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Pathophysiology Thorax > Module #1: Structure and Function of Pulmonary System > Flashcards

Module #1: Structure and Function of Pulmonary System Flashcards

1
Q

Name 2 components of respiratory tract

A

Upper Respiratory Tract and Lower Respiratory Tract

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2
Q

What are the components of the upper respiratory tract?

A

Nasal Cavity - warms/humidifies air; air at rest moves exclusively through nasal cavity

Pharynx - oropharynx/nasalpharynx/laryngopharynx
not as efficient to warm/humidify

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3
Q

What does the larynx do?

A

connects upper and lower respiratory tracts

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4
Q

What structures are found in the larynx?

A

epiglottis
thyroid
cricoid cartilages
smaller cartilage structures

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5
Q

What are the components of the Lower Respiratory Tract?

A

Pulmonary tree

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6
Q

Describe the velocity of air as it passes through the pulmonary tree

A

First passes through trachea –> high velocity (trachea has a small cross sectional area)

Velocity slows as the air passes through the bronchiole segments –> large cross sectional area

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7
Q

Describe how the pulmonary tree is segmented

A

Trachea bifurcates (splits) @ the sternal angle = carina into R and L primary bronchi and enters lungs @ Hilum

Primary bronchi split into lobar bronchi (3 R; 2 L)

Lobar bronchi break down into segmental bronchi (10) = surgical lobes; these are just specific areas on the lung that can be surgically removed if need be

Eventually divide and end @ terminal then respiratory bronchioles

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8
Q

What is the acinus and what happens here?

A

where the pulmonary tree ends

site of respiration (gas exchange)

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9
Q

What are the 3 structures that make up the acinus?

A

respiratory bronchiole
alveolar ducts
alveoli

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10
Q

What are the functions of the Pulmonary System?

A

Respiration (gas exchange) = PRIMARY FUNCTION

Phonation

Acid-Base balance

Pulmonary Defense Mechanisms

Olfaction

Metabolism

Filtration/removal of particles/microorganisms

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11
Q

What is phonation?

A

production of sounds by movement of air through vocal chords (larynx)

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12
Q

How does the lungs function in acid-base balance?

A

remove CO2 from blood stream

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13
Q

What is the pulmonary defense mechanisms?

A

Air Condition - insures optimal air temp/humidity for body

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14
Q

How does the Pulmonary System warm/humidify colder ambient air?

A

nasal/oral mucosa cavities are rich in blood supply –> warm/humidify the air

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15
Q

What is olfaction?

A

smelling

happens in nasal cavity, and is able to detect dangerous gases/material w/o bringing air into the lungs

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16
Q

What are the metabolic functions of the pulmonary system?

A

removal of some prostaglandins

removal leukotrines

removal of seratonin

removal of norepinephrine

inactivate bradykinin

production of ACE (angiotensin converting enzyme) that converts Angiotensin I to Angiotensin II

removal of ATP and AMP

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17
Q

Why is it important to filter/removal particles and microorganisms?

A

keep from reaching distal end of pulmonary tree so they don’t interfere w/ gas exchange

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18
Q

How are particles filtered/removed?

A

trapped in mucus sheath lining tubules

removed by ciliary action and reflex mechanisms

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19
Q

Describe Mucociliary Escaltor

A

Lining of respiratory tract produce mucous

particles become trapped in mucous

Mucous propelled away from alveoli via cilia

coughing forcefully propels mucous up towards pharynx

mucous is removed via swallowing or blowing or spitting

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20
Q

What do the irritant receptors do?

A

they produce sneeze or cough

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21
Q

where are sneeze receptors located?

A

nasopharynx - protect “front end” of conducting zone

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22
Q

where are cough receptors located?

A

trachea - protect deep structures of respiratory zone

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23
Q

How is the airways functional divided?

A

2 Zones:

Conducting Zone

Respiratory Zone

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24
Q

Describe the Conducting Zone? Anatomy and Function

A

Upper Respiratory Tract –> Terminal Bronchioles
First 16 generations of tracheal tree (NO ALVEOLI)

brings air into and out of gas-exchange areas of lungs

NO GAS EXCHANGE

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25
Q

Describe air flow through the conducting zone

A

fast through trachea (small cross sectional area) and then slows as travels down tracheal tree (large cross sectional area)

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26
Q

What is the Anatomical Dead Space?

A

conducting zone

volume of air that is brought into lungs but DOES NOT REACH respiratory (gas exchange) zone

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27
Q

What are the Defense Mechanisms in the conducting zone?

A

Mucociliary escalator (particles get trapped in mucous blanked” swept but towards pharynx by cilia where it is blown out or swallowed or spit

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28
Q

What are the components of the Respiratory Zone?

A

Transitional section

Respiratory Section

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29
Q

What segments do you start seeing alveoli?

A

Transtitional section –> divisions 17 - 19

30
Q

How is the respiratory section of the respiratory zone divided?

A

Alveoli completely line 20-22 divisions

Alveolar Sac = 23 generation

31
Q

What is the first site of gas exchange?

A

Respiratory bronchioles of acinus

32
Q

Describe the Alveolar ducts

A

portion of acinus that is surrounded by grape-like cluster of the alveoli

33
Q

What do the Pores of Kohn do?

A

connect adjacent alveoli and allow air exchange between them

34
Q

What are alveolar sacs?

A

grape like cluster of individual alveoli

contain Pores of Kohn that connect alveoli to eachother

35
Q

Where is the primary sites of gas exchange in the lung?

