Final Flashcards
What are the 2 primary functions of the respiratory system
Bring O2 from the outside air to the cells of the body and carry CO2 from the cells of the body to the outside air
What is external respiration
Occurs at the level of the lungs by taking oxygen from the air inhaled in our lungs and diffusing it into our blood
What is internal respiration
Occurs at the level of the tissues when oxygen in our blood is diffused into the tissue via capillaries
What are the secondary functions of the respiratory system
Voice production, body temperature regulation, acid-base balance regulation, and sense of smell
What is phonation
Voice production begins in the larynx and air passes over the vocal folds
What determines the pitch of the voice
The rate the vocal folds vibrate and width at which they open
What can happen to the vestibular fold if brachycephalic airway syndrome
The vestibular fold can have swelling
How does the respiratory system assist w/ body temperature regulation
Superficial blood vessels in the nasal epithelium warms air as it passes over the pseudostratified columnar epithelium, mucus, and cilia
What is the ideal pH of blood
7.35-7.45
How does the respiratory system control the amount of CO2 in blood
Adjusting volume and rate of breathing
What is pH regulated so carefully
Peak metabolism
What is Jacobson’s organ
The vomeronasal organ that detects pheromones thru the Flehmen response
Where does the Jacobson’s organ open into
The roof of the mouth thru the incisive papilla
What is the URT
All structures outside the lungs such as the nostrils, nasal passages, sinuses, pharynx, larynx, and trachea
What is the LRT
All structures w/in the lungs such as the bronchi, bronchioles, alveolar ducts, and alveoli (these all form the bronchial tree)
What is the medical term for nostrils
Nares
What is the nasal passage
Everything btw the nares and the pharynx
What is the nasal septum
The midline of the nose
What are turbinates
Nasal conchae that are scroll like bones covered in epithelium
What are the three main turbinates
The dorsal nasal conchae, middle nasal conchae, and the ventral nasal conchae
What anatomic features are located in the nasal passages
Lined by pseudostratified columnar epithelium, mucus secreted by mucous glands and goblet cells, and cilia that is bent toward the pharynx
What are the functions of the nasal passages
To condition inhaled air by warming, humidifying, and filtering it
What happens when cilia in the nasal passages fail to do their job
URIs can occur causing excess secretions to build up obstructing air flow and causes coughing/sneezing
What are paranasal sinuses
Outpouchings of nasal passages that are named from the bones they are contained in such as the 2 frontal sinuses and 2 maxillary sinuses
How can sinuses be species specific
Some species have more sinuses such as the sphenoidal and ethmoidal sinuses
What is sinus trephination
Treatment for severe/chronic sinusitis to release the pressure build up and help drainage in the sinuses by creating a hole in the sinuses
What is the pharynx
The throat is the common passageway btw the respiratory and digestive systems that is controlled by reflexes
What is the larynx
The voice box that has segments of cartilage connected by muscle and is supported by the hyoid apparatus
What are the segments of cartilage in the larynx
Epiglottis, arytenoid (2), thyroid, and cricoid
What is the epiglottis
The most rostral of the larynx cartilages that covers the larynx opening when swallowing
What are the vocal cords
Vocal folds that are attached to arytenoid cartilages, they form the boundaries of the glottis, and have muscles that attach to cartilages to adjust tension
What are vestibular folds
False vocal cords in non ruminant species are a second set of CT bands near the vocal cords
What are lateral ventricles
Blind pouches btw vocal folds and vestibular folds
What are the functions of the larynx
Phonation, prevent inhalation of foreign material, and control air flow to/from the lungs
What are the ways the larynx controls air flow to/from the lungs
Coughing and valsalva maneuver
What is the valsalva maneuver
Forced expiration against a closed glottis that occurs w/ vomiting or passing stool
What is the trachea
The windpipe made of fibrous tissue, smooth muscle, and cartilage rings
What is the trachea’s cartilage rings
C shaped cartilage w/ the opening facing dorsally preventing collapse
Why does tracheal collapse occur
The pressure of breathing is larger than the cartilage can stand
