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FHB 1 > Exam 4: Respiratory L1 > Flashcards

Exam 4: Respiratory L1 Flashcards

1
Q

What is the primary function of the respiratory system?

A

Primary function of the respiratory system is gas exchange (O2 in and CO2 out)

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2
Q

What are the steps of external respiration?

What happens during internal respiration?

A

External respiration: exchange of air in lungs and O2 and CO2 exchanged in alveoli

Internal Respiration: mitochondria consume O2 and produce CO2

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3
Q

What structures comprise the upper airway?

Lower airway?

A

Upper airway: nose, pharynx, glottis, vocal chords

Lower airway: trachae, bronchial tree, alveoli

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4
Q

What are the major functions of the upper airway?

A

Major Functions of the Upper Airway:

  1. Filter (nose filters out particles greater than 10 um)
  2. “condition inspired air” : increase temp and humidify the air
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5
Q

What are three mechanisms for bypassing the upper airway?

A

Ways to bypass the upper airway:

Intubation

Tracheostomy (long-term)

Cricothyroidoyomy “cric”

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6
Q

What happens when we bypass the upper airway?

A

When the upper airway is bypasses, we lose upper airway functions like humification of air

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7
Q

How many lobes are in the right lung vs the left lung?

A

Right lung: 3 lobes

Left lung: 2 lobes

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8
Q

Explain parietal pleura and visceral pleura

A

Parietal pleura: outer wall that contains capillaries that release pleural fluid, and stomata and lymphatics that drain that fluid

Visceral pleura: inner wall

Pleural space is space between the two, and there is NO AIR in the pleural space normally

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9
Q

Pleural fluid:

Primary function?

How much?

Space is _______ (_____ pressure)

Low/high protein content

A

Pleural fluid:

Primary function: lubricant

10-20 mLs

Space is subatmospheric (negative pressure)

Low protein ( < 1.5 g/dL)

  • protein content is critical for clinical diagnosis

(high protein means inflammatory…. low protein means hydrostatic/oncotic balance)

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10
Q

Define pleural effusion

A

Pleural effusion is excess fluid in the pleural space

(pulmonary edema is a general term for fluid in the lungs, where as pleural effusion is more spefically describing fluid in the pleural space)

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11
Q

Explain the anatomy of the trachae (and the function of each section)

A

Trachae: have a c shaped cartilage ring, with a smooth muscle section

The cartilage maintains the structure and protects the airway

The smooth muscle helps with constriction and flexibility

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12
Q

Just like the ___ side of the lungs is slightly larger, the _____ mainstem bronchus is also larger

Inhaled foreign bodies are more commonly lodged in the _____ lung

A

Just like the right side of the lungs is slightly larger, the right mainstem bronchus is also larger in diameter

Inhaled foreign bodies are found more commonly in the right side of the lungs

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13
Q

The base of the trachae is called the _____

A

Base of trachae is called the “carina”

gets structurally damaged in smokers

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14
Q

Explain the primary, secondary, and tertiary sections of the bronchi

A

Main bronchi > lobar bronchi (secondary) > segmental bronchi (tertiary)

Segmental bronchi:

10 in right lung

8-10 in left lung

can remove one with minimal effect on the others

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15
Q

What is the functional anatomic unit of the lower airway?

A

Functional anatomic unit: bronchopulmonary segment

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16
Q

The trachea is part of the _____ airway

A

Trachae is part of lower airway

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17
Q

What is the difference between the bronchi and bronchioles

A

Difference between bronchi and bronchioles is that bronchi contain cartilage and broncioles do not

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18
Q

Explain the segments that count as “conducting airways” vs “respiratory units”

A

Conducting zone: trachea, bronchi, nonrespiratory bronchioles

Res[piratory zone: respiratory bronchioles and alveoli

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19
Q

Respiratory Unit:

contains______

Volume

Surface Area

A

Respiratory unit is respiratory broncioles and alveoli

volume: 2500 mL

Surface area of seventy square meters or 750 sq ft

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20
Q

Most of the cross sectional area within the respiratory system is within the ____

A

LARGE cross sectional area of the respiratory zone

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21
Q

Alveoli:

Type I cells vs Type II cells

What are alveolar macrophages?

