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respiratory 1-4 Flashcards

1
Q

What does the upper respiratory tract consist of?

Hint - NNPP; all different including posh way of saying nostrils

A
  • nose
  • nasal cavity
  • pharynx
  • paranasal sinuses
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2
Q

What does the lower respiratory tract consist of?

A
  • larynx (voice box)
  • trachea
  • bronchi
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3
Q 
What are the following composed of:
a) septal cartilage? 
(Hint - glass)
b) greater alar cartilage?
(Hint - not as thick)
A

a) hyaline cartilage

b) thin, flexible plate

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4
Q

Which 2 components make up the nose?

A
  • the external nose

- the internal nasal cavity

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5
Q

What can be found in the internal nasal cavity?

Hint - VIPEr

A
  • external nares (nostrils)
  • vestibule (anterior part of nasal cavity)
  • internal nares (choanae)
  • posterior region of nasal cavity
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6
Q

What is the nasal septum?

A
  • divides L & R nasal cavity
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7
Q

What is the anterior portion of the nasal septum made of?

A

hyaline cartilage

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8
Q

What is the posterior portion of the nasal septum made of?

Hint - two bones

A

fusion of vomer and ethmoid bone

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9
Q

What is the nasal cavity floor made of?

A

made of hard palate

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10
Q

Which structure does the nasal cavity floor form?

Hint - trace down from that area

A

forms roof of mouth

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11
Q

Where can the 3 conchae and meatuses be found?

A

lateral wall of nasal cavity

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12
Q

What is a concha?

Hint - O

A

openings of nasal cavity

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13
Q

What is a meatus?

A

passageways betw/ conchea

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14
Q

Where can the openings of paranasal sinuses be found?

Hint - M+S

A

within superior & median meatuses

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15
Q

Where can the openings of the nasolacrimal duct be found?

Hint - naslacrImal duct

A

within inferior meatus

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16
Q 
Which epithelia and cells line the:
a) vestibule 
(Hint - quite far in, no hairs, lots of layers)
b) posterior nasal cavity
(Hint - the full shebang + balgam)
c) superior nasal cavity
(Hint - for smelling)
A

a) stratified squamous epithelium
b) pseudostratified ciliated columnar epithelium and goblet cells
c) olfactory epithelium

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17
Q

What is the pharynx?

Hint - a place where two systems meet

A

chamber shared by digestive and respiratory tracts

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18
Q

What are the 3 regions of the pharynx going downwards?

Hint - Nas-Oro-La

A
  1. nasopharynx
  2. oropharynx
  3. laryngopharynx
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19
Q

What can be found in the nasopharynx?

hint - ears and a mass of lymphoid tissue

A
  • eustachian tube openings

- pharyngeal tonsils (posterior)

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20
Q

What is the oropharynx the junction between?

Hint - two systems again

A

GI and respiratory tract

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21
Q

Where does the oropharynx run and what can be found within it?

(hint - flap to voicebox; epithelia and remaining PL tonsils)

A
  • uvula to epiglottis
  • stratified squamous epithelium
  • two sets of tonsils: palatine and lingual
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22
Q

Which region is classed as the laryngopharynx?

hint - EOL

A

epiglottis to openings of oesophagus and larynx

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23
Q

What are the 3 unpaired cartilages of the larynx?

Hint - thy-epi-cri

A
  • thyroid (largest, superiorly-positioned, forms laryngeal prominence/adam’s apple)
  • epiglottis (elastic and forms free flap)
  • cricoid (forms base of larynx)
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24
Q

What are the 3 paired cartilages of the larynx?

Hint - ary-cor-cune

A
  • arytenoid
  • corniculate
  • cuneiform
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25
Q

Describe the arytenoid cartilage.

Hint - people you know with an A are usually loud

A
  • two ligament pairs extend from anterior surface
  • extend to posterior of thyroid to form vestibular/false vocal cords
  • skeletal muscles here can modify sound by changing the length of vocal folds
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26
Q

What is the glottis?

Hint - rima glottidis etc…

A

two types of vocal cords and associated opening betw/ them

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27
Q

Structure of the trachea.

A
  • long membranous tube

- made of 15 - 20 C-shaped cartilages

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28
Q

How can the diameter of the trachea be modified?

A

by posterior wall (SM and ligamentous membrane)

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29
Q

What are the lungs?

A

conical-shaped organs; extend from diaphragm to 2.5cm superior to clavicle

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30
Q

Describe the right lung shape, lobes lobules and the reasons for this.

