L05 Flashcards

1
Q

Functions of the respiratory system

A

Consists of two tracts
* Upper respiratory tract
* Lower respiratory tract
* Supplies the body with oxygen
and eliminates carbon dioxide
(ventilation).

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2
Q

upper respiratory tract

A
  • Consists of the nose, sinuses and nasal passages, pharynx,
    tonsils and adenoids, larynx, and trachea.
    ● Warms and filters inspired air.
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3
Q

the nose

A

A passageway for air to pass to and from the lungs.
● Filters, humidifies, and warms the air as it is inhaled.
● Air entering the nostrils is deflected upward to the roof of the
nose before it reaches the nasopharynx.
● Ciliated mucous membranes (nasal mucosa) trap all the dust
and microorganisms in the inhaled air.

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4
Q

paranasal sinuses

A

ncludes 4 pairs of bony cavities.
● These airspaces are connected by ducts that drain into the nasal cavity.
● The sinuses are named by their location: frontal, ethmoidal, sphenoidal, and
maxillary.
● Prominent function: a resonating center for speech.
● Common site for infection.

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5
Q

pharynx, tonsils and adenoids

A

includes 4 pairs of bony cavities.
● These airspaces are connected by ducts that drain into the nasal cavity.
● The sinuses are named by their location: frontal, ethmoidal, sphenoidal, and
maxillary.
● Prominent function: a resonating center for speech.
● Common site for infection.

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6
Q

larynx

A

A cartilaginous epithelium-lined structure that connects the pharynx and
trachea.
● Also known as the “voice organ” or “voice box”.
● Protects the lower airway from foreign substances and facilitates coughing.
● Consists of the following:
○ Epiglottis: A valve flap of cartilage that covers the opening to the larynx
during swallowing
○ Glottis: The opening between the vocal cords in the larynx
○ Thyroid cartilage: The largest of the cartilage structures; part of it forms
the Adam’s apple
○ Cricoid cartilage: The only complete cartilaginous ring in the larynx
(located below the thyroid cartilage)
○ Arytenoid cartilages: Used in vocal cord movement with the thyroid
cartilage
○ Vocal cords: Ligaments controlled by muscular movements that produce
sounds; located in the lumen of the larynx

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7
Q

trachea

A

Windpipe
● Composed of smooth muscle with c-shaped rings of
cartilage.
● The cartilage rings give firmness to the wall of the trachea.
● The passageway between the larynx and the bronchi.

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8
Q

lower respiratory tract

A

Consists of the lungs which
include the bronchial and
alveolar structures.
● Responsible for gas
exchange.

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9
Q

the lungs

A

Paired elastic structures enclosed in the thoracic cage.
● Ventilation requires movement of the walls of the thoracic cage and floor – the
diaphragm.
● The inspiratory phase of respiration requires energy. The expiratory phase is
normally passive.
● Pleura: a serous membrane lining the lungs and walls of the thorax.
○ Visceral pleura: covers the lungs.
○ Parietal pleura: lines the thorax.
● Pleural fluid between the visceral and parietal pleura acts as a lubricant and
permits smooth motion of the lungs.

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10
Q

the lungs

A

Mediastinum: the middle of the thorax, between the pleural sacs that contain the
lungs.
○ Contains all thoracic tissue outside of the lungs.
● Lobes: each lung is divided into lobes.
○ Right lung: upper, middle, and lower lobes (3)
○ Left lung: upper and lower lobes (2)
● Bronchi & bronchioles: there are several divisions of the bronchi within each
lobe of the lung.
○ Bronchi: surrounded by connective tissue containing arteries, lymphatics,
and nerves.
○ Bronchioles: contain no cartilage in their walls. Patency depends on the
elastic recoil of the surrounding smooth muscle and alveolar pressure.
● Both bronchi & bronchioles are lined with cells covered with cilia. These cilia
propels mucus and foreign substances away from the lungs.

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11
Q

the lungs

A

Respiratory bronchioles: the transitional passageways between the conducting
airways and gas exchange airways.
○ Further leading into the alveolar ducts  alveolar sacs  alveoli
● Physiological dead space: the conducting airways (containing 150 mL of air)
that does not participate in gas exchange.
● Alveoli: where oxygen and carbon dioxide exchange takes place.

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12
Q

respiratory physiology

A

Most cells in the body obtain their energy from chemical reactions involving
oxygen and the elimination of carbon dioxide.
● There are three steps in the process of oxygenation:
○ Ventilation
○ Perfusion
○ Diffusion

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13
Q

ventilation

A

The process of moving gases into and out of the lungs.
● Requires coordination of the muscular and elastic properties of the lung and
thorax.
● The major inspiratory muscle of respiration is the diaphragm.
○ Controlled by the phrenic nerve

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14
Q

perfusion

A

The ability of the cardiovascular system to pump oxygenated blood to the
tissues and return deoxygenated blood to the lungs.

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15
Q

diffusion

A

Responsible for moving the molecules from one area to another.
○ From an area of higher concentration to an area of lower concentration.
● Diffusion of respiratory gases occurs at the alveolocapillary membrane.
○ Rate of diffusion can be affected by the thickness of the membrane.
● Patients with pulmonary edema, pulmonary infiltrates, or a pulmonary effusion
have an increased thickness of the alveolocapillary membrane, resulting in
slowed diffusion, slowed gas exchange, and impaired delivery of oxygen to
tissues.
● Surface area of the membrane can be altered as a result of chronic disease.