A

Alveoli:

Type I: where gas exchange happens (95-98% of surface area)

Type II cells: produce surfactant (2-4% of surface area)

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22
Q

What are the secondary functions of the alveoli?

A

Secondary functions of the alveoli:

Barrier functions

Immune functions

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23
Q

Alveolar surface tension is due to _____

What is the eqn given by law of laplace and what does it say about smaller bubbles vs larger bubbles?

A

Surface tension in alveolar is caused by H20 molecules being attracted to one another

Law of Laplace: Inward Pressure= 2 x Surface Tension/ Radius of the bubble

This equation suggests that the small bubbles would collapse and the larger bubbles would become distended

This does not happen physiologically

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24
Q

Stability of Alveoli:

Alveoli do not collapse like the Law of Laplace would suggest because:

1.

2.

A

Alveoli do not collapse because:

  1. Surfactant
  2. Interdependence
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25
Q

Surfactant:

Produced by ______ cells

Made up of ______

It ____ surface tension

A

Surfactant is produced by Type II alveolar cells

Surfactant is a lipoprotein complex (made up of phospholipids)

Surfactant reduces surface tension and stabilizes alveoli

26
Q

Explain Infant Respiratory Distress Syndrome

Most commonly from _____

Treatment?

A

Infant Respiratory Distress Syndrome:

  • Most commonly from premature delivery
  • Type II cells differentiate and produce surfactant after week 24, with normal surfactant levels at week 35
  • Treatment: steroids pre-birth to increase Type 2 differentiation, external surfactant for infants
27
Q

Stability of Alveoli:

Interdependence:

Explain how alveoli are mechanically tethered

Explain “collateral ventilation”

A

Tendency of alveoli to collapse is opposed by the traction to excerted by the surrounding the neighbor alveoli

Collateral Ventilation: “MLK”, channels of martin, channels of lambert, pores of kohn (makes sure air flows in uniformly by having channels and pores for it to flow through)

28
Q

What are the two vascular systems that supply blood to the lungs?

A

Bronchial circulation (systemic)

Pulmonary circulation

29
Q

Bronchial Circulation:

Explain bronchial arteries

A

Bronchiole Arteries:

  • from aorta to terminal bronchioles
  • merge with pulmonary arteries and capillaries
  • 1-2 % of total cardiac output
30
Q

Explain bronchial veins:

1/3 of the blood goes to ___

2/3 of the blood goes to __

A

Bronchial Veins:
1/3 of blood returns to right heart

2/3 of blood drains into pulmonary circulation (causing a mixture of deoxy and oxy blood)… contributes to venous admixture of anatomic shunt

31
Q

Explain the pulmonary circulation

primary purpose

vascular area

capillary volume

A

Pulmonary circulation:

Near 100% of right heart output

Primary purpose to deliver blood to lung for gas exchange

Largest vascular bed in the body (70 meters squared)

Capillary volume- at rest is 70mL, during exercise is 200mL

32
Q

Because 100% of right cardiac output goes to the lungs, it is the hotspot for _____

A

Because 100% of right cardiac output goes to the lungs, they are a hotspot for modifying/removing components of the blood

Pulmonary endothelia express many enzymes and transporters

33
Q

Explain the deposition of inhaled material:

Where does impaction, sedementation and diffusion happen?

A
34
Q

Explain the clearance of inhaled particles within the bronchi vs within the alveoli

A

Clearance of inhaled particles:

nasopharynx: particles swallowed

Bronchi: mucociliary system

Alveoli: alveolar macrophages engulf particles

35
Q

What are the three components of the mucociliary clearance system?

A

Three components of the mucociliary clearance system: mucous layer, periciliary fluid, cilia

36
Q

Explain the mucociliary clearance system?

What kind of cytoskeletal parts play a role?

