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C&B1 > Respiration basics & Spirometry > Flashcards

Respiration basics & Spirometry Flashcards

1
Q

DRG

A

Dorsal respiratory group
Fundamental contral -> Initiate inspiration
Generate basic rythm : burst inspiratory AP
Make Inspiratory “Ramp” signal, controls : rate “Ramp” (lungs can fill more rapidly), ceasing point (rate of respiration, shorter ramp -> shorter inspiration)
Most neurons in NST (nucleus of the solitary tract) : sensory information from pontine respiratory group (pneumatoxic & apneustic center), vagus nerve and glossopharyngeal nerve.
Receive info from chemo,bara and stretch receptors
It gives its output to the VRG to modify breating rythm
Goes through spine and connects to muscles : Diaphragm & External intercostal muscles

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2
Q

VRG

A

Ventral respiratory group
neurons for inspiration and expiration
inactive in quiet breathing
Contribute to extra respiration when signal “spill” on VRG
Active in forced insipiration and expiration
Goes to spine and connects to accessory muscles : internal intercostal muscle & abdominal muscle

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3
Q

PRG

A

Pontine respiratory group

Pneumatoxic and Apneustic centers

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4
Q

Pneumotaxic center

A

part of PRG
control rate and pattern of breathing
stronger signal : shorter inspiration & increased RR
It inhibits the apneustic center to make inhalation more or less short -> limit the amount of AP to phrenic nerve -> tidal volume down
without pneumatoxic : longer inhale, lower RR
influence VRG and DRG

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5
Q

Apneustic center

A

part of PRG
promote inhalation
constantly stimulate neurons: signal DRG to delay the switch off of the “Ramp”signal
inhibited by stretch receptors and pneumatoxic center
influence VRG and DRG

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6
Q

Regulation of breathing locations and connections

A

All in brainstem : medulla, pons
Pneumotaxic center above apneustic center
Both in pons to the dorsal side : towards cerebellum
Then in medulla there is the VRG and DRG
DRG towards dorsal side : to cerebellum
VRG ventral side (side of bumps on brainstem)
Pneumatoxic center connected to apneustic and DRG
Apneustic connected to DRG
DRG connected to VRG

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7
Q

NTS

A

Nucleus of the tractus solitarius
DRG neurons
Sensory termination of glossapharyngeal and vagus nerve
Signal from : baro,chemo & stretch receptors

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8
Q

Inspiratory “Ramp” Signal

A

Excite the diaphragm for 2 sec -> steady increase volume

Cease for 3 sec -> elastic recoil lungs & chest wall : expiration

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9
Q

Stretch receptors

A 
on lung
inhibit VRG
Signal to vagi -> DRG
too stretched -> inspiratory "Ramp" goes down RR goes up
=> inflation reflex
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10
Q

Lungs gaz exchange

A

Inspiration: O2 in, diaphragm contract -> diaphragm down, chest muscle contract -> lungs expand
Expiration: CO2 out, muscle relax -> lungs back to normal

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11
Q

O2 trajectory

A

Nasal cavity -> pharynx -> larynx -> trachea -> Right/Left bronchus -> bronchioles -> terminal bronchioles -> respiratory bronchioles -> alveolar duct -> sacs -> alveoli

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12
Q

Nasal cavity

A

hair, mucus with lyzozymes to kill bacteria, connected to sinuses ( air cavities, air becomes wet & moist, amplify sound)

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13
Q

Pharynx

A

Nasopharynx (right after nasal cavity), orapharynx (right after oral cavity) : they are seperate by the ulva when eating
laryngopharynx: connect to oesophagus and larynx

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14
Q

Larynx

A

Blocked by epiglotis when eating such that only air comes in and food goes to esophagus -> connects to pharynx (laryngopharynx)

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15
Q

Trachea

A

After Larynx and connects to Right/Left bronchus
Cartilage rings as support
membrane contains (in order of inside to out) :
mucus, globet cells (secrete mucus) and ciliated columnar cells (move mucus to pharynx), basement mebrane, lamina propria, smooth muscle (nerves from autonomic nervous system lies there), cartilage

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16
Q

Autonomic nervous smooth muscle airways

A

Sympathetic and parasympathetic nerves
Sympathetic: B2 adrenargic receptors -> increase diameter
Parasympathetic: muscarinic receptors -> decrease diameter

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17
Q

Right/Left Bronchus

A

Connect to right/left lung
Right bronchus : wider and more vertical -> swallowed object goes there
3 generations: primary, secondary(lobar) and tertiary(segmental) then bronchioles
Same structure trachea:
membrane contains (in order of inside to out) :
mucus, globet cells (secrete mucus) and ciliated columnar cells (move mucus to pharynx), basement mebrane, lamina propria, smooth muscle (nerves from autonomic nervous system lies there), cartilage

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18
Q

Bronchioles

A

<1mm in diameter
after 3 generations of bronchi
15-20generations and each have 50-80 terminal bronchioles
get oxygenated blood from bronchial arteries
Don’t have cartilage unlike Trachea and Right/Left bronchus !!
Instead club cells : secrete glycosaminoglycans (protects epithelium), regenerate & replace columnar cells
membrane contains (in order of inside to out) :
mucus, globet cells (secrete mucus), club cells and ciliated columnar cells (move mucus to pharynx), basement mebrane, lamina propria, smooth muscle (nerves from autonomic nervous system lies there)

