Respiration * Flashcards
what is the thoracic cage composed of ?
sternum, ribs, costal cartilage and thoracic vertebrae
how do ribs join the sternum ?
on the anterior aspect via costal cartilage (also join the vertebrae on the posterior aspect via two joints)
what are two joints that articulate at posterior aspect between ribs and vertebrae ?
costotransverse and costovertebral joints
what are the three types of thoracic muscles ?
- external intercostals
- internal intercostals
- innermost intercostals
describe external intercostlas:
- elevates ribs (inspiration)
- super-lateral to inferomedial
- “hands in your pocket”
which thoracic muscle is used during inspiration ?
external intercostals
describe internal and innermost intercostals :
- depressed ribs (forced expiration)
- superomedial to inferolateral
- “grab your collarbones”
what happens to the diaphragm when contraction occurs ?
- lowers dome
- increases volume of thoracic cavity
which thoracic muscles are used during expiration ?
innermost and internal
what happens to volume when you are breathing in ?
increasing volume
what happens to volume when you are breathing out ?
decreasing volume
increasing volume =
inspiration
decreasing volume =
expiration
why are lungs under tension ?
- naturally want to collapse
- stuck to visceral pleura
alveolar pressure =
atmospheric pressure
what two layers does the pleura have that creates a sac ?
parietal and visceral layers
what is intrapleural pressure ?
around 4 mmHg below atmosphere
when the thoracic cage expands (muscle contraction) what does the parietal pleura do ?
the parietal pleura also contracts… screaming the intrapleural pressure
what is pneumothorax ?
puncture to pleural membrane causes air (pneumo) in pleural space (lung is deflated)
does the intrapleural space pressure change during pneumothorax ?
yes
in what case does the lung no longer go under tension + collapses ?
pneumothorax
if blood is involved in an pneumothorax what is this called ?
hemothorax
what happens if you reseal the hole during an pneumothorax ?
can shift the position of organs in the thorax which can be really problematic
how’s the pressure inside the alveoli during pneunothorax ?
same as atmospheric pressure under normal conditionse
what are two forms of circulation (gas exchange) ?
pulmonary and bronchial
which circulation system supplies the lung tissue ?
bronchial (systemic)
describe the origin of the pulmonary circulation:
deoxygenated blood from the right ventricle
describe the location of the pulmonary circulation:
arteries = center of bronchopulmonary segment
veins = outside of bronchopulmonary segment
describe the features pf the pulmonary circulation:
high flow, low pressure, low resistance
what is the goal of pulmonary circulation ?
oxygenated blood
describe the origin of bronchial circulation :
oxygenated blood from the left ventricle
describe the location of bronchial circulation :
arteries = center of bronchopulmonary segment
veins = drains into pulmonary vein
describe the features of the bronchial circulation :
high pressure and high resistance
describe the goal of bronchial circulation :
perfume lung tissue
what drains via pulmonary vein ?
bronchial artery
the bronchial artery is a part of which circulation ?
systemic circulation
how does the bronchial artery drain its blood ?
originally at the left ventricle, it carries oxygenated blood, under high pressure, to perfuse lung tissue
where does gas exchange occur ?
capillary bed on alveolus
what is the gals of gas exchange ?
oxygenate blood and remove carbon dioxide
how does gas exchange occur ?
this occurs via passive diffusion of these two gasses between the alveoli of your lungs and the pulmonary capillaries carrying blood
what happens when you breathe in ?
oxygen moved into the alveoli and then diffuses across the membrane to get into the capillary; at the same time carbon dioxide present in the capillary is going to move into the alveoli and be breathed out
what are the three zones gas has to pass through ?
- pulmonary capillary
- fused basement membrane
- alveoli
how does oxygen move between the three gas zones ?
alveoli to fused basement membrane to pulmonary capillary
how does carbon dioxide move between the three gas zones ?
pulmonary capillary to fused basement membrane to the alveoli
what is ventilatoin ?
air in alveoli
what is perfusion ?
blood flow through capillaries
what is a shunt ?
adequate perfusion, but no ventilation
what is dead space ?
adequate ventilation, but no perfusion
what causes a shunt ?
pulmonary edema, asthma, COPD, pneumothorax and gas trapping
what causes dead space ?