A

Mucociliary Clearance System:

Highly organized microtubule cytoskeleton and dynein motors drive ciliary “beating”

37
Q

Humidity impacts both ______ & _______

A

Humidity impacts both virus containing particles and mucociliary clearance

38
Q

Low humidity leads to an ______ in stable virus that is _________

A

Low humidity leads to an increase in stable virus that is more capable of making it to its favorite cellular receptor (example, the COVID 19 receptor is thought to be ACE 2 which is very deep within the respiratory system)

39
Q

Cilia stall in dry cold air because:

dry air _____ the mucous layer

cold ____ ciliary function

A

Cilia stall in dry cold air because:

dry air dehydrates the mucous layer

cold inhibits ciliary function

40
Q

Increasing humidity from 20% to 50% will ____ mucociliary clearance

A

Increasing humidity increases mucociliary clearance (think about WHY people put humidifiers in their room)

41
Q

Upper airways ____, ___, and _____ air

Airways are divided into two zones:

Volume of the anatomic dead space is ___

A

Upper airways filter, warm, and humidify air

Airways are divided into two zones : conducting zone (down to terminal bronchioles) and a respiratory zone

Volume of anatomic dead space is 150 mL

42
Q

Volume of the respiratory region is ____

The ______ segment is the functional anatomic unit, whereas the _____ is the basic physiological unit

The alveolar capillary network is extremely ___, ideal for gas exchange

A

Volume of the respiratory region is 2.5-3 L, surface area of 50-100 meters squared

The broncho-pulmonary segment is the functional anatomical unit, whereas the respiratory segment (respiratory bronchi and alveolar ducts) is the basic physiological unit

The alveolar capillary network is extremely thin, idea for gas exchange

43
Q

_______, _______, and _____ stabilize alveoli

The lung has 2 circulations: _____ and _____

A

Surfactant (reduction of surface tension), interdependence, and collateral ventilation stabilize alveoli

The lung has two circulations: bronchial (systemic) and pulmonary

44
Q

The _______ has the largest vascular bed in the body

The lung has also metabolic functions (convertion of ____ into _____)

The mucociliary transport system removes inhaled particles (humidity impacts both ___ and ___)

A

The pulmonary circulation is the largest vascular bed in the body

The lung also has metabolic functions (conversion of AngI to AngII by ACE)

The mucociliary transport system removes inhaled particles (humidity impacts both virus-containing droplets AND mucociliary clearance)

45
Q

Air flows _________ a pressure gradient (from ___ to ___)

Explain inspiration vs expiration in terms of pressure and air flow

A

Air flows DOWN a pressure gradient (from high pressure to lower pressure)

Inspiration: alveolar pressure is lower than atmospheric pressure (air flows in)

Expiration: alveolar pressure is above atmospheric pressure (air flows out)

46
Q

Explain how boyle’s law relates to breathing?

A

Boyle’s law: pressure and volume of a gas are inversely proprotional to one another

P1V1 = P2V2

If volume goes down, pressure increases, etc

47
Q

What are the Major muscles of inspiration?

Accessory muscles of inspiration?

A

Major Muscles of Inspiration: diaphragm and external intercostal muscles

Accessory muscles: sternocleidomastoid and scalenus

48
Q

______ & ______ contract with every inspiration

A

Diaphragm and external intercostals contract with every inspiration

49
Q

Intercostals: label which helps with inhaling vs exhaling

External :

Internal:

A

External Intercostals: inhaling

Internal intercostals: expiration

50
Q

The major inspiratory muscles are the ___ and the ___

The diaphragm:

  • is stimulated by the ____ nerve
  • accounts for _____ increase in thorax cavity volume
  • stimulation causes ____

External Intercostal Muscles:

  • are stimulated by _____ nerves
  • Stimulation causes___
A

Major inhale muscles: diaphragm & external intercostals

Diaphragm:

  • stimulated by the phrenic nerve
  • accounts for 75% increase in thoracic cavity
  • stimulation causes muscle to flatten/contract/move downward, which enlarges the cavity in a vertical way

External Intercostal Muscles:

  • stimulated by the intercostal nerves
  • stimulation causes ribs to move up and outward, enlarges cavity laterally and anteroposterior direction
51
Q

Diaphragm contraction lowers the floor of the thoracic cavity, thus increasing the volume of the thoracic cavity, and ____ the pressure

A

Increasing the volume and therefore lowering the pressure

52
Q

Inspiration:

Contraction of the _____ moves the rib cage out and up

Similar to moving the handle on a bucket

A

Contraction of the external intercostal muscles moves the rib cage up and out.

