HLTH 2501: review of respiratory and general manifestations Flashcards
upper respiratory tract
is made up of the passageways that conduct air between the atmosphere and the lungs
lower respiratory tract
consists of the trachea, bronchial tree, and the lungs, or where gas exchange takes place
scarlet fever
is caused by group A streptococcus bacteria and originates in the respiratory system
signs of scarlet fever
abscess around the tonsils, swollen lymph nodes in the neck, ear, sinus, and skin infections, pneumonia, heart disease caused by rheumatic fever, kidney disease, and arthritis
4 pairs of paranasal sinuses
these are small cavities in the skull bones and are the frontal, ethmoid, sphenoid, and maxillary sinuses
respiratory mucosa
is pseudostratified ciliated columnar epithelium, along with mucus secreting goblet cells
ciliary escalator
is the process of the mucus that traps particles and the cilia that sweep up the mucus out of the respiratory tract
purpose of sneezing and coughing
is used to remove unwanted materials away from the lungs
damage of smoking to the upper respiratory tract
smoking impairs the function of cilia and also causes the ciliated epithelium to be replaced by squamous cells
pharyngeal tonsils
consist of lymphoid tissue and are another defence against foreign material; these are located on the posterior wall of the nasopharynx
palatine tonsils
are lymphoid tissue located in the posterior portion of the oral cavity
resident flora in the respiratory tract
the upper tract has flora whereas the lungs contain no microorganisms
larynx
consists of various cartilages and their associated muscles; contains thyroid cartilage, vocal cords, and the glottis
trachea structure
is 16 to 20 hyaline cartilage rings, fibroelastic tissue, and smooth muscle
right vs left bronchus
the right is larger and straighter than the left
what coats the inside surfaces of alveoli?
surfactant, which reduces the surface tension of the alveolar fluid, thus preventing total collapse of these during expiration
mediastinum
is the region in the center of the chest that contains the heart, major blood vessels, esophagus, and the trachea
lobes of the lungs (R vs L)
right lung has three and left lung has 2
the thorax
consists of the ribs, vertebrae, and sternum, which provide a rigid, protective wall for the lungs
what are the true ribs?
the upper seven pairs; these articulate with the vertebrae and the sternum
false ribs
are the 8th-12th pairs that do not connect to the sternum directly
Boyle’s law for respiration
as the size of the thoracic cavity decreases, the pressure inside the cavity increases
compliance meaning
refers to the ability of the lungs to expand; depends on the elasticity of the tissues, alveolar surface tension, and the shape, size, and flexibility of the thorax
pulmonary volumes
are a measure of ventilatory capacity, which is the measure of air moving in and out of the lungs
tidal volume
amount of air entering the lungs with each normal breath
residual volume
the amount of air remaining in the lungs after forced expiration
inspiratory reserve
maximal amount of air that can be inhaled in excess of normal quiet inspiration
expiratory reserve
maximal volume of air expired following a passive expiration
vital capacity
maximal amount of air expired following a maximal inspiration
total lung capacity
total volume of air in the lungs after maximal inspiration
what maintains partial inflation of the lungs?
residual volume
dead space
refers to the passageways or areas where gas exchange cannot take place
where are breathing control centres located?
the medulla and the pons
Hering-Breuer reflex
when stretch receptors in the lungs prevent excessive lung expansion
what factors can impair respiration
drugs like morphine, hypothalamus controls like the Hering-Bruer reflex, and concentrations of CO2 in the blood
central vs peripheral chemoreceptors
central are located in the medulla and respond to partial pressures of CO2 and peripheral ones are located in the carotid bodies and are sensitive to decreased O2 levels and low PH
hypercapnia
when CO2 levels in the blood increase
how is the inspiration centre activation?
via high CO2 levels in the blood that diffuse into the CSF, lowering the pH in the brain and stimulating the respiratory centre; respiratory acidosis also occurs
partial pressure
the concentration of a gas in a mixture
Dalton’s law
each gas in a mixture moves or diffuses according to its own partial pressure gradient and is independent of other gases
what is found in atmospheric air?
