Resp Session 1 Flashcards

1
Q

What is inspiratory reserve volume?

A

Additional volume that can be breathe in over that at rest

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2
Q

What is expiratory reserve volume?

A

Additional volume that can be breathed out at rest

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3
Q

What is partial pressure?

A

The fraction of total air pressure exerted by each gas

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4
Q

What is the partial pressure of gas proportional to?

A

Volume of the gas in the mixture

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5
Q

What is the partial pressure of oxygen in air at atmospheric pressure?

A

21.1 kPa

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6
Q

What does Boyle’s law state?

A

Pressure of a gas is inversely proportional to its volume of the temperature and amount of gas remain constant

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7
Q

Why does air become less dense as altitude increases?

A

Fewer molecules pressing down therefore molecules are more widely dispersed

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8
Q

What does Charles’s law state?

A

Is volume and amount of gas present is constant pressure is proportional to absolute temperature

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9
Q

What is saturated vapour pressure?

A

Pressure exerted by water molecules as they enter and leave the gas phase as in gas exchange at mucosal surfaces

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10
Q

What does saturated vapour pressure exclusively depend on?

A

Pressure

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11
Q

What is saturated vapour pressure at 37 degrees Celsius?

A

6.28 kPa

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12
Q

Why is air saturated with water vapour as it passes the URT?

A

To reduce the risk of damage to the LRT?

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13
Q

What causes The Bends?

A

Swimming up to the water surface too quickly so partial pressure changes are not gradual resulting in gas exchange which is not quick enough –> nitrogen bubbles

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14
Q

Describe the movement of gas molecules with relation to a liquid for example in gas exchange at a mucosal surface.

A

Gas molecules move in and out until an eqm of tension exerted by the gas in the liquid = partial pressure of gas in air

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15
Q

What can we assume about the gas tension of oxygen in arterial plasma?

A

It is equal to the partial pressure of oxygen in air assuming exchange time is sufficient

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16
Q

How is the amount of a gas dissolved in a liquid calculated?

A

Solubility x tension

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17
Q

What does using the tension of a gas dissolved in a liquid take into account when calculating how much gas is presentation?

A

any reaction that takes place so calculates the total content of reacted and dissolved gas

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18
Q

What components of oxygen transport need to be considered when considering the amount of oxygen dissolved in blood?

A

Fraction dissolved in plasma + fraction reacted with Hb

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19
Q

Why does the pulmonary circulation form basically no tissue fluid?

A

Low resistance
Low pressure
Receives whole cardiac output
Ventilation/perfusion ratio

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20
Q

Lost the airways in the lungs from largest to smallest.

A

Trachea –> bronchi –> bronchioles –> terminal bronchioles –> respiratory bronchioles –> alveolar ducts –> alveolar sacs

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21
Q

In which airways does gas exchange take place?

A

Respiratory bronchioles
Alveolar ducts
Alveolar sacs

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22
Q

Describe the blood supply to the airway tree.

A

Similar structure with bronchial arteries supplying bronchi themselves

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23
Q

What is tidal volume?

A

Volume breathed in and out with each breath during quiet respiration at rest

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24
Q

What are conducting airways?

A

Larger airways where gas exchange does not take place

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25
Q

Which airways are the last of the conducting airways?

A

Terminal bronchioles

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26
Q

Where do mucous membranes line in the respiratory tract?

A

Conducting portion

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27
Q

Are the number of mucus secreting cells in the mucus membranes constant throughout the respiratory system?

A

No

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28
Q

Where do serous membranes line the respiratory tract?

A

Pleural sacs which envelope each lung

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29
Q

Why does the lung appear ‘shiny’ on examination?

A

Covered by moist visceral pleura

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30
Q

What are Clara cells?

A

Domed cells without cilia that secrete lipoprotein surfactant and CC16 (Clara cell protein 16)

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31
Q

What does raised CC16 in serum indicate?

A

Leakage across air-blood barrier

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32
Q

What is the function of the lipoprotein surfactant secreted by Clara cells?

A

Prevents bronchiole collapse

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33
Q

What epithelium lines from the nasal cavity to the largest bronchioles?

A

Pseudostratified columnar with cilia and goblet cells

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34
Q

What epithelium lines the bronchioles to respiratory bronchioles?

A

Simple columnar with cilia and Clara cells

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35
Q

What epithelium lines respiratory bronchioles to alveolar ducts?

