Respiratory Flashcards
Surface tension of the alveoli is reduced by the secretion of:
surfactant
Which alveolar cells produce surfactant?
type II alveolar cells
The amount of air that remains in the lungs at the end of full expiration is referred to as:
residual volume
With respect to Boyles law which of the following is true?
as the volume of the container increases the pressure within the container decreases
During external respiration, gases are exchanged between the:
alveoli and the blood
The process of moving air into and out of the lungs is referred to as:
ventilation
The pleura is:
the serous membrane surrounding the lungs
Which combination of muscles is involved in active expiration?
internal intercostals and abdominals
During internal respiration:
oxygen diffuses from the blood into the tissues
Hemoglobin will have increased affinity for oxygen when
the temperature is decreased
The amount of air moved during quiet breathing is which of the following?
tidal volume
Most oxygen is transported in the blood by:
hemoglobin in red blood cells
The internal nose is lined by an epithelium that is designed to warm and humidify air as well as trap dust. The type of epithelium lining the internal nose is:
pseudostratified ciliated columnar epithelium
All the following are functions of the nose except:
external respiration
Type 1 alveolar cell is a:
simple squamous epithelial cells
Which muscle of quiet inspiration functions to increase thoracic volume by increasing the vertical dimensions of the thoracic cavity?
diaphragm
The function of the epiglottis is to:
close off the larynx during swallowing
The exchange of gases between the alveoli and the blood occurs over:
2 basement membranes and 2 simple squamous epithelium
The trachea divides into:
left and right bronchi
Most carbon dioxide is transported in blood by:
conversion to bicarbonate ion
The two areas of the brain that contain respiration centers are the:
medulla and pons
Each lung can be divided into segments supplied by secondary bronchi called:
lobes
does not requires muscle contractions to force air out of the lungs.
Quiet expiration
Gas exchange in the lung begins at the level of the:
respiratory bronchioles
Which portion of the pharynx receives the openings from the auditory (Eustachian) tubes?
nasopharynx
Airway resistance is affected primarily by the:
diameter of the bronchioles
All gases in a mixture of air exert a pressure that is proportional to the content of each gas. The pressure a single gas exerts is referred to as:
partial pressure
Compliance is affected primarily by the amount of elastic tissue in the lungs and the:
amount of surfactant
An increase in which chemical in the bloodstream will cause increased inhalation?
CO2
Which spinal levels contribute to the phrenic nerve?
C3-C5
he phrenic nerve is responsible for innervating the:
diaphragm
is a clinical term describing changes in the lungs due to a number of different factors, - Generally begins as injury to either the alveolar lining cells or the endothelial lining of the capillaries of the lung.
Acute Respiratory Distress Syndrome - ARDS
all of which cause Acute Respiratory Failure *
Most common malignant tumor of internal organs in Canada * Most often related to cigarette smoking – Approximately 90% of all patients with lung cancer are smokers
Lung Carcinoma
(Secondary) in the Lungs * Most common malignant tumor of the lungs
Metastatic Cancer
75% of all human infections diagnosed clinically, after skin infections and irritations have been eliminated.
Respiratory tract infections
Has peak incidence in school aged children * Due to Haemophilus infuenzae, rate down because of vaccinations. * S&S sudden loss of voice and hoarseness and throat pain on swallowing. Edema and redness of the epiglottis and surrounding tissue. Need antibiotics and humidified oxygen mask to treat.
Acute Inflammation of Larynx Cont’d Acute epiglottitis
Life threatening infection of larynx and adjacent structures.
Croup
an inflammatory conditions caused by a virus that affects the bronchioles and bronchi. Does not involve alveolar spaces.
Bronchiolitis
clinically unrecognized in 95% of cases) – Mild pulmonary disease, low grade fever.
Primary TB
When tuberculosis spreads to the bone and specifically the spine it is called
Pott’s disease.
is a catch all for lung diseases. * Chronic bronchitis * Emphysema * Bronchiectasis
Chronic Obstructive Pulmonary Disease COPD
Pink Puffer * Definition: enlargement to the airspaces distal to terminal bronchioles with destruction of alveolar walls.