19
Q

Respiratory bronchioles

A

last bronchioles
have bulges : alveoli
connected to alveolar dyct

20
Q

Alveolar duct

A

1.5 -2 millions

connect respiatory bronchioles to alveolar sacs

21
Q

Alveolar sacs

A

contains collection of alveoli : gaz exchange location
Pulmonary artery deoxygenated blood -> capillary -> alveoli absorb CO2 and gives back O2 -> pulmonary veins -> heart -> body

22
Q

Alveoli

A

mucus (epithelial cells) lined pouches
pneumocyte type 1 (most present)
pneumocyte type 2, bigger and secrete surfactant + regenarate damaged cells

23
Q

Pleural fluid

A

circulate in pleural cavity
surfactant
molecules of similar sign : repulse each other -> lubrication
-> not too much friction

24
Q

Asthma

A

Obstructive
Chronic inflammation
smooth muscle spasms & increased mucus → narrow → permanent damage → scaring, edema, fibrosis → thickened basement membrane
FEV1 & PEF: amount obstruction
symptoms: dyspnea, chest tightness, wheezing, coughing sputum
Bronchodilators; beta receptor agonist

25
Q

Spirometry influence

A

obesity compress diaphragm, lung and chest cavity → FEV1,FVC, FEV1/FVC down
Height up → TLC, VC, RV, FVC, FEV1 up
age → FVC and FEV1 down
women: airway diameter and lung volume down → PEF down

26
Q

Muscles in respiration

A

Quiet Breathing:
Diaphragm & external intercostal muscles (inspiration)
expiration passive
Forced expiration:
internal intercostal: pull ribs down
abdominal muscle (eg: obliques): push diaphragm up and pull ribs down
Forced inspiration:
Accessory muscles: sternomastoids, scalenes → elevate sternum and upper ribs

27
Q

Acinus

A

functional unit of lungs
respiratory bronchioles, alveolar ducts, sacs, alevolar
gaz exchange with pulmonary arteries

28
Q

Bronchial arteries

A

supply pleura and connective tissue

29
Q

Diaphragm

A

skeletal muscle
seperate abdomen and chest
contract and flatten when inhale: vaccum pulls air
relax → push air out

30
Q

Nerve supply

A

innervated by sympathetic and parasympathetic
sympathetic: bronchodilation and vasodilation
parasympathetic: bronchoconstriction and vasoconstriction
controlled by respiratory centre: in pons and medulla oblongata
interactions with chemoreceptors

31
Q

Tracheobronchial tree

A

trachea → respiratory bronchioles

16 generations

32
Q

Pleura

A

each lung enclosed in pleural sac
2 membranes: visceral(inner) and parietal (outer) pleura
parietal pleura adhere to thoracic wall, diaphragm and mediastinum
4 grooves to extend

33
Q

Pleural cavity

A

space between visceral and parietal pleura
allow sliding during respiration
create surface tension
contain pleural fluid

34
Q

Mediastinum

A

Loose connective tissue in the thoracic cavity
contains heat, vessels, esophagus, trachea, phrenic nerve, cardiac nerves, thoracic duct, thymus, lymph node
lungs on the sides, spine in the back
center-middle of the thorax

35
Q

Lung

A

base on diaphragm
apex at the top
lie in thoracic cavity
separated by mediastinum
helium: slit for bronchus, blood vessels, lymphatic vessels, nerves
right lung larger: 3 folds
heat tilts to left: left lung smaller (2 folds) with cardiac impression / notch

36
Q

FEV1, FVC, PEF,

A

Forced expiratory volume in 1 second
Forced vital capacity: volume that can be expired after deep inhalation (x axis)
Peak expiratory flow: highest point in the graph

37
Q

Tidal volume

A

the lung volume representing the normal volume of air displaced between normal inhalation and exhalation when extra effort is not applied. In a healthy, young human adult, tidal volume is approximately 500 ml

38
Q

IRV

ERV

A

Inspiratory reserve volume
extra inhaled volume compared to tidal volume
max inspired volume
Expiratory reserve volume
extra exhaled volume compared to tidal volume
max expired volume

39
Q

VC

FR

A 
Vital Capacity
max of air expired ERV+TV+IRV
Functional residual volume
volume remaining in lung after normal expiration
ERV+RV
40
Q

Total lung volume

A

6L

IRV+TV+ERV+RV

41
Q

Spirometry

A 
y axis is flow
x axis is volume
under x axis is inspiration
above x axis is inspiration
ULN: upper limit of normal
LLN: lower limit of normal
42
Q

Obstructive

A

Residual capacity increase
Insipiratory residual volume decrease
Total lung capacity increase
shifts the spirometry to the right but the loop stays roughly the same
volume over time slope is less steep but still reach the max
FEV1/FVC ratio changes

43
Q

Restrictive

A

IRV, ERV, and RV smaller
FEV1/FVC ratio unchanged
total lung capacity decrease
spirometry shift to left and volume loop is smaller
volume over time slope is less steep and don’t reach max

C&B1 (23 decks)

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