Respiratory 1 Flashcards

1
Q

Define “external respiration”.

A

External respiration is the exchange of gases across the blood vessels and lungs.

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2
Q

What does “URT” stand for?

A

Upper respiratory tract.

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3
Q

What structure make up the URT?

A

Nose and naval cavity
Pharynx
Larynx

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4
Q

What structures make up the LRT?

A

Trachea
Bronchi
Bronchioles

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5
Q

What is the medical term for breathing?

A

Ventilation.

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6
Q

List the 3 structures of the pharynx.

A

Nasopharynx
Oesophaynx
Laryngophaynx

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7
Q

Define “internal respiration”.

A

Internal respiration is gas exchange from blood vessels to tissue cells in body.

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8
Q

Describe the function of the elastin fibres within the respiratory system.

A

Allows the airways and alveoli to expand and return to resting state.

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9
Q

Describe the function of cilia and mucous in the respiratory system.

A

Mucous traps foreign bodies and cilia moves the mucous to the pharynx.

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10
Q

Are elastin fibres present in all three listed below

  • Large bronchi
  • bronchioles
  • alveoli
A

Yes all three contain elastin fibres

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11
Q

Is smooth muscle present in all listed below

  • large bronhi
  • bronchioles
  • alveoli
A

No, only the large bronchi and bronchioles contain smooth muscle.

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12
Q

Identify the two major respiratory muscles.

A

Diaphragm

Intercostal muscles

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13
Q

Identify the respiratory systems main defences from pathogens.

A
  • Tonsils
  • Normal respiratory flora
  • Mucociliary escalator
  • Alveolar macrophages
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14
Q

List the 3 tonsils.

A
  • Pharyngeal tonsils ( adenoids when enlarged)
  • Palatine tonsil (left and right)
  • Lingual tonsil
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15
Q

Describe the role of the tonsils.

A

Trap bacteria

        - remove pathogens 
        - stimulate immune response for memory
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16
Q

What is the danger of giving someone a drink when they are unconscious?

A

Aspiration, due to an inactivation of the cough reflex.

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17
Q

Trachea divides into the left and right bronchi at the ___________.

A

Carina (clinical relevance as this is the site for intubation).

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18
Q

Describe the “mucociliary escalator”.

A

Mucus traps particles and the cilia sweeps this mucus towards the pharynx.

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19
Q

Describe the structures of the alveoli.

A

Type 1 cells (gas exchange)
Type 2 cells (secrete surfactant)
Alveolar macrophages
Also contains elastin fibres

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20
Q

Gas exchange can be reduced if the respiratory membranes are thickened due to ____________.

A

Pulmonary oedema

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21
Q

Gas exchange can be reduced if the respiratory membranes area is reduced due to ___________.

A

Emphysema

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22
Q

Tachypnoea means?

A

Elevated ventilation rate

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23
Q

Bradypnoea means?

A

Decreased ventilation rate.

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24
Q

Define elastic recoil of the lungs.

A

The tendency of the lungs to return to resting state after inspiration.

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25
Q

Define lung compliance.

A

Lung compliance is the distensibility or stretchiness of the lungs and chest wall

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26
Q

How is surface tension over come in the lungs?

A

Surfactant.

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27
Q

Define airway resistance.

A

Friction of air against walls of the airways.

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28
Q

Airway resistance is decreased due to ___________.

A

Bronchiconstriction ( decreased bronchial diameter)

obstruction (by mucus or tumor)

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29
Q

Loss of surfactant in RDS cause what.

A

Alveoli to collapse.

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30
Q

AGBA stands for?

A

Arterial blood gas analysis

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31
Q

What are the normal values for PaO2 in systemic blood?

A

80-100mmHg

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32
Q

What are the normal values for PaCO2 in systemic blood?

A

35-45mmHg

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33
Q

What is the normal range for pH?

A

7.35 - 7.45

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34
Q

What is the Pa02 for blood entering and leaving the lungs?

A
Entering = 40mmHg
Leaving = 100mmHg
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35
Q

What is the PaC02 for blood entering and leaving the lungs?

A
Entering = 46mmHg
Leaving = 40mmHg
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36
Q

How is C02 transported in the body?

A

Most C02 transported as HC03

Some binds to the globin

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37
Q

Increase in C02 leads to an increase in ________ which cause a decrease in __________.

