Practicum 2 Respiratory Flashcards
Major functions of the respiratory system (2):
- Supply body with oxygen
- Remove carbon dioxide form body that is produced by metabolism
What are the 4 processes that define respiration and their descriptions:
- Pulmonary Ventilation: movement of air in and out of lungs
- External Respiration: gas exchange between the capillaries and alveoli
- Transport of Respiratory Gases: blood transport through cardiovascular
- Internal Respiration: cellular respiration between blood and tissue cells
2 divisions of the respiratory system
Upper and Lower Respiratory Tract
URT Components and its basic function:
-Nasal cavity and paranasal sinuses, pharynx (naso,oro, and laryngo), larynx
-To warm, moisten, and filter inspired air
LRT Components:
Trachea, Primary bronchi, Lungs
2 Zones of the Respiratory System:
Conducting and Respiratory Zone
Conducting Zone Components:
Oral Cavity-
1. Nasal Cavity
2. Pharynx
3. Larynx
4. Trachea
Lungs-
5. Primary bronchus
6. Secondary bronchus
7. Bronchioles
8. Terminal bronchiole
Where gas exchange occurs
Respiratory Zone
Respiratory Zone Components:
- Respiratory bronchiole
- Alveolar ducts
- Alveolar sacs
Where air conduction occurs
Conducting zone
Conducting Zone info:
-Conducts air in and out of lungs
-Filters, humidifies, and warms air
-Passageways from nasal cavity to terminal bronchioles
Respiratory Zone info:
-Provides surfaces for gas exchange with pulmonary capillaries
The larynx is commonly known as:
The voice box
The Larynx Basic Functions:
- Passages air to the trachea
(windpipe) - Vocalization
- Valsalva maneuver
_____ is a maneuver in which one tries with force to exhale with the ____ closed, impeding the return of venous blood to the heart. It is also used to aid in ______
Valsalva maneuver, windpipe, defecation, urination, and lifting
Lower Respiratory Tract– What is the name of the part from the larynx into the mediastinum (between the lungs)
The trachea (windpipe)
Lower Respiratory Tract–
The wall that’s composed of 3 layers of mucosa:
Ciliated pseudostratified epithelium with goblet cells
Lower Respiratory Tract–
The outermost layer made of connective tissue that encases 16-20 C-shaped rings of hyaline cartilage:
Adventitia
Primary site of gas exchange
Alveolus
Lower Respiratory Tract–
Connective tissue with seromucous glands
Submucosa
Alveoli are surrounded by _____
Blood capillaries > Pulmonary veins > Heart
____ occurs through membranes of Type I cells
Rapid gas exchange
Type II cells produce ____ which reduces alveolar surface tension and
each alveolus has ____
Surfactant, Alveolar macrophage (phagocyte)
Double-layered sac that encloses each lung
Pleura
Space between pleura; filled with pleural fluid which prevents friction
Pleural Cavity
____ is “negative” (<760 mmHg or 1 atmosphere) during ___ which aids in air entering the lungs
Pleural pressure, Quiet breathing
The act of breathing:
Pulmonary Ventilation
Breathing in: ____ Pressure in Lung is ____
Inspiration (inhalation), less than 760 mmHg
Breathing out: ____ Pressure in lung is _____
Expiration (exhalation), greater than 760 mmHg
Fundamental Respiratory Mechanics–Key Functions:
- Inhale Oxygen
- Exhale CO2
- Regulate blood pH
Fundamental Respiratory Mechanics–Key Components:
- Pump (Musculoskeletal)
- Gas Exchanger (Alveoli)
- Controller (Neural)
Inspiration: active or passive?
Expiration: active or passive?
Active Process
Passive Process
Boyle’s Law equation:
P1V1=P2V2
Fundamental Respiratory Mechanics Key Functions:
- Inhale Oxygen: Inspiration
- Exhale CO2: Quiet and Forced Expiration
Inspiration is a ____ and the
Key Muscles are _____
Active Process
-External intercostals
-Diaphragm
-Scalene
Quiet Expiration is a ___ and there’s a ____
Passive process, Natural recoil of lung
Forced Expiration is a ___ and the Key muscles used are ____
Active Process
-Internal intercostals
-Abdominals
The ____is a ____ structure with a peripheralattachmentto a number of bony structures.