How does the ANS control the LRT
Using smooth muscle to control the diameter of the airways by contracting (bronchoconstriction) or relaxing (bronchodilation) the muscle fibers
What are alveoli
Thin walled sacs surrounded by capillaries that is lined w/ fluid containing surfactant and is the site of external respiration
What is the purpose for the alveoli to be lined w/ fluid containing surfactant
To lower the surface tension allowing alveoli to stay open when breathing occurs
What is the base of the lungs
The concave lower surface that rests on the diaphragm
What is the apex of the lungs
The top most round part of the lung that extends into the neck
What is the convex lateral surface of the lungs
The costal surface of the lungs
What is the hilus
The medial aspect where air, blood, lymph, and nerves enter/leave
Where is the mediastinum
Between the lungs
What is the basic pattern of lungs
3 lobes in the left (cranial, middle, and caudal) and 4 lobes in the right (cranial, middle, caudal, and accessory)
How are horse’s lung pattern special
They are missing the middle lung lobe on both lungs
What binds the thorax
Thoracic vertebrae, ribs/intercostal muscles, and sternum
What all is contained in the thorax
Lungs, heart, large blood vessels, nerves, trachea, esophagus, lymphatic vessels, and lymph nodes
What is contained in the mediastinum
Heart, trachea, esophagus, blood vessels, nerves, and lymphatic structures
What is the diaphragm
Thin sheet of skeletal muscle that is the caudal boundary of the thorax
What is the function of a diaphragm
A respiratory muscle that forms a dome shape when relaxed and flattens when muscle contracts to enlarge the volume
What are the functions of the thorax
Negative intrathoracic pressure, inspiration/inhalation, expiration/exhalation, respiratory volumes, exchange of gases in alveoli, partial pressures of gases, and control of breathing
Why is negative intrathoracic pressure critical for breathing
When the pressure in the thorax is greater than the atmospheric pressure it allows for a partial vacuum to pull the lungs against the thoracic wall and has a small normal amount of fluid in the pleura allowing the lungs to slide past the interior structures
What are the 2 functions of negative pressure
Inspiration/expiration and return of blood to heart
What is a bulla
A bister of air in the lungs that can cause a collapse lung if it ruptures
What is a pneumothorax
Air in the chest cavity
What is inspiration/inhalation
The active process of drawing air into lungs increasing the volume of the chest
What are the inspiratory muscles
Diaphragm that flattens opening the chest cavity and external intercostal muscles that help move the ribs cranially and dorsally
What is expiration/exhalation
The passive process of pushing air out of the lungs
What are the expiratory muscles
Internal intercostal muscles that move ribs back to normal location and abdominal muscles that are used to help exhalation when there is difficulty breathing
What is the tidal volume
Volume moved in/out per breath
What is minute volume
Volume inspired/expired in 1 min (MV = TV * RR)
What is residual volume
Volume of air remaining in the lungs after maximum expiration
What exchange of gases occur in the alveoli during inhalation
Exchanges CO2 for O2 because blood always has a higher CO2 concentration in the blood so they run into the alveoli while O2 rush into the blood as the concentration gradient will always be higher in the alveoli
What is the driving force of gas exchange between the alveoli and blood
The concentration gradient causes diffusion of gases from areas of high to low concentration
What exchange of gases occurs in the alveoli during expiration
CO2 is removed from the alveoli allowing for more O2 to get brought in and reset the concentration gradient
What is Dalton’s law
The total pressure of a mixture of gases is the sum of the pressures of each individual gas
what is partial pressure
The pressure of an individual gas
What determines to partial pressure of O2 and CO2 in the blood of the capillaries
The partial pressure of O2 and CO2 in the alveolar air
What does PO2 mean
Partial pressure of oxygen
What does PAO2 mean
Partial pressure of oxygen in alveoli
What does PaO2 mean
Partial pressure of oxygen in arterial blood
What is Bovine High Mountain Disease
Typically occurs when calves of 6-8 months old at 3-4 weeks after moving to an area of higher altitudes such as CO, WY, NM
What are does BHMD cause