A

Alveoli

36
Q

How many layers make up the alveolar septa and what are their names?

A

2 layers:

Epithelial Layer

Basement Membrane

37
Q

What are the cell types that make up the epithelial layer of the alveolar septa and what do they do?

A

Type I alveolar Cells = physical structure of alveoli

Type II alveolar cells = surfactant production

38
Q

What is the function of the basement membrane?

A

thin elastic layer that ALLOWS GAS EXCHANGE

39
Q

Describe the wall and lining of the Trachea

A

Anterior/lateral = C shaped cartilage

Posterior = smooth muscle

40
Q

Describe the wall and lining of the large - smaller bronchi

A

cartilage continues to surround them but the progressive dimities in distal airways

41
Q

describe the wall and lining of the bronchioles

A

no more cartilage

42
Q

What are the 3 wall layers of the tracheal tree

A

Outer layer = connective tissue (cartilage)

Middle layer = smooth muscle

Inner layer = epithelial lining

43
Q

What Regions would you NOT find mucous producing cells/ciliated cells?

A

Respiratory bronchioles (region of gas exchange)

Anterior 1/3 of nose

Portions of Pharynx

44
Q

What is the defense mechanism of the alveoli?

A

Phagocytes

Macrophages

45
Q

Is there a cough reflex in the alveoli?

A

NO

Macrophages/Phagocytes ingest particles/bacteria and migrate up to terminal bronchiole and move into lymphatic system

46
Q

What cells make up the epithelial lying of the Respiratory Tract?

A

Ciliated cells

Mucous producing cells

Mucous glands

47
Q

What is the function of ciliated cells?

A

“beat” to produce “waves” that provide physical movement of mucociliary elevator

48
Q

What are the 2 types of mucous producing/excritory cells and where are they found?

A

Goblet cells = proximal to bronchioles

Clara cells = terminal bronchioles

49
Q

Where are mucus glands found and what do they do

A

produce/secrete mucous

found throughout respiratory tract

50
Q

What happens pathologically to mucuos producing cells in pt w/ Chronic Bronchitis?

A

hypertrophy of mucus produces cells –> to much mucuos produced

51
Q

What happens to mucous production in an intubated pt?

A

mucous is still produced but removal mechanism are impaired

52
Q

What is the pathology of Cystic Fibrosis?

A

excessive production of mucous, sweat and digestive juices

mucous accumulation in lungs promotes infection

53
Q

Descibe pulmonary circulation

A

deoxygenated blood flows from right ventricle to pulmonary capillaries for gas exchange

54
Q

Describe bronchial circulation

A

oxygenated blood flows from left ventricle

supplies structures of pulmonary system

55
Q

What is the function of pulmonary circulation?

A

gas exchange!

act as reservoir for left ventricle

act as filter –> remove particles/emboli (clots or air)

56
Q

Describe the Pressure and flow dynamics of pulmonary circulation

A

LOW PRESSURE SYSTEM (only 10-20 mmHg)

only 1/3 pulmonary blood vessels are perfused (filled) @ any given moment; allows for increased stroke volume w/o increasing pressure

57
Q

How are the pulmonary capillaries arranged? What is the consequence of this arrangement?

A

capillary beds surround alveolar sacs

allows a lot of blood to be exposed to gases in alveoli

58
Q

Describe the alveolocapillary membrane composition

A

Alveolar and capillary walls merge to form gas exchange membrane

  1. alveolar epithelium and basement membrane
  2. interstitial space
  3. capillary basement membrane and epithelium
59
Q

what is the function of the alveolocapillary membrane

A

site of gas exchange

have a small amount of blood (100 ml) spread across a large area (70-100 m2)

60
Q

What are the consequences of damage to the alveolocapillary membrane?

A

leakage of plasma/blood into alveolar space

impairment of gas exchange

61
Q

What is Hypoxic Vasoconstriction

A

arterioles can direct blood away from site of damage or low partial pressure of O2

unique to lungs

62
Q

Describe Bronchial circulation. What supplies it and what’s its function?

A

part of systemic circulation (oxygenated blood from left ventricle)

supplies nutrients to structures of the lung

DOES NOT PARTICIPATE IN GAS EXCHANGE

63
Q

Describe the shunting of blood flow of some bronchiole veins

A

some bronchial capillaries (capillaries that feed oxygenated blood to structures of the lung) drain into pulmonary veins that are returning to left atria

right to left shunt - deoxygenated blood is passing into oxygenated circulation

64
Q

What structures are NOT drained by lymphatic capillaries?

A

acinus

accumlating fluid and macrophages have to migrate up to terminal bronchioles to drain

65
Q

What are the components of the chest wall?

A

ribs

intercostal musculature

66
Q

What is the pleura?

A

double folded serous membrane

Visceral pleura lines the lungs

Parietal pleura lines the chest wall

67
Q

What is the pleural space (aka pleural cavity)?

A

space between visceral pleura and parietal pleura

contains pleural fluid

68
Q

Pleural Fluid:

Where does it come from?

What does it do?

A

Secreted by pleura itself

provides lubricant (allows frictionless movement between visceral and parietal pleura)

69
Q

What is the pressure of the pleural space?

A

low (negative/sub-atmospheric) -4 - 10 mmHG

allows the lungs to expand and take in outside air

70
Q

What is a Pneumothorax?

A

condition in which air enters into pleural cavity

increases pressure in pleural cavity –> compresses or collapses lung

Pathophysiology Thorax (5 decks)

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