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CHI 335 > Lecture 5 Respiratory system Part 1 > Flashcards

Lecture 5 Respiratory system Part 1 Flashcards

1
Q

What is external respiration?

A
  1. gas exchange between alveoli and the capillaries.
  2. o2 and co2 must be transported between lungs and body.
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2
Q

What is internal respiration?

A

Exchange of gases at the tissue

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3
Q

What is Type I alveolar cell?

A

Alveolar wall –> Gas exchange

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4
Q

What is Type II alveoli cell?

A

surfactant secreting cells –> reduce surface tension

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5
Q

What controls your breathing?

A
  1. Respiratory centre in brainstem –> detect increase of PaCO2.
  2. Receptor in brain, blood vessels –> detect decrease of PaCO2.
  3. Receptor in lungs –> detect irritant and fluid
  4. Receptor in muscles and joints –> changes based on physiological demand for oxygen
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6
Q

What is Serosa membrane?

A
  1. It is pleura surrounds the lung.
  2. Outer membrane is parietal pleural
  3. Innermost membrane is visceral pleura.
  4. It produce a slippery, serous fluid called pleural.
  5. It helps decrease friction as the membranes move against each other during breathing.
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7
Q

Which are the two events of respiratory?

A
  1. inspiration
  2. expiration
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8
Q

What is inspiration?

A
  1. Nerve impulses travel on phrenic nerves to muscle fibers in the diaphragm, contracting them.
    (Nerve impulse –> phrenic nerve –> muscle fibers –> contracting)
  2. As the dome-shaped diaphragm moves downward, the thoracic cavity expands.
  3. The intra-alveolar pressure decreases
  4. Atmospheric pressure, greater on the outside, forces air into the respiratory tract through the air passages.
  5. The lungs fill with air.
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9
Q

Describe the muscles involved in maximal inspiration and the mechanism.

A

The external intercostal muscles, SCM and scalenes also contract, raising the ribs and expanding the thoracic cavity further.

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10
Q

What is expiration?

A
  1. Diaphragm relax
  2. Elastic tissues of the lungs and thoracic cage, stretched during inspiration, suddenly recoil, and surface tension collapses alveolar wall.
  3. Tissues recoiling around the lungs increase the alveolar pressure.
  4. Air squeezed out of the lungs.
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11
Q

Describe external respiration in gas exchange.

A
  1. Exchange in the lungs
  2. Gases diffuse across two cells to move back and forth between capillaries and the alveoli.
  3. Concentration of O2 is greater in the LUNG than in the BLOOD.
  4. Concentration of Co2 is greater in the BLOOD than the LUNG.
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12
Q

Describe internal respiration in gas exchange – oxygen.

A
  1. Exchange with tissues.
  2. Concentration of O2 is greater in the BLOOD VESSEL than in the TISSUE.
  3. Concentration of Co2 is greater in the TISSUE than the BLOOD.
  4. Almost 99% of O2 entering blood binds to hemoglobin in red blood cell.
  5. Hemoglobin bound to O2 is call OXYHEMOGLOBIN and is bright red in colour.
  6. Approximately 1% of O2 stays dissolved in plasma.
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13
Q

Describe gas transport – carbon dioxide.

A
  1. Bind to the protein part of hemoglobin, different from the oxygen binding site.
  2. Hemoglobin bound to Co2 is called carbaminohemoglobin.
  3. Only about 20% of the Co2 is transported bound to hemoglobin.
  4. 10% of Co2 travels free or dissolved in the plasma.
  5. 70% travel as bicarbonate ion.
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14
Q

Factors that control breathing.

A
  1. Breathing is controlled by the respiratory center of the brain.
  2. Medulla oblongata controls the rhythm and the depth of breathing.
  3. Pons controls the rate of breath.
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15
Q

Factors influencing rate and depth of breath.

A
  1. Co2 level rise –> increase the rate and depth of breathe.
  2. pH drops –> increase the rate and depth of breathe
  3. Fear and pain –> increase breathing rate
  4. Hyperventilation –> decrease amount of Co2 in the blood –> decrease rate and depth
  5. ” inflation reflex” –> decrease depth of breathing to prevent over-inflation of the lung
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16
Q

S&S of Eupnoea (Normal Breathing)

A

12-20 breath per min

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17
Q

S&S of tachypnoea (Fast breathing)

A

A critical risk factor of deterioration

18
Q

S&S of Bradypnoea (Slow breathing)

A

Sign of impending crisis, especially in the context of narcotic (麻醉) overdose or traumatic brain injury

19
Q

S&S of Apnoea (睑眠ηͺ’息症): total absent of any effective respiratory rate for greater than 20 seconds

A

Central or obstructive, or a mixture of both

20
Q

Describe the feature of cough

A
  1. Common presenting respiratory symptom
  2. Reflex explosive expiration
  3. Occur when deep inspiration
  4. Cough enable the airway to be cleared of secretions and foreign bodies
  5. Acute cough is less than 3 weeks.
21
Q

What is the cause of acute cough?