hemorrhage, dehydration, pulmonary embolism
what is pulmonary edema ?
usually secondary to heart failure
what does it mean if someone has pulmonary edema ?
blood not effectively pumped from left ventricle leads to back up in pulmonary veins and lungs
what are some signs that = fluid accumulation + increased pressure interstitium ?
swelling and eventual leaking of pulmonary capillaries
what happens to diffusion in the case of pulmonary edema ?
diffusion (thus oxygenation) becomes more difficult
if fluid may leak into the pleural cavity (pulmonary effusion) or mediastinum… what does this mean
pulmonary edema
is alveolar flooding possible in the case of pulmonary edema ?
yes and very problematic
what do lungs always want to do ?
lungs always want to collapse (but are held open by the intrapleural pressure)
what does thoracic cage expansion mean ?
intrapleural pressure is decreased therefore lungs expand
what does it mean when pressure drops within the lung tissue ?
air is inspired
what is pneumothorax ?
disruption in pleura (loss of pressure differential and lung collapse)
where does diffusive gas exchange occur ?
between alveoli and pulmonary capillaries
what causes problems between perfusion and ventilation ?
when there is a mismatch
what are the branches of the conducting zone ?
trachea, main bronchi, lobar & segmental bronchi, bronchioles and terminal bronchi
what are the branches of the respiratory zone ?
respiratory bronchioles, alveolar ducts and alveolar sacs
how many tubes are in the trache ?
1
how many tubes are in the main bronchi ?
1
how many tubes are in the lobar and segmental bronchi ?
lobar = 2-3
segmental = 10
how many tubes are in the respiratory bronchioles ?
17-19
how many tubes are there in the alveolar ducts ?
20-22
how many tubes are there in the alveolar sacs ?
23
how many lobes are there in the right lung ?
3
how many lobes are there in the left lung ?
2
what is the lung made of ?
pulmonary capillaries (gas exchange) and interstitium (fibroblasts for elastic tissue production + macrophages for protection)
what is the name of the space between 2 adjacent alveoli ?
interalveloar septum
each lung has how many surfaces ?
3
what are the three surfaces of the lungs ?
- costal surface
- diaphragmatic surface
- mediastinal surface
where is the costal surface located ?
against the ribs
where is the diaphragmatic surface located ?
against the diaphragm
where is the mediastinal surface located ?
against the mediastinum
what is the apex ?
the top of lung
what is the root/hilum of lung ?
mediastinal surface
what is the term used to separate the lungs into lobes ?
fissures
how are the lungs connected to the heart ?
via pulmonary (gas exchange) and bronchial (systemic) circulation
anatomy of the right lung:
apex, superior lobe, anterior border, horizontal fissure, middle lobe, oblique fissure, base, inferior border, inferior lobe and costal surface
anatomy of the left lung:
apex, superior lobe, oblique fissure, inferior lobe, inferior border, lingual, costal surface and anterior border
what are hilum structures ?
- place of transition
- where tubes and vessels
what are hilum structures ?
- bronchi
- pulmonary arteries
- pulmonary veins
- lymphatics
- bronchial arteries
- pulmonary ligament
which hilum structure has cartilaginous rings surrounding lumen ?
bronchi
which hilum structure has anterior to bronchi, thicker walled than veins ?
pulmonary arteries
which hilum structure is systemic circulation ?
bronchial arteries
which hilum structure is pleural reflection ?
pulmonary ligaments
which hilum structure is oxygenated blood ?
pulmonary veins
which hilum structure os deoxygenated blood ?
pulmonary arteries
what do the numbers of divisions in the hilum structures depend upon ?
location of X-section
what are pleural cavities ?
sac in which the lung resides
what are the two layers of the pleural cavities ?
visceral and parietal
where is visceral located ?
next to lung
Whereis parietal located ?
next to thoracic wall
what do we do lungs fill up the whole pleura ?
no lungs dont actually fill up the whole thing
how many clinical significant recesses within the pleura are there ?
2
what are the two clinically significant recesses within the pleura ?
costomediastinal and costofiaphragmatic
what are the 2 clinical significant recesses important for ?
potential areas where fluid can collect
what two things do the lungs consist of ?
alveoli and interstitium
what are alveoli ?
air pockets
what are interstitium ?