A

Acid decreasing pH

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38
Q
Low Pa02 causes \_\_\_\_\_\_\_\_\_ of pulmonary arterioles. 
A) dilation
B) spasm
C) constriction
D) inflammation
A

C) constriction

39
Q
Obstruction of airways in COPD leads to?
A) bronchiole constriction
B) bronchiole dilation
C) hypoxaemia and hypercapnia
D) hyperaemia and hypocapnia
A

C) hypoxaemia and hypercapnia

40
Q
Respiratory control centres are located in?
A) hypothalamus 
B) hippocampus 
C) medulla oblongata 
D) occipital lobe
A

C) medulla oblongata

41
Q

The sympathetic nervous system releases __________ and __________ to ___________ ventilation.

A

Adrenaline and noradrenaline to increase ventilation

42
Q

The parasympathetic nervous system releases _________ to ___________ ventilation.

A

Acetylcholine to decrease ventilation

43
Q

Define a sympathetic agonist.

A

A drug that mimics the effects of adrenaline and noradrenaline.

44
Q
Adrenaline and noradrenaline bind to \_\_\_\_\_\_\_ receptors on bronchioles and bronchi to cause \_\_\_\_\_\_\_\_\_\_\_.
A) b2 andrenic , bronchodilation
B) b1 andrenic, bronchodilation 
C) b1 andrenic, bronchoconstriction
D) b2 andrenic, bronchoconstriction
A

A) b2 andrenic, bronchodilation

45
Q

Define agonist.

A

Agonist = enhance

46
Q

Define cholinergic.

A

Cholinergics = block

47
Q

Respiratory control centres in brainstem receive sensory input from __________.

A

Chemoreceptors

48
Q

What is a more important chemical control O2 or C02?

A

C02 , as O2 has a huge reservoir before stimulation increases.

49
Q
Respiratory acidosis is caused by a \_\_\_\_\_\_\_\_\_\_ in C02 and a \_\_\_\_\_\_\_\_\_\_\_\_ in pH.
A) increase, decrease
B) decrease, decrease
C) increase, increase
D) decrease, increase
A

A) increase, decrease

50
Q
Respiratory alkalosis is caused by a \_\_\_\_\_\_\_\_\_\_ in C02 and a \_\_\_\_\_\_\_\_\_\_\_\_ in pH.
A) increase, decrease
B) decrease, decrease
C) increase, increase
D) decrease, increase
A

D) decrease, increase

51
Q
Respiratory acidosis is causes by 
A) hyperventilation
B) hypoventilation
C) hypernataemia 
D) hyponataemia
A

B) hypoventilation

52
Q
Respiratory alkalosis is caused by,
A) hyperventilation
B) hypoventilation
C) hypernataemia 
D) hyponataemia
A

A) hyperventilation

53
Q
Healthy lungs can exhale 
A) 85% or more of FVC in 2 seconds
B) 70 % of FVC in 1 second
C) 80% or more of FVC in 2 seconds
D) 80% or more of FVC in 1 second
A

D) 80% or more of FVC in 1 second

54
Q
Obstructive lung disease will cause an \_\_\_\_\_\_\_\_\_\_\_\_ in airway resistance causing a \_\_\_\_\_\_\_\_\_\_\_ FEV1.
A) increase, increase
B) decrease, decrease
C) decrease, increase
D) increase, decrease
A

D) Increase, decrease

55
Q
Restrictive lung disease will cause \_\_\_\_\_\_\_\_ lung expansion and will show a \_\_\_\_\_\_\_\_\_\_\_ FEV1.
A) impaired, decreased
B) impaired, normal
C) impaired, increased
D) normal, impaired
A

B) impaired , normal

56
Q

RDS stands for

A

Respiratory distress syndrome of the newborn

57
Q

Respiratory distress syndrome is associated with _____________ lungs

A

Immature

58
Q

RDS causes alveoli to collapse due to _____________ .

A

Deficiency of surfactant

59
Q
Surfactant is produced at \_\_\_\_\_\_\_\_\_\_ weeks of gestation.
A) 25
B) 30
C) 28
D) 35
A

B) 30

60
Q

RDS clinical features include,

A
  • Nasal flaring
  • Tachypnoea
  • Dyspnoea
  • Pale colour
  • Progressive hypoxaemia
61
Q

RDS risk factors

A
  • Prematurity
  • Caesarian delivery
  • Maternal diabetes
  • Asphyxia
62
Q

RDS treatment

A
  • Prevent premature birth
  • Maternal glucocorticoids
  • treatment based on prematurity
    - Surfactant therapy
    - CPAP
63
Q

ARDS stands for

A

Acute respiratory distress syndrome

64
Q

What can cause ARDS?