A

Simple cuboidal with Clara cells and a few sparse cilia

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36
Q

What type of cells are found in the alveoli?

A

Type I and II pneumocytes

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37
Q

What pushes odorons away from the olfactory regions of the respiratory tract?

A

Bauman’s glands

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38
Q

Describe the epithelium in the olfactory regions of the respiratory tract.

A

Thick pseudostratified columnar (particularly tall)with microvilli and no goblet cells
LP blends with submucosa

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39
Q

Where are the olfactory regions of the respiratory tract found?

A

Posterior and superior region of each nasal fossa

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40
Q

What maintains patency of non-olfactory regions in the nasal cavities?

A

Surrounding cartilage and bone

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41
Q

What is the function of venous sinuses in the non-olfactory regions of the nasal cavities?

A

Swell every 20-30 mins to alternate airflow and prevent over drying

42
Q

What is the effect of arterial blood flow on inspired air in the nasal cavity?

A

Warms inspired air

43
Q

What are olfactory cells?

A

Bipolar neurones where one dendrite extends to the surface to form swelling from which non-motile cilia extend parallel with surface to detect scents

44
Q

What forms an olfactory nerve?

A

Axons of bipolar neurones joining

45
Q

What is located in the ventricle of the larynx which contributes to resonance of voice?

A

Ventricular folds

46
Q

What epithelium lines the true vocal cord?

A

Stratified squamous

47
Q

What forms the true vocal cord?

A

Vocal ligament and vocalis muscle combined by a large bundle of elastic fibres front and back

48
Q

What is the action of the vocal cords in coughing to prevent entry of a foreign object into the lungs?

A

Cords close to build up pressure

49
Q

What lines the ventricular folds of the larynx?

A

Pseudostratified epithelium with mucus glands and lymph nodules

50
Q

Why are foreign objects more likely to lodge in the right lung?

A

Right bronchus is more vertical so provides easier passage

51
Q

What is found in the submucosa of the trachea?

A

Seromucous glands

52
Q

What type of cartilage if sound in the trachea?

A

Hyaline

53
Q

What allows variable trachea lumen diameter?

A

Trachealis muscle

54
Q

What is the trachealis muscle contained in?

A

Fibroelastic membrane

55
Q

Describe the cilia found in the trachea.

A

~250 per cell beating at 12Hz

56
Q

What is the structure of the tracheal wall?

A

Pseudostratified ciliated columnar epithelium
Lamina propria
Submucosa with seromucous glands
C-shaped cartilage rings

57
Q

What is the lamina propria of the trachea rich in?

A

Elastin fibres

Immune cells

58
Q

What does the epithelium and submucosa of the trachea secrete?

A
Mucins
Water
Serum proteins
Lysozymes 
Anti proteases
Lymphocytes contribute IgA
59
Q

How does the histology of the bronchioles compare to the primary bronchi?

A

Largely the same except cartilage decreases in size and turns from ring-shape to more irregular islands

60
Q

What do bronchioles rely to keep them open as they decrease in diameter?

A

Elastic properties of surrounding alveoli

61
Q

How does the lining epithelium of bronchioles change as their diameter decreases in size?

A

Pseudostratified –> simple columnar ciliated –> cuboidal

Goblet cells give way to Clara cells

62
Q

What causes collapse of bronchioles in expiration of asthma pts which exacerbates the bronchoconstriction already present?

A

Lack of cartilage and surrounding alveoli not being able to maintain a patent airway

63
Q

How does the number of alveolar openings vary from terminal bronchioles down to alveolar sacs?

A

Progressively increases

64
Q

What can alveoli open into?

A

Repository bronchiole
Alveolar duct
Alveolar sac
Another alveolus via an alveolar pore

65
Q

When do new alveoli stop developing?

A

When you reach 8 y.o.

66
Q

What are found in type II pneumocytes?

A

Lamellar bodies

67
Q

What is the function of type II pneumocytes?

A

Cuboidal cells to secrete surfactant to decrease surface tension and prevent alveoli collapse

68
Q

What line the alveolar surface to decrease the likelihood of infection?

A

Macrophages which reach through into alveolar lumen

69
Q

What is the advantage of having a capillary basket around each alveolus?

A

Short diffusion distance

Slow blood flow but RBCs spend

70
Q

What is the pathogenesis of emphysema?

