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MUSC Physiology > EXAM 2 Respiratory System > Flashcards

EXAM 2 Respiratory System Flashcards

1
Q

major cause of morbidity and mortality in premature infants

A

Immaturity of the respiratory tract

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2
Q

when does surfactant production typically begin?

A

around week 20

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3
Q

_________ allows lungs to expand

A

Surfactant

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4
Q

what will happens to infants without surfactant?

A

unable to respire after birth

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5
Q

when are sufficient alveoli present in fetuses to permit survival

A

25th-28th week of gestation

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6
Q

at 3-7 years of age, how much surfactant does the child have?

A

300 million

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7
Q

how much surfactant does an adult have?

A

700 MILLION

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8
Q

how much alveoli are there at birth?

A

20-50 million

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9
Q

when do we develop our maximum number of alveoli?

A

around age 20

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10
Q

Lack of stiff structural support for airways makes children more susceptible to what two things?

A

atelectasis (lung collapse) and obstruction

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11
Q

Neonates are predominately what type of breathers?

A

nose breathers

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12
Q

why is there more resistance to airflow in infants?

A

Infant airways are smaller than adults

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13
Q

what is mucous effect on air flow?

A

increases resistance to airflow

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14
Q

a sign of increased respiratory resistance in babies

A

nasal flaring

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15
Q

Presenting sign for hypoxia in babies

A

nasal flaring

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16
Q

what can negatively affect airflow in babies?

A

Small amounts of mucus, edema, or airway constriction

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17
Q

Most respiratory disorders in infants result in what two things?

A

REDUCED LUNG COMPLIANCE AND INCREASED AIRWAY RESISTANCE.

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18
Q

The ability of the lungs to stretch

A

COMPLIANCE

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19
Q

6 signs of Reduced compliance or increased resistance

A
  1. Increased respiratory rate
  2. Grunting
  3. Nasal flaring
  4. Retractions
  5. Stridor
  6. Wheezing
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20
Q

what is tachypnea

A

Increased respiratory rate

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21
Q

sound caused by increased turbulence of air moving through the trachea and proximal airways

A

stridor

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22
Q

three things that make up upper airway

A
  • Nasopharynx
  • Oropharynx
  • Laryngopharynx
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23
Q

4 things that make up lower airway

A
  • Larynx
  • Trachea
  • Bronchi
  • Acinus
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24
Q

nasal cavity functions (6)

A
  1. Conducts gases to and from lungs
  2. Filters, warms, humidifies air
  3. Turbinates are convoluted and vascular
  4. Rigid (bone/cartilage) to prevent collapse
  5. Vibrissae (large hairs) trap foreign particles
  6. Cilia sweep mucous into nasopharynx
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25
Q

four paranasal sinuses

A

Maxillary, frontal, ethymoid, and sphenoid

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26
Q

two things the parasal sinuses contribute to

A

speech resonance and heat and water vapor exchange

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27
Q

in sinuses, what action removes bacteria and debris?

A

Mucociliary

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28
Q

Primary role for sinuses

A

speech resonance

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29
Q

where is the Eustachian Tube located?

A

Runs from middle ear to posterior pharynx

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30
Q

what Allows pressure equalization of middle ear?

A

Eustachian Tube

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31
Q

what closes Eustachian tubes during swallowing

A

Pharyngeal muscles

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32
Q

what predisposes children to otitis media?

A

Eustachian Tube angle and shorter length

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33
Q

genetic abnormality that lacks functional cilia. Patient presents with frequent upper respiratory infections, pulmonary infections, and infertility

A

Kartagener syndrome

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34
Q

Conducting Airways function

A
  • Direct air to respiratory exchange zones of the lung

- Warm, filter, and humidify air

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35
Q

Number of bifurcations

A

around 20 divisions

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36
Q

w2here does gas exchange happen?