A
  1. inhaled foreign body
  2. respiratory tract infection
22
Q

What is the cause of chronic productive cough?

A
  1. COPD (ζ…’ζ€§ι˜»ε‘žζ€§θ‚Ίη—…) (Purulent)
  2. Bronchiectasis (Plurulent)
    3.Pulmonary oedema (Pink, forthy)
    4.Lung Cancer (bloodstained)
  3. Pulmonary embolism (bloodstained)
    6.TB (硐核病) (bloodstained)
23
Q

What is the cause of non productive cough?

A
  1. Asthma
  2. Gastro-oesophageal reflux
  3. Drugs (ACE inhibitors)
  4. Sarcoidosis
24
Q

What is the cause of Sudden Dyspnoea?

A
  1. Pneumothorax
  2. Aspiration
  3. Anxiety
  4. Pulmonary oedema
  5. Pulmonary embolism
  6. Anaphylaxis οΌˆιŽζ•ζ€§δΌ‘ε…‹οΌ‰
25
Q

What is the cause of acute dyspnoea?

A
  1. Asthma
  2. Respiratory tract infection
  3. Pleural effusion
  4. Metabolic acidosis
26
Q

What is the cause of Chronic Dyspnoea?

A
  1. COPD (Chronic airflow limitation)
  2. Anaemia
  3. Arrhythmia
  4. Valvular heart disease
  5. Cardiac failure
  6. Cystic fibrosis
    7.idiopathic pulmonary fibrosis
  7. Chest Wall deformities
  8. Pulmonary hypertension
  9. Lung tumours
27
Q

What is cyanosis?

A

Central cyanosis
1. decreased oxygen saturation
2. Severe respiratory disease
3. Pulmonary oedema
4. Pulmonary embolism

28
Q

What can cause clubbing?

A
  1. bronchial carcinoma
  2. Chronic suppurative lung disease
  3. Bronchiectasis
  4. Lung abscess
  5. Empyema
  6. cystic fibrosis
  7. Interstitial lung disease
29
Q

What is the cause of chest pain

A
  1. Pleurisy
  2. Pneumonia
  3. Pneumothorax
  4. Pulmonary embolism
30
Q

What is the feature and cause of Haemoptysis?

A

Feature: Coughing up blood can be a sinister sign of lung disease. (must always be investigated) It must be distinguished from hematemesis and nasopharyngeal bleeding.

Cause:
1. Bronchial carcinoma
2. Pneumonia
3. Chronic Bronchitis
4. Bronchiectasis
5. TB
6. Pulmonary embolism
7. Pulmonary hypertension

31
Q

Describe the adventitious breath sound β€” Wheeze.

A

Later

32
Q

Describe the adventitious breath sound β€” crackles.

A

Later

33
Q

Describe the adventitious breath sound β€” Rhonchi.

A

Later

34
Q

Describe the adventitious breath sound β€” stridor.

A

Later

35
Q

Describe respiratory Volumes and capacities

A
  1. Volume of air entering and leaving the lungs = effort that is used when breathing.
  2. Different volumes are called respiratory volumes
  3. Measured to assess the health of the respiratory system
  4. respiratory capacities can be calculated.
36
Q

What is respiratory function test β€” spirometry?

A
  1. Used to assist in the diagnosis, monitor progress and treatment of respiratory condition.
  2. Forced expiratory volume and vital capacity are most common.
  3. Spirometry results can show the type and severity of respiratory condition experienced.
  4. Valuable data can determine the effectiveness of treatment before and after administration of bronchodilating agent.
37
Q

What is spirometry DDx β€” obstructive disease

A

Decrease FEV1: FVC

38
Q

What is spirometry DDx β€” restrictive disease

A
  1. Reduce in both FEV1 and FVC
  2. FEV1: FVC remains normal or high
39
Q

What factors cause the alveolar ventilation mismatch?

A
  1. Bronchoconstriction
  2. Atelectasis (Alveolar collapse)
  3. Emphysema
40
Q

What factors cause the perfusion mismatch?

A
  1. Any condition causing decrease blood flow to the pulmonary capillaries
  2. Pulmonary artery vasospasm
  3. Pulmonary embolism

CHI 335 (8 decks)

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