

volume is inversely proportional to pressure

29
Q

the 2 pressures

A

Barometric air pressure (PB ) – atmospheric air pressure outside the body
Intra-alveolar pressure (Palv) – pressure inside the alveoli

30
Q

End of expiration

A

Just blown all air out, the barometric pressure, so atmospheric pressure around you is equal to the intra-alveolar pressure
Pb = Palv

31
Q

End of inspiration

A

Pb = Palv

32
Q

During expiration

A

Volume of lungs decrease, pressure in lungs increases, diaphragm relaxes, rib-cage and sternum depress down
Palc > Pb

33
Q

Changing alveolar volume

A
  • Intrapleural pressure = pressure in the pleural cavity
  • Forces which promote alveoli recoil:
     Alveoli are covered in fine elastic fibers
     Fluid which coats alveoli which is surfactant
    ——- Surfactant produced by pneumocyte
  • Forces which promotes lungs expansion:
     Intrapleural pressure < intra alveolar pressure
    ——–Visceral pleura adhering to parietal pleura via pleural fluid, if other way around lungs would collapse
34
Q

Why does expanding your thoracic cavity make you take a breath in?

A

Increasing volume in lung decreases pressure so atmospheric air goes from high to low into lungs

35
Q

Why would your lungs collapse if you were stabbed in the chest?

A

If intrapleural pressure was lost, lungs would collapse like a balloon

36
Q

How do O2 and CO2 pass between capillaries and tissue cells?

A

Simple diffusion from high to low concentration

37
Q

Pulmonary volumes

A

Tidal volume – the amount of air inspired or expired with each breath, 500 mL healthy adult

Inspiratory reserve volume – the amount of air that can be inspired forcefully after inspiration of the tidal volume

Expiratory reserve volume – the amount of air that can be forcefully expired after expiration of the tidal volume

Residual volume – the volume of air still remaining in the respiratory passages and lungs after the most forceful expiration

38
Q

Pulmonary capacities

A

The sum of two or more pulmonary volumes
Inspiratory capacity – the amount of air a person can inspire maximally after normal expiration (tidal volume + inspiratory reserve volume)

Functional residual capacity – the amount of air remaining in the lungs at the end of a normal expiration (expiratory reserve volume + residual volume)

Vital capacity – the maximum volume of air that can be expelled from the respiratory tract after a maximum inspiration (inspiratory reserve volume + tidal volume + expiratory reserve volume)

Total lung capacity – inspiratory reserve volume + expiratory reserve volume + tidal volume +residual volume

39
Q

some definitions

A

Respiratory rate – number of breaths taken per minute

Minute ventilation – total amount of air moved into and out of the respiratory system each minute (tidal volume X respiratory rate)
- E.g. 500 ml X 12 breaths per minute = 6000 ml per minute

Anatomic dead space – space formed by nasal cavity, pharynx, larynx, trachea, bronchi, bronchioles and terminal bronchioles. – the regions within the respiratory system where gas exchange is not taking place

Alveolar ventilation - volume of air available for gas exchange per minute

40
Q

measuring lung function

A

Why?
- Diagnose and monitor diseases of the lungs
- e.g. asthma, chronic obstructive pulmonary diseases
How?
- Static versus dynamic (dynamic = time factor, static = no time factor)
- Using a spirometer – what we used in class
What?
- Lung volumes and capacities

41
Q

Dynamic lung function

A
  • Lung volume measurement in relation to time
  • Vitalograph
    Parameters measured:
  • Forced vital capacity (FVC) – maximal volume of air that can be forcefully expired as fast as possible after a deep breath in
  • Forced expiratory volume in 1 second (FEV1 sec) – the volume of air expired in the first second of the test
  • Forced expiratory volume 1% (FEV1%) – FEV1sec expressed as a percentage of the FVC- how much u breathe out in 1 sec, e.g. 72.3%
42
Q

Obstructive lung disease:

A
  • they can get all the air out of their lungs but the rate at which the air comes out might be slower than healthy person
    Vitalograph
    FVC: obstructive = normal
    FEV1 sec: obstructive «< normal
    FEV1%: obstructive «< normal
    FEV1 sec is an indicator of an obstructed airway
  • E.g. Asthma, bronchitis, chronic obstructive pulmonary disorder (COPD)
43
Q

Restrictive lung disease:

A
  • Can’t get all of air out even though rate might be same as healthy person
    vitalograph
    FVC: restrictive «< normal
    FEV1 sec: restrictive < normal
    FEV1% : restrictive = normal
    FVC is an indicator of a restricted airway
  • E.g. Emphysema
44
Q

Exercise and ventilation

A 
Ventilation increases abruptly 
-	Onset of exercise
-	Movement of limbs has a strong influence
Ventilation increases gradually
Exercise adaptations 
-	Slight increase in vital capacity
-	Slight decrease in residual volume
-	At maximal exercise, tidal volume and minute ventilation increases
45
Q

Why do we breathe faster during and after exercise?

A

Muscles need more O2, lungs are the source

46
Q

What information do dynamic tests of lung function give you?

A

Can tell you your lung function

- Vitalograph

HSF (8 decks)

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