A

at terminal end

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37
Q

primary defense mechanism in Ciliated columnar epithelial cells

A

Mucociliary transport

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38
Q

Ciliary function is impaired by (7)

A
  1. Smoking
  2. ETOH
  3. Hypo or hyperthermia
  4. Cold or hot air, low humidity
  5. Anesthetics, corticosteroids, noxious gases
  6. Viral infection (common cold)
  7. Excessive mucous production
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39
Q

hoe much mucous to goblet cells produce per day?

A

100 mL/day

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40
Q

where does mucous come from?

A

goblet cells

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41
Q

unique antibody that is produced and secreted on ALL mucosal surfaces

A

Secretory IgA

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42
Q

do children or adults have more goblet cells?

A

children

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43
Q

functions of larynx

A
  1. Sound protection
  2. Valve to prevent air from escaping the lungs
  3. Prevent foreign substances from entering the trachea and lungs
  4. Expel foreign substances (coughing)
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44
Q

Serves as a separation between lower and upper respiratory tract.

A

larynx

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45
Q

To hold air in we clamp off _____.

A

vocal folds

46
Q

critical for clearing lungs

A

cough

47
Q

a horseshoe shaped bone from which the larynx is suspended

A

hyoid bone

48
Q

Strangled people have this bone crushed

A

hyoid bone

49
Q
  • One of few bones not connected to other bones, suspended by sensory ligaments and muscles
A

hyoid bone

50
Q

3 types of cartilage in larynx

A

thyroid, cricoid, arythenoid

51
Q

A V-shaped cartilage containing the vocal folds

A

Thyroid

52
Q

A ring shaped cartilage connected to the trachea, supports the arythenoid cartilages posteriorly

A

cricoid

53
Q

vocal folds connect on posterior side of this cartilage

A

Arythenoid

54
Q

Vocal cords are strung between what two cartilages?

A

arythenoid cartilage and cricoid cartilage.

55
Q

Defense against excessive secretions or foreign/irritating substances

A

Cough Reflex

56
Q

receptors for cough reflex are located in the ____.

A

carina

57
Q

Diminishing cough reflex results in?

A

increases risk of aspiration

58
Q

how can cough reflex be diminished?

A

by cough suppressant medications, brainstem injury, age

59
Q

where is cough reflex coordinated?

A

brainstem (medulla oblongata)

60
Q

how is cough produced?

A 
when vocal folds and epiglottis close tightly against air trapped in lungs
Expiratory muscles (intercostal and abdominal) contract and increase pressure against closed vocal folds and epiglottis. Vocal folds and epiglottis suddenly open. High pressure air escapes, ejecting debris, mucus.
61
Q

nerve that stimulates constriction of bronchial smooth muscle

A

Vagus nerve

62
Q

branch of Autonomic Nervous System that results in BRONCHIODILATION

A

SYMPATHETIC

63
Q

branch of Autonomic Nervous System that results in - BRONCHIOCONSTRICTION

A

PARASYMPATHETIC

64
Q

what causes relaxation of bronchial smooth muscle

A

epinephrine/norepinephrine (adrenal gland medulla)

65
Q

bronchiodilation in sympathetic nervous system is mediated by what type of receptors?

A

beta-2 adrenergic receptors

66
Q

stimulation of these will result in sympathetic response

A

beta-2 adrenergic receptors

67
Q

where does the Trachea divide into right and left mainstem bronchi

A

carina

68
Q

how many lobes does the right lung have?

A

3

69
Q

how many lobes does the left lung have?

A

2

70
Q

bronchiole branching (start from trachea)

A

trachea -> right and left mainstem bronchi -> Lobular bronchi -> segmental bronchi -> bronchopulmonary segments -> the terminal bronchioles (smallest units)

71
Q

why can pneumonia be in a certain lobe and not in the others?

A

Bacteria can be isolated in segments, Lobular bronchi divide into bronchial segments

72
Q

where are alveoli found?