A
  • broader
  • as the heart and great vessels project into left thoracic cavity
  • 3 lobes
  • 10 lobules
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31
Q

Describe the left lung shape, lobes lobules and the reasons for this.

A
  • longer
  • as diaphragm rises on right side for liver
  • 2 lobes
  • 9 lobules
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32
Q

What is the pleura of the lungs and what is each lung contained within?

A
  • pleura; two serous membranes (with parietal and visceral parts)
  • a separate pleural cavity
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33
Q

What is thoracentsis?

A

sampling pleural fluid

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34
Q

What is the mediastinum of the lungs?

A

membranous partition between lungs

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35
Q

State the 2 functions of pleural fluid.

LA

A

1) lubrication

2) attachment

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36
Q

What is the major and minor blood supply of the respiratory tract?

A
  • major route; pulmonary artery supplies deoxygenated blood

- minor route; bronchial artery (branched off thoracic aorta) supplies oxygenated blood to respiratory bronchioles

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37
Q

What are the muscles of respiration?

A
  1. diaphragm; arises from lateral and posterior walls of body cavity which lungs rest upon
  2. muscles that elevate ribs
  3. muscles that depress ribs
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38
Q

What must air flow in/out of lungs be associated with?

A

pressure difference between the internal/external environment of lungs

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39
Q

What is atmospheric pressure?

A

760 mmHg

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40
Q

State two reasons for collapse of the lungs.

A
  1. elastic recoil

2. surface tension - formation of droplets in alveoli cause alveolar membranes to draw together; alveolar collapse

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41
Q

Which two factors normally prevent lung collapse?

A
  1. surfactant (a mixture of lipoproteins which produce attractive force by surface tension)
  2. intrapleural pressure (drops to balance w/ negative intrapleural pressure to stop elastic recoil)
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42
Q

What is compliance?

A

ability of lungs and thorax to expand (increased lung volume per unit of intrapulmonary pressure change; L/cm of water)

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43
Q

What is the normal value compliance value for lungs & thorax?

A

0.13L/cm

so every cm increase in intrap. pressure + 0.13L lung volume

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44
Q

What are a spirometer and spirometery?

A
  • measures flow of air in/out of lungs

- examination of pulmonary air-flow

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45
Q

What is a pulmonary capacity?

A
  • measure of two or more pulmonary volumes combined
46
Q

What is dead air space?

A

regions of respiratory system where gas exchange does not occur

47
Q

What is dead air space divided into and what is the healthy value?

A
  • anatomical and physiological spaces

- volume taken up by nasal cavities to terminal bronchioles (normally 150ml)

48
Q

What is the alveolar ventilation rate (AVR)?

hint - the volume that is single

A

volume of air available for gas exchange (V/min)

49
Q

What is respiration mostly controlled by?

A

neurones in medulla oblongata

50
Q

Medullary neurones set basic respiration rhythm but what else can it can be influenced by inputs from?

A
  • other parts of brain

- peripheral sensory receptors

51
Q

What is the respiratory centre and what does it control?

hint - literally parts a cell in a certain place

A
  • three pairs of nuclei in a reticular formation
  • located in medulla oblongata and pons
  • controls respiratory minute volume by adjusting the frequency and depth of pulmonary ventilation
52
Q

What are the two regions of the respiratory centre?

A

1) inspiratory centre

2) expiratory centre

53
Q

What is the inspiratory centre and when does it function?

hint - 2D, in the brain

A
  • two dorsal (upper) regions of medulla oblongata

- functions in every respiratory cycle (quiet/forced)

54
Q

Describe the activity of neurones within the inspiratory centre?

A
  1. show spontaneous rhythmicity

2. cyclic form of activity (every few seconds)

55
Q

Which nerves and muscles do APs in the inspiratory centre pass along?

A
  • intercostal nerves and phrenic nerve

- to muscles of inspiration

56
Q

What is the expiratory centre and when does it function?

hint - 2V, in the brain

A
  • two groups of ventral neurones (under) either side of medulla oblongata
  • mostly inactive; functions only during heavy breathing
57
Q

Which muscles do APs of the expiratory centre pass to?

A

muscles associated w/ expiration i.e. diaphragm and rib muscles

58
Q

Complete the following diagram with green arrows for stimulates and red arrows for inhibits.