O2, CO2, Nitrogen, and Water
what happens when fluid accumulates in the alveoli or ISF?
the respiratory membrane thickens and diffusion of gases becomes difficult
what may destroy an alveolar wall?
fibrosis in the lungs or emphysema
ventilation-perfusion ratio
the ratio of the amount of air reaching the respiratory membrane from the lungs and from the vessels
fully saturated meaning
when all four heme molecules in a hemoglobin have taken up the oxygen
oxyhemoglobin
refers to oxygen being transported by a hemoglobin
how is CO2 transported?
dissolved in plasma, bound to hemoglobin, or most is buffered to H2CO2 and converted to HCO3-
carbaminohemoglobin
when CO2 binds to hemoglobin through attaching to an amino group on the globin portion
common tests for respiratory function
spirometry, ABG determinations, oximeters, exercise tolerance, radiography, bronchoscopy, and culture tests
spirometry
pulmonary function testing and is used to test pulmonary volumes, measuring volume and airflow times
ABG determinations
are used to check O2, CO2, HCO3-, as well as serum pH
oximeters
measure O2 saturation
exercise tolerance testing
is useful in patients with chronic pulmonary disease for diagnosis and monitoring
radiography
is helpful in evaluating tumors of infections
bronchoscopy
may be used to check the site of a lesion or bleeding
general manifestations of respiratory disease
sneezing, coughing, sputum, breathing patterns, breath sounds, dyspnea, cyanosis, pleural pain, friction rub, clubbed fingers, and changes in ABGs
sneezing
is a reflex response to irritation in the upper respiratory tract and assists in removing the irritant; it is associated with inflammation or foreign material in the nasal passages
coughing
may result from irritation caused by a nasal discharge dripping into the oropharynx, from inflammation or foreign material in the lower respiratory tract, or from inhaled irritants like toacco
where is the cough reflex controlled?
the medulla
how does coughing work?
coordinated actions coordinated by the medulla that inspire air and then close the glottis and vocal cords; this is then followed by a forceful expiration, in which the glottis is opened and the unwanted material is blown upward and out of the mouth
example of a cough suppressant medication
codeine
sputum
aka mucoid discharge from the respiratory tract; secretions are usually thin, clear, colorless or cream coloured, and other colours may signify a problem
yellow-green sputum
often is indicative of a bacterial infection
rusty or dark-colored spuntum
is usually a sign of pneumococcal pneumonia
sputum with a foul odor and lots of pus
is associated with bronchiectasis
thick, thicky sputum
associated with asthma or cystic fibrosis
hemoptysis, frothy sputum
is associated with pulmonary edema and contains blood
eupnea
normal breathing rate; is 10-18 respirations per minute and is effortless
kussmaul respirations
are deep, rapid respirations or ‘air hunger’; these are typical of an acidosis state or may follow strenuous exercise
labored respirations
are often associated with obstruction in the airways
wheezing
indicates obstruction in the small airways
stridor
is a high-pitched crowing sound and is usually indicative or upper airway obstruction
what are abnormal breath sounds called (2)?
rales and rhonchi; these result from air mixing with excessive secretions in the lungs
rales
are light, bubbly, or cracking sounds associated with serous secretions
rhonchi
are deeper and harsher sounds resulting from thickers mucus
what does absence of breath sounds indicate?
non aeration or collapse of a lung
name for a collapsed lung?
atelectasis
dyspnea
is a subjective feeling of discomfort when a person feels they are unable to inhale enough air
severe dyspnea
may be accompanied by flaring of the nostrils, use of the accessory respiratory muscles, or retraction of the muscles between or above the ribs
orthopnea
is dyspnea that occurs when a person is lying down and occurs as blood pools in the lungs and the abdominal contents push upward against the lungs; body should be lifted with pillows
paroxysmal nocturnal dyspnea
is a sudden acute type of dyspnea common in those with left-sided CHF; during sleep, the body fluid is redistributed, leading to pulmonary edema and the individual waking up gasping for air and coughing
three types of dyspnea
severe dyspnea, orthopnea, and paroxysmal nocturnal dyspnea
cyanosis
is the bluish coloring of the skin and mucous membranes that results from large amounts of oxygenated hemoglobin in the blood; common in those with cardiovascular conditions and respiratory disease
pleural pain
results from inflammation and infection of the parietal pleura
friction rub
is a soft sound produced as the rough membranes move against each other and may be heard; may be caused by lobar pneumonia or lung infarction
clubbed fingers
result from chronic hypoxia associated with respiratory or cardiovascular disease; is a firm, painless, fibrotic enlargement at the end of the digit, and may also occur in toes
hypoxemia vs hypoxia
hypoxemia is inadequate O2 in the blood and hypoxia is inadequate supply to cells
what can hypoxemia or hypoxia be caused by?
a deficit of RBCs, circulatory impairment, excessive release of O2 from RBCs, impaired respiratory function, and carbon monoxide poisoning
signs of carbon monoxide poisoning
bright red coloring of the skin and mucosa, headache, and drowsiness
effects of hypoxia
affects cell metabolism, reducing function and leading to anaerobic metabolism and the development of metabolic acidosis; cerebral hypoxia affects the sympathetic NS; erythropoietin secretion is also increased
signs of hypoxia
fatigue, muscle weakness, lethargy, tachycardia, and increased BP
productive vs unproductive cough
a productive cough removes exudate and fluids from the lungs whereas a nonproductive does not and is dry
