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CardioRespiratory Year 1 > Introduction to the respiratory system > Flashcards

Introduction to the respiratory system Flashcards

1
Q

what are the functions of the respiratory system

A
  • Gaseous Exchange
  • Acid-Base Balance (in metabolic)
  • Phonation
  • Warming, humidification, filtration of gas
  • Defence against airborne pathogens
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2
Q

describe the upper respiratory tract

A

Oro-pharynx & larynx.

Non-respiratory

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3
Q

describe the lower respiratory tract

A

Conducting airways- trachea and large bronchi.

Non-respiratory

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4
Q

what does non respiratory mean

A

this means that they do not exchange gases

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5
Q

what are the respiratory regions

A 
Respiratory regions (alveoli and terminal bronchioles) 
Respiratory component of lungs.
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6
Q

what is the structure of the lungs

A
  • top of the lung is apex
  • bottom of the lung is base
    on right hand side
  • 3 lobes - superior middle - inferior
  • 2 fissures - oblique and horizontal

on the left hand side

  • 2 lobes, superior and inferior
  • 1 fissure - horizontal fissure
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7
Q

how many divisions are in the airway three

A

23 times

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8
Q

what divisions make up the conducting airways

A

The first 16 divisions make up the conducting airways

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9
Q

what divisions make up the respiratory zone

A

The last 7 make up the respiratory zone

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10
Q

how many alveolar ducts are in each lung

A

there are about 2^23 which is approx. 8 million alveolar ducts in each lung
- each duct divided into many terminal alveolar sacs each contain many alveoli

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11
Q

where does gas exchange take place

A

Gas exchange takes place in alveolar sacs and alveolar ducts, and to a lesser extent in respiratory bronchioles

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12
Q

what is the volume increase during alveoli

A

there is only about 20% volume increase in alveoli during normal inspiration

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13
Q

what happens to the alveoli during normal breathing

A
  • they do not go from fully collapsed to fully inflated

- they stay partially inflated even at full expiration

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14
Q

what do alveoli do

A
  • increase the surface area as the total surface of the alveoli is greater than 70m2
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15
Q

as the total cross sectional area of the airways increases…

A

the inward velocity of the gas during inspiration decreases
This low velocity together with the small increase in alveolar volume means that gaseous diffusion becomes an important component of gas exchange in the alveoli, at least during restful breathing.

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16
Q

what is a critical factors in gas exchange

A

Diffusion into and out of the alveoli and diffusion across the membranes surrounding the alveoli are critical factors in gas exchange in the lungs.

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17
Q

describe the function of the elastic fibres in the alveoli

A
  • during normal expiration the elastic fibres around the alveoli produce passive elastic recoil which shrinks the alveolar volume
  • alveoli does not collapse completely
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18
Q

what is the microanatomy of the conducting airways

A
  • Ciliated pseudo-stratified columnar (or simple columnar) epithelium (varies with level)
  • Cartilage / Smooth muscle (varies with level)
  • Glands (sero-mucous, sub-mucosal)
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19
Q

what is the volume of air in the tidal volume approximately

A

500ml

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20
Q

what is the volume of air that stays in the conducting airways

A

150-200ml

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21
Q

what is the volume of air that goes to the alveoli

A

300-350ml

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22
Q

what is dead space gas

A

When you exhale, you have to breathe out the volume of the conducting airways first before you exhale alveolar gas. This is sometimes called dead space gas

23
Q

what can increase dead space gas

A
  • this can increase if the some of the alveoli does not have gas exchange
24
Q

what epithelium is present in the upper airways

A

in upper airways there is thicker (more resistant to wear and tear) pseudostratified columnar epithelium

25
Q

what epithelium is present in the lower airways

A

in lower airways simple epithelium

26
Q

what epithelium is in the alveoli

A

In alveoli very thin epithelium to enable gas exchange

27
Q

what is epithelium covered by

A

The epithelium everywhere except in the alveoli is covered with a layer of mucus

28
Q

what does mucus do and what does cilia do

A
  • mucus traps dust and bacteria, it is secreted by goblet cells
  • Cilia moves the mucus upwards to the throat where it is swallowed and then it goes into the stomach where the acidity kills the bacteria
29
Q

where are C shaped rings of cartilage present in

A
  • present in the trachea
  • present in the main bronchi
  • these can stiffen the airways and prevent them collapsing
30
Q

what is the movement of mucus by cilia called

A

MUCOCILIARY ELEVATOR

31
Q

what are the two cells lining the alveoli

A

Type I pneumocytes (squamous, 90% of area)

Type II pneumocytes (cuboidal, 10% of area)

32
Q

what other cells are present in alveoli

A

Macrophages, lymphocytes, granulocytes, Mast cells –these get rid of pathogens in the alveoli

33
Q

alveoli are not..

