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Western Medicine 502 > Respiration > Flashcards

Respiration Flashcards

1
Q

Respiration has three meanings:

A
  1. ventilation of the lungs (breathing)
  2. the exchange of gases between the air and blood, and between blood and the tissue fluid
  3. the use of oxygen in cellular metabolism
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2
Q

Principal Organs of Respiratory System: Upper and Lower Respiratory Tracts

A

Upper respiratory tract: in head and neck
-nose through larynx
Lower respiratory tract: organs of the thorax
-trachea through lungs

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3
Q

Organs of Respiratory System

A

nose, pharynx, larynx, trachea, bronchi, lungs

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4
Q

Pharynx (throat)

A

a muscular funnel extending about 13sm (5in) from the choanae to the larynx

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5
Q

Three regions of the pharynx

A

nasopharynx: posterior to nasal apertures and above soft palate. receives auditory tubes and contains pharyngeal tonsil.
oropharynx: space between soft palate and epiglottis.contains palatine tonsils.
laryngopharynx: epiglottis to cricoid cartilage. esophagus begins at that point.

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6
Q

Nasopharynx: what passes through it? What is it lined with?

A

passes only air and is lined by pseudostratified columnar epithelium

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7
Q

Oropharynx and Laryngopharynx: what passes trough? And what is it lined with?

A

pass air, food, and drink and are lined by stratified squamous epithelium

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8
Q

Larynx-Voice Box: 3 parts

A
  1. epiglottis: flap of tissue that closes airway and directs food to the esophagus behind it
  2. Thyroid cartilage: largest, laryngeal prominence (Adam’s apple) shield-shaped (larger in males)
  3. Cricoid cartilage: connects larynx to trachea, ringlike
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9
Q

Trachea (windpipe)

A

a rigid tube about 12cm (4.5 in.) long and 2.5cm (1 in.) in diameter

Found anterior to esophagus
Supported by 16 to 20 C-shaped rings of hyaline cartilage. They reinforce the trachea and keeps it from collapsing when you inhale

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10
Q

Lung Anatomy

A

Costal surface: pressed against the ribcage
Mediastinal surface: faces medially toward the heart.
-hilum-slit through which the lung receives the main bronchus, blood vessels, lymphatics and nerves
-these structures constitute the root of the lung

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11
Q

Asymmetrical Lungs

A

Right Lung: shorter that left because the liver rises higher in the right. Has three lobes: superior, middle, and inferior separated by horizontal and oblique fissure

Left Lung: taller and narrower because the heart tilts toward the left and occupies more space on this side of mediastinum. Has indention: cardiac impression. has two lobes: superior and inferior separated by a single oblique fissure

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12
Q

Visceral Pleura

A

serious membrane that covers lungs

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13
Q

Parietal Pleura

A

adheres to mediastinum, inner surface of the rib cage, and superior surface of the diaphragm

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14
Q

Pleural Cavity

A

potential space between pleurae.

Normally no room between membranes, but contains a film of slippery pleural fluid

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15
Q

Functions of Pleurae and Pleural Fluid: 3 functions.

A

Reduce friction

Create pressure gradient: lower pressure than atmospheric pressure and assists lung inflation

Compartmentalization: prevents spread of infection from one organ in the mediastinum to others

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16
Q

Main (primary) Bronchi

A

supported by c-shaped hyaline cartilage rings

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17
Q

Lobar (secondary) Bronchi

A

supported by crescent shaped cartilage plates

  • three right lobar (secondary) bronchi: superior, middle, and inferior
  • one to each lobe of the right lung
  • two It. lobar bronchi: superior and inferior
  • one to each lobe of the left lung
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18
Q

Segmental (tertiary) Bronchi

A

Supported by crescent shaped cartilage plates

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19
Q

Bronchial Tree

A

All bronchi are lined with ciliated pseudostratified columnar epithelium

  • cells grow shorter and the epithelium thinner as we progress distally
  • terminal and respiratory bronchioles: final are passages which finally give rise to alveoli
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20
Q

Pulmonary Ventilation (Breathing)

A

Consists of a repetitive cycle one cycle of inhalation (inhaling) and expiration (exhaling)

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21
Q

Respiratory Cycle

A

One complete inspiration and expiration

  • quiet respiration: while at rest, effortless, and automatic
  • forced respiration: deep rapid breathing, such as during exercise
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22
Q

Flow of air in and out of Lungs depends on ?