Emphysema:
Cause: chemicals contained in cigarette smoke.
Emphysema: Pink puffer
Blue Bloater Definition: excessive production of tracheobronchial mucus causing cough and expectoration for at least 3 months during the last 2 years.
Chronic Bronchitis:
S&S prolonged bouts of coughing with expectoration of mucus and dyspnea (shortness of breath) * blue colouration is due to hypoxia from prolonged coughing this is known as cyanosis * right ventricular failure due to peripheral venous stagnation, also contributing to cyanosis * Enlarged heart. * Vasculature affected by periobronchial fibrosis which results in pulmonary hypertension
Chronic Bronchitis:
Causes: smoking, air pollution, occupational exposure to toxic fumes, various respiratory infections. One bout of viral pneumonia in childhood predisposes that individual to COPD later in life.
Chronic Bronchitis:
S&S: Get sneezing, congestion, runny and irritated nose – Most common allergen – pollens.
Allergic rhinitis (Hay Fever) – Type 1 Hypersensitivity reaction in nose – Definition: acute vasomotor response mediated by histamine and related vasoactive substances released in the nose from the mast cells
S&S (for both) – wheezing during expiration, dyspnea and cough, brought on by exposure to specific allergens.
Asthma * Extrinsic –Exposure to exogenous allergens – Type 1 hypersensitivity rx. – Mostly affects children and associated with other allergies. * occurs in children before the age of 10 and lasts several years, 50% of cases will continue throughout lifetime. 2x more common in men.
Cause: persistent inflammation and inflammatory cell act on smooth muscle (contraction) and blood vessels (increase permeability). * Starts in adulthood before 40yrs. * Treat both types with bronchodilators during an attack.
Asthma * Intrinsic—attacks precipitated by: – Physical factors – Exercise – Psychological stress – Chemical irritants and air pollution – Bronchial infection – Aspirin
S&S low grade fever tired and anorexic, dyspnea, cough or wheezing. Damaged tissue can not be repaired and is replaced by granulation tissue and fibrosis, which can result in end-stage lung disease.
Sarcoidosis * Define: a multisystemic granulomatous disease mediated by cell mediated immunity. * Lungs become infiltrated with T lymphocytes
Autosomal recessive disorder – Involves fluid secretion in exocrine glands in the epithelial lining of respiratory, GI and reproductive tracts Defected gene codes protein cystic fibrosis conductance regulator, a critical part of the chloride transport channel in cell membrane. - This results in a lack of NaCl in the glandular secretions of all exocrine glands most importantly the pancreas, intestine, bronchi. Those secretions have less H2O b/c NaCl has an osmotic effect. Makes secretions viscid.
Cystic Fibrosis
Signs and symptoms are non-specific and resemble those of other restrictive lung diseases. (dyspnea, coughing etc.) Note that progressive dyspnea will result in respiratory failure.* Coal-workers’ lung disease * Silicosis * Asbestosis = Lung cancer
Pneumonoconioses
Incomplete expansion or collapse of alveoli (collapsed lung)
Atelectasis
Causes:
- Deficiency of surfactant (premature babies born before lungs have matured) Type II alveolar cells not mature yet.
2.Compression of lungs from outside (due to fluid in pleural cavity – heart failure or exudates from pleuritis) (air from outside world)
3.Resorption of air distal to bronchial obstruction (obstruction may be mucous plug, tumor or foreign material that has been aspirated into bronchial tree) Air resorbed and alveoli Collapse.
Atelectasis
S&S: loud snoring, wake up with shortness of breath, episodes of breathing cessation while sleeping witnessed by another person, dry mouth or sore throat, morning headache, tired, and insomnia
Sleep Apnea
Causes: Muscles at the back of the throat relax narrowing the airway or brain not sending correct signals to breathing muscles or both.
Sleep Apnea