A

see document

59
Q

What is the apneustic centre and what does it do?

hint - neurone arrangement. 2 sec rule

A
  • scattered neurones in pons
  • sends APs to inspiratory centre
  • increases inhalation intensity for 2 seconds under normal conditions
60
Q

What do both inspiratory and apneustic centres function together to regulate?

A
  • regulate rate/depth of respiration

- ensure rhythmical breathing

61
Q

What is the Herring Breuer reflex ?

A
  • control mechanism to prevent over-inflation of lung
  • to do w/ stretch receptors in SM in alveolar wall
  • during inspiration (inflation)
  • during expiration (deflation)
62
Q

Name the two chemoreceptors which achieve control of respiration, their location and the nerves they are connected to.

(hint - c for central)

A

1) central chemoreceptors
- located in medulla oblongata in chemosensitive area
- influence respiratory centres
2) peripheral chemoreceptors
- located in carotid & aortic bodies
- connect to respiratory centres by glossopharyngeal & vagus nerve respectively

63
Q

What do chemoreceptors in the body respond to?

A

Whanges in conc. of:

  • [H+]/pH
  • Oxygen
64
Q

What effect does changes in [CO2] have?

hint - hypo/hyper and arterial Px

A
  • hypercapnia - excessive PCO2 in arterial blood (note Px means partial pressure of)
  • hypocapnia - a lower than average PCO2 in arterial blood
65
Q

How is the [CO2] of blood detected and by which type of receptors?

(hint - direct/indirect)

A
  • indirectly by chemoreceptors as changes in blood pH

- by peripheral and sensory chemoreceptors

66
Q

What detects [O2] of blood?

A

chemoreceptors in carotid and aortic bodies

67
Q

If PCO2 remains constant how much must PO2 drop before blood [O2] has large stimulatory effect on respiration? Why?

A
  • 50% of normal value in aorta and carotid arteries

- because Hb is still filled w/ O2 at 80mm

68
Q

What are the three normal defence mechanisms of the respiratory system?

(Hint - MIF)

A
  1. filtration
  2. mucociliary transport -
    cilia beat rhythmically and carry trapped particles towards digestive tract to be broken down by low pH and pepsin
  3. immunological response - tonsils and adenoids (rich in lymphatic tissue), macrophages in IS
69
Q

Which two factors allow inhaled particles to become trapped in mucus lining mucosa?

A

1) upper respiratory tract turbulence
2) large surface
- smaller particles trapped by mucus further down respiratory tract
- macrophages clear particles that may reach alveoli

70
Q

What can filtration in the respiratory tract affect?

hint - think pharmacology

A

drug delivery

71
Q

State 4 signs of respiratory disease.

A
  • cough
  • sneeze
  • dyspnoea - difficult/laboured breathings (air hunger)
  • cyanosis - abnormal bluish skin associated with low blood PO2 in capillary beds
72
Q

What does a cough involve and what is it caused by?

A
  • inspiration + closure of epiglottis and vocal cords
  • forceful abdominal contraction opening glottis and vocal cords
  • expulsion of air under pressure
  • cause: irritation of lower respiratory tract
73
Q

What may result in sneezing and what may cause it?

A
  • airway obstruction

- reduced lung compliance

74
Q

Which 2 things can cause cyanosis?

A

1) peripheral vasoconstriction - extreme cold

2) respiratory disorders where blood supply exceeds ventilation rate so increased Hb, thus increased physiological shunt

75
Q

What are infections?

A

diseases due to pathogenic microorganisms

76
Q

What does poor ventilation of lungs increase?

A

incidence of respiratory infections

77
Q

What can infections lead to?

A

inflammation – term ending in ‘itis’ indicates inflammation, i.e., rhinitis (inside of nose), pharyngitis (throat), bronchitis (bronchus), etc.

78
Q

What has greatly reduced respiratory infection-related mortality?

A

antibiotic and vaccine use

79
Q

Name an upper respiratory tract infection.

hint - the most common thing we all get in winter

A
  • common cold; viral, affects nose, throat, sinuses
    (symptoms: cough, runny nose, sneezing
  • different forms; sinusitis, tonsillitis, otitis media, pharyngitis)
80
Q

Name two lower respiratory tract infections.

hint - PT

A
  • pneumonia; inflammatory, affects alveoli, usually caused by streptococcus pneumoniae
  • tuberculosis; affects lungs; caused by mycobacterium tuberculosis
81
Q

What are obstructive lung diseases? give three examples.

Hint - ABE

A

group of diseases associated with narrowing of air passages

- i.e. asthma, bronchitis, emphysema

82
Q

What is asthma, its symptoms and how can it be treated?