A

Pressure difference between air pressure within lungs and outside body

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23
Q

Breathing muscles do what?

A

Change lung volumes and create differences in pressure relative to the atmosphere

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24
Q

Diaphragm

A
  • prime mover or respiration
  • contraction flattens diaphragm and enlarging thoracic cavity and pulling air into lungs
  • relaxation allows diaphragm to bulge upward again, compressing the lungs and expelling air
  • accounts for two-thirds of airflow
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25
Q

Internal and External Intercostal Muscles

A
  • synergist to diaphragm
  • between ribs
  • stiffen the thoracic cage during respiration
  • prevents it from caving inward when diaphragm descends
  • contribute to enlargement and contraction of thoracic cage
  • adds about one-third of the air that ventilates the lungs
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26
Q

Scalenes

A
  • synergist to diaphragm

- quiet respiration holds ribs 1 and 2 stationary

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27
Q

Forced Inspiration: muscles involved

A
  • erector spinae, sternocleidomastoid, pectoralis major, pectoralis minor, and serratus anterior muscles and scalenes
  • greatly increase thoracic volume
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28
Q

Normal Quiet Expiration

A
  • an energy-saving passive process by the elasticity of the lungs and thoracic cage
  • as muscles relax, structures recoil to the original (smaller) size of thoracic cavity, results in air flow out of the lungs
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29
Q

Forced Expiration: muscles involved

A
  • rectus abdominis, internal intercostals, outer lumbar, abdominal, and pelvic muscles
  • greatly increased abdominal pressure pushes viscera up against diaphragm increasing thoracic pressure, forcing air out
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30
Q

Valsalva Maneuver

A

consists of taking a deep breath, holding it by closing the glottis, and then contracting the abdominal muscles to raise abdominal pressure and pushing organ contents out

  • normally occurs in: childbirth, urination, defecation, vomiting
  • helpful diagnostic tool for evaluating disc herniations/visceral hernias
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31
Q

Neural Control of Breathing: Involuntary

A

Neurons in medulla oblongata and pons control unconscious breathing

  • no autorhythmic pacemaker cells for respiration, as in the heart
  • exact mechanism for setting the rhythm of respiration remains unknown
  • breathing depends on repetitive stimuli of skeletal muscles from brain
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32
Q

Neural Control of Breathing: Voluntary

A

Control provided by motor cortex

  • inspiratory neurons: fire during inspiration
  • expiratory neurons: fire during forced expiration
  • innervation: fibers of phrenic nerve supply diaphragm. intercostal nerves supply intercostal muscles
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33
Q

Hyperventilation

A

Rapid breathing (anxiety)

  • Co2 is “blown off” from the body faster than it is produced
  • Ph rises
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34
Q

Central Chemoreceptors

A

Brainstem neurons respond to changes in PH of cerebrospinal fluid

-pH of cerebrospinal fluid reflects the CO2 level in the blood

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35
Q

Peripheral Chemoreceptors

A

carotid and aortic bodies of the large arteries above the heart

-respond to the O2 and CO2 content and the pH of blood

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36
Q

Stretch Receptors

A

found in the smooth muscles of bronchi and bronchioles, and in the visceral pleura

  • inflation (Hering-Breuer) reflex: triggered by excessive inflation
  • protective reflex that inhibits inspiratory neurons stopping inspiration
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37
Q

Irritant Receptors

A

Nerve endings amid the epithelial cells of the airway

  • respond to smoke, dust, pollen, chemical fumes, cld air, and excess mucus
  • trigger protective reflexes such as bronchoconstriction, shallower breathing, breath-holding (apnea), or coughing
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38
Q

Inspiration (due to lower intrapulmonary pressure)

A
  1. Ribs are lifted by scalenes and associated muscles
  2. Diaphragm contracts and drops down
  3. Lung volume and Intrapleural volume increases (decreases inner air pressure)
  4. Atmospheric air pressure is greater
  5. Air flows in
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39
Q

Expiration (passive process)

A
  1. Relaxed Breathing
    - passive process achieved mainly by the elastic recoil of the thoracic cage
  2. forced breathing (Ex: playing a wind instrument)
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40
Q

Airflow

A

Pressure and resistance determines airflow
The greater the resistance: slower the flow

  1. Diameter of bronchioles: constriction limits air flow
  2. Pulmonary compliance (elasticity)
  3. Presence of surfactant
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41
Q