A

terminal bronchioles branch off to smaller respiratory bronchioles which have alveoli

73
Q

Adults have _____ alveoli per lung

A

350 million

74
Q

Adults have _____ alveoli total

A

700 million

75
Q

how many square meters of surface area for gas exchange in adult?

A

75 square meters

76
Q

3 types of alveolar cells

A

Type 1: squamous epithelial cells (pneumocytes)
Type 2: produce surfactant
Type 3: alveolar macrophages

77
Q

alveolar cell type- Majority of cells, form gas exchange surface

A

Type 1: squamous epithelial cells

78
Q

alveolar cells that produce surfactant

A

Type 2

79
Q

alveolar cells that phagocytize particles/microbes that reach alveoli

A

type 3: alveolar macrophages

80
Q

Purpose of surfactant

A

to change surface tension

81
Q

Patient with collapsed alveoli will have what sounds when listening to them breathe

A

crackle sounds

82
Q

why is there crackling sounds in patients with collapsed alveoli?

A

not enough surfactant in alveoli to allow them to smoothly open up

83
Q

Thin, continuous membranes covering lungs

A

visceral pleura

84
Q

Thin, continuous membranes covering thoracic cavity

A

parietal pleura

85
Q

visceral pleura and parietal pleurae separated by what?

A

serous fluid

86
Q

purpose of serous fluid?

A

to lubricate

87
Q

Intrapleural space maintained at what type of pressure?

A

negative pressure

88
Q

accumulation os serous fluid causes what symptom in patients?

A

shortness of breath

89
Q

Blood supply to the lungs and bronchia through what 2 systems?

A

Bronchial artery system

Pulmonary artery system

90
Q

system that Supplies blood to bronchi and supporting lung structures

A

Bronchial artery system

91
Q

Bronchial artery system arises from ___.

A

thoracic aorta

92
Q

Pulmonary artery system arises from ___.

A

Pulmonary artery

93
Q

it is critical that the Pulmonary artery system is maintained at what kind of pressure?

A

low

94
Q

artery system that has Huge capillary network for gas exchange

A

Pulmonary artery system

95
Q

why is ability for exchange gas less efficient in elderly and infants?

A

Fewer capillaries

96
Q

Oxygenated blood exits through pulmonary vein into ____.

A

left atrium

97
Q

Normally only what % of pulmonary capillaries are perfused

A

25%

98
Q

why do we have high levels of carbon dioxide in alveoli

A

We have high levels when we do not ventilate alveoli.

99
Q

3 ways that we can recruit the other 75% of all the capillaries we have in respiratory tree

A
  • recruiting (opening) previously closed capillaries
  • dilating capillaries that are open
  • increasing pulmonary artery pressure
100
Q
  1. As children approach puberty, risk of developing middle ear infections (otitis media) falls. Why?
A

More acutely angled Eustachian tube

101
Q
  1. Your patient complains of a 3-day history of nasal drainage and nagging cough. They request a powerful cough suppressant, what is a possible significant negative consequence of its use?
A

Increased risk for respiratory infection.

102
Q

Pulmonary arterioles ______in response to alveolar hypoxia

A

constrict

103
Q

Fluid balance across lung tissue is regulated by:

A

hydrostatic pressure, colloid osmotic pressure, capillary permeability

104
Q

what is hydrostatic pressure?

A

blood pressure vs tissue pressure, - pushes fluid to alveoli

105
Q

what is Colloid Osmotic Pressure (oncotic)

A

related to protein concentration on either side of a membrane,pulls water back into vessel

106
Q

when does colloid pressure change?

A

when protein concentration changes in blood

107
Q

leakiness between endothelial cells lining capillaries

A

Capillary Permeability

108
Q

what is ventilation?

A

Ventilation is the process of moving air into and out of the lungs

109
Q

purpose for ventilation

A

Purpose is to provide for oxygen absorption from inspired air and removal of carbon dioxide to expired air.

110
Q

Ventilation is influenced by

A

age, body shape and size, body position

MUSC Physiology (12 decks)

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