A
  • recurrent, reversible airway obstruction, caused by bronchial hyper-responsiveness
  • allergic component
  • symptoms: wheeze, shortness of breath, nocturnal cough; bronchospasm
  • treated w/ bronchodilators or anti-inflammatory drugs
83
Q

What is status asthmaticus?

A

severe acute asthma; a medical emergency

84
Q

What is emphysema?

Hint - form of something caused by sootay

A

COPD caused by elastin loss (smoking)

85
Q

What is elastase and how is it affected by smoking?

A
  • serine protease
  • breaks down elastin (which decreases lung elasticity)
  • smoking = inhalation of nicotine
  • nicotine accumulates in pulm. epithelial cells causing elastin loss
  • can act directly on alveolar macrophages and neutrophils
  • increasing elastase secretion and oxygen radicals (DNA/RNA damage)
86
Q

What produces elastase and how are they deactivated?

A
  • neutrophils and macrophages

- by serine-protease inhibitor 1-antitrypsin

87
Q

How is serine-protease inhibitor 1-antitrypsin activity inhibited?

A
  • by oxygen radicals
88
Q

How is susceptibility to faulty 1-antitrypsin controlled?

A
  • genetic; 1-antitrypsin gene is polymorphic w/ 3 major alleles: M, S and Z (see table)
89
Q

What are restrictive lung diseases?

Hint - what it says on the tin w/ lungs

A
  • diseasesthat restrictlung expansion

- resulting in decreasedlungvolume, increased work of breathing and inadequate ventilation

90
Q

What are the effects of restrictive lung diseases and what are they caused by?

A
  • pulmonary fibrosis, reduced lung compliance and VC

- caused by inelastic replacing elastic tissue, typically by materials, i.e. asbestos, silica, coal dust

91
Q

Diseases of the respiratory tract.

A
  • invasive cancer cells
  • pleural cavity diseases/effusion (fluid in pleural cavity)
  • pneumothorax (hole in pleura)
  • pulmonary vascular disease, embolism, arterial hypertension, oedema, haemorrhage, inflammation, capillary damage,
92
Q

commonly-used tests to assess pulmonary function.

A
  • spirometry
  • respiratory rates
  • vitalograph
  • peak flow meters
  • FEV1/
  • FEV1/FVC ratios
  • blood gas and pH measurements
93
Q

Effects of ageing on the respiratory system.

EAE

A
  1. elastic tissues deteriorate
  2. arthritic changes
  3. emphysema (SOB)
94
Q

Define the respiratory minute volume (VE).

A

total volume of air that passes through respiratory system per minute

95
Q

What is the respiratory minute volume in healthy individuals?

A

6L

96
Q

What is anatomical dead space?

A

region where gas exchange does not occur

97
Q

What is alveolar ventilation?

A

amount of air reaching alveoli each minute

98
Q

What is a vitalograph?

A

used to measure forced expiratory volumein one second (FEVI) and forcedvital capacity(FVC)

99
Q

What is a peak flow meter?

A

small handheld device that measures peak flow by the patient blowing into it as hard as possible

100
Q

State the % predicted for FEV1 and FEV1/FVC values that are:

a) normal
b) mild
c) moderate
d) severe

A

a) > 80%
b) 65-80%
c) 50-65%
d) <50%

101
Q

What type of respiratory disease is it if FVC is normal but FEV is low?

A

obstructive lung disease

102
Q

What type of respiratory disease is it if FEV1/FVC ratio and the % predicted FEV1/FVC ratio is high?

A

restrictive lung disease

103
Q

What are the pros of taking blood gas and pH measurements?

Hint - not bottles of blood and straight away

A
  • simple
  • quick
  • may only need small amounts of blood
104
Q

tidal volume

A

volume of air that passes in and out of lungs during normal inspiration/expiration

105
Q

inspiratory reserve volume

A

volume of air can be inspired on top of tidal volume

106
Q

expiratory reserve volume

A

volume of air can be forcefully exhaled

107
Q

residual volume

A

volume of air remains in lungs after maximal exhalation

108
Q

inspiratory capacity

A

air inspired after 1 cycle of respiration

109
Q

functional residual capacity (FRC)

A

total air left in lungs after a normal expiration

110
Q

vital capacity

A

total amount of air that can be exhaled after maximal inspiration

111
Q

total lung capacity

A

total volume of your lungs

CRR (11 decks)

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