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16
Q

work of breathing

A

Inspiration: an active process stimulated by receptors in the aorta.
● Expiration: a passive process depending on the elastic-recoil properties of
the lungs.
● Surfactant: a chemical produced by the lungs that maintains the surface
tension of the alveoli – preventing them from collapsing.
○ Atelectasis: the collapse of the alveoli that prevents normal gas
exchange.
● Compliance: the ability of the lungs to distend or expand in response to
increase intra-alveolar pressure.
● Airway resistance: the pressure difference between the mouth and the
alveoli in relation to the rate of flow of inspired gas.
● Decreased lung compliance, increased airway resistance, active respiration, or

17
Q

respiratory gas exchange

A

Occurs in the alveoli and capillaries of the body tissues.
● In the lungs:
○ Oxygen is transferred from the lungs to the blood.
○ Carbon dioxide is transferred from the blood to the alveoli to be exhaled.
● In the tissues:
○ Oxygen is transferred from the blood to the tissues.
○ Carbon dioxide is transferred from the tissues to the blood to return to
the alveoli to be exhaled.
● These transfers are dependent on diffusion!

18
Q

respiratory gas transport

A

Oxygen Transport:
○ Transported by hemoglobin
○ Hemoglobin molecules combine with oxygen to form oxyhemoglobin.
○ Hemoglobin and oxygen dissociate – freeing oxygen to enter the tissues.
● Caron dioxide transport:
○ Diffuses into red blood cells
○ Reduced hemoglobin (deoxyhemoglobin) can combine with carbon
dioxide easily, therefore; venous blood transports most of the carbon
dioxide.

19
Q

regulation of respiration

A

Necessary to ensure sufficient oxygen intake and carbon dioxide elimination to
meet the body’s demands.
● Neural and chemical regulators control the process of respiration.
● Neural regulators include the central nervous system (CNS) control of resp
rate, depth, and rhythm.
● Chemical regulation involves the influence of carbon dioxide and hydrogen
ions on the rate and depth of inspiration

20
Q

alterations in respiratory functioning

A

Illnesses and conditions that affect ventilation or oxygen transport cause
alterations in respiratory functioning.
● The goal of ventilation is to produce a normal arterial carbon dioxide between
35-45 mmHg and a normal arterial oxygen between 80-100 mmHg.
● Three primary alterations are:
○ Hyperventilation
○ Hypoventilation
○ Hypoxia

21
Q

hyperventilation

A

Excess ventilation required to eliminate the normal venous carbon dioxide.
* Anxiety, infections, drugs, or an acid-base imbalance can induce hyperventilation.
* RR > 20 breaths/min

22
Q

hypoventilation

A

Occurs when alveolar ventilation is inadequate to meet the body’s oxygen demand or
to eliminate sufficient carbon dioxide.
* As ventilation decreases – PaCO2 is elevated.
* Can be caused by atelectasis and inappropriate administration of oxygen in patients
with COPD.
* Atelectasis: the collapse of alveoli that prevents normal respiratory exchange. Less
lung is able to be ventilated and hypoventilation occurs.
* RR < 12 breaths/min
* Signs and symptoms include: change in mental status, dysrhythmias, and potential
cardiac arrest.

23
Q

hypoxia

A

nadequate tissue oxygenation at the cellular level.
● Results from a deficiency in oxygen deliver or oxygen utilization.
● Can be caused by:
○ Decreased hemoglobin level
○ Diminished concentration of inspired oxygen
○ Inability of the tissues to extract oxygen from the blood
○ Decreased diffusion of oxygen from the alveoli to the blood
○ Poor tissue perfusion with oxygenated blood
○ Impaired ventilation
● Signs & symptoms include:
○ Restlessness/agitated
○ Decreased level of consciousness
○ Dizziness
○ Tachycardia
○ Increased respiratory rate (early signs)

24
Q

cyanosis

A

blue discoloration of the skin and mucous membranes caused by the
presence of desaturated hemoglobin in capillaries. This is a late sign of hypoxia!
○ Central cyanosis: observed in the tongue, soft palate, and conjunctiva of the
eye – indicates hypoxemia.
○ Peripheral cyanosis: seen in the extremities, nail beds, and earlobes – often a
result of vasoconstriction and stagnant blood flow.

25
Q

gerontologic considerations

A

A gradual decline is respiratory function begins in early to middle adulthood
and affects the structure and function of the respiratory system.
● Vital capacity of the lungs and strength of the respiratory muscles decreases.
● Alveoli lose elasticity
● Decreased chest wall mobility
● Increased amount of respiratory dead space – resulting in a decreased diffusion
capacity.
● In the absence of chronic disease, most older adults continue to be able to
carry out activities of daily living but with decreased tolerance and require
additional rest.

26
Q

symptoms of respiratory disease

A

Dyspnea: subjective feeling of difficult or labored breathing, breathlessness, shortness of
breath.
● Cough: a reflex that protects the lungs from the accumulation of secretions or inhalation of
foreign bodies.
● Sputum Production: the reaction of the lungs to any constantly recurring irritant. The nature
of the sputum is often indicative of its cause.
● Chest pain: may be associated with pulmonary or cardiac disease. Chest pain that is
pulmonary in nature presents as sharp, stabbing, and intermittent or it may be dull, aching
and persistent.
● Wheezing: a high-pitched musical sound heard mainly on expiration (asthma) or inspiration
(bronchitis. A major finding with airway narrowing
● Hemoptysis: expectoration of blood from the respiratory tract.

27
Q
A