Chronic hypoxia, pulmonary artery hypertension, right sided heart failure which presents as SQ edema, ascites, and pleural effusion
How is BHMD treated
Removing from altitude, thoracocentesis, and diuretics
What is the respiratory center
The area of the medulla oblongata has individual control centers for inspiration, expiration, and holding breath
What are the 2 methods of controlling breathing
Mechanical control and chemical control
What is mechanical control of breathing
Stretch receptors in the lungs produce a normal rhythmic resting breathing pattern
How do the mechanical control signals work to control breathing
When the lungs inflate a signal is sent to the brain, the respiratory center singals back to cease inspiration, lungs deflate sending another signal to the brain, and the respiratory center signals back to cease expiration
What is chemical control of breathing
Fine tuning of respiration to maintain equilibrium these receptors are in the carotid and aortic bodies and in brainstem constantly monitor CO2 content, pH, and O2 content
What is hypercapnia
Excessive CO2 in bloodstream
What is hypoxia
Decrease oxygen in the tissue
What is hypoxemia
Decrease oxygenation in the blood
What are irritant receptors
Receptors that detect thing that irritate the lungs such as mucus and dust that constrict bronchioles
What are inflation reflex
Baroreceptors that sense the lungs over inflating and sends a signal to the medulla causing a decrease in inspiration
What are temporary alterations in normal respiratory pattern
Irritants (cough and sneeze), imbalances (yawn and sign), and idiopathic (hiccup)
What are laryngospasm
Spasming/constricting of the larynx can occur due to smoke inhalation and water inhalation this is intended to be a self protective measure that can lead to respiratory stress if prolonged
What is bronchospasm
Spasming/constricting of bronchioles
What are diagnostics that can be used for respiratory issues
Observation, auscultation, radiographs, advance imaging (MRI, CT, bronchoscopy), bronchoalveolar lavage, pulse oximetry, capnograph, and blood gas
What is the medical term for high RR and panting
Polypnea
What is the medical term for high RR and shallow breathing
Tachypnea
What is the medical term for increased RR and depth of breathing (increased minute ventilation)
Hyperpnea
What are examples of dyspnea
Congestion, stridor, stertor, and grunting on expiration
What are auscultation
Listing for internal normal sounds and abnormal sounds such as crackles, wheezes, referred upper airway sounds, lack of respiratory sounds, and harsh lung sounds
What is bronchoalveolar lavage
Placing saline in a bronchiole or bronchi and withdraw the saline allowing us to collect cells/debris from the fluid which can be used for diagnostics
What does pulse oximetry tell us
The percentage of hemoglobin that is oxygenated in the blood
What is a capnography
Measures the concentration-time display as a waveform (capnogram) from a CO2 sample
What is capnometry
Measurement and numeric display of the CO2 concentration w/o waveform measured by a capnometer
What are commonly seen respiratory diseases in dogs
Pneumonia, canine infectious respiratory disease complex (CIRDC), tracheal collapse, laryngeal paralysis (lar par), brachycephalic obstructive airway syndrome (BOAS), chronic bronchitis, neoplasia, and fungal disease
What are commonly seen respiratory diseases in cats
Asthma, heartworms, lungworms, upper respiratory infection (URI), nasal polyps, neoplasia, or fungl disease
What are commonly seen respiratory diseases seen in ruminants and pigs
Bovine/porcine respiratory diease complex (BRDC/shipping fever) and verminous pneumonia (pigs)
What are commonly seen respiratory diseases in horses
Recurrent airway obstruction (heaves), inflammatory airway disease, strangles, laryngeal hemiplegia (roaring), exercise induced pulmonary hemorrhage (racehorses), and guttural puch disease
What are treatments for respiratory diseases
Thoracocentesis, coupage, oxygen supplementation, nebulization, medications, and salvage/emergency procedures such as tracheostomy, lung lobectomy, and tracheal stent
What is a hydrothorax
Watery secretions in the thorax
What is a pyothorax
Neutrophils filled fluid in the thorax
What is a chylothorax
Lymph fluid found in the thorax
What are treatments for pneumonia in dogs and cats
Nebulization, coupage, antimicrobials, and supportive care
What are pulmonary origin indications for supplement oxygen
Pulmonary edema (CHF), pulmonary contusion (trauma), and pneumonia
What does feline asthma look like in the lungs