Alveolar Surface Tension

A
  • thin film of water needed for gas exchange
  • pulmonary surfactant produced by the great alveolar cells
  • Premature infants that lack surfactant suffer from infant respiratory distress syndrome (IRDS)
42
Q

Spirometer

A

a device that recaptures expired breath and records such variables such a rate and depth of breathing, speed of expiration, and rate of oxygen consumption

43
Q

Tidal Volume

A

Volume of air inhaled and exhaled in one cycle during quiet breathing (500mL)

44
Q

Inspiratory Reserve Volume

A

air in excess of tidal volume that can be inhaled with maximum effort (3000 mL)

45
Q

Expiratory Reserve Volume

A

air in excess of tidal volume that can be exhaled with maximum effort (1200 mL)

46
Q

Residual Volume

A

air remaining in lungs after maximum expiration (1300 mL)

47
Q

Vital Capacity

A

total amount of air that can be inhaled and then exhaled with maximum effort
-important measure of pulmonary health

48
Q

Inspiratory Capacity

A

maximum amount of air that can be inhaled after a normal tidal expiration

49
Q

functional residual capacity

A

amount of air remaining in lungs after a normal tidal expiration

50
Q

total lung capacity

A

maximum amount of air the lungs can contain

51
Q

spirometry

A

the measurement of pulmonary function

52
Q

restrictive disorders

A

those that reduce pulmonary compliance (black lung, tuberculosis)

53
Q

obstructive disorders

A

those that interfere with airflow by narrowing or blocking the airway (asthma, chronic bronchitis)

54
Q

Emphysema

A

combines elements of restrictive and obstructive disorders

55
Q

eupnea

A

relaxed quiet breathing

56
Q

apnea

A

temporary cessation of breathing

57
Q

hyperpnea

A

increased rate and depth of breathing in response to exercise, pain, or other conditions

58
Q

hyperventilation

A

increased pulmonary ventilation in excess of metabolic demand

59
Q

hypoventilation

A

reduced pulmonary ventilation

60
Q

Kussmaul respiration

A

deep, rapid breathing often induced by acidosis

61
Q

orthopnea

A

dyspnea that occurs when a person is lying down

62
Q

respiratory arrest

A

permanent cessation of breathing

63
Q

tachypnea

A

accelerated respiration

64
Q

composition of air

A
  1. 6% nitrogen, 20.9% oxygen, 0.04% carbon dioxide, 0-4% water
    - vapor depending on temperature and humidity, and minor gases argon, neon, helium, methane, and ozone
65
Q

Dalton’s Law

A

the total atmospheric pressure is the sum of the contributions of the individual gases

  • partial pressure: the separate contribution of each gas in a mixture
  • at sea level 1 atm. of pressure: 760 mmHg
66
Q

Alveolar Gas Exchange

A

the back-and-forth traffic of O2 and CO2 across the respiratory membrance

67
Q

Gases diffuse down their own concentration gradient until?

A

the partial pressure of each gas in the air is equal to its partial pressure in water

68
Q

Carbon Dioxide Transport

A
  • 90% of CO2 is hydrated to form carbonic acid
  • 5% binds to the amino groups of plasma proteins and hemoglobin to form carbamino compounds - chiefly carbaminohemoglobin (HbCO2)
  • 5% is carried in the blood as dissolved gas
69
Q

Oxygen Transport

A
  • arterial blood carries about 20 mL of O2 per deciliter
  • 95% bound to hemoglobin in RBC
  • 1.5% dissolved in plasma
70
Q

Hemoglobin

A

molecule specialized in oxygen transport

  • four protein (globin) portions
  • each with a heme group which binds one O2 to the ferrous ion (Fe2+)
  • one hemoglobin molecule can carry up to 4 O2
  • 100% saturation: Hb with 4 oxygen molecules
71
Q

oxyhemoglobin

A

(HbO2): O2 bound to hemoglobin

72
Q

deoxyhemoglobin

A

(HHb): hemoglobin with no O2

73
Q

Carbon Monoxide Poisoning

A
  • Carbon monoxide (CO): competes for the O2 binding sites on the hemoglobin molecule
  • colorless, odorless gas in cigarette smoke, engine exhaust, fumes from furnaces and space heaters
74
Q