A

Smoking or alpha-1-antitrypsin deficiency –> destruction of alveolar walls –> permanent enlargement of air spaces –> bronchioles collapse on exhalation whilst air is still in the lungs

71
Q

What is the hallmark function of emphysema and what is its action?

A

Pursed lip breathing to create back-pressure to prevent bronchiole collapse

72
Q

What is the pathogenesis of pneumonia?

A

Bacterial infection –> inflammation of lung –> lung consolidation due to filling of alveolar spaces with fluid and inflammatory cells –> prevention of gas exchange

73
Q

What are the borders of the three parts of the pharynx?

A

Nasopharynx: above lower border of soft palette
Oropharynx: lover border of soft palette –> tip of epiglottis
Laryngopharynx: below tip of epiglottis

74
Q

Why does URT lead to middle ear infections, especially in children?

A

Nasopharynx connects to eustaschian tube

75
Q

What can viral URTIs lead to?

A

Sinusitis

Middle ear infection

76
Q

What can cause laryngeal obstruction leading to respiratory difficulty?

A

Oedema in anaphylaxis or severe infection –> vocal cord swelling
Tumour
Aspiration of foreign body

77
Q

What can cause pharyngeal obstruction causing respiratory difficulty?

A

Tongue in unconscious pts or sleep apnoea where pharyngeal muscle tone decreases during sleep and floppy muscles obstruct the airway

78
Q

What is the glottis?

A

2x vocal cords and aperture between them (rima glottidis)

79
Q

What controls movement of vocal cords?

A

Intrinsic muscle of the larynx

80
Q

What supplies all intrinsic laryngeal muscles except one?

A

Recurrent laryngeal nerve

81
Q

What is the course of the RLN?

A

Arises form vagus nerve, curves around subclavian artery on R or arch of aorta on L and moves back up to larynx

82
Q

Why does hoarseness of voice >3 weeks indicate investigation of RLN?

A

Suggests possible damage in the thorax due to lung tumour or aortic aneurysm

83
Q

What is the function of the vocal cords with reference to the trachea?

A

Act as a valve to guard the entrance to the trachea

84
Q

How does the position of the vocal cords change in different situations?

A

Open during respiration
Closed during swallowing
Partially closed during speech
Initially closed them rapidly open in coughing

85
Q

What defines speech in admiration to partial opening of vocal cords?

A

Pharynx, tongue and lips

86
Q

How are the false vocal cords found?

A

Red tissue located adjacent to the pearly true white vocal cords

87
Q

Why are mechanisms to prevent aspiration of food particle important?

A

Air and food have common passage through the oropharynx and laryngopharynx

88
Q

What are the features of the external nose?

A
Root (radix)
Bridge (dorsum)
Wing (alar)
Nostril
Septum
Tip
89
Q

What are the functions of the nose in respiration?

A

Filters air using hairs in nostrils and mucus
Humidifies air using watery nasal secretions
Warms air using BV just below epithelium
Turbinates air and slows its flow

90
Q

What does the mucus in the nose contain?

A

Ig and other antibacterial components

91
Q

How does the nose act as the organ of smell?

A

Olfactory mucosa at roof of nasal cavity is specially adapted

92
Q

Where do local secretions received by the nose arise?

A

Sinuses and the nasolacrimal duct

93
Q

What are the bony processes in the nasal cavity called?

A

3x Concha/turbinate - superior, middle and inferior

94
Q

What are the spaces between the bony processes in the nasal cavity called?

A

3x meatus - superior, middle and inferior

95
Q

Where does the nasal cavity extend from and to?

A

From nostrils –> posterior nares

96
Q

What forms the medial wall of each nasal cavity?

A

Nasal septum = cartilage and 2 bones

97
Q

What are the four paranasal sinuses?

A

Frontal
Ethmoid
Maxillary
Sphenoid

98
Q

How are the paranasal sinuses names?

A

By the bones they are located in

99
Q

What lines the paranasal sinuses?

A

Pseudostratified columnar epithelium with cilia and goblet cells

100
Q

What are the respiratory functions of the paranasal sinuses?

A

Humidify and warm inspired air

101
Q

Which sinus is only visible on lateral view?

A

Sphenoid

102
Q

Why does the frontal bone which forms the roof of the nasal cavity have perforations?

A

For olfactory nerves