Air is trapped in the alveoli due to tightened smooth muscle around a bronchiole that could have mucus in it
What are treatments to manage feline asthma
Glucocorticoids such as fluticasone (inhaled), prednisolone (oral), depo-medrol (subcutaneous) and bronchodilators such as albuterol (inhaled) and terbutaline or theophyline (oral)
What is inhalation therapy
Aerosolization of glucocorticoids, antibiotics, and bronchodilators to increase the delivery to the airway bypassing the systemic circulation
What is expectorants
Liquefy and dilute mucoid secretions that indicated w/ a productive cough and may cause drowsiness and vomiting
What are mucolytics
Decrease viscosity of secretions by breaking down disulfide bonds
What are examples of mucolytics
N-acetylcysteine and dembrexine for horses
What are methemoglobinemia
Oxidation of iron in hemoglobin presenting w/ cyanotic MM, lethargy, and dyspnea can be aused by acetominophen or nitrite toxicity
What are treatments for methemoglobinemia
N-acetylcysteine w/in 2 hrs and riboflavin and methylene blue if over 2 hours
What are antitussives
Centrally acting agents that suppress cough by depressing cough center in the brain examples are butorphanol (IV), hydrocodone (II), codeine (II,III, or IV), dextromethorphan, and temaril
What are bronchodilators
Cholinergic blockers that is rarely used examples are antihistamines, beta 2 adrenergic agonists, and methylxanthine derivatives
How do antihistamines work
They are released from mast cells and bind to H1 receptors on bronchiole smooth muscle
What are corticosteroids used for
Allergy therapy and anti inflammatory these can cause PU/PD, panting, polyphagia, behavior changes, and GI ulceration
What are respiratory stimulants
Doxapram that stimulates CNS for respiratory system these are not recommended for resuscitation of neonates because they increase oxygen demand for respiratory muscles and cerebrum decreasing cerebral blood flow
What do inhalant anesthetics do
Respiratory depressants decreases the RR and tidal volume
What are the causes for cell injury
Oxygen deprivation (hypoxia or ischemia), physical agents, chemical agents/drugs, infectious agents, immunologic reactions, genetic derangements, and nutritional imbalances
What does increased demand do to the cell
Causes hypertrophy or hyperplasia
What does chronic irritation do to a cell
It causes metaplasia
What is hypertrophy
Increased cell size increasing the organ size this can be due to physiologic or pathologic reasons
What is hyperplasia
Increased number of cells leading to an increase in organ size this can be physiologic or pathologic
What are the causes of hypertrophy
Increased workload or hormone induced
What are the causes of hyperplasia
Medication, hormone, compensatory, and infectious
What is atrophy
Decreased cell size and number decreasing the size of the organ due to physiologic or pathologic reasons
What is metaplasia
Stress or chronic irritation that leads to reversible changes often replacing one cell type w/ another
What are reversible injuries to a cell
Those that are from reduced ATP or cellular swelling
What is necrosis
Premature death due to pathology that leads to large areas of contiguous cells, cells and organelles swell, lost in control of the intracellular environment, and inflammation
What are chemical mediators of inflammation
Short lived chemicals such as histamine that may be derived from plasma or cells (mast cells) that act on one or a few target cells, have a widespread of targets, and may have differing effects depending on cell and tissue types
What is histamine
Produced by primarily mast cells (basophils and platelets) that dilates arterioles and increases permeability of venules
What is the release mechanism of histamine
Binding of antigen to IgE on mast cells releases histamine containing granules they can also be released by nonimmune mechanisms such as a cold, trauma, or other chemical mediators
When does histamine cause a wheal and flare skin reaction
W/ type 1 hypersensitivity reactions
What is acute inflammation
Has a short duration and has 3 major components increased blood flow, edema, and leukocyte migration (neutrophils)
What is chronic inflammation
Has a longer duration, lymphocytes and or macrophages are predominately present, and fibrosis/angiogenesis occurs
What are stimuli for acute inflammation
Infections, trauma, physical or chemical agents, foreign bodies, and immune reactions
What is the systemic manifestations of acute inflammation