Similar to moving the handle on a bucket

53
Q

Deep Forceful Inspiration:

Occurs via the acessory inspiratory muscles

Contraction of neck muscles: ___ and ___

Enlarges the thorax

Nasal muscles can also be activated

A

Deep Forceful Inspiration:

Occurs via accessory muscles

Contraction of neck muscles: scalenus and sternocleidomastoid raise the sternum and elevates the first two ribs

These are only used during forceful inspiration such as exercise or trouble breathing

Nasal muscles can also be activated

54
Q

Expiration is mostly _____

Diaphragm relazation allows____

________ muscles relax, causing the rib cage to__

Lungs deflate and thorax compressues due to ___

A

Expiration is mostly passive

Diaphragm relaxation allows muscle to assume its natural dome shape

Intercostal muscles relax, causing rib cage to fall down due to gravity

Lungs deflate and thorax compresses due to natural recoil

55
Q

What does forced expiration require?

_____ contraction increases pressure and pushes diaphragm upward

______ contraction flattens the rib cage by pulling the ribs downward and inward

A

Forced Expiration requires contraction of expiratory muscles

Abdominal muscle contraction increases abdominal pressure and pushes the diaphragm upward

Internal Intercostal muscles contraction flatten the rib cage by pulling the ribs down and in

56
Q

How do intercostal muscles connecting the same ribs have opposing effects?

A

Direction of contraction and flexibility

57
Q

What determines the volume of air in the lungs?

The serous fluid within intra-pleural space has a total volume of ____

A

Lung-chest wall interactions determines volume of air in lungs. Lung and chest wall move together as a unit: they have the same volume changes.

The serous fluid within intra-pleural space has a total volume of 10-20mL distributed over entire surface of the lung (very thin)

58
Q

During quiet breathing, the lung and chest wall are ___

A

During quiet breathing, the lung and chest wall are pulling away from one another, thus creating negative pressure in the pleural space

59
Q

Explain traumatic pneumothorax vs spontaneous pneumothorax

What is the treatment for pneumothorax?

A

Traumatic pneumothorax: puncture wound in chest wall

Spontanoues penumothorax: hole in lung

Both instances, the pleural space equilibrates to the pressure in the atmosphere and collapses the lung volume

Treatment for pneumothorax: for mild ones it’s observation and manual aspiration…for more severe ones it’s chest tube or under water seal drain

60
Q

Pressure volume gradients during a tidal volume breath

Intrapleural pressure is always ____

Lungs are always ___

At end inspiration and end exhalation____

DRAW THE GRAPHS for inspiration and expiration of volume, pleural pressure, flow, and alveolar pressure

A

Interpleural pressure is always below atmosphere (in tidal breathing)

Lungs are always stretched to some degree, even during expiration

At end inspiration and end exhalation, alveolar pressure is the same as atmospheric

61
Q

Air flows in/out the airways through _____

Inspiration is ___, whereas expiration is ___

___ is most important muscle of respiration

___ are used during forced inhalation/exhalation

Lung volumes are determined by the ____

When there is no air flow, inward recoild of the lung and outward recoild of chest wall are ___, pressure across entire system is __

A

Air flows in/out of airways through pressure gradients

Inspiration is active, exhalation is passive

Diaphragm is most important muscle of respiration

Accessory muscles are used during forced inhalation and exhalation

Lung volumes are determined by the balance between the elastic revoil of the lung and the properties of the chest wall/muscles

When there is no air flow, inward recoild of the lung and outward recoild of the chest wall are balanced, pressure across the entire system is 0 (this happens at end of inspiration and expiration)

62
Q

Conducting zone vs respiratory zone:

Air moves in conducting zone by_____

Air moves in respiratory zone by ___

A

Conducting zone: air moves by convection/bulk flow

Respiratory zone: air moves by diffusion

FHB 1 (24 decks)

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