A

lined with mucus as this impedes gas exchange, instead that contain immune system cells such as macrophages and lymphocytes to combat inhaled pathogens
- these cells move around the inside of the alveolus

34
Q

what are the holes in the alveolar walls called

A

pores of Kohn

35
Q

what are the pores of Kohn

A

These are pores between adjacent alveoli

36
Q

what is the function of the pores of Kohn

A

they normalise pressure between alveoli thus allowing for collateral ventilation

37
Q

what cells in the alveolus produces the surfactant

A

type II pneumocytes

38
Q

what runs around the margins of the alveoli

A

capillaries

- type II pneymocytesf are found in the septa between the alveoli

39
Q

what is a surfactant and what is the function of a surfactant

A

This is a phospholipoprotein dissolved in a watery secretion that lines the alveolar sac.
It reduces the surface tension in the alveoli and stops the alveoli collapsing during expiration.

40
Q

what would happen if there was no surfactant

A

the alveoli would collapse

41
Q

how do you work out the partial pressure of gas

A

Partial pressure of gas (A) = total pressure in gas mixture x fractional concentration of (A)

42
Q

what is the unit of partial pressure of gas

A

mmHg

43
Q

what do you do with the partial pressure of water vapour

A
  • the air first inhaled is dry inspired air
  • water vapour is added to the inspired air as it moves through the mouth or nasopharynx
    therefore in order to estimate the partial pressure of oxygen in tracheal air you have to remove the parital pressure of water which is 47mmHg
44
Q

what is the partial pressure of water

A

47 mmHg

45
Q

what is the partial pressure of oxygen in the alveoli

A

100 mmHg

46
Q

what is the partial pressure of carbon dioxide in the alveoli

A

40 mmHg

47
Q

how does carbon and oxygen tensions vary between systemic and pulmonary ciruclation

A

Carbon and oxygen tensions vary between systemic and pulmonary circulation. Partial pressure of oxygen (PO2) is highest leaving the lungs, and that of carbon dioxide (PCO2) is highest entering the lungs.

48
Q

what happens as you move up altitude

A

as you move up

  • percentage of gas remains the same (oxygen fraction) but the total gas pressure is less therefore oxygen partial pressure does
  • this means that the respiratory rate and depth must be increased at altitude - this means you will have to use oxygen supplementation at very high altitudes
49
Q

what is the impact of respiratory disease

A
  • single main cause of emergency admissions during a 4 year study period
  • in London 8.3% of all deaths are due to respiratory disease mainly pneumonia, bocirhitis and emphysema
50
Q

what are the respiratory diseases

A

Asthma
COPD (chronic bronchitis and emphysema, etc.).
Tumours (Carcinoma of the lung, mesothelioma, etc.).
Pulmonary fibrosis (including fibrosing alveolitis).
Occupational lung disease (silicosis, pneumoconiousis, asbestosis).
Disorders of chest wall, pleura and diaphragm (eg pneumothorax)

51
Q

what are notable infections respiratory disease

A 
Common cold (acute coryza)
Influenza
Pneumonia (viral, bacterial and fungal)
Pulmonary tuberculosis
(Poliomyelitis)
52
Q

respiratory statistics

A

Respiratory disease accounted for 13% of all deaths in 2005 in those aged 65-74 years and 17% of all deaths in those aged 75 years and over.

In men aged 65 + chronic obstructive pulmonary disease (COPD) was the main cause of respiratory death, closely followed by pneumonia;
In women aged 65 + pneumonia was the most common cause, followed by COPD

GP registers for COPD suggest that the prevalence of diagnosed COPD in older people is 7.5%

During 2005/06 59 Westminster residents aged 65 years and over were identified as having been admitted to hospital as an emergency average 2.7 admissions.

53
Q

common respiratory viruses

A 
Rhinovirus 
Coronavirus 
Respiratory syncytial virus (RSV)
Parainfluenza virus 
Adenovirus
54
Q

what are the social, enivronmental, and occupational factors

A

social factors
Poor housing, nutrition and income (eg TB)
Smoking (COPD and CA-lung)
Travel (TB, etc.)
STDs and iv drug abuse (HIV, TB/pneumonia, etc.)

environmental factors
Air pollution, especially particulates and SO2 (COPD/asthma)
House dust mites (asthma)

occupational factors
Dust and chemical exposure, and allergies (asbestosis, mesothelioma, silicosis, pneumonconiosis, pulmonary fibrosis, fibrosing alveolitis, etc.)

CardioRespiratory Year 1 (28 decks)

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