Increased production of positive acute phase proteins, decreased production of albumin, increased glucocorticoids, fever, redirected blood flow away from skin, increased HR/BP, and shivering, chills, and malaise
What are chronic inflammation macrophages
Monocytes that begin to emigrate into tissues early in inflammation where they transform into the larger phagocytic cell known as the macrophage they predominate for 48 hrs and their activation results in secretion of biologically active products
What are granulomatous inflammation
Distinctive pattern of chronic inflammation that is predominantly activated by macrophages and contain a granuloma (acral lick granuloma) that is the focal area of the inflammation
What are the steps of wound healing
Injury induces acute inflammation, parenchymal cells regenerate, both parenchymal and connective tissue cells migrate and proliferates, entracellular matrix is produced, parenchyma and connective tissue matrix remodel, and increase in wound strength due to collagen deposition
What variables can affect wound healing
Infection, nutrition, anti inflammatory meds, mechanical variables, vascular disease, and tissue type
What are the 4 definitions of shock
Significant compromise to capillary perfusion, inadequate cellular energy production, inability of body cell mass to metabolize nutrients normally, inability of body to supply cells and tissues w/ oxygen, nutrients, remove waste
What are the types of shock
Hypovolemic (circulatory), cardiogenic, distributive, obstructive, hypoxic, and metabolic
What is the most common type of shock
Hypovolemic
What are causes of hypovolemic shock
Hemorrhage (ruptured splenic or hepatic mass, coagulopathy, and trauma), severe dehydration (vomiting & diarrhea), and hypoproteinemia (loss of fluid into body cavities)
What is hypovolemic shock
hypoperfusion secondary to decreased intravascular volume
What are clinical signs of hypovolemic shock
Pale MM, prolonged CRT, tachycardia, and poor pulse quality
What are treatments for hypovolemic shock
Shock dose fluids and blood products
What is cardiogenic shock
Failure of the heart pump w/ normal to increased intravascular volume and decreased cardiac output
What are causes of cardiogenic shock
CHF, myocardial disease (HCM & DCM), arrhythmias
What are clinical signs of cardiogenic shock
Tachypnea, dyspnea, abnormal lung sounds
What are treatments for cardiogenic shock
Beta agonist for decreased myocardial contractility, diuretic for excessive preload, and nitroprusside for excessive afterload
What is distributive shock
Relative hypovolemia resulting from maldistribution of blood flow despite adequate blood volume
What are causes for distributive shock
Sepsis, systemic inflammatory response syndrome (SIRS), and anaphylaxis
What are the treatments of distributive shock
IV fluid therapy, vasopressors, and inotropic therapy
What are clinical signs of early distributive shock
Brick red MM, rapid <1s CRT, tachycardia, hyperdynamic femoral pulses, fever, and tachypnea
What are clinical signs of late distributive shock
Pale MM, tachycardia, poor femoral pulse quality, hypothermia, and hypotension
What is obstructive shock
Obstruction or maldistribution of blood flow causing decreased preload and decreased cardiac output
What are causes of obstructive shock
Gastric dilatation and volvulus (GDV), cabal syndrome, and pericardial effusion
What are treatments for obstructive shock
Correct underlying cause and IV fluid therapy
What is hypoxic shock
Normal tissue perfusion but decreased oxygen content of arterial blood
What are the causes of the hypoxic shock
Anemia, decreased Hgb saturation, pulmonary disease leading to decreased PaO2
What are clinical signs of hypoxic shock
Dyspnea, tachypnea, tachycardia, and cyanotic
What are treatments of hypoxic shock
Oxygen therapy, blood transfusion, and treat underlying diease
What is metabolic shock
Tissues receive the appropriate perfusion, nutrients, and oxygen delivery but the cells are unable to utilize these fuel sources
What are causes of metabolic shock
Cyanide toxicity, cytopathic hypoxia of sepsis, and hypoglycemia
What are the treatments of metabolic shock
Dextrose supplementation and other causes difficult to treat
What diagnostics are preformed when we are concerned the patient is in shock
Exam, bloodwork, blood pressure, pulse oximetry + venous blood gas, arterial blood gas, lactate, radiographs, and ultrasonography
What are overall treatments of shock
IV fluids, corticosteroids, antimicrobials, oxygen, bicarbonate, and warmth