- areas in between them
- contain elastin fibers within to aid in contraction
where do pleural cavities exist?
exist to the right and left of the mediastinum (contains lungs and pleura)
what is the respiratory system ?
series pf passages conducting air from environment to alveoli to facilitate gas exchange
what are the structural divisions of the respiratory system ?
upper and lower
what is the upper division of the respiratory system ?
nose and pharynx
what is the lower division of the respiratory system ?
larynx, trachea, bronchioles and alveoli
what are the two functional divisions of the respiratory system ?
conducting and respiratory
what is the responsibility of the conducting zone ?
cleanse, warm and humidify air
what is the responsibility of respiratory zone ?
gas exchange
what are the parts of the conducting zone ?
nasal cavities to the terminal bronchioles
what are the parts of the respiratory zone ?
respiratory bronchioles to the alveoli
what are the parts of the mucous linings ?
- olfactory mucosa (smell on cribriform plate)
- respiratory mucosa (cleaning)
what are the 5 parts of the bony protrusions (conchae) of the naval cavity ?
- increases surface area
- covered in epithelium +highly vascular
- superior + middle = ethmoid bone
- inferior conchae is a bone
- meatus = space under conchae
anything we dont want to breath fully in will stay where ?
mucosa
after the nasal cavity where do we go ?
pharynx
what does the pharynx connect together ?
nasal cavity with larynx
what is the pharynx made of ?
skeletal muscle
what is the pharynx lined with ?
mucous membrane
what are the three sections of the pharynx ?
- nasopharynx = air only
- oropharynx = air + food
- larygopharynx = divides air + food
which part of the pharynx is the esophagus posterior to that goes to the stomach ?
laryngopharynx
what is the nasopharynx responsible for ?
air only
what is the oropharynx responsible for ?
air + food
what is the larygopharynx responsible for ?
divides air + food
where does air travel through to eventually get to the lungs ?
larynx
what are the three functions of the larynx ?
1) prevent food from entering trachea
2) permit passage of air
3) produce vocalization
what are the 9 cartilages of the larynx ?
- thyroid
- cricoid
- epiglottis
- 2x arytenoid
- 2x cuneiform
- 2x corniculate
which cartilages of the larynx are unpaired ?
thyroid, cricoid and epiglottis
which cartilages of the larynx are paired ?
arytenoid, cuneiform and corniculate
what two things are responsible for speech production ?
vocal ligaments/folds (cords) and vestibular fold
what are vocal ligaments/fold (cords) ?
- arytenoid to thyroid cartilage
- intrinsic laryngeal muscles control tension and length of cords
if there is an increase in tension what does this mean for the pitch of voice ?
increase pitch
what is the vestibular fold ?
- superior to vocal folds
- no role in voice production
- important for holding pressure within lungs
why is the vestibular fold important ?
for holding pressure within the lungs
between the vocal ligaments and vestibular fold which has no role in voice production ?
vestibular fold
what are the vestibular folds covered in ?
mucosa
what are the trachea and bronchial tree held open by ?
“c” shaped cartilages
what does the trachea + bronchial tree divide into ?
primary bronchi @ carina
describe the differences between the left and right part of the trachea + bronchial tree ?
left = longer and more horizontal
right = shorter, more vertical and wider
secondly (lobar) of the tracheal +bronchial tree has how many lobes ?
left = 2 and right = 3
tertiary (segmental) of the trachea + bronchial tree further divides into what ?
bronchopulmonary segments (segmental bronchus and vessels)
what is each bronchopulmonary segment supplied by ?
by its own neuromuscular bundle
in which lobe is chocking usually more common in ?
the right lobe
what are the parts o the respiratory zone ?
- tertiary bronchiole
- respiratory bronchiole
- alveolar duct
- alveolar sac
- alveoli
where are alveolar sacs located at the end of ?
alveolar ducts
what are the two cell types of alveoli structure ?
type 1 pneumocyte and type 2 pneumocyte
describe type 1 pneumocytes:
- long and flat shaped
- make up walls of alveoli + interface with pulmonary capillaries
describe type 2 pneumocytes:
- cuboidal
- secrete surfactant to reduce surface tension
- allows alveoli to remain popped open
what is the main responsibility of type 1 pneymocytes ?
diffusion
what is the responsibility of type 2 pneumocytes ?
pulmonary surfactant
