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Respiratory > ILA respiratory failure > Flashcards

ILA respiratory failure Flashcards

1
Q

Describe the anatomical structure air will pass through as it travels from the nose to the alveoli

A

External nares, nasal cavity, internal nares, nasopharynx, oropharynx, laryngopharynx, trachea, main bronchi, lobar bronchus, segmental bronchus, subsegmental bronchus, conducting bronchiole, terminal bronchiole, respiratory bronchioles, alveolar ducts, alveolar sacs and alveoli.

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2
Q

Upper airway structures

A

nose, nasal passages, paranasal sinuses (frontal and sphenoid), pharynx (naso, oro and laryngo), larynx above vocal cords

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3
Q

Paranasal sinuses

A

Sphenoid and frontal

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4
Q

Nasal chonchae

A

superior, middle and inferior

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5
Q

Lower airway structures (sequence)

A

larynx below vocal cords, trachea, main bronchus, lobar bronchi, segmental bronchi, subsegmental bronchi, conducting bronchiole, terminal bronchiole, respiratory bronchioles, alveolar ducts, alveolar sacs and alveoli

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6
Q

Where are lower airway structures derived from?

A

developing foregut

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7
Q

Number of generations in respiratory tree

A

23 on average

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8
Q

Proximal divisions

A

closest to top of tree - bronchi. Transmit air to lower airways

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9
Q

Distal divisions

A

respiratory bronchiole, alveolar ducts and alveoli. Specialised for gas exchange

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10
Q

Structure of trachea and its divisions

A

C shaped tracheal rings of hyaline cartilage. Branches into left and right main bronchus. Bronchi branch into smaller sections (bronchioles). Bronchioles lead to air sacs and alveoli.

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11
Q

Tracheal rings

A

C-shaped hyaline cartilage, Prevents trachea from collapsing.

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12
Q

Suspension of lungs

A

suspended within pleural cavity of thorax

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13
Q

Pleurae

A

2 thin membranes, one cell layer thick, surrounding the lungs.

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14
Q

Inner and outer pleurae

A

Inner is visceral pleura covering the lungs. Outer is parietal pleura lining inner surface of chest wall.

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15
Q

Function of pleura

A

Secretes fluid, which allows the lungs to move freely within the pleural cavity while expanding and contracting

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16
Q

Lung lobes

A

Right lung has three - superior, middle and inferior. Left lung has two - superior and inferior, and portion of superior lobe (lingula). Divided into bronchopulmonary segments.

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17
Q

Carina

A

Point where two mainstem bronchi branch off from base of trachea.

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18
Q

Lung surfaces

A

costal surface - adjacent to ribcage, diaphragmatic surface - downward toward diaphragm, mediastinal surface - toward centre of chest, againts heart, vessels and carina

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19
Q

Costal surface

A

Adjacent to ribcage

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20
Q

Diaphragmatic surface

A

Faces downwards toward diaphragm

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21
Q

Mediastinal surface

A

Faces toward centre of chest, lies against heart, great vessels and carina

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22
Q

Airway resistance formula

A

R(AW) = deltaP/volumetric airflow

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23
Q

deltaP formula

A

atmospheric pressure - alveolar pressure

24
Q

Determinants of airway resistance

A

diameter of airways

airflow being laminar or turbulent

25
Q

Laminar airflow

A

Less resistance. Fluid flows in parallel layers w/out disruption between them.

26
Q

Turbulent airflow

A

Large changes in pressure difference. Increased resistance.

27
Q

Airways prone to turbulent airflow

A

Larger airways more prone to turbulent airflow

28
Q

Where is the greatest resistance to airflow? (+explanation)

A

Bronchi of intermediate size, between 4th and 8th bifurcations. Individual small airways have greater resistance than large airways - more small airways than large ones.

29
Q

Medullary respiratory centre function

A

Sets basic rhythm for breathing

30
Q

Ventral respiratory group function

A

Generates breathing rhythm and integrates data coming into the medulla

31
Q

Dorsal respiratory group

A

Integrates input from stretch receptors and peripheral chemoreceptors

32
Q

Pontine respiratory group

A

influences and modifies medulla oblongata functions. Controls involuntary respiration

33
Q

aortic and carotid bodies

A

monitor blood pCO2, pO2, pH

34
Q

hypothalamus

A

monitors emotional state and body temp

35
Q

cortical areas of the brain

A

control voluntary breathing

36
Q

proprioceptors

A

send impulses regarding joint and muscle movements

37
Q

pulmonary irritant reflexes

A

protect respiratory zones from foreign material

38
Q

inflation reflex

A

protects lungs from over-inflating

39
Q

where is involuntary respiration controlled?

A

not under concious control. respiratory centre in upper brainstem: medulla oblongata and pons

40
Q

where are chemoreceptors located?

A

central: ventrolateral surface of medulla oblongata. peripheral: aortic and carotid bodies

41
Q

medulla oblongata function and components

A

sends signals to muscles controlling respiration and controls reflexes for non-respiratory air movements.
contains ventral respiratory group (VRG) and dorsal respiratory group (DRG)

42
Q

VRG function

A

stimulates expiratory movements. neurons stimulate accessory muscles to contract –> forced inspiration or expiration. exhalation

43
Q

VRG neurons

A

rostral retrofacial nucleus
caudal nucleus retroambiguus
nucleus paraambiguus
pre-boetzinger complex

44
Q

where do VRG neurons send their impulses to?

A

inspiratory - down the phrenic nerve: laryngeal and pharyngeal (from nucleus ambiguus)
diaphragm and external intercostals (from rostral area of nucleus retroambigualis)
expiratory - output stops: abdominals and internal intercostals (caudal area)

45
Q

where is the DRG located?

A

dorsomedial region of medulla. composed of cells in solitary nucleus.

46
Q

what is the solitary nucleus?

A

series of purely sensory nuclei in the medulla oblongata. solitary tract runs through it, w/ nerves innervating it from facial, glossopharyngeal and vagus. forms circuits contributing to autonomic function

47
Q

DRG function

A

generation of respiratory rhythm and inhalation

48
Q

DRG stimulation and inhibition

A

stimulated by apneustic centre in lower pons. inhibited by pneumotaxic centre. SN appropriates responses from chemoreceptors and mechanoreceptors

49
Q

DRG inspiration and expiration mechanisms

A

increase in firing of cells in solitary tract and VRG –> contraction of respiratory muscles. DRG neurons send impulses down the phrenic and intercostal nerves to stimulate diaphragm and external intercostals to contract. exhalation - cells stop firing.

50
Q

pneumotaxic centre location

A

upper part of the pons

51
Q

pneumotaxic nuclei

A

subparabrachial nucleus and medial parabrachial nucleus

52
Q

pneumotaxic centre function

A

controls rate and pattern of breathing. limits inspiration - inspiratory off-switch. limits bursts of action potentials in phrenic nerve.

53
Q

pneumotaxic centre and increasing rate and length of breathing

A

signals drg to speed up

bursts of drg activity are elongated

54
Q

pneumotaxic centre and tidal volume

A

decreases tidal volume

55
Q

apneustic centre location

A

lower pons

56
Q

apneustic centre function

A

promotes inspiration by stimulation of DRG in medulla - delays switch off signal of inspiratory ramp provided by pneumotaxic centre. Controls intensity of breathing. inhibits expiratory neurons

57
Q

Apneustic centre inhibition

A

inhibited by pulmonary stretch receptors

Respiratory (15 decks)

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