Diaphragm, musculotendinous
Physical factors influencing pulmonary ventilation
- Hinder air passage and pulmonary ventilation
- Require energy to overcome
- Airway resistance
- Resistance to gas flow = friction occurs in airways
- Airway resistance rises, and breathing movements become more strenuous
Severe ____ or obstruction of ____ can occur during acute asthma attacks or ____ this stops/reduces _____
Constriction, bronchioles, anaphylactic shock, ventilation
Asthma, also known as ___ or anaphylaxis also known as ____ dilates _____ which reduces airway resistance
Albuterol, Epinephrine, bronchioles
Surface tension that resists any force that tends to increase surface area of liquid. Also a water–high surface tension that coats alveolar walls and reduces alveoli to smallest size
Alveolar surface tension
Reduces surface tension of alveolar fluid and discourages alveolar collapse
Surfactant
Measure of change in lung volume that occurs with given change in transpulmonary pressure
Lung compliance
The higher the ____ the easier it is to expand and fill lungs. This is diminished by:
Lung compliance
- Nonelastic scar tissue replacing lung tissue (fibrosis)
- Reduced production of surfactant
- Decreased flexibility of thoracic cage
Used to assess respiratory status and the 4 different types
Respiratory Volumes
- Tidal Volume (TV)
- Inspiratory Reserve Volume (IRV)
- Expiratory Reserve Volume (ERV)
- Residual Volume (RV)
Instrument for measuring respiratory volumes and capacities
Spirometer
Spirometry can distinguish between:
Obstructive Pulmonary Disease and Restrictive Disease
Increased airway resistance (e.g., bronchitis) TLC, FRC, RV may increase
Obstructive pulmonary disease
Reduced TLC due to disease or fibrosis
VC, TLC, FRC, RV decline
Restrictive disorders
FEV: measure the rate of gas movement during exhalation (when blowing out)
FORCED EXPIRATORY VOLUME (FEV)
AMOUNT OF GAS EXPELLED DURING SPECIFIC TIME INTERVALS OF FVC
INDICATES THE AIRWAY RESISTANCE
FVC (Forced Vital Capacity)
total volume of air expired after a full inspiration.
Normal/decreased in patients with obstructive lung disease
Decreased in patients with restrictive lung disease
FEV1 (Forced Expiratory Volume in 1 Second) –
volume of air expired in the first second during maximal expiratory effort.
reduced in both obstructive and restrictive lung disease. The FEV1 is reduced in obstructive lung disease because of increased airway resistance. It is reduced in restrictive lung disease because of the low vital capacity.
FEV1/FVC –
% of the vital capacity which is expired in the first second of maximal expiration.
In healthy patients the FEV1/FVC is usually around 70%.
reduced only in patients with obstructive lung disease (as low as 20-30% in severe obstructive airway disease).
Restrictive disorders have a near normal FEV1/FVC because lung volume is reduced which affects both FEV1 and FVC. The airway resistance is not affected.
RESTRICTIVE disease
ex; Pulmonary fibrosis, Infant Respiratory Distress Syndrome, weak respiratory muscles, pneumothorax
volumes are decreased
often in a normal range (0.8 - 1.0)
OBSTRUCTIVE disease
asthma or COPD
volumes are normal/reduced but flow rates are impeded
often low (Asthma can reduce the ratio to 0.6, Emphysema can reduce the ratio to 0.78 - 0.45)
FVC (Forced Vital Capacity)
Normal/slight decreased in patients with obstructive lung disease
Decreased in patients with restrictive lung disease
FEV1/FVC –
In healthy patients the FEV1/FVC is usually around 70%.
In patients with obstructive lung disease FEV1/FVC decreases and can be as low as 20-30% in severe obstructive airway disease.
Restrictive disorders have a near normal FEV1/FVC.
Takes into account the fact that the FVC is different for different size folks and can be affected by unrelated restrictive disease, making it better than the peak flow meter type tests (which are still often used)
OBSTRUCTIVE LUNG DISEASE = UNABLE TO GET AIR OUT (OR IN) AT THE NORMAL RATE
FEV1/FVC < 70-75% (70% USED IN COPD)
THE LOWER THE RATIO, THE WORSE THE OBSTRUCTION
RESTRICTIVE LUNG DISEASE = UNABLE TO GET AIR IN TO FILL THE NORMAL VOLUME
LOW FVC; NORMAL OR ELEVATED FEV1/FVC
GOLD STANDARD: LOW TLC
Bronchial breath sounds:
-Tubular, hollow sounds which are heard when auscultating over the large airways (e.g. second and third intercostal spaces).
-They are louder and higher-pitched than vesicular breath sounds.
Procedure: Place stethoscope beneath larynx below throat. Follow down throat and sternum until sounds disappear.
In adults, the normal respiratory rate is roughly 12 to 20 breaths per minute.
In children, the normal respiratory rate varies by age.
The speed, pattern, and depth of your breaths indicate how well your body is working to deliver oxygen to all your vital organs and tissues.
- Vesicular breath sounds:
-Caused by the normal movement of air through the bronchioles during inspiration and expiration.
-Characterize by a hollow blowing sound that is even and low pitched which diminishes in intensity during the expiratory phase.
Procedure: Listen below scapula, in between ribs, and under the clavicle.
Term for listening to
Auscultating
_____ is one of the main vital signs of the human body and the number of breaths taken per minute.
Respiratory Rate