Carboxyhemoglobin

A

CO binds to ferrous ion of hemoglobin

  • binds 210 times as tightly as oxygen
  • ties up hemoglobin for a long time
  • non-smokers: less that 1.5% of hemoglobin occupied by CO
  • smokers: 10% in heavy smokers
  • atmospheric concentrations of 0.2% CO is quickly lethal
75
Q

Blood gases and the Respiratory Rhythm

A
  • Most potent stimulus for breathing is pH, followed by CO2, and least significant is O2
  • Brainstem respiratory centers receive input from central and peripheral chemoreceptors that monitor the composition of blood and CSF
76
Q

acidosis

A

blood pH lower that 7.35

77
Q

alkalosis

A

blood pH higher that 7.45

78
Q

hypocapnia

A

P CO2 less that 37mm Hg (normal 37-43 mm Hg)

79
Q

hypercapnia

A

P CO2 greater that 43 mm Hg

80
Q

respiratory acidosis and respiratory alkalosis

A

pH imbalances resulting from a mismatch between the rate of pulmonary ventilation and rate of CO2 production

81
Q

What is a corrective homeostatic response to acidosis?

A

hyperventilation

82
Q

What is a corrective homeostatic response to alkalosis?

A

hypoventilation

83
Q

ketoacidosis

A

acidosis brought about by rapid fat oxidation releasing acidic ketone bodies (diabetes mellitus)

84
Q

What usually has little effect on respiration?

A

Po2

85
Q

chronic hypoxemia

A

Po2 less than 60mm Hg, can significantly stimulate ventilation

-emphysema, pneumonia

86
Q

hypoxia

A

a deficiency of oxygen in tissue or the inability to use oxygen
-consequence of respiratory diseases

87
Q

hypoxemic hypoxia

A

state of low arterial PO2

  • usually due to inadequate pulmonary gas exchange
  • oxygen deficiency at high elevations, impaired ventilation: drowning, aspiration of a foreign body, respiratory arrest, degenerative lung diseases
88
Q

ischemic hypoxia

A

inadequate circulation of blood

-congestive heart failure

89
Q

anemic hypoxia

A

due to anemia resulting from the inability of the blood to carry adequate oxygen

90
Q

histotoxic hypoxia

A

metabolic poisons such as cyanide prevent the tissues from using oxygen delivered to them

91
Q

cyanosis

A

blueness of the skin

-sign of hypoxia

92
Q

Chronic Obstructive Pulmonary Disease

A

refers to any disorder in which there is a longterm obstruction of airflow and a substantial reduction in pulmonary ventilation

93
Q

What are two major COPDs?

A

Chronic Bronchitis and Emphysema

  • usually associated with smoking
  • other risk factors include air pollution or occupational exposure to airborne irritants
94
Q

pneumothorax

A

presence of air in pleural cavity

  • thoracic wall is punctured
  • inspiration sucks air though the wound into the pleural cavity
  • potential space becomes an air filled cavity
  • loss of negative intrepleural pressure allows lungs to recoil and collapse
95
Q

atelectasis

A

collapse of part or all of a lung

-can also result from airway obstruction

96
Q

chronic bronchitis

A
  • inflammation and hyperplasia of the bronchial mucosa
  • cilia immobilized and reduced in number
  • goblet cells enlarge and produce excess mucus
  • develop chronic cough to bring up extra mucus with less cilia to move it
  • sputum formed (mucus and cellular debris)
  • leads to chronic infection and bronchial inflammation
  • symptoms include dyspnea, hypoxia, cyanosis, and attacks of coughing
97
Q

emphysema

A
  • alveolar walls break down
  • lungs fibrotic and less elastic
  • air passages collapse
  • weaken thoracic muscles
98
Q

What are the effects of COPD?

A
  • reduces pulmonary compliance and vital capacity
  • hypoxemia, hypercapnia, respiratory acidosis: hypoxemia stimulates erythropoietin release from kidneys: leads to polycythemia
  • cor pulmonale: hypertrophy and potential failure of right heart due to obstruction of pulmonary circulation
99
Q

Lung Cancer

A

accounts for more deaths than any other form of cancer

-most important cause is smoking (15 carcinogens)

100
Q

Squamous-cell carcinoma

A

Most common lung cancer

  • begins with transformation of bronchial epithelium into stratified squamous from ciliated pseudostratified epithelium
  • dividing cells invade bronchial wall, cause bleeding lesions
  • dense swirls of keratin replace functional respiratory tissue

Western Medicine 502 (10 decks)

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