Pulmonary System

Question 1

Function of the pulmonary system

Answer 1

• supply oxygen & eliminate carbon dioxide from the body through ventilation & respiration
• enzymatic reactions for blood pressure
• acid base balance

Question 2

What is included in the upper respiratory system

Answer 2

• nose
• nasal cavity
• oral cavity
• pharynx
• larynx

Question 3

What is included in the lower respiratory system

Answer 3

• trachea
• bronchial tree (lungs)

Question 4

Anatomy of the lungs

Answer 4

• right lung has 3 lobes and is larger
• left lung has 2 lobes
• there is a inner visceral pleura and an outer parietal pleura creating a pleural cavity which contains pleural fluid

Question 5

Describe the anatomy of the airway

Answer 5

• starts in the trachea, goes into bronchi, then bronchioles, and finally alveolar ducts

Question 6

Describe ventilation

Answer 6

• passive process for the lungs - changes in atmospheric pressures
• inspiration: size of thoracic cavity increases due to the diaphragm contraction & descending, pressure in thorax decreases
• expiration: size of thoracic cavity decreases due to diaphragm relaxing & ascending, pressure in thorax increases

Question 7

Describe external respiration

Answer 7

• gas exchange at alveolar capillary between atmosphere & pulmonary capillaries
• inhalation from environment
• diffuses through pulmonary capillary wall
• travels blood plasma into RBC & occupies hemoglobin
• left side of heart to system

Question 8

escribe internal respiration

Answer 8

• gas exchange at the tissue capillary level
• arterial blood reaches the tissues
• oxygen moves from hemoglobin out of RBC, through capillary, cell membrane to mitochondria of tissue
• producing carbon dioxide as by product of metabolism, enters into hemoglobin
• venous system takes over back to pulmonary artery & capillary to atmosphere

Question 9

Define quit inspiration

Answer 9

• resting or sitting quietly, 70% diaphragm, external intercostals prime movers

Question 10

Define deep inspiration

Answer 10

• actions of quiet increase, increase in effort, increase action of muscles that pull ribs up
• Sternocleidomastoid, scalenes, pec major, levator costarum, & serratus posterior superior

Question 11

Define forced inspiration

Answer 11

• state of hard work, increase O2 demand, muscles of shoulder stabilization/elevation engage
• diaphragm, external intercostals, sternocleidomastoid, scalenes, pec major, elevator costarum, serratus posterior superior, elevator scapulae, upper traps, rhomboids, & pec minor

Question 12

Define quiet expiration

Answer 12

• passive action, relaxation of diaphragm & gravity
• relaxation of diaphragm & external intercostals, recoil of thoracic wall, lungs, & bronchi, gravity

Question 13

Define forced expiration

Answer 13

• engage muscles, pull down ribs & compress abdomen, force diaphragm upward
• internal intercostals, external & internal obliques, transverse abdominus, quadratus lumborum, & serratus posterior inferior

Question 14

Describe renin angiotensin system (RAS)

Answer 14

• regulates BP by regulating volume of fluids & vascular resistance
• renin is released by the kidneys into the blood stream, binds to angiotensinogen which is released by the liver and activates it into angiotensin I
• lung capillaries - ACE convert angiotensin I to angiotensin II
• angiotensin II - vasoconstrictive peptide, blood vessels to narrow = increased BP

Question 15

Maintenance of pH

Answer 15

• scale is 0 is acidic - 7.0 is neutral - 14.0 is basic/alkaline
• normal pH is 7.4; <7.35 = acidic; >7.45 = basic/alkaline
• acids form H+ ions
• bases combine with H+ ions

Question 16

Describe the acid-base balance in the body

Answer 16

• CO2 is slightly acidic, release regulates by decreasing acidity
• kidneys also assist by releasing acids & bases into blood

Question 17

How do you measure the acid-base balance

Answer 17

• respiratory - PCO2 (partial pressure of CO2)
• metabolic - HCO3 (bicarbonate)

Question 18

Describe metabolic acidosis

Answer 18

• too much acid production due to failure of kidneys
• results inability to rid excess acid or results from loss of HCO3
• low pH from metabolic acidosis increases respiration (>20/min), fatigue, confusion, sepsis, & ketoacidosis

Question 19

Describe flow rates

Answer 19

• measure volume of air moved in a period of time
• exhaled gas volume divided by time required to exhale volume

Question 20

What are flow rates used for

Answer 20

• to determine ease of gas movement
• state of airways
• elasticity of lung tissue

Question 21

Lung volumes, capacities, flow rates, & mechanics can depend on

Answer 21

• size & configuration of thorax
• age
• disease
• height
• gender

Question 22

Functional requirements for the pulmonary system

Answer 22

• adequate & unaltered hemoglobin
• diffusion capacity of lungs
• pulmonary surfactant & alveoli
• chest cavity mobility
• atmospheric conditions

Question 23

Autonomic control requirements for the pulmonary system

Answer 23

• midbrain
• nerve conduction
• muscle contraction
• elastic lung tissue
• no airflow obstruction

Question 24

Pulmonary risk factors for COPD (chronic obstructive pulmonary disease)

Answer 24

• cigarette smoking
• air pollution, second hand smoke, dust, fumes, & chemical irritants
• genetics, overweight & insulin resistance
• over the age of 40

Question 25

Indicators of pulmonary dysfunction

Answer 25

• cough
• dyspnea
• chest pain
• cyanosis
• clubbing
• altered breathing patterns
• musculoskeletal pain that increases with respiratory movement
• shortness of breath with rest or exertion
• oxygen saturation below 90%
• can not elicit palpation tenderness
• pain doesn’t change with postural changes or increases in supine
• ROM doesn’t reproduce symptoms