A
  • Sepsis
  • Trauma
  • Pneumonia
  • Aspiration
  • Smoke inhalation
65
Q

Pathophysiology of ARDS

A

Multiple inflammatory mediators are activated causing damage to the alveoli and capillaries

66
Q

ARDS can lead to

A
  • Pulmonary Oedema
  • Collapsed alveoli
  • Hypoxaemia
67
Q

ARDS clinical feature

A
  • Marked Dyspnoea
  • Hyperventilation
  • Severe hypoxaemia unresponsive to O2 therapy
68
Q

ARDS treatments include

A
  • Maintain adequate O2 levels in tissues
  • Altering from prone to supine positions
  • Minimise lung injury
  • Avoid complications
69
Q

Define aspiration.

A

Aspiration is the inhalation of fluid or solids into the lungs.

70
Q

Aspiration clinical features include,

A
  • Hypoxaemia
  • Cough
  • Dyspnoea
71
Q

Can aspiration cause ARDS?

A

Yes , progressive deterioration causes ARDS.

72
Q

What is the treatment for Aspiration?

A
  • Oxygen therapy
  • Suction of trachea
  • Bronchoscopy to remove particulate matter
73
Q

What are the clinical features of drowning?

A
  • Hypoxaemia
  • Hypercapnia
  • acidosis
  • possible hypothermia
  • cyanosis
74
Q
What is a symptom of Obstructive sleep apnoea?
A) impairment of surfactant 
B) Alveolar injury
C) repeated episodes of hypoxia
D) closing of the pharynx
A

C and D

Repeated episodes of hypoxia due to closing of the pharynx which can last 10 to 60 seconds

75
Q

Signs and symptoms of sleep apnoea include,

A
  • Snoring
  • Restless sleep
  • Chronic tiredness
76
Q

Obstructive sleep apnoea is associated with?

A
  • Obesity
  • Enlarged tonsils (children)
    May require CPAP
77
Q

What is a pulmonary embolism?

A

Blockage of pulmonary arteries by an embolism.

78
Q

Where does a pulmonary embolism most commonly arise from?

A

Deep vein thrombosis (DVT)

79
Q
Clinical features of a pulmonary embolism include,
A) Tachycardia, Tachypnoea, Dyspnoea 
B) Bradycardia, thrombotic inflammation
C) Myocardial infarction, pneumonia 
D) all of the above
A

A) Tachycardia, Tachypnoea, Dyspnoea

80
Q
Pulmonary embolism diagnosis includes a \_\_\_\_\_ test.
A) Embolism CT
B) D dimer
C) C dimer
D) blood test
A

B) d dimer, which test for increased fibrinolysis

81
Q
Pulmonary oedema caused by pulmonary hypertension aries from,
A) Recurring pulmonary embolism
B) left side heart failure
C) COPD
D) ARDS
A

All of the above

82
Q

Define pulmonary oedema.

A

Excess fluid which lines the alveoli

83
Q

Clinical feature of pulmonary oedema include,

A
  • Dyspnoea
  • Hypoxaemia
  • Cyanosis
  • Tachycardia
  • Chest pain
  • Basal crepitation ( base crackles in the lungs)
84
Q

Management of pulmonary oedema includes,

A
  • Anticoagulants
  • Diuretics
  • Oxygen
  • Digoxin
85
Q

What are the main feature of respiratory infections?

A
  • Fever
  • Sore throat
  • Cough
  • Increased sputum
86
Q

What are the main types of respiratory infections?

A
  • Pneumonia
  • Acute bronchitis
  • Common cold
  • Influenza
87
Q

Define pneumonia.

A

Infection of the lower respiratory tract.

88
Q

Mains routes of infection for pneumonia include,

A
  • Aspiration of oropharyngeal secretions

- Inhalation from infected cough

89
Q

Does pneumonia cause ventilation perfusion mismatch.

A

Yes

90
Q

Define acute bronchitis.

A

Acute infection of the bronchi. Similar feature of pneumonia.

91
Q

What is the main cause of the common cold?

A

Rhinovirus

92
Q

What is the incubation period for the common cold?

A

72 hours

93
Q

What is an Epidemic?

A

Increase in a number of people infected

94
Q

What is a Pandemic?

A

Infects a